By drmereau
June 14, 2012
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Lawnmowers and Feet Don’t Mix

Keep your feet and those around you safe this summer by using caution when mowing your grass.
Did you know the blades on lawnmowers can spin at 3,000 revolutions per minute and produce
three times the kinetic energy of a .357 handgun? Yet, each year our office continues to see patients
who have been hurt while operating a lawnmower barefoot.

Enjoy the beautiful summer season but be sure to protect
your feet and ankles from yard-work injuries and mishaps.
Take caution when mowing and remember:

-Don’t mow wet grass. Losing control from slipping on rain-soaked grass is the leading cause of
foot injuries caused by power mowers.
-Wear heavy shoes or work boots when mowing—no sneakers or sandals.
-Don’t allow small children to ride on your lap while on a lawn tractor. Children can be severely
injured by the blades when getting on or off the machine. Keep children away while mowing.
-Mow across slopes, never go up or down.
-Never pull a running mower backwards.
-Use a mower with a release mechanism on the handle that automatically shuts it off when your
hands let go.                                                                                                                                                                             

If you or someone around you is injured by a mower, be sure to seek treatment immediately.
Superficial wounds can be treated on an outpatient basis at our office or at your closest emergency
department. More severe wounds may need surgical intervention to repair damage.
Caring for your lawn can be an enjoyable summer experience, just make sure you use caution to
protect yourself from injury.

By drmereau
April 15, 2012
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The average moderately active person takes about 7500 steps a day. Assuming every day the person walks, an eighty year old person who began walking at one year of age, would have taken 216,262,500 steps in their lifetime. An average person, with an average stride, living to this age of 80 will walk about 108,131 miles. Given this is the average (and Austinites are above average!), it is important to keep your feet in good health.

Good foot health can improve the health and well-being of our whole body. To start, begin by choosing smart foot wear with the right insole for your foot’s needs. Just remember, feet aren’t supposed to continuously be in pain; if you're feet are hurting, get them checked out by a podiatrist.

All this being said, let’s celebrate Foot Health Awareness Month. Whether that be by increasing our weekly physical activity, enrolling in a race or a sports program or by simply... taking a walk!

By drwalters
December 05, 2011
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A few weeks ago, Houston Texans starting quarterback Matt Schaub sustained a LisFranc injury effectively ending his season.

What is the Lisfranc Joint?

The Lisfranc joint is the point at which the metatarsal bones (the long bones that lead up to the toes) and the tarsal bones (the bones in the arch, which include the cuneiform bones) connect. The Lisfranc ligament is a thick band of tissue that joins two of these bones. It is important for maintaining proper alignment and strength of this joint.

 How do these injuries occur?

Lisfranc injuries occur as a result of trauma to the midfoot.  In the case of a football player, a Lisfranc injury most commonly occurs when the forefoot is planted on the ground with the heel in the air. A downward or twisting force on the heel causes stress on and potential damage to the foot.  Other common causes of this injury are Motor vehicle accidents and falls from a height.

 How are these injuries diagnosed?

A Lisfranc injury is initially diagnosed based on the history and description of the injury.  A patient may describe the immediate onset of pain in the midfoot region.  There may be difficulty or even an inability to put weight on the injured foot.  Over the course of the ensuing days, swelling and bruising often occurs, and on a physical exam, the injured patient will be tender over Lisfranc's joint.

 Further evaluation begins with x-rays of the foot. When an injury occurs that involves a fracture in this region, a CT scan or MRI are best for evaluating the complex bony detail of the region. MRI in particular is helpful in detailed evaluation of the ligaments, and it can see bruising in the small bones of the foot, which indicates an acute injury.

Treatment Options

 If testing determines that the injury is stable, with the bones still in their proper orientation, a Lisfranc injury may be treated with a period of non-weightbearing followed by gradual return to normal activites.

If the injury is unstable,  surgical treatment is warranted.   Surgery typically involves rigidly stabilizing the injured joints. The specific midfoot joints that are stabilized depend on the specific ligaments that are injured and may vary somewhat on a case-by-case basis. The majority of the time, stabilizing the injured region requires the placement of screws and in some cases wires.  By holding the involved joints rigid, the torn ligaments are allowed to heal.

 Postoperatively following a typical Lisfranc joint repair, the patient must be non-weightbearing on the operative foot for about 6-8 weeks. Subsequently, the amount of weight bearing allowed is gradually increased over the next few weeks, followed by physical therapy.  The hardware used to stabilize the injury  is also removed. 

By drmereau
August 11, 2011
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As we come upon the 1 year mark of becoming board certified (both docs!) I want to take the opportunity to explain the distinction.  

Board certification is when an individual in a field of specialty has met specific specialized educational requirements in that field of interest, have shown their specific medical knowledge through written and oral examination, and have demonstrated a practical standard of competency in that area of specialization.  It is a rather long and arduous process, and any podiatric physician who has been certified by a particular board has passed the rigid standards of qualification and examination set forth by that particular board of examiners.  


1. All physicians need to be board certified to legally practice medicine. They don't.  Board certification is an extra level of achievement beyond school, residency and licensure.

2. Board certification is the same as passing the provincial or state licensure board.  It's not.  The board certification exam process is much more strenuous--and it's an optional one.  Only those physicians who wish to demonstrate interest and achievement in a certain field attempt to achieve board certified. 

3. All boards offering board-certification are the same.  They're not.  In fact, there may be several boards that offer board certification.  But only those boards that are recognized by their professional association are seen as credible by that profession.

The American Podiatric Medical Association (APMA) only recognizes one surgical board:    To read more about what the APMA has to say about Board Certification

                                                                                                                                                                                                           The American Board of Podiatric Surgery -Offering 2 certifications: one in Foot Surgery & the other in Reconstructive Rearfoot/Ankle Surgery

What Is The Board Certification Process?

The board certification process varies somewhat with each medical discipline, and it has evolved over time.  But today, for podiatric medicine, the process begins after getting your doctorate, and proceeds as follows: 

1.  Completion of a particular type of residency training that is recognized by the board of examiners.
2.  Next, the candidate undergoes a rigorous and comprehensive written examination carefully constructed by professional examiners to maintain the highest standards.  This exam tests the academic and clinical knowledge that is necessary to achieve certification. 
3.  Once the candidate passes the written examination, the candidate must demonstrate that he/she is able to translate that basic knowledge into a competent level of practice.  At this stage, the candidate goes back into practice and has up to seven years to assemble a diverse array of surgical cases for approval by the credentials committee.  These cases involve actual patients treated by the physician. The documentation consists of the charts, x-rays and other imaging, consults, operative and perioperative notes, and other information of the involved patients displaying the outcome of the physician’s treatment. This qualification serves to ascertain that the physician is performing at a high level, as established by leaders in that particular medical field.  
4.  After case approval is achieved, the candidate takes a timed oral examination to evaluate the candidate’s clinical judgment and reasoning skills.  The exam is conducted over 2 days for the foot and  an additional 1 day for the Rearfoot/Ankle. 

When a board certification candidate passes the examination, the board-certified physician is called a "Diplomate" of that organization.  In order to retain this status, Diplomates must maintain continuing education and re-certify on a regular basis.

So how should the patient consider board certification?

Board-certified podiatrists have, by a rigid and difficult examination process,  set themselves apart from other non-certified physicians by demonstrating a particular level of interest, training and basic competence in certain areas of medical specialization. 

In podiatric medicine, patients may wish to use board certification as one factor to consider when choosing a podiatrist.  To check to see the certifcation status of your podiatrist check out APMA FInd a Podiatrist.

By drmereau
July 19, 2011
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Several studies now show that dogs can be powerful motivators to get people moving. ( I write this as my 2 year old lab paces back and forth, what we fondly call her "sharking", as we wait for the pavement to cool for her evening walk).

Check out this great article from the NY times:

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11614 FM 2244 Suite 130 Austin, TX 78738 (Located within Bee Cave Urgent Care)