General Services

Clarendon Podiatry Center

Common foot ailments treated frequently by Dr. Fine include flat feet, plantar fasciitis, heel and arch pain, warts, ingrown toenails, fungal toenails, dermatological conditions, bunions, hammertoes, arthritis, traumatic foot and ankle injuries. He provides routine foot care, including trimming of nails, corns and calluses. In addition, Dr. Fine provides wound care in the office and twice a week at the Virginia Hospital Center Wound Care Center. Diabetic patients are treated very successfully and their care frequently includes custom-molded shoes and insoles or commercially made shoes meeting the guidelines for diabetic therapeutic shoes and insoles.

Dr. Fine is board certified in wound care by the Council on Medical Education Testing and is a Fellow of the American Professional Wound Care Association.

Medicare Diabetic Shoe Program

Diabetes is reaching epidemic proportions in the United States. During the past decade there has been an increase of 33% with the diabetic population currently topping 22 million people. There are many complications associated with diabetes including kidney, heart, vision, circulatory and foot problems. The good news is that many of these potential problems can be minimized as a result of life style changes, medications and other preventive care.

Amputations, or partial amputations, of the feet and legs are also growing at an alarming rate. In fact, it is the leading cause of non-traumatic amputation in the United States. Recently a task force was created by officials from Medicare, the American Podiatric Medical Association and the American Diabetes Association in order to explore ways to reduce the number of amputations in the diabetic populations. The number of these lower extremity amputations grew by 28% in just the past several years. However, it has been determined that over half of these amputations could have been prevented by timely conservation foot care.

Dr. Michael G Fine is an authorized Medicare Supplier to evaluate, prescribe and dispense high quality shoe and 3 pairs of removable protective shoe inserts per calendar year. Many diabetic patients qualify for this benefit and Medicare will pay 80% of the cost for shoes and insoles and your supplemental insurance should pay the other 20% in most cases, except Virginia Medical Assistance which does not pay.

Descriptions of our leading services:

Achilles Tendon
Ankle Instability
Ankle Sprain
Arthritis
Athlete's Foot (tinea pedis)
Calluses
Corns

Achilles Tendon

Achilles tendonitis is an inflammation of the tendon in the back of the heel which occurs as a result of over use. This occurs in professional athletes and weekend athletes as well. Causes of Achilles tendonitis include:

1) Tightness of calf muscles, soleus, and gastrocnemius
2) Running on hills or stair climbing
3) Rapid increase in mileage or speed
4) After a la off, starting abruptly

Symptoms of Achilles tendonitis begin with mild pain after running or exercise which gradually worsens. There is recurring localized pain about the tendon during or several hours after running. Additional symptoms include morning tenderness near the insertion of the achilles tendon in back of the hell bone, mild of severe swelling, and leg sluggishness. As the Achilles tendon is used the stiffness diminishes. Treatment includes rest-ice-compression-elevation (the RICE technique), prescription non-steroidal anti-inflammatory medication, avoid cortisone injection, silicone heel cushions with elevation and shock absorption, custom molded orthotics, swimming instead of running, physical therapy, durable medical equipment, and a bandage designed to restrict motion of the tendon.

Ankle Instability

Signs and symptoms include difficulty walking on the ground if it is not level or in high heels, repetitive ankle sprains, pain on the outer side of the ankle, tenderness, swelling, and stiffness. The most common cause of chronic lateral ankle pain is a sprained ankle. Other causes include ankle arthritis, fracture of distal tibiofibular or talus bone making up the ankle joint, torn or inflamed tendon. Treatments include custom molded orthotic devices to treat the underlying biomechanical instability, physical therapy, anti-inflammatory medications, ankle supports.

Ankle Sprain

Traumatic twisting injury or force on the ankle bones of the foot results in excessive stretching or tearing of one or more of the lateral ankle ligaments. To avoid chronic problems this injury should be properly treated. The RICE technique is required ( rest-ice-compression-elevation). Durable medical equipment or supportive bandages may be required to immobilize and support the injured ankle.

Arthritis

Almost 40 million Americans are disabled or crippled by this disease. Wear and tear or osteoarthritis is an overuse of the joints and is not hereditary. Rheumatoid arthritis is hereditary and is very deforming and crippling. Prevalence of arthritis increases with age and over age of 50 are prime targets. There are 33 joints in the feet responsible to carry the weight bearing load of the feet. Loss of mobility and independence are the result of arthritis in the feet. Early diagnosis and proper medical care may lessen the severity of this disease which is a component in over 100 other complex medical conditions.

Symptoms of arthritis include stiffness in early morning range of motion in a joint is limited, tenderness or recurring pain in any joint, swelling in 1 or more joints, redness or increase in skin temperature in a joint, skin changes, rashes and growths. Osteoarthritis also known as DJD (Degenerative Joint Disease), is the most common form of arthritis. With aging and cartilage destruction pain gets progressively more severe. Characteristic is dull, throbbing nighttime pain which can be accompanied with deterioration and muscle weakness. It can be relieved with rest. Rheumatoid arthritis is very crippling and deforming and is hereditary and less common than osteoarthritis.

Athlete's Foot (tinea pedis)

Athlete's foot is a disease of the skin caused by a fungal infection between toes and on the bottom of the feet. Shoes provide a warm dark moist environment which is a perfect breeding ground for a fungus to reside. Swimming pools, showers and locker rooms are perfect areas for this organism to live. Acute blister formation, itching of the skin with oozing of fluid is the initial onset of athletes foot. Dry scaling of the skin in a moccassin type distribution is the chronic version of tinea pedis. Athlete's foot infection if not treated promptly can spread to the toenails, and also involve the groin, underarms and skin fold areas. Prevention of Athlete's foot by drying feet carefully after a bath or shower, wearing flip flops when showing, wearing light and ventillated shoes, using talcum powder to reduce perspiration, frequently changing socks, to reduce heavy perspiration. Treatment of Athlete's foot of fungal infection of the skin is with prescription fungi static or fungicidal topical or oral medications.

Calluses

Thickened skin can occur on the bottom of the toes, ball of the foot or perimeter of the heels. Shoe pressure and friction are the main cause of calluses. Wearing sandals of sling-back shoes can cause calluses on the heels or when the areas of the feet experience friction when wearing shoes. Wearing high heeled dress shoes with a thin sole or a plantar flexed or elongated metatarsal bone is a major contributing factor to callus formation. Excessive friction or pressure can cause an ulceration or open wound which may become infected and very painful.

Corns

Corns are thickening of the skin which develops with shoe friction. The most common location is on top of the toes at joint prominences where hammertoe or claw toe deformities are most bothersome with pressure from improperly fitting shoes. Treatment includes trimming the painful thick skin with sterile scalpel blades, padding and adjusting of shoes which are comfortable and attractive, and properly fitting with a round deep toe box. Surgery can correct the underlying deformity and remove the bone spur if conservative care does not resolve the problem.