Welcome to CITYFOOTCARE.COM,
Lawrence Silverbergthe Internet home of Dr. Lawrence Silverberg, one the most compassionate and skilled foot doctors in the New York City Metro area and the country.

Dr. Silverberg is Board Certified by the American Board of Podiatric Surgery. Dr. Silverberg’s office is conveniently located in Midtown Manhattan near Grand Central Station.

Dr. Silverberg takes great pride in providing excellent medical care along with great bedside manner and takes the extra time to explain your problems and the treatment options in detail.

At City Footcare we treat all problems related to the foot and ankle. We use state of the art diagnostic and therapeutic equipment.

Dr. Silverberg believes in patient education, and patient participation in their care. He takes pride in spending time with his patients and listening to them. His patients never feel rushed. He also takes histime to explain patients problems in detail and spells out explicit treatment plans.

When your problem requires surgery, you can rest assured that you are in the hands of a competent and highly trained surgeon. Dr. Silverberg has been called the best foot surgeon in NYC and the best bunion surgeon in NYC. The doctor performs all foot and ankle surgery including traditional open surgery, minimally invasive surgery, laser surgery, radio frequency surgery and extra-corporeal shock wave therapy. Dr. Silverberg is an expert in all aspects of foot surgery. He is very detail oriented from start to finish. A good surgical outcome starts prior to entering the operating room. After expertly diagnosing patients’ conditions, he plans out his procedures with great skill. In the operating room he is skillful and precise. He also takes into consideration aesthetics with his incision planning and plastic surgery type suturing techniques.

He is hospital and surgery center affiliated.

To resolve all of your foot and ankle problems, simply look around this site and make an appointment with Dr. Silverberg today. Your feet will be glad you did!

Please see the medical DISCLAIMER on the ‘about this blog page‘.

Skiing (foot) tips from a podiatrist

I recently went skiing in Whistler-Blackcomb Mountain, British Columbia, Canada. Ironically, I suffered from toe pain on my first day on the mountain.

This ironic injury gave me the idea to write a blog on how to protect your feet when skiing. I also figured it would be nice to share a little about my personal life with my blog readers by posting pictures and video of skiing at Whistler, the best skiing I’ve ever done. (Pictures and video are at the bottom below.)

We spent 1.5 days in Vancouver prior to going skiing. As almost expected, it rained a lot of the time there. We explored the city on foot and by car and then drove Route 99 the “Sea to Sky Highway” up to Whistler.

This scenic drive allows you to see the fjords where the mountains meet the water. IMG_2341

We stayed right at the base of the Mountain at the beautiful Westin Hotel. We rented skis and boots at their ski shop which brings me to my first podiatric skiing tip:

Boot rental… The technician measured my feet and brought me a boot. The boot fit well except for the fact that I thought my left big toe was hitting the front end of the boot inside. The technician instructed me to stand up and lean forward and if my toe did not hit the boot at that time, then the boot was the proper fit.

When I leaned forward standing, the toe no longer felt like it was hitting the front of the boot so I took his advice and took the pair of boots he recommended for skiing the next day…

That night I decided to cut my toenails short so that the nail did not stick out any further than the skin of the tip of the toe. This is tip number one, cut your nails prior to skiing. I have seen many people with toenail injuries from tight footwear when participating in sports and recreation.

Often, tight footwear puts pressure on the nail and pushes it slightly up and back with every step or other movement like skiing. Often the person feels nothing as the nail slowly separates from the skin below it, called the nail bed. Repetitive forces cause the nail to separate and blood to accumulate under the nail. Most times with no pain, the nail turns black as the blood fills the area.

Additionally, often there is no discoloration or blood under the nail, but rather a colorless fluid fills the area under the nail in the same manner as a blister forms in the skin. Whether it’s blood or a blister, the results are the same. The nail separates from the skin and eventually falls off.

We often estimate that if 75% or more of the nail separates, then the person will eventually lose the entire nail. Most often this occurs over 1-3 months after the injury.

In my case the nail did not separate but it was sore after my first day of skiing. I believe by cutting my nails the night before, I escaped this more severe injury. At the end of the first day, I went back to the rental place and exchanged my boots for the next larger size. The boot no longer pressed on the big toe but the boot was a little bit too large and my heel elevated slightly when leaning forward. To alleviate that, I just wore a second pair of socks and then the boots fit perfectly for the next three days of skiing. I guess that’s tip number one point five; when the ski boot is a bit too large, wear an extra pair of socks instead of getting a smaller boot.

The next tip addresses arch pain. Often people with arches that collapse get pain, soreness or fatigue of the arches when skiing. Ski boots, like most other shoes and boots, do not have great arch support. Spending 4-8 hours skiing in rigid boots is similar to standing in one place for hours at a time as the foot is locked and immobilized in the hard boot.

In order to alleviate this soreness or pain, I recommend using insoles in the boot which is tip number two.

Different people will respond differently to the type of insoles one uses.The first are soft insoles. These soft insoles are the ones you can buy in the pharmacy which are just cushions and not arch supports. These offer the least arch control and the most cushion of the ones I recommend.

The next type sacrifice cushioning slightly and are over the counter, non-custom arch supports that are slightly more rigid than just the cushions. These offer some control of the arch and some cushioning.

There are also more rigid over the counter insoles that one can buy that offer even less cushion and more arch control. Because these are generic and not custom, they will only fit into the arch of some people that have arches that are not too high nor too low. Many people will not feel comfortable with these and feel like there is a hard ball under the foot.

The final type of insole are custom molded orthotics that I make in my office by taking a mold of the foot and sending it to my laboratory. With these I can make them as hard or as soft as I determine is necessary based on my physical examination of the patient and professional opinion. These also are the exact shape of the persons arch.

The next tip is kind of common sense but you’d be surprised how many patients I’ve seen that lack enough of it to follow this simple tip. If you’re having pain, you’re doing harm. This applies to other parts of the body too when skiing. Don’t ‘work through pain’. Address that foot pain or knee pain by seeing a doctor before you cause more significant harm and become harder to treat.

The last tip is to pay attention to frostbite. While I admit that I don’t see too many frostbite patients in New York City, it does often happen to the feet in colder climates when skiing. Frostbite can cause permanent problems and even amputation. If your ‘feet are freezing’ they might actually be freezing. This is especially dangerous for people with peripheral vascular disease and worst for people with Reynaud’s disease.

Okay, enough of the podiatry skiing tips for now, let’s talk about the incredible skiing at Whistler-Blackcomb. We got lucky with a really nice week of snowfall just prior to our arrival. We enjoyed skiing amazing powder conditions and even had lots of fresh snowfall while we were there.

Below are pictures and videos of our trip. (click to enlarge)

Videos: (Tip: double click the videos to watch in YouTube, faster download)

Dr. S. Skiing the bowl.
Dr. S. skiing a traverse.

 

Dr. S. POV skiing. (2288)
POV 2 Dr. S. Skiing (2287)
I make funny faces when I ski! Skiing Blackcomb Whistler

 

Dr. S. with one hand on the camera, one holding poles skiing.

I hope you enjoyed sharing my ski vacation and reading about foot health while skiing.

Please feel free to leave any comments or questions. Dr. Silverberg

4 Responses to Skiing (foot) tips from a podiatrist
  1. Podiatrist Melbourne
    April 19, 2012 | 7:58 am

    Why do you always get injured on the first day of a ski trip!

    Interesting observations on foot health for skiing! thanks

    • drsilver
      July 23, 2012 | 1:48 am

      Yeah! Murphy’s law!

  2. Albaazul
    June 18, 2012 | 5:22 pm

    Nice! Those patient foot look great! after you took care of it. And you look awesome skiing and recording yourself. I have a long time wishing to have this type of trip. Mountain, water and snow to ski. Yours picture are beutiful. I didn’t know you’re good skiing. Thank you for the tips: cut nails, wear 2 pairs of socks, …. Etc.

    • drsilver
      July 20, 2012 | 11:45 pm

      Hi Albania. Nice to hear from you and read your comments in my skiing blog post. I hope you’re well. It has been a pleasure taking care of you.

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