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We now accept Anthem Blue Cross Covered California insurance.
Dr. Koelewyn will be in the Porterville location on Monday, Tuesday, Wednesday & Friday.
On Thursdays Dr. Koelewyn is in the Visalia location, and Dr. Shah is in the Porterville location.

Paul Mayo, DPM
Kathan Shah, DPM
Kristopher Koelewyn, DPM

Visalia, CA (559) 636-3668
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Porterville, CA (559) 615-0420
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March 2022

Poor blood circulation in the feet and legs is often caused by peripheral artery disease (PAD), which is usually the result of a buildup of plaque in the arteries. Plaque buildup, or atherosclerosis, can be the result of excess calcium and cholesterol in the bloodstream. This restricts how much blood can flow through arteries. Reduced blood flow to a certain area of the body severely limits the amount of oxygen and nutrients that part of the body receives. This leads to degeneration in the muscles and other tissues. Sometimes, poor blood circulation in the feet and legs can be caused by other conditions, such as the damaging or inflammation of blood vessels, known as vasculitis.

The lack of oxygen and nutrients caused by poor blood circulation can restrict muscle growth and development, as well as cause muscle pain and cramps, weakness, and stiffness. Other common symptoms include numbness in the legs and feet, skin discoloration in the affected limbs, slower nail and hair growth, and erectile dysfunction in men. In more severe cases of PAD, pain can be present even when a person isn't exercising, and may range from mildly uncomfortable to completely debilitating.

Poor blood circulation in the feet and legs is more common in those who are overweight or obese, have diabetes, high blood pressure, high cholesterol, who smoke, or who have a family history of PAD or related conditions such as a heart attack, stroke, etc. Diabetes and smoking place a person at greatest risk for developing poor blood circulation, although advanced age, over 50, can also increase risk.

If you are experiencing poor blood circulation in the feet and legs caused by PAD, it is important to make changes to your lifestyle in order to reduce your risk of experiencing a heart attack or stroke caused by this condition. If you smoke, quit completely. This will increase the amount of oxygen in your bloodstream. Exercising and reducing the saturated fats in your diet. Saturated fats come from fatty meats, fried foods, whole milk, etc., can make a difference in improving blood circulation in feet. It is also important to avoid developing influenza and to carefully control your blood sugar if you have diabetes.

Your doctor may recommend combining lifestyle changes with a prescription medication regimen to improve blood circulation. The most commonly-used medications for PAD are called statins and work by blocking the amount of enzymes in your body that produce cholesterol. They are known by the brand names Zocor, Lipitor, Crestor, and others.

Published in Featured
Tuesday, 29 March 2022 00:00

How Poor Circulation Can Affect Feet

When the heart pumps blood around the body, it is called circulation. Good blood circulation works to provide oxygen and nutrients to cells and remove waste from the body. Factors that can lead to poor circulation include high or low blood pressure, high red blood cells, a weak heart, and problems with veins and arteries interfering with the flow of blood to the body. Circulation can be improved by being more active, implementing cardiovascular and stretching exercises, and maintaining good health habits, like having a healthy body weight and not smoking. Other ways include reducing saturated fats, increasing omega-3 fatty acids and antioxidants in the diet, and having a balanced level of iron intake. Underlying conditions that can impact proper blood circulation include obesity, diabetes, and a heart condition. When one has poor circulation they may experience numbness, tingling, and pain in their limbs, including the feet. This can lead to falls or other conditions that can be dangerous and should be checked by a qualified podiatrist who can examine the feet, diagnose problems, and suggest proper treatment methods.

 

Poor circulation is a serious condition and needs immediate medical attention. If you have any concerns with poor circulation in your feet contact one of our podiatrists of Central Valley Foot & Ankle. Our doctors will treat your foot and ankle needs.

Poor Circulation in the Feet

Poor blood circulation in the feet and legs is can be caused by peripheral artery disease (PAD), which is the result of a buildup of plaque in the arteries.

Plaque buildup or atherosclerosis results from excess calcium and cholesterol in the bloodstream. This can restrict the amount of blood which can flow through the arteries. Poor blood circulation in the feet and legs are sometimes caused by inflammation in the blood vessels, known as vasculitis.

Causes

Lack of oxygen and oxygen from poor blood circulation restricts muscle growth and development. It can also cause:

  • Muscle pain, stiffness, or weakness   
  • Numbness or cramping in the legs 
  • Skin discoloration
  • Slower nail & hair growth
  • Erectile dysfunction

Those who have diabetes or smoke are at greatest risk for poor circulation, as are those who are over 50. If you have poor circulation in the feet and legs it may be caused by PAD and is important to make changes to your lifestyle in order to reduce risk of getting a heart attack or stroke. Exercise and maintaining a healthy lifestyle will dramatically improve conditions.

As always, see a podiatrist as he or she will assist in finding a regimen that suits you. A podiatrist can also prescribe you any needed medication. 

If you have any questions please feel free to contact our offices located in Visalia and Porterville, CA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Causes, Symptoms, and Treatment of Poor Blood Circulation in the Feet
Published in Blog
Tuesday, 22 March 2022 00:00

Flipping Out About Flip Flops

Although it may be tempting to wear flip-flops in warm weather, they are not the best choice of footwear for your feet. Flip-flops may be ideal for the beach, pool, spa, and shared showers, but you should avoid wearing them unless it is completely necessary.

Flip-flops only have a small strip of fabric holding your foot in place, but your toes need a better grip to keep your foot in place. The repetitive gripping can lead to an overuse of your muscles, which could result in tendinitis. This is only one of the many problems that stem from wearing flip-flops too often.

Flip flops aren’t good for extensive walking because they fail to offer arch support, heel cushioning, or shock absorption. As a result, people who wear flip flops are at a higher risk of experiencing an ankle sprain. Additionally, these shoes offer little protection for your feet, putting those who wear them at a greater risk for stubbed toes, glass cuts, and puncture wounds.

Although flip flops aren’t recommended for everyday use by anyone, it is especially important for diabetics to avoid them. A diabetic foot injury can easily become very serious, and it may even lead to amputation.

If you are experiencing pain from wearing flip-flops, you shouldn’t be hesitant to replace them with a more comfortable shoe that offers more support. If your flip-flop foot pain doesn’t go away, you should seek assistance from a podiatrist right away. It is possible that you may have a more serious foot problem such as a stress fracture or arthritis.

Published in Featured
Tuesday, 22 March 2022 00:00

Will Wearing Flip Flops Damage My Feet?

People often wear flip-flops in summer and warmer weather. These shoes often feel comfortable, but if worn too much and for long periods of time they can cause foot and body problems. The lack of support in flip-flops can lead to issues with foot arches and heels, including painful plantar fasciitis – an inflammation of the fascia on the bottom of the foot. Long-term pain in foot arches and heels can further lead to bone spurs or impact the way one walks, which can cause further problems with the knees, hips, and the back to develop. If pain in the feet results from wearing such shoes, a visit to a podiatrist is suggested to halt or treat serious issues from developing.

 

Flip-flops are not always the best choice of footwear. If you have any concerns about your feet or ankles, contact one of our podiatrists from Central Valley Foot & Ankle. Our doctors will assist you with all of your foot and ankle needs.

Flip-Flops and Feet

When the weather starts warming up, people enjoy wearing flip-flops.  Flip-flops are comfortable, stylish, and easy to slip on and off; they're perfect for any summer beach goer.  However, these shoes can cause harm to the feet.

How Can Flip-Flops Affect Me Long-Term?

  • Ankle problems
  • Hip problems
  • Lower back problems
  • Pain in the balls of the feet
  • Problems with foot arches
  • Changes in the way you walk

Are There Injuries Associated with Flip-Flops?

Yes.  Since flip-flops are relatively weak and do not provide the same amount of support as sneakers, people who wear flip-flops regularly are more susceptible to injuries. On top of that, the open nature of the shoe makes your feet more prone to other problems, such as cuts and even infections.  Common injuries and ailments include:

  • Sprained ankles
  • Blisters
  • Infections
  • Cuts and Scrapes

I like Wearing Flip-Flops. Are There Safe Alternatives?

When buying flip-flops, try to find ones that have sturdy soles and that are made of high-quality materials that will support for your feet.  These flip-flops will cost more but will also last longer as a result.

If you have any questions please feel free to contact our offices located in Visalia and Porterville, CA .  We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Flipping Out About Flip Flops
Published in Blog
Tuesday, 15 March 2022 00:00

How to Care for Your Arthritic Foot

Arthritis is an inflammation of the joints and it can occur at any joint in the body, especially in the foot. It generally effects those who are older, however, it can occur at any age. Although there are many different forms of arthritis, there are three main types that occur in the foot. The three types are osteoarthritis, rheumatoid arthritis, and gout.

The primary cause of osteoarthritis is aging. As you age, cartilage degenerates around the joints which causes friction and pain. Obesity can cause osteoarthritis through mechanical stress. Injuries that damage joints can increase the probability as well. Finally, a family history of osteoarthritis can also increase chances of having it.

Rheumatoid arthritis occurs when the immune system attacks the joint linings and weakens them over a long time. While there is no known cause of rheumatoid arthritis, obesity and smoking can increase your chances of getting it. Women are also more likely to get it than men.

Gout is a form of arthritis that occurs when there is too much uric acid in your blood and painful crystals form in your joints. Men are more likely to have gout than women. People who are obese or drink alcohol often are also more likely to develop gout. Furthermore, having diabetes, heart disease, high blood pressure, high cholesterol, gastric bypass surgery or a family history of gout may increase your likelihood of developing the condition.

Symptoms of arthritis include pain, stiffness, swelling in the joints. These symptoms can make it harder and more painful to walk. Physical activity can increase pain and discomfort. Furthermore, joint pain can worsen throughout the day for osteoarthritis. Gout attacks generally last several days with the first few being the worst.

Diagnosis of gout includes either a joint fluid test or a blood test. X-ray imaging can detect osteoarthritis but not gout. On the other hand, there is no blood test for osteoarthritis. Rheumatoid arthritis is difficult to diagnosis. Doctors utilize family and personal medical history, a physical examination, and antibody blood tests to determine if you have rheumatoid arthritis.

Treatment varies for the different kinds of arthritis. Anti-inflammatory medication or steroids can help reduce pain from inflammation of the joints. Changing shoe types can help with some symptoms. Wider shoes can help with discomfort from gout and osteoarthritis. High heels should be avoided. Shoes with proper arch support and that take pressure off the ball of the foot can help with rheumatoid arthritis. Drinking lots of water can also help rid uric acid from the blood. Losing weight, improving your diet, and limiting alcohol and smoking can also help prevent or lessen the symptoms of arthritis.

If you are having trouble walking or pain in your feet, see a podiatrist to check if you have arthritis.

Published in Featured

Rheumatoid arthritis (RA) is a progressive disease that causes the body’s immune system to mistakenly attack healthy tissue. RA can break down cartilage between bones in the ankle. Without healthy cartilage between ankle bones, bones rub together and cause friction that can lead to inflammation and pain in the ankle joint. In addition, RA can also weaken surrounding tissues that normally support and stabilize the ankle. Over time, the damage RA inflicts on the ankle can change how the joint functions and may lead to further destruction. A podiatrist can diagnose RA in your ankles and help determine the best course of treatment, which may include non-steroidal anti-inflammatory medications, corticosteroid injections, custom orthotics, physical therapy, and in some cases, surgery.

Arthritis can be a difficult condition to live with. If you are seeking treatment, contact one of our podiatrists from Central Valley Foot & Ankle. Our doctors can provide the care you need to keep you pain-free and on your feet.

Arthritic Foot Care  

Arthritis is a term that is commonly used to describe joint pain.  The condition itself can occur to anyone of any age, race, or gender, and there are over 100 types of it.  Nevertheless, arthritis is more commonly found in women compared to men, and it is also more prevalent in those who are overweight. The causes of arthritis vary depending on which type of arthritis you have. Osteoarthritis for example, is often caused by injury, while rheumatoid arthritis is caused by a misdirected immune system.

Symptoms

  • Swelling
  • Pain
  • Stiffness
  • Decreased Range of Motion

Arthritic symptoms range in severity, and they may come and go. Some symptoms stay the same for several years but could potentially get worse with time. Severe cases of arthritis can prevent its sufferers from performing daily activities and make walking difficult.

Risk Factors

  • Occupation – Occupations requiring repetitive knee movements have been linked to osteoarthritis
  • Obesity – Excess weight can contribute to osteoarthritis development
  • Infection – Microbial agents can infect the joints and trigger arthritis
  • Joint Injuries – Damage to joints may lead to osteoarthritis
  • Age – Risk increases with age
  • Gender –Most types are more common in women
  • Genetics – Arthritis can be hereditary

If you suspect your arthritis is affecting your feet, it is crucial that you see a podiatrist immediately. Your doctor will be able to address your specific case and help you decide which treatment method is best for you.

If you have any questions, please feel free to contact our offices located in Visalia and Porterville, CA . We offer the newest diagnostic and treatment technologies for all your foot care needs.

Read more about How to Care for Your Arthritic Foot
Published in Blog
Wednesday, 09 March 2022 00:00

Heel Pain Can Be Treated!

Do you suffer from heel pain when you get up in the morning? If so, you should seek the professional help of your podiatrist and have a proper diagnosis performed. Heel pain can be caused by several different foot-related conditions.

Published in Blog
Tuesday, 08 March 2022 00:00

Blisters

Blisters are pockets of fluid that occur under the top layer of your skin. These fluid pockets are usually filled with pus, blood, or serum. Blisters may itch or hurt and can appear as a single bubble or in clusters.

The most common types of blisters are friction blisters. This type of blister may be caused by wearing shoes that are too tight. Friction blisters can also occur on the hands. A change in temperature may also cause blisters on the feet. In the freezing air, frostbite on your toes can lead to blisters, as well as sunburn from hot weather.

The best way to treat a blister is to keep it clean and dry. Most blisters will get better on their own. Once the skin absorbs the fluid within the blister, it will flatten and eventually peel off. You should avoid popping your blister unless you podiatrist does it for you. Additional treatment options include applying an ice pack to the blister or using over-the-counter blister bandages to cover the affected area.

If your blister becomes discolored, inflamed, or worsens it is advised that you speak to your podiatrist. Blisters that are yellow, green, or purple may be infected and require immediate medical attention. Blisters that are abnormally colored may be a sign of a more serious underlying health condition such as herpes.

Published in Featured
Tuesday, 08 March 2022 00:00

Possible Causes of Blisters

Blisters on the feet can be uncomfortable, painful, and if infected, can become a serious health issue. Blisters are a small pocket of fluid that develops over a damaged portion of skin. This is the body’s natural defense in protecting the area as new skin forms. Blisters can develop from wearing shoes that do not fit correctly, and this can cause the foot to rub against the shoe. Many patients find it helpful to keep their feet as dry as possible, and this can aid in preventing blisters. Additionally, blisters can develop from a severe sun or chemical burn, frostbite, or possibly from an allergic reaction. If you have developed blisters on your feet, it is suggested that you speak to a podiatrist who can guide you toward proper treatment and healing techniques.

Blisters are prone to making everyday activities extremely uncomfortable. If your feet are hurting, contact one of our podiatrists of Central Valley Foot & Ankle. Our doctors can provide the care you need to keep you pain-free and on your feet.

Foot Blisters

Foot blisters develop as a result of constantly wearing tight or ill-fitting footwear. This happens due to the constant rubbing from the shoe, which can often lead to pain.

What Are Foot Blisters?

A foot blister is a small fluid-filled pocket that forms on the upper-most layer of the skin. Blisters are filled with clear fluid and can lead to blood drainage or pus if the area becomes infected.

How Do Blisters Form?

Blisters on the feet are often the result of constant friction of skin and material, usually by shoe rubbing. Walking in sandals, boots, or shoes that don’t fit properly for long periods of time can result in a blister. Having consistent foot moisture and humidity can easily lead to blister formation.

Prevention & Treatment

It is important to properly care for the affected area in order to prevent infection and ease the pain. Do not lance the blister and use a Band-Aid to provide pain relief. Also, be sure to keep your feet dry and wear proper fitting shoes. If you see blood or pus in a blister, seek assistance from a podiatrist.

If you have any questions, please feel free to contact our offices located in Visalia and Porterville, CA . We offer the newest diagnostic and treatment technologies for all your foot care needs.

Read more about Blisters
Published in Blog
Tuesday, 01 March 2022 00:00

Stress Fractures of the Foot and Ankle

Our bones are important aspects of our body and they are constantly changing. The heavier the workload for a bone, the more likely it is that calcium will be placed in it. When a bone isn’t used often, there won’t be much calcium within it. When stress from repetitive loads prevent the bone from being able to repair itself, cracks will start to form. Stress fractures are defined as cracks in a bone that result from repetitive force, such as overuse.

The most common cause of stress fractures is a sudden increase in intensity and duration of physical activity. For example, if you begin to run long distances without working your way into doing so, you will be more likely to develop a stress fracture.

Common symptoms of stress fractures are pain and swelling near the weight bearing area on the injured bone. When initial x-rays are performed, it is possible that the fracture will not show up. However, once the stress on the area continues, the damage will increase, and the fracture will be severe enough to show up on an x-ray. Certain parts of the foot are more likely to develop stress fractures than others. Areas that typically have these fractures are: the metatarsals, the navicular bone, the calcaneus, tibia, and fibula.

Since women are at an increased risk of developing osteoporosis, they are twice as likely as men to sustain a stress fracture. Additionally, old age causes a decrease in bone mineral density which is why elderly people are also likely to develop these fractures.

It is important for you to be professionally diagnosed by a podiatrist if you suspect you have a stress fracture, because there are other injuries that can easily be mistaken for a fracture.  Sprains, strains, shin splints, plantar fasciitis, and Morton’s neuroma can all easily be mistaken for stress fractures in the foot. Your podiatrist will likely ask you a series of questions to determine what type of pain you are experiencing. These questions will help your doctor identify whether you have a stress fracture.

The best method of treatment for a stress fracture is rest. Additionally, a walking boot, cast, or crutches, will help rest the area that is injured. The typical healing time for stress fractures is 4-12 weeks, however this depends on which bone is involved.

Published in Featured
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