Category Archives: Practice Areas

Ultrasound Evaluation

Ultrasound Evaluation

Before Dr. Perlstein is able to come up with a treatment plan for your specific condition, he may need to perform an in-office procedure.  One such procedure to help identify specific conditions is called a Musculoskeletal Ultrasound. 

A Musculoskeletal Ultrasound is non-invasive and used when an x-ray is not providing an accurate picture of what is going on in your foot.   Some foot ailments may not show up on an x-ray because it’s not a bone problem, but a soft tissue problem.   An ultrasound can help identify issues going on in the muscles or ligaments around the area of concern.

How does a Musculoskeletal Ultrasound work?

Your foot will be exposed to high-frequency sound waves, which produce pictures of the inside of your foot.  These images are captured in real-time and show the structure and movement of the area which is being captured.   Images of the musculoskeletal system include pictures of muscles, tendons, ligaments, joints and soft tissue. 

A Musculoskeletal Ultrasound can help diagnose the following foot problems:

  • Ankle Sprains – an ultrasound can visualize the area and look at the soft tissue.  A tear will show up as black.  
  • Anterior Tibial Tendonitis – an ultrasound shows tears and inflammation in the anterior tibial tendon.
  • Bursitis – an ultrasound can show any fluids in the metatarsal area, which indicate inflammation. 

How can it help?

Using a Musculoskeletal Ultrasound can help Dr. Perlstein identify the problem causing your foot pain.  Typical treatment options include, but not limited to the following:

  • Physical therapy
  • Custom-made orthotics
  • Recommendations for the right type of footwear  

 

If you are interested in learning more about how Dr. Perlstein uses ultrasounds to help identify foot conditions, call our office.  



Dr. Michael Perlstein’s podiatry office is located at 4414 14th Avenue in Brooklyn, New York. He serves patients throughout the greater New York City area, including those residing in Manhattan, Queens, Staten Island, the Bronx, New Jersey, and Connecticut.

Dr. Perlstein’s office is open Monday through Friday as well as on Sunday.



Welcome! Information for New Patients

Your first visit to Dr. Perlstein establishes a vital foundation for our relationship with you. During the first visit, we make sure to obtain important background information, like your medical history, and give you time to get to know your doctor. To understand what to expect for your first visit to our practice, please read through this page. You’ll find all the practical information you need, such as a map and directions to our office, practice hours, payment policies and more. There’s also background information about our committed staff and our first visit procedures. You can even save some time at your first visit by printing out and completing the patient forms in advance of your appointment.

Mission Statement
By combining experience, individualized care, combined with state of the art diagnostics and treatments we will provide you with the finest in foot care.


Patient Forms
Please print and fill out these forms so we can expedite your first visit:

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.



What to expect
Your initial visit will include a review of your medical history and a physical examination. Every effort will be made to relieve your discomfort on the first visit. Since some symptoms of foot problems may emanate from the leg, knee, hip or back we may question you about these areas. Some diseases such as diabetes, arthritis and gout may have important effects on the foot; therefore, it is important to inform us of any medical problems you may have. Also, please mention any medication which you may be taking or any allergic conditions.
If a child is being seen it is important that he/she be accompanied by an adult.


Dr. Michael Perlstein’s podiatry office is located at 4414 14th Avenue in Brooklyn, New York. He serves patients throughout the greater New York City area, including those residing in Manhattan, Queens, Staten Island, the Bronx, New Jersey, and Connecticut.

Dr. Perlstein’s office is open Monday through Friday as well as on Sunday.




Videos about New Patients:

Get Help For Your Foot Wounds, Poor Circulation

Wounds

For the past 25 years, Dr. Perlstein has seen people come into his office on a daily basis with wounds.  Wounds can be acquired from simply cutting yourself, or bumping your foot into an object.  Also, people with diabetes can acquire foot ulcers and infections, which are open wounds.  However, the majority of wounds that need treatment are ones that don’t heal themselves.  An open wound on your foot is not to be taken lightly and should be checked as soon as you notice the area. 

Common symptoms of wounds include:

  • Bleeding
  • Foot pain, tenderness and swelling
  • Redness on the skin

Also, for those with diabetes who develop foot ulcers, pain is not common.  Many people with diabetes who develop foot ulcers lose the ability to feel pain.  However, you will be able to see drainage on the socks, redness and swelling. 

Causes of wounds

You can acquire a wound from a variety of different ways.  You can step on an object and pierce the skin, you can accidently cut yourself or acquire complications from diabetes.  Unfortunately, people with diabetes who use insulin are at a higher risk of developing an open wound, also called a foot ulcer.  For a person with diabetes a foot ulcer can occur from a variety of reasons.  It could be from lack of feeling in the foot, poor circulation, other foot conditions, irritation, trauma to the foot and length of diabetes.    

Treatment

To begin treatment, Dr. Perlstein would need to hear the history about your wounds.  He would have to know how long you’ve had the wounds, how the wound was acquired and types of treatments you tried.  The most important thing Dr. Perlstein would need to know is your history and medications to find out why the wound has not healed. 

Dr. Perlstein will analyze the area, and may also take x-rays and ultrasounds.  Using our office technology, he can see if there’s an infection in the muscle or bones.  He can also see if there are bones sticking out causing the irritation.  He will also examine your shoes and the way you walk either by watching your movements or using our computerized gait analysis machine treadmill.  After he’s gathered all the information, he can form a very effective treatment plan. 

Dr. Perlstein offers two treatment options for foot wounds and poor circulation.  They include: 

  • Microvas™ – this specific treatment is used for circulation.  Dr. Perlstein has used Microvas™ for five years.  The treatment stimulates the body to heal itself.  What happens is the cells are stimulated to re-grow and stimulates the muscles to increase blood flow.  Treatment is effective and wounds are healed.  This treatment is done twice a week for several weeks.  
  • Mist Therapy – is used to gently stimulate new blood vessels, clear wounds and destroy infections.

Who Can Be Helped?

  • Ischemic ulcers
  • rest pain or claudication (pain with walking)
  • Threatened gangrene
  • Insufficient blood supply at the amputation site
  • Persisting ischemia after embolectomy or bypass surgery
  • Pre and Post-arterial reconstruction to improve runoff

Both treatments are simple and no pain is involved.  Better yet the results are great!

If you have a wound and it is not healing then you should come into our office before the wound advances and causes all sorts of problems. 



Dr. Michael Perlstein’s podiatry office is located at 4414 14th Avenue in Brooklyn, New York. He serves patients throughout the greater New York City area, including those residing in Manhattan, Queens, Staten Island, the Bronx, New Jersey, and Connecticut.

Dr. Perlstein’s office is open Monday through Friday as well as on Sunday.




Videos about Wounds:

Women’s Foot Health & Common Issues

High Heels: Use & Abuse

High heels may contribute to knee and back problems, disabling injuries in falls, shortened calf muscles, and an awkward, unnatural gait. In time, high heels may cause enough changes in the feet to impair their proper function. Most women admit high heels make their feet hurt but they tolerate the discomfort in order to look taller, stylish, and more professional. In a Gallup Poll, 37 percent of the women surveyed said they would continue to wear high heels, even though they did not think them comfortable.

Toward Greater Comfort

If women persist in wearing high heels, there are ways to relieve some of the abusive effects; they can limit the time they wear them, for example, alternating. with good-quality oxford-type shoes or flats for part of the day. High heels that are too tight compound the abuse; it’s good advice to buy shoes in the afternoon, since feet tend to increase in size later in the day.

Women have other heel-size choices, fortunately. They don’t have to endure pain at the expense of their foot health. The key is wearing the right shoe for the right activity – and that means varying heel height, determining what heel is most suitable.

For example, there are comfortable and attractive “walking” pumps (also called “comfort” or “performance” pumps) for women for work and social activities. The shoe manufacturers who have introduced them seek a marriage of fashion considerations and comfort, offering fashionable pumps with athletic shoe-derived construction, with reinforced heels and wider toe room. They are using space-age materials, like long-lasting memory cushioning that acts as a shock absorber. And the soles are more pliable. At least three lines of walking pumps have the use of the American Podiatric Medical Association’s Seal of Acceptance.

Several companies have also designed footwear for certain athletic activities, including aerobics, specifically for women.

Perhaps the best shoe for women, from an structural point of view, is a walking shoe with ties (not a slip-on), a Vibram type composition sole, and a relatively wider heel, no more than a half or three-quarters of an inch in height – even though such a shoe may not be widely acceptable in the work place.

What About Stockings?

Women who always wear nylon pantyhose are also inviting foot problems. Nylon is occlusive – it doesn’t breathe – and the heat that it generates and traps causes excessive perspiration. A warm, damp area is an ideal place for the encouragement of fungal infections such as athlete’s foot. (Pantyhose aren’t the only apparel that cause excessive perspiration; the dress boots and shoe boots many women don in cold weather shouldn’t be worn all day in an office.) Nylon, which tends to be abrasive, is even more so when it’s damp; in a tight shoe that’s already irritating, it offers little protection against blisters. Support hose, because they’re so much tighter, can be the worst culprits of all.

Inexpensive nylon pantyhose can also cause forefoot problems, because the stretch mechanism constricts normal expansion of the foot when walking, and may pull the toes backward when the pantyhose ride up. The cramping and pressure of the hose can contribute to ingrown toenails and hammertoes. A better quality nylon will provide a better fit, and the better the fit, the less likely cramping will be. Women’s feet have grown larger because of improved health care and nutrition. The one-size-fits-all stocking no longer is the universal answer, if it ever was. Attention to proper fit is essential.

Pregnancy

Pregnant women need to observe good foot health to prevent pain and discomfort. Since the body undergoes changes and acquires a new weight-bearing stance, women should wear shoes with broad-based heels that provide support and absorb shock. Additional body weight also calls for more support to prevent foot “breakdown”.

The expectant mother often experiences more than ordinary swelling of her feet and ankles, which can aggravate existing foot conditions and promote inflammation or irritation. Pregnancy also triggers the release of hormones which enhance laxity in ligaments, which can contribute to foot strain. If problems develop, she should see Dr. Perlstein.

Women Over 65

Older women have more trouble with their feet than younger ones, for the simple reason that fat pads on the bottom of the feet tend to deteriorate in the aging process. They can alleviate some foot problems by wearing properly fitted, well-constructed shoes – shoes which provide cushioning and have a soft, flexible upper that will conform to the shape of their feet. They also need leather shoes which “breathe” and can reduce the possibility of skin irritation. Soles should be lightweight, with enough flexibility and shock-absorbing quality to provide solid footing and not be slippery. Low-heeled shoes provide greater stability, more protection for the feet, and greater comfort. Because older women often have circulatory problems, they have a special need to keep their feet warm in cold weather, to prevent frostbite or chilblains.

Women’s Foot Afflictions

Whether the sources are congenital problems, foot abuse, high heels, poorly fitting shoes, or other maltreatment of the feet, women are subject to a number of afflictions involving the feet (most of which can also occur to men):
Achilles tendinitis: inflammation of the Achilles tendon, the link between the calf muscle and heel bone. Those who wear high heels regularly can expect to acquire shortened tendons; switching to low heels for strenuous physical activity without appropriate warm-up exercises creates an ideal scenario for Achilles tendonitis.

Bunions: misaligned big toe joints which become swollen and tender. Bunions tend to be familiar, but the tendency can be aggravated by shoes that are too narrow in the forefoot and toe.

See Our Bunion Video

Hammertoe: a condition in which the toe is contracted in a claw-like position. Although the condition usually stems from muscle imbalance, it is often aggravated by ill-fitting shoes, socks, or hosiery that cramp the toes.

See Our Bunion Video

Metatarsalgia: general pain in the ball of the foot; often caused by wearing high heels.
Neuromas: enlarged, benign growths of nerves, most commonly between the third and fourth toes. They may stem, in part from ill-fitting shoes, resulting in pain, burning, tingling or numbness between the toes and in the ball of the foot. Treatment includes orthotic devices and/or steroid injections, and sometimes surgery. Click here to see our Cryo Surgery video for Neuromas & Heel pain videos.
Plantar fasditis/heel pain: Inflammation of the long band of connective tissue running from the heel to the ball of the foot, a main cause of rear-foot pain. This condition is sometimes caused by shoes that cramp the feet, especially in the arch area.
Pump bump (Haglund’s deformity): A bone enlargement at the back of the heel bone, in the area where the Achilles tendon attaches to the bone. The deformity generally is the result of faulty bio mechanics causing increased motion of the heel bone against the shoe counter.


Dr. Michael Perlstein’s podiatry office is located at 4414 14th Avenue in Brooklyn, New York. He serves patients throughout the greater New York City area, including those residing in Manhattan, Queens, Staten Island, the Bronx, New Jersey, and Connecticut.

Dr. Perlstein’s office is open Monday through Friday as well as on Sunday.




Blog for Women’s Feet


Videos about Women’s Feet:

Toenail Injuries, Infections, and Conditions Can Cause Pain and Discomfort

Do you have problems with your shoes? Do you feel like taking your shoes off after a half an hour? Are your toes rubbing against your shoes and becoming extremely annoying? Even the simplest shoes, and sometimes sneakers, press on your toes. If there’s not enough room in the toe box, shoes can cause your toes to dig into the end of your shoes. When that happens it gives your toes all sorts of aches and pains.

Dr. Perlstein has 25 years of treating a variety of foot conditions, especially toe problems. If you come into our office with toe problems, Dr. Perlstein can evaluate you properly. He can use x-rays, ultrasounds, vascular testing or our computerized gait analysis, to help identify the problem. Once Dr. Perlstein has evaluated you properly, he can formulate a treatment plan. There are a variety of different options available.

Common toenail problems seen in the office nclude the following and Toenail Surgery is employed to alleviate the following concerns: 

  • Ingrowing Toenail
  • Incurvated Nail
  • Fungus Nail
  • Thick Nail (Hypertrophied)
  • Injury to a Toenail

Ingrown Toenail & Incurvated Nail

This is a condition in which a portion of nail presses into the flesh, causing pain, redness and sometimes infection. If this condition is untreated, proud flesh may form along the nail border and you may get an infection.

Say Goodbye To Painful Nails Permanetly

This surgery is performed with local anesthesia. Preoperative X-rays may be taken to be sure there is no bone spur involved. Removal of a portion of the nail border causing the problem will give temporary relief. Permanent correction may be required if this is a recurring problem. This correction is performed under local anesthesia, and consists of removal of the offending portion of nail and nail root.

Subungal Exostosis (Bone Spur under the Nail)

Sometimes deformed nails are assoociated with a small bone spur on the tip of the toe under the nail. This can cause considerable discomfort at the nail or just underneath. The skin between the nail and the bone can get pinched and sometimes a corn can form in that spot. If the nail is removed, without removing the bone spur, the corn will continue to form on the tip of the toe. Therefore the most effective way to treat this condition is to make a small openning in the tip of the toe and insert a small surgical instrument to reduce the spur. This bone spur can easily be removed with this technique and helps to insure a lasting result. Sometimes a stitch or stitches are used to close the opening in the tip of the toe. Most likely there will be mild tenderrness in the tip of the toe for a few days which will pass by quickly. Many people may not experience this tenderness. The ability to walk following this proocedure is usually no problem.

Thickened Deformity of Toenails

This condition can be associated with a fungus of the nails, injury to the nail or it may be inherited. Treatment may require removal of the nail and destruction of the nail root. This type of permanent correction requires local anesthesia.

Chemical Cauterization for Permanent Nail Removal

This procedure involves the removal of one side of a toenail and the careful debriding and cleansing of this area for any type of fungus tissue that may be present. The root area of that portion of the toenail that is to be removed permanently is then treated with a chemical agent which destroys that portion of the root. If the entire toenail is removed, then the same procedure is employed for the entire tissue under the nail and the complete root area of the toenail to prevent the nail from growing back.
Dr. Perlstein will dress your toe after chemical surgery with appropriate medication, and give you instructions for home care and an appropriate prescription for medication to dress your toe. There is normally very little, if any, pain after either one of these surgical procedures. Dr. Perlstein will instruct you accordingly, and prescribe whatever appropriate medication you may need for pain. Usually, after the first day, you do not need to wear a cut-out or surgical shoe, if you follow Dr. Perlstein’s instructions. You will usually be able to walk comfortably after either of these procedures.

Post – Operative Care

Most of these surgeries can be performed in the office. Walking is usually permitted immediately following the surgery. Dr. Perlstein may allow you to walk in your normal shoe or sneaker. Dr. Perlstein may prescribe medication to be taken if needed for discomfort.

Summary

Dr. Perlstein will instruct you as to the proper way to cut your nails in the future. If you have difficult nails to cut (incurvated or thick), Dr. Perlstein will advise you to have periodic professional foot care at his office. You should follow Dr. Perlstein’s advice carefully to avoid any future problems with your toenails. There may be additional methods of treatment for this common foot problem. Dr. Perlstein will discuss this with you. Each doctor develops a favorite treatment, and probably has the best percentage of results with that approach. Complete cooperation between you and Dr. Perlstein is essential for a satisfactory result.



Dr. Michael Perlstein’s podiatry office is located at 4414 14th Avenue in Brooklyn, New York. He serves patients throughout the greater New York City area, including those residing in Manhattan, Queens, Staten Island, the Bronx, New Jersey, and Connecticut.

Dr. Perlstein’s office is open Monday through Friday as well as on Sunday.




Blog for Toenail Problems


Library for Toenail Problems:

  • Un-Treated Problems with Toe Nails   
    Podiatrist Michael Perlstein successfully treats toenail problems related to injuries and toenail fungus. Located in Brooklyn New York and open on Sundays.

View All


Frequent Questions for Toenail Problems:


Videos about Toenail Problems:

Sports Treatment

Whether you are actively involved in sports on a professional level, or just engage for fun, protection of your feet is very important. Many athletes are prone to foot injuries,some which can be difficult to diagnose and treat. Because people participating in sports related activities bear the entire weight of their body during the activity, feet are under a big amount of stress. Many times in sports a person’s feet take a lot of the forces from the activity. If you visit Dr. Perlstein for a sports related injury, he will listen to the problem, examine the area, and provide a treatment plan.
The most common causes for sports related foot injuries are from:
• Not warming up properly
• Overuse
• Intense workouts
• Improper footwear
• Playing on hard surfaces

Conditions Associated With Sports
Plantar Fasciitis
Plantar fasciitis is caused by overuse of the plantar fascia, the arch tendon of the foot. Your plantar fascia is a thick band of tissue, which runs from under the heel to the front of the foot. This condition is common among individuals involved in running, dancing, and jumping. Symptoms for plantar fasciitis include: pain under the heel, pain is worse
in the morning, stretching causes pain.

Heel Spur
A heel spur is a bony growth that happens at the attachment of the plantar fascia to the heel bone, and many times occurs with plantar fasciitis. It occurs because of repetitive pulling of the plantar fascia. This condition is common among individuals involved in running, dancing, and jumping. Symptoms for heel spurs include: pain and tenderness
on the base of the heel, pain when you bear weight on the heel, and sometimes it’s difficult to walk.

Bruised Heel
Bruised heels can be caused by a sudden impact, like landing hard on your foot, or repetitive pounding. When the heel incurs repetitive pounding and can cause the fat pad to be pushed up the side of the heel. If this happens then there is less protection on the heel, which causes pain. Symptoms for a bruised heel include: pain while walking, and pain at the heel.

Achilles Tendon Bursitis
Achilles Tendon Bursitis happens when the bursa sacs of fluid, which cushion the Achilles tendon and protect it from rubbing against the heel bone or outer skin, become inflamed and irritated. This condition is a common foot pain in athletes, but especially those that run. Symptoms of Achilles tendon bursitis include: pain at the back of the heels, pain when running uphill or on soft surfaces, tenderness, and swelling.

Blisters
Blisters occur when shoes rub repeatedly on the skin causing friction burns. This happens as the outer lay of skin separates from the inner layers, which cause the space between to fill with lymph fluid. This condition occurs in athletes wearing new shoes, and those athletes who take place in events like marathons. Symptoms for blisters
include: redness on the foot, either at the back of the heel or toes.

Tarsal Tunnel Syndrome
Tarsal tunnel syndrome happens when there is damage to the tibial nerve. Your tibial nerve provides movement and sensation to the calf and foot muscles. This condition can be caused by direct trauma to the area, or pressure on the nerve for a long period of time. Symptoms for tarsal tunnel syndrome include: burning sensation, numbness,
tingling, pain, and weakness of foot, toes or ankle.

Turf Toe
Turf toe happens when the big toe is bent upward. At one point the shoe grips the hard surface and sticks, which causes the person’s body weight to go forward and bends the toe upward. When a toe bends upward it causes damage to the ligaments under the toe. It’s named this because it happens more often in athletes who play games on artificial surfaces. Symptoms for turf toe include: swelling and pain at the joint of the big toe, and pain and tenderness on bending the toe or pulling it upward.

Athlete’s Foot
Athlete’s foot is a skin infection that occurs among athletes, and others, who wear nonbreathable footwear. It happens most often on the toes, between them, and the soles of the feet. It’s caused by a fungus that lives in warm and moist environments. It can be transferred through direct contact when people use the same towels, socks, and walk barefoot in changing room floors. Symptoms for athlete’s foot include: itching, burning, and peeling or flaking skin.

Stress Fractures
Stress fractures can occur with overloading the foot and ankle with excessive pressure in sports and exercise .It comes from doing too much too soon, and your body is not ready for this overload. The bone starts to crack and the area over the bone becomes swollen and painful. It’s important to treat this injury before the bone breaks completely .

What You Can Do For Temporary Relief
• Take time out of your schedule to rest the affected foot
• Stay away from activities that will aggravate the condition even more
• Apply ice to the area to help reduce pain, and inflammation
• Take anti-inflammatory medication, such as ibuprofen
• Tape the foot to provide stability
• Replace shoes, and make sure your new ones are comfortable and fit correctly.
If you are involved in sports related activities, and are having difficulty with your feet, give our office a call. We would be happy to assist you in identifying, and coming up with a plan for treatment.



Dr. Michael Perlstein’s podiatry office is located at 4414 14th Avenue in Brooklyn, New York. He serves patients throughout the greater New York City area, including those residing in Manhattan, Queens, Staten Island, the Bronx, New Jersey, and Connecticut.

Dr. Perlstein’s office is open Monday through Friday as well as on Sunday.




Blog for Sports Treatment


Library for Sports Treatment:

  • Running The Race To Good Foot Health   
    Podiatrists know that runners are susceptible to a number of foot issues and injuries, including tendonitis, heel pain, and foot stress fractures.

View All


Videos about Sports Treatment:

Shoes

Footwear is truly an important part of your wardrobe. Not only do they keep your feet nice and warm during the winter months, but they are also protection against rough terrain, infection, and an accidental step on. Depending on what your interests are and size, it may be hard to find a shoe you like, and one that actually fits. However, it’s important to not only look at style, but be practical about what shoe you decide to purchase. Your feet may not always be impressed with comfort as you are with the shoe style. Buying and wearing the right footwear may reduce, and keep away foot problems.

Your feet are under a lot of pressure. Think about it – you use your feet constantly to get around, you bear weight on them as you walk about – of course they are under pressure! According to the American Medical Podiatric Association (AMPA), when you spend an average day of walking it brings a force equal to several hundred tons on your feet. Your feet are the one body part that incurs more injury than any other part of your body. So you want to make sure to take care of them, and Dr. Perlstein can help! 

What You Should Know Before You Buy Shoes
• Go to the store later in the day to shop for shoes. Our feet swell during the day, and you are going to want to try them on at their largest.
• Just because your last pair was in a specific size, does not mean that the new pair will be the same size. Your feet do get bigger, and think about it, different brand shoes may not fit you the same in your usual size.
• Measure your feet while you are standing, try on both shoes, and walk around the store in them. Wear, or bring a pair of socks, that you are expecting to wear with the shoes. You want to put these on when you walk around in the shoes.
• You’re going to want shoes that do not need a “break-in” period. The shoes you buy should feel comfortable right away.
• Buy shoes for the larger foot. Also, make sure shoes fit well in the front, back, and sides. You don’t want shoes that are going to pinch your toes.
• If you have an orthotic, make sure to bring it along when you are trying on shoes.
You want to make sure that this will be comfortable to wear in your new shoes. Children’s shoes should be picked out the same way; however, there are a few additional things to look out for when purchasing shoes.
• Shoes should have about one-half inch of space between the tip of the toes and at the end of the shoe. Have your child wiggle his or her toes; if they can do this comfortably then you’re set.
• When you have your child walk around the store in the new shoes, make sure to feel the inside of the shoe for any irregularities or for anything that can cause irritation. Also, look for any irritation on your child’s foot after the shoe has been worn.
• Your child’s shoes should not slip off at the heels. The shoe should have a firm heel counter, cushioning of the insole, and a built-in arch.


Gender Specific Footwear

Women
Women tend to wear shoes that are not necessarily good for their feet, which cause preventable foot problems. High heels are one such shoe, which have heels of more than two inches. Wearing high heels should be limited, and is recommended to change it up by switching shoes during the day. There are heels that are not so high, giving your feet a fashionable look without the pain of the heel. The best shoe for women is a walking shoe with laces, along with a polymerized composition sole, and a wider heel with a rigid and padded heel counter. The heel should be no more than three-quarters of an inch in height.
Men
Men’s shoes are a bit easier to address as a good oxford style shoe would be good. Also, slip-on shoes, and dressy loafers would be a good shoe style for men. If you are a man who spends a lot of time on his feet, then having cushioned-sole shoes, which give good support are recommended. If you work in an industry, which requires you to be around heavy equipment then purchasing safety shoes or boots is important. Wearing safety shoes or boots that are water-resistant, with insulated steel toe caps and soles of non-conducting materials, can help prevent injury to your feet.
Problem Specific Shoes
We carry specific shoes for arch and heel pain.

Still have questions? Dr. Perlstein can help you figure out what type of footwear will work for you. Give our office – we would be happy to assist you.



Dr. Michael Perlstein’s podiatry office is located at 4414 14th Avenue in Brooklyn, New York. He serves patients throughout the greater New York City area, including those residing in Manhattan, Queens, Staten Island, the Bronx, New Jersey, and Connecticut.

Dr. Perlstein’s office is open Monday through Friday as well as on Sunday.



Orthotic Inserts Can Correct Abnormal, Uncomfortable, Or Painful Gaits

Orthotics are shoe inserts that correct an abnormal or irregular walking pattern. The purpose of these inserts is to support the weakness in foot structure and function. Which allows the foot ,ankle and knee to function in the best possible way so that injuries and pain can be a thing of the past. Orthotics allow people to stand, walk, and run more efficiently and comfortably because they alter the angles the foot strikes a surface. Foot pads and heel inserts can be purchased at local pharmacies and sporting good stores, but sometimes that will not be enough to relieve the problem. Individuals may need custom made and molded orthotics to treat conditions of the foot and ankle. Dr. Perlstein sometimes prescribes orthotic devices to correct an abnormal walk, or gait, and often for patients following surgery. Ultimately, the type recommended will depend on your symptoms, the cause of symptoms, and shape of your feet. Orthotics has proved successful in treating specific conditions of the feet.

Reasons for Orthotics

  • They give alignment and support of a foot and ankle
  • They can prevent, or correct foot deformities
  • They help improve function of a foot and ankle
  • Diminish the pain of arthritis of the foot.

Conditions Treated With Orthotics
  • Bunions
  • Corns/calluses
  • Flatfoot
  • Hammertoes
  • Plantar fascitis
  • Diabetic foot conditions
  • Limb length deformity

Types of Orthotics
Orthotic devices come in many shapes, sizes, and materials. They fall into three main categories: those designed to change foot function, are primarily protective in nature, and those that combine functional control and protection. Their main purpose is to improve foot function, and minimize stress forces, which could cause pain and deformity in the feet.

We use a computerized scanner to give us unsurpassed accuracy for the impression cast. Experts at the fabricating lab perform over 20 additional steps with the finest high tech. materials to give us the best orthotics. This cannot be gotten from a cheap lab. or from some over the counter arch supports.

Below are some common types orthotics made for individuals:
Rigid Orthotics
Rigid orthotics are a type of orthotic designed to control function. It’s made of a firm material like plastic or carbon fiber and used mainly for walking or dress shoes. This orthotic is molded to an individual foot, and extends along the sole of the heel to the ball or toes. Rigid orthotics help control the motion of two major foot joints, and do not change shape or break easily. Also, shoe size would not need to be changed because of the orthotic.

Soft Orthotics
Soft orthotics are a type of orthotic designed to absorb shock, increase balance, and take pressure off uncomfortable or sore spots of the foot. This type of orthotic is made of soft materials, and molds from the foot while walking or other activities. The orthotic extends from the heel past the ball of the foot to include the toes. However, this orthotic
must be changed or replaced periodically. Soft orthotics are used a lot for people with arthritis, and diabetic feet. Extra room in shoes may be required for comfort.

Semi rigid Orthotics
Semi rigid Orthotics are a type of orthotic designed specifically for balance of the foot while walking or playing sports. Many times athletes will use this type of orthotic. It’s made of layers of soft materials, and reinforced with rigid materials. When a person wears this orthotic it helps the foot go through the proper functions to perform.

Children’s Orthotics
Orthotics for children can help with the treatment of foot deformities. It’s important for a child’s feet to be checked as soon as an issue arises. If there is a need for orthotics then they should be fitted for the child after they start walking. Having orthotics will help stabilize the child’s foot. This type of orthotic can be inserted into the child’s shoe, and will more than likely need to be replaced as the foot grows. As far as how long a child will need to wear an orthotic depends on the seriousness of the condition.

Sports and Orthotics
Athletes tend to cause injury to their feet due to the physical aspect of their activities. However, it’s important that athletes make an informed choice before choosing to wear orthotics. Shoe selection and the right fitting shoe is important, and ultimately, may take away the need for any orthotic wear. However, if you need to wear orthotics stay away from rigid or hard orthotics, as both may contribute to foot problems. As you begin to adjust, and break in your orthotics, it’s important to remember the following:

  • Pick out shoes that are going to make wearing your orthotics comfortable.
  • When you buy new shoes make sure to bring your orthotics with you. You don’t want to buy new shoes without trying the orthotics in the shoes, and walking around a bit.
  • Follow-up with your podiatrist. It’s important that your orthotics are functioning the right way for you

At our office Dr. Perlstein can help you figure out if you need orthotics, and what type will work for your situation. Take time and call our office today, as we would love the chance to talk to you about your orthotic needs.



Dr. Michael Perlstein’s podiatry office is located at 4414 14th Avenue in Brooklyn, New York. He serves patients throughout the greater New York City area, including those residing in Manhattan, Queens, Staten Island, the Bronx, New Jersey, and Connecticut.

Dr. Perlstein’s office is open Monday through Friday as well as on Sunday.




Blog for Orthotics


Library for Orthotics:

  • Children and Orthotics   
    Children’s Feet require special consideration for foot pain and treatment. Orthotics are specifically designed by Brooklyn Podiatrist, Michael Perlstein for your child’s foot.
  • Foot Scanners For Custom-Fit Orthotics Help Fight Foot Pain   
    At Dr. Perlstein’s Brooklyn Podiatric office, patients suffering from foot pain can have custom-fit orthotics made from accurate scans of their feet.

View All


Frequent Questions for Orthotics:


Videos about Orthotics:

Peripheral Neuropathy Information & Treatment Options

Point where your foot hurts and click to get more information:


Great Toe Toes 1st Metatarsal Forefoot Midfoot Rearfoot Ankle Medial Lateral Toes Ball of Foot Sesamoids Arch/Midfoot Heel Medial Lateral Medial Ankle Achilles Tendon Heel Medial Arch 1st Ray Toes Dorsal Foot Plantar Dorsal Lateral Ankle Achilles Tendon Heel 5th Metatarsal Toes Dorsal Foot Plantar Dorsal

Dorsal Foot







(Click on the area for more information)

Peripheral neuropathy is a condition that many patients suffer from, particularly diabetic patients. This condition can rob patients of a normal life. Peripheral neuropathy can cause sleepless nights, burning pain and trouble simply walking. While the symptoms and complications of peripheral neuropathy have been difficult to resolve, Dr. Perlstein offers devices for reducing the discomfort and even reducing the symptoms. AnodyneTM as well as MicrovasTM therapy, nerve conduction testing, as well as nerve biopsy reduces the pain associated with neuropathy and helps our patients to recapture the life they once enjoyed.
The device emits painless monochromatic infrared photo energy (MIRE) to substantially increase local circulation and temporarily reduce pain. AnodyneTM has been designed to maximize the effectiveness of infrared photo energy using highly efficient light emitting diodes (LED’s) placed in direct skin contact. Nearly 89% of the patients who used the AnodyneTM therapy in a national study reported excellent to total pain relief within 12 forty-five minute sessions. Most patients say that AnodyneTM therapy feels warm and soothing. Other say they feel some tingling and pulsing, which is normal as blood flow returns to the affected areas. Some patients respond very quickly while others take longer based on the degree of impairment. Anodyne therapy reduces pain and increases circulation to impaired tissues and nerves. In conjunction with stretching and strengthening exercises prescribed by Dr Perlstein, it is a valuable tool in his treatment program.

Don’t let pain and numbness of peripheral neuropathy rob you of a normal life.

As you may have experienced, neuropathy is often painful and can put limits on your life. Put simply, peripheral neuropathy is nerve damage resulting from poor blood flow to nerves in the feet, legs and hands. Peripheral neuropathy is one of the most common complications of diabetes, but may also be caused by circulatory problems, medications, chemotherapy, alcohol, AIDS, and unknown causes.
Each month, thousands of people with neuropathy are getting relief from their foot and leg pain. Our clinically proven program may reduce the discomfort of neuropathy and help our patients recapture the life they once enjoyed. More than 5,000 therapists, nurses and doctors are now using and recommending this comprehensive therapy program at Microvas and Anodyne Neuropathy Care Centers in virtually every state in the country.

What is our approach to caring for those with neuropathy?

We begin with an individual assessment of the functional difficulties you are experiencing. We sometimes need to take X – rays, do computerized circulation, muscle, or nerve testing. We ask you how you would like to improve, and then design a specialized therapy program to help you reach your personal goals.

Why do we use Microvas and Anodyne as part of our comprehensive therapy program?

Anodyne emits infrared photo energy to increase circulation and temporarily reduce pain in the area it is applied. It has been designed to maximize the effectiveness of infrared photo energy by using highly efficient light emitting diodes (LEDs) placed in direct skin contact. The following medical images show just how substantial these increases in circulation can be in the feet of a patient with diabetic neuropathy. Microvas stimulates the muscles to allow blood to flow in the affected muscles that are numb and weak.


Dr. Michael Perlstein’s podiatry office is located at 4414 14th Avenue in Brooklyn, New York. He serves patients throughout the greater New York City area, including those residing in Manhattan, Queens, Staten Island, the Bronx, New Jersey, and Connecticut.

Dr. Perlstein’s office is open Monday through Friday as well as on Sunday.




Videos about Neuropathy:

Foot Pain? Know the Signs and Symptoms of Neuromas

Neuromas

At our office we have people come in that tell Dr. Perlstein they have pain in the ball of the foot.  Many times women are the ones who are complaining of this type of foot pain.  Often people suffering from the condition think there is something broken because the area is so painful and swollen.  If you have pain in the ball of your foot, pain comes and goes and simple solutions such as changing your shoes or massaging the area does not help, then you may be suffering from a neuroma.  

A neuroma, also referred to as a “pinched nerve” or a nerve tumor, is a benign thick growth of nerve tissue.  When a neuroma happens on the foot it’s called Morton’s neuroma.  For the most part there are no physical signs of Morton’s neuroma, but you will be able to feel its symptoms pretty easily.    Usually it is found between the third and fourth toes and causes sensations of burning, tingling or numbness because it has been inflamed.  People have also described the feeling of Morton’s neuroma as walking with a stone in the shoe. 

Common symptoms of Morton’s neuroma include:

  • Pain between the toes, and in the forefoot, while walking
  • Sensations of tingling and numbness in the ball of the foot
  • Swelling of the toes

There is not one specific cause for the condition, but growths have occurred from injury and pressure.  It also occurs because of irritation to one of the nerves that lead to the toes.  Also, people with foot conditions such as bunions, hammertoes or flatfeet are at a higher risk for developing a neuroma.   If you are a woman that likes to wear high-heels or narrow-toed shoes, then you are also at risk for a neuroma because this type of foot wear can increase pressure on your toes.  For those active in sports type activities, be careful because repetitive irritation to the ball of the foot put you at risk as well.    

Treatment

If you come into the office, Dr. Perlstein will examine the location of your pain.  If an x-ray is used the area may look very normal.  However, Dr. Perlstein will work to get to the root of the problem and perform an ultrasound, which he can actually see an inflamed neuroma.  However, treatment really depends upon the severity of the neuroma. 

Common treatment options include:

  • Anti-inflammatory medication
  • Footwear modifications or custom made orthotics
  • Resting and icing the area
  • Physical therapy

In most instances Dr. Perlstein could supply an orthotic to distribute pressure away from the neuroma, which will allow it to heal.  However, certain circumstances rely on a more aggressive procedure because the problem has been neglected.  In severe cases, or if you do not respond to conservative treatments, surgery may be recommended by Dr. Perlstein. 

It’s important to make an appointment with Dr. Perlstein so he can help you determine the best approach for your specific circumstances.  Getting the neuroma looked at early on is very important!  If a neuroma is left untreated it could become worse.  If you are feeling pain it’s crucial that you call our office to set up an appointment. 



Dr. Michael Perlstein’s podiatry office is located at 4414 14th Avenue in Brooklyn, New York. He serves patients throughout the greater New York City area, including those residing in Manhattan, Queens, Staten Island, the Bronx, New Jersey, and Connecticut.

Dr. Perlstein’s office is open Monday through Friday as well as on Sunday.




Blog for Neuromas


Videos about Neuromas: