Amanda Wilde (Host): Welcome to Woodlawn Health Doc Talk. I'm your host, Amanda Wilde. Today we'll demystify one of the most overlooked areas of our health, feet and ankles with podiatrist and foot and ankle surgeon, Dr. Eric Rindlisbacher. Dr. Rindlisbacher, thank you so much for being here.

Eric Rindlisbacher, DPM: Thank you for having me. Excited to be here.

Host: Well, let's talk about when to see a podiatrist, because we all know our feet take a beating every single day. First of all, can I just go to see a podiatrist or do I need to make an appointment with my primary care provider before I can go on to get an appointment with a podiatrist?

Eric Rindlisbacher, DPM: So most insurances, consider us a primary care provider. So referrals are not needed typically. There are some specialty insurances that will ask for a referral. But for the most part, you're safe just to call and schedule an appointment directly. Happy to go through your provider as well. But either way works.

Host: So as a primary care provider, what are some reasons a podiatrist might be the first provider to consult foot and ankle concerns?

Eric Rindlisbacher, DPM: So a lot of times with chronic conditions that affect the feet namely, diabetes, sometimes the first signs of concern or problems start with the feet, neuropathy, sores and other things. So a lot of times that's the first time that you'll realize that you have had maybe a chronic problem.

 I diagnose often diabetes in a person for the very first-time, on one of their first office visits to a podiatrist. And then we get them set up with the care they need for the whole body.

Host: Wow. So you can tell through the foot that there is diabetes possible.

Eric Rindlisbacher, DPM: A lot of times. A lot of times. And then, we see so much of it. The other general concerns you see with diabetes, we're very familiar with, with testing and things, very easy to determine very rapidly what's going on.

Host: Are there daily habits that prevent foot and ankle problems?

Eric Rindlisbacher, DPM: I don't think anybody, you know, if you think for yourself, how often do you spend time, stretching your feet, exercising your legs, um. specifically, probably not a lot, and I don't think most people do. So a lot of the common problems that we see, plantar fascitis, and other issues, those could really be resolved if we spent some time stretching our feet and doing just regular maintenance that sometimes we do a lot of other places, but don't really focus on the feet and the ankles.

Host: I bet that's one of those exercises that we don't do, but probably aren't that hard.

Eric Rindlisbacher, DPM: Exactly. My very favorite way to exercise and stretch the bottom of your foot, is a golf ball. It's real hard. It's a little bit uncomfortable, but it does a great job at keeping those muscles, and the fascia on the bottom of your foot stretched out and loose. You just drop it on the carpet or on a towel and you just kind of roll it in a seated position all through the bottom and you get a lot of relief and a lot of stretch from that, and a lot of just maintenance that prevents problems in the future.

Host: That sounds like good massage action.

Eric Rindlisbacher, DPM: That's fantastic. I always tell patient's the first few times they do it, they can curse my name a little bit because sometimes it doesn't feel great initially.

Host: Well, I've used golf balls on my back unfortunately, and, it was unfortunate when I had to do that, but this sounds a lot more comfortable and they did help with that too. So we should all have that in our first aid kit. How can I tell the difference between normal foot pain and something that needs professional attention?

Eric Rindlisbacher, DPM: For any kind of injury, anybody should rest it, ice, elevate, some compression for a period of time. If that lasts more than a few days or a week, that pain definitely needs to be looked at. And of course, any acute injury, where you're unable to put weight on the foot, absolutely needs to be seen.

Host: Well, I was going to ask, and maybe you've just answered that, to describe some common early signs of foot problems that we might ignore but shouldn't.

Eric Rindlisbacher, DPM: You know, I think you look at the foot and ankle and kind of, I do in two different realms. There's kind of the sports medicine type of realm, the injuries, those kind of abnormalities. Then there's the chronic conditions that you see and that's more diabetic related.

Focusing on the diabetic signs and symptoms, which is such a huge problem, all over the world. But, especially where I practice, neuropathy symptoms, so numbness, tingling, difference changes in feeling in the feet, changes in the skin texture. all of a sudden your foot's dry and no moisturizer fixes it.

Those kind of things are things to start looking at, and if you see them, you might as well get checked out and try to prevent things early on as opposed to letting them last.

Host: Yeah, definitely. What kind of symptoms suggest that foot or ankle pain could be related to another health condition? You mentioned like diabetes.

Eric Rindlisbacher, DPM: A lot of it starts with just a change in sensation. So diabetes affects nerves. Diabetes is just extra sugar in your blood. And the easiest way I think about it is when there's that much sugar in your blood, it kind of coats everything, kind of candies it, in sugar crystals and it does that to your nerves.

And when it does it to your nerves, they don't fire as well. And so that happens most frequently in the nerves in your feet and your hands further away from the center of your body and that, when that happens, you start getting sensations that are either not there or are painful. So those are the really, the first signs that there's likely a problem.

Host: Hmm. Sugar coating, despite its reputation is not always a good thing then.

Eric Rindlisbacher, DPM: No, not especially not when it's in your body.

Host: If someone knows they do have diabetes, or have found out through their feet they've had diabetes; how often should those with diabetes get their feet checked?

Eric Rindlisbacher, DPM: A lot of it depends on how well-controlled they are with their diabetes. An annual foot check is always recommended. Sometimes we'll do every three months, for people who are having symptoms or problems that need checked more frequently.

Host: If not, then if we're not seeing signs and symptoms, we can assume we're okay.

Eric Rindlisbacher, DPM: For the most part. Yeah. You should have your blood sugar checked by your physician regularly. Right. And that would be my first thing to say, you know, you don't always need to see the foot doctor, but if you haven't checked your blood sugar or been to the doctor in a few years, go and get some blood tests done.

And then if there is an issue, you definitely want to get your feet checked.

Host: I just mentioned no symptoms, but what happens when a patient does have a diagnosis and it becomes surgical? At what point does it become surgical?

Eric Rindlisbacher, DPM: A lot of the surgeries that I do, they can deal with the diabetes. Those diabetic surgeries are typically more, acute related. People who have let their diabetes go. You know, there's chronic problems that have crept in with sores and ulcers. You don't feel your feet, you walk on them, the skin breaks down.

What you or I would feel as a rock in your shoe if you were walking on a down the road, they don't feel at all. And they can walk that rock right into their foot. So those are the acute things I deal with surgically. A lot of cleanups, debridement, amputations of toes and feet. And that's diabetic related, but a lot of what I do is not that.

It's fixing bunions and hammer toes, fixing ankle fractures those other kind of surgeries that are just kind of fit that other side, the sports medicine or.

Host: Those very common but painful conditions.

Eric Rindlisbacher, DPM: Yep.

Host: You're a surgeon as well as a podiatrist. What's the percentage of cases that you see do result in surgery?

Eric Rindlisbacher, DPM: You know, it's actually really low. It seems higher to me because I see so many patients, with those problems. But I'd say, you're looking at probably five or 10% of patients who end up in the surgery realm with most issues. Most of it's treated conservatively and me especially, but anybody should be trying to treat everything as conservatively as possible.

Host: Can you talk about the benefits of going to a podiatrist who also is a surgeon?

Eric Rindlisbacher, DPM: You know, one of the things you'll see, kind of all over is there's people who are specialized in surgery, and even lower extremity surgery. I spent my entire training on the foot and the ankle and the lower leg. And that started in medical school. That's why I chose podiatry school.

I do firmly believe that the training that a podiatrist receives to the lower extremity is much greater than you're going to get in other fields. And that includes gaits and how you walk. That includes a lot of different aspects. Sometimes, a more full understanding of what's going on in the foot and the ankle as opposed to, maybe another surgeon who treats the foot and the ankle and they just treat it surgically and that's all they've been trained to do.

I see that frequently with orthopedic surgery. It's not that they're not doing good surgery. They absolutely are. But sometimes the intricacies of the foot and ankle are missed. That's why I would choose a podiatrist, someone who's trained in surgery over, maybe something else.

Host: Well, I certainly will put my feet in your hands. Thank you so much for this great information, Dr. Rindlisbacher. I really appreciate you taking the time and the insights you've provided and the work that you do at Woodlawn Hospital.

Eric Rindlisbacher, DPM: Well, thank you so much for your time as well.

Host: That was podiatrist and foot and ankle surgeon, Dr. Eric Rindlisbacher. For more information, please visit woodlawnhospital.org. If you enjoyed this podcast, please share it on your social channels and check out the entire podcast library for topics of interest to you. This is Woodlawn Health Doc talk. Thanks for listening.