Dr. Berg's Foot Facts

Posts for tag: seattle

By Rion A. Berg, DPM
June 19, 2012

As I approach the summer, the number of patients coming in who go barefoot at home, and wear minimal foot gear during the day increases.  It’s totally understandable given the fact that we at least want to pretend summer’s here, dress down, and give our feet some air.

Here are some tips on how to keep foot loose and worry free.

First, remember that no matter how much you love shedding those shoes, being barefoot all day for most of us, is too much.  There are a select number of people who with the right training and the right foot, can be coached in barefoot running. For the rest of us however, who are carrying on a full load of household and play activities, a limited amount of time without closed shoes will not hurt you. That means, however, for the rest of our day, our feet need support to carry our load.

With that said and done, the question is, how much support is enough? Can we get by wearing thongs/flip flops? Are Tevas and other “supportive” sandals supportive enough?

To answer this question, you may need to be honest with yourself regarding how much support usually feels good with in each activity. Thus, if you’re lucky enough to have a good arch, you may be fine around the house barefoot or in sandals, but you are probably better off wearing more supportive shoes for extended standing or walking activities.

Second, open backed shoes, such as Crocs and Merrills are likely more supportive than thongs/flip flops, they still should be used a limited amount of time.  The reason for this is very simple. The closed back of a shoe and the full lacing adds a tremendous amount of support to your foot. So, yes, if you’re going to be on your feet all day, travelling, or hiking, you should be wearing a supportive athletic shoe or light weight hiking shoe.

Third, remember that even the best athletic shoes come with a very flimsy arch support. That means spending more and adding at least an over the counter full length support such as Powerstep. It truly will make a world of difference in helping you avoid developing chronic foot strain or plantar fasciitis.

Lastly, beware of stepping on foreign objects while you’re foot loose. A recent traveler came in and after performing bathroom surgery elected to have me take a look. Multiple spines had to be removed and the foot can become infected easily once an object penetrates the skin. If you suspect you’ve stepped on something foreign, have a foot specialist evaluate you as soon as possible. We really do want to keep you foot loose and worry free!

If you're experiencing foot pain, call us at 206-368-7000 or request an appointment online.



By Rion A. Berg, DPM
February 16, 2012
Tags: seattle   CDFE   foot ulcer   ulceration  

For those of you with Diabetes or who have a family member or friend with Diabetes, there is renewed hope. In a recent article in the Seattle Times, the Center for Disease Control (CDC), indicated that for the first time, there has been a drop in the number of lower extremity amputations. This has occurred despite the increased number of people who have diabetes.  Two of the reasons given for the drop in number of amputations were the increased number of patients who have their feet evaluated and, the Medicare Approved Diabetic Shoe Program.                                                                                                        

I have been a member of the team at the Northwest Hospital  Wound Care Center for over twelve years. There, I have worked alongside several members of the team to treat and heal diabetic foot ulcers. Our success rate in healing diabetic wounds and preventing amputations has been wonderful.  Now, Medicare has approved the Comprehensive Diabetic Foot Evaluation, (CDFE), which is designed to help prevent the ulcerations from occurring in the first place. 

The CDFE is performed at my office and includes a complete review of your medical history and an evaluation of the feet particularly focused on your sensation, circulation, and all foot deformities that may contribute to the development of a foot ulcer. With special pressure testing and temperature testing, we are then able to identify any areas of the foot at risk,  and implement preventive measures immediately.

The most important part of the evaluation is the patient education. Throughout your visit, Dr. Berg will teach you about the warning signs of an ulcer, and how to detect them. You will receive a packet of information that describes the simple steps to take to evaluate your own feet daily, and what to do should any of the warning signs appear in your feet.  Finally, the evaluation will help Dr. Berg determine whether you need diabetic therapeutic shoes, inserts, or further diagnostic studies such as testing your circulation or evaluating your balance. Depending on the results of the exam, you may receive a recommendation to repeat the CDFE between one and four times per year. 

Don’t bury your head in the sand, or wait until the horse is out of the barn! Come in today and let us help you prevent diabetic foot ulcers.  Protect your feet. They are your foundation and you only receive one pair that must last you a lifetime.

Thank you for listening.

Rion A. Berg, DPM
Podiatrist and Board Certified Foot Surgeon

2611 NE 125th St., #130
Seattle, WA 98125


Our office is located in Lake City within 10 minutes of Shoreline, Kenmore, Juanita, Sandpoint, Meadowbrook, Wedgewood, Maple Leaf, Broadview, Greenwood, Northgate, and Pinehurst. Parking is free. For bus commuters, routes 41 and 243 stop right in front of our office at 26th & NE 125th.





By Rion A. Berg, DPM
November 01, 2011
Tags: seattle   balance   fall prevention   falls   falling   parent   grandparent  

“I’ve fallen and I can’t get up!”

We’ve probably all seen the commercial for LifeCall. An elderly woman has fallen, no phone is nearby, and she can’t get up to call for help. Isn’t that everyone’s worst nightmare for their parents or grandparents?

People of any age can fall incidentally. But when patients tell me that walking feels as though they’re balancing on a fallen log, or that they can’t feel their feet, (due to neuropathy)... if  they have to touch or hold on to the wall or furniture while walking, it’s time to put some preventative measures in place.

Falls and fall related injuries are the leading cause of accidental deaths in older people, and 3 in10 seniors fall each year! Nearly half of the seniors who fall reduce their activity after a fall. Now, who wants that to happen?  If your loved one has been through a balance program before and is still falling, (or afraid of falling), there is more that can be done.

The Foot and Ankle Center of Lake City now offers the Back In Balance Fall Prevention Program. Back In Balance is a comprehensive program where a prescription custom-made, ankle-foot orthotic is designed to fit easily into the patient’s shoes. It is a long-term solution that can be used in combination with a fall prevention strength training program such as physical and occupational therapy, environmental changes in the home and a review of current medications. The ankle-foot orthotic is covered by most insurance companies.

Our first patient in the Back In Balance program reports that he now walks without feeling like he will fall and appreciates how easy the device is to put on and take off. Visit our homepage at www.bergdpm.com to see photos of the ankle-foot orthotic and learn more about it.

Remember, serious falls can happen inside or out, on level or uneven ground, wet or dry sidewalk. Here in Seattle we have all of that and more on any given day, especially in the winter! If you or someone you love has fallen in the past or is at risk for falls, call our office for an evaluation to see if the ankle –foot orthotic can help prevent a fall.

Rion A. Berg, DPM
Podiatrist and Board Certified Foot and Ankle Surgeon
Lake City Professional Center 
2611 NE 125th, Ste 130 

The Foot and Ankle Center of Lake City is Conveniently Located in Northeast Seattle:

  • 15 minutes from Downtown Seattle
  • 10 minutes from Shoreline, Kenmore, Juanita, Sandpoint, Meadowbrook, Wedgewood, Maple Leaf, Broadview, Greenwood, Northgate, and  Pinehurst
  • 5 minutes from the 130th Street Exit on I-5
  • Bus routes 41 and 243 stop close to our office
  • Parking is free
By Rion A. Berg, DPM
October 11, 2011
Tags: seattle   ITBS   knee pain   custom orthotics  

Are you a runner who has been experiencing lateral (outside) knee pain? Have you recently been increasing how much you run? Whether you run for fun, fitness, or competition, pay attention to knee pain should it appear.

Ilio-Tibial Band Syndrome is the most common cause of knee pain in runners. The ilio-tibial band (ITB) is a thickening of superficial tissue that runs from your pelvis down the outside of your thigh, passing over the hip and knee before finally inserting on the outside of your leg below the knee (see pic).

The ITB helps to stabilize the knee during the continuous flexion and extension of the knee during running activities. During these knee motions, the ITB slides back and forth across a normal bump on your thigh bone (femur), called the lateral femoral condyle. This continuous rubbing can lead to ITB syndrome, which is a sharp or stinging pain above and on the outside of your knee due to inflammation of the ITB.  While the area may be tender to touch, you likely will not see redness or swelling usually associated with inflammation.

The most common cause of ITB syndrome is overtraining, whether that means adding too much to your normal exercise regimen or perhaps starting out with too much too fast if you are a new to running. Other physical factors also play a role, such as hip abductor weakness, one leg being shorter than the other, or a cavus (very high arched) foot structure. Other factors can be related to the exercise itself, including always running on the same side of uneven or banked surfaces, inadequate warm-up or cool-down, or too much running up or down hills. All of these things put more strain on the ITB, causing it to become tight and inflamed.

Treatment for ITB Syndrome starts initially with rest, ice and anti-inflammatory medication, but this is usually not enough. Physical therapy modalities such as ultrasound, electrical stimulation, massage therapy and hip abductor strengthening may also be useful in not only calming down the inflammation, but also in preventing further injury. Once the pain is controlled, it is very important to stretch the ITB (and the hamstrings, calf muscles, and quadriceps to maintain proper balance between muscle groups). One way to do this is to use a foam roller on the ground and roll the outside of your hip and thigh across the roller.

Custom orthoses and a change in shoe gear may also be warranted to prevent chronic pain from ITB syndrome. Supportive, properly fitting shoes are important for running, and shoes tend to lose their valuable properties (and should be replaced) every 300-500 miles of use. It is usually necessary to make a change in the exercise itself. Once you return to running after getting rid of the pain, start slow and gradually increase your frequency and intensity. Minimize the amount of up and down hill running if possible. If you run on a sloped/banked running surface, make sure you switch which side of your body is dropping down lower (ie – if you run on the right side of the path going one direction, run on the left side coming back).

When in doubt about your pain, stop running and call for an appointment at 206.358.7000 or request an appointment through our website! Pain usually means something is wrong and should be fixed, not suffered through.

Rion A. Berg, DPM

Foot and Ankle Center of Lake City
2611 NE 125th St., Ste.130
Seattle, WA 98125

Keeping Feet Happy and Healthy In Seattle Since 1980



By Rion A. Berg DPM
September 02, 2011
Tags: seattle   diabetes   Rion A. Berg   Tingling   Infection  

Last week we learned a little about  Diabetes Mellitus (DM) Type 1 and 2 and Pre-diabetes, as well as what can cause them. This week we are going to discuss some of things DM does to your body.

Most of the damaging effects of DM are due to the high levels of glucose streaming in the blood (aka – high blood sugar). That is why it is so important to control your blood sugar, first and foremost by diet and exercise, and lastly by medicine prescribed by your doctor. The effects of DM can be divided into two categories: “macrovascular” (effects are seen in larger blood vessels) and “microvascular” (effects are seen in smaller sized blood vessels). “Macrovascular” damage from DM can lead to heart disease, stroke, or a buildup of fatty plaques in the walls of the blood vessels which starts to clog up the vessels, like dirt and hair in a shower drain, which makes it hard for blood to flow normally (this is call “atherosclerosis”). Consult your primary care physician for more information regarding these topics.

Today we are going to focus on some of the “microvascular” effects of DM. There are three main areas where symptoms are seen with uncontrolled high blood sugar. The first two areas are “retinopathy” and “nephropathy”. Retinopathy refers to damage to the retina of the eye that involves blurring of vision or possibly seeing “floaters” or dark spots floating around in your normal vision. Nephropathy refers to damage to various parts of the kidneys. The exact causes of damage and areas that become dysfunctional may vary, but the end result is a decline in the normal function of the kidney, which can progress to a very serious life-threatening problem over time if not addressed.

The third area of microvascular damage caused by DM, and the area we will talk most about today, is called neuropathy”, which is  damage to nerves in arms, legs, and torso. Nerves actually have a cell body and a long tail, so to speak, that connects body parts to the brain for both muscle function and sensations such as pain, temperature, and touch. When blood sugar is high and uncontrolled, early symptoms are usually related to nerve damage. This is seen as tingling, burning, pins-and-needles sensations or total loss of feeling that usually starts at the ends of the toes and progresses towards your foot and eventually up your legs. Since feeling is impaired at this point, a person would not be able to tell if something was wrong with his or her feet unless he looked at them closely every single day.

Diabetes also causes a person to be more prone to infections which, combined with the loss of feeling in the feet, can lead to serious ulcerations and infections that, in the worst case scenario, could lead to amputation of a foot or entire leg. There are many other possibilities that this loss of feeling could lead to, including fungal infections, joint dysfunction or collapse, skin and bone infections, decreased blood supply leading to poor health of your skin and toenails, and overall unawareness of traumatic injuries such as cuts or blisters.

If you are experiencing any tingling, burning, numbness or other abnormal feeling in your toes, feet, legs, or anywhere in your body, you should contact Dr. Berg immediately. Call our office at 206.368.7000 or request an appointment through our website.

It is best to catch these symptoms early to find out the cause and start a treatment plan to slow down or stop the progression of nerve damage (and other damages previously discussed, as well as those not discussed in this blog).

Persons diagnosed with diabetes mellitus should inspect their feet daily to check for open wounds or other changes, as well as have regular visits to a podiatrist, who is specialized in detection and treatment of effects of diabetes in the feet. Whether you have been diagnosed with diabetes or think you are in perfect health, the number one way to take care of your body, prevent or treat diabetes, and ensure the long-term health of your feet is simple: exercise regularly and develop a healthy well-balanced diet.

It starts with small changes and a daily choice to make yourself better. Consult Dr. Berg today if you are concerned in any way about the health of your legs or feet. 

Rion A. Berg DPM
Podiatrist and Board Certified Foot Surgeon

Located In Northeast Seattle

Foot and Ankle Center of Lake City
2611 NE 125th, Ste 130
Seattle, WA 98125