2009 June | Total Care Podiatry

How to be sensible about shoes

this article courtesy of Malu Fernandez of Philippine news

Thanks to Imelda Marcos, one thing Filipina women are known for is their love for shoes. Every Filipina woman I know from every socioeconomic background has an infinite love for footwear. But how many times have women bought a pair of shoes and worn it only once, leaving it in the back of the shoe cabinet forever?

When shopping for shoes, always try on shoes in the late afternoon when your feet are already tired and have expanded in size. That way, if you find a comfortable fit, it will be comfortable even when your feet are tired. Unless you work in a corporate environment, wear open-toed shoes or sandals. Not only do you allow your feet to breathe, but you avoid other foot problems such as calluses and painful corns from rubbing your feet against the leather-bound closed shoe. But do remember that when wearing open-toed sandals, make sure your feet are neat and clean or well-manicured. Otherwise, leave them in closed shoes.

Flat shoes, although comfortable, have their own caveat. If you wear flats without the proper arch or heel support, you could develop heel spurs or plantar fascia—a painful heel condition—or you could get tendonitis. The best thing to do is to find a flat shoe. Hold each end of a shoe and try to twist it. If the shoe bends too much, it won’t be supportive. Look for flats with a little bit of a heel if you have high arches. Heels provide relief from foot pain. Buy shoes with leather or rubber soles for optimum shock absorption. Wear only shoes that have leather or suede insoles. Breathable and pliable, they help prevent chafing and blistering, and they mold to the feet. Opt for round-toe flats. They follow the shape of the foot and allow the toes to move. Avoid cuts on your heel by finding a shoe with a back that fits snugly and holds your foot securely. Although sometimes we sacrifice comfort for fashion, it is best to not wear the same shoe all the time even if it’s your favorite. That way your feet can change its position every day and avoid any permanent injuries.

If you choose to purchase pumps with stiletto heels, you should hold the shoe at the heel and toe areas. The sole should be flexible and bend at the front. The bottom of the arch should be stiff. If you must choose a high heel, choose a pump with a high heel that is directly underneath the center of your heel. That should make it easier to balance. If it is too far forward or at the back of the shoe, you might keel over or injure your spine from standing incorrectly.

If you opt for pointy toes, choose a false front. It’s an area much longer than the foot. It will help give your toes more wiggle room. Make sure you have the right width as well so the toe area is wide enough. Wedge shoes are known for distributing your weight more evenly. Be aware, however, that the limited sole flexibility of a wedge may make you accident prone and result in a sprained ankle.

To avoid the burning sensation at the ball of your feet when wearing heels, test a shoe for cushioning by pressing a finger into the ball area. It should have a little give or a slightly padded feel. If it doesn’t have any cushioning, purchase a reusable pair of party feet cushions from Dr. Scholl to give you the added comfort.

If you can afford it, avoid synthetics. Wear shoes with leather, suede, or fabric uppers. These materials breathe, which lessens the chance of blistering. Synthetics make your feet sweat and have a tendency to give you blisters.

When buying open-toed sandals, the thing to remember is to avoid wobbly shoes. Examine a shoe’s quality by looking at how it sits on a table. A well-built shoe will be balanced and look stable when standing on its own. Otherwise you will end up wobbling along with it. Stacked heels that have a broad heel are a better choice. This not only gives better shock absorption but it makes you steadier on your feet. Wear only sandals that have leather or suede-lined straps to prevent chafing. Make sure the toe area is wide enough for the broadest part of your foot. Look for shoes that give the illusion of a higher heel without actually being a high heel.

I’m a firm believer of the saying:” Once your feet hurt, your whole body hurts…,” which is why reflexology centers have become so popular. It is true that if your feet are in pain, chances are other parts of your body become affected too like your back, your knees and your upper thigh. And that is just a horrible feeling to have just for the sake of a pretty shoe. So love your feet and take care of them. And chances are your healthy pretty feet will take care of the rest.

Back to Top

Health Information – Fernley-Foot Pain

This article is courtsey of Dr. David Kahn, DC • Fernley Chiropractic • June 17, 2009

For most our feet rarely garner much attention till we stub our toe or twist an ankle. But, those calloused and abused underpinnings for our bodies are pretty amazing. They have 26 bones apiece, 33 joints and can take on about four times your actual weight with every step. Foot problems are so prevalent that there are over 13,000 podiatrists in the U.S. alone. 75% of use will have a serious foot problem at some time our lives.

When I did research for this article I found that almost all of our foot problems are self-inflicted. Very few of us are born with any true foot pathology. Foot injuries run the gamut from athlete’s foot and toe fungus to fractures and surgical joint replacements and all complicated by age and weight.The basic age and weight related problems are what most of use will run into. Bunions, plantar fasciitis, hammer toes, stress fractures, heel spurs, flat feet and loss of the fat pad of the foot all fit this category. The feet tend to spread out a bit as we age and our shoe size may change.

Add to this the few pounds most of us gain over the years and the feet are destined to show some degenerative and arthritic changes over time. Every few years you might want to check your shoe size to see if it is the same. And women are four times more likely to have foot problems. This is most often due to choices in shoes.

Wearing sizes that are too small, wearing heels and wearing pointed toed shoes bend feet to positions they were not meant to be in for long periods. Here is a quick way to check your shoe fit that I plagiarized from webmd.

“¢Stand on a piece of paper. (Make sure you are standing and not sitting, because your foot changes shape when you stand.)

“¢Trace the outline of your foot.

“¢Trace the outline of your shoe.

“¢Compare the tracings: Is the shoe too narrow? Is your foot crammed into the shoe? The shoe should be at least 1/2 inch longer than your longest toe and as wide as your foot.

Sprain/strains and fractures of the feet need special care. Not only do you need to rehab the muscles and joints, but your entire gait pattern. When you damage a foot you naturally begin to walk differently, limp.

Once you have healed the foot time needs to be devoted to repairing changes in the way you walk and bear weight. I see many people who have an odd gait, years after they have twisted their ankle and do not even realize it. Left alone for long enough and the feet, knees and hips will wear differently on one side than the other.

A quick check to see if you are walking around unbalanced is to get two regular household scales and put one under each foot and see if you are putting the same weight through each foot. If not, you still have some rehab to do.

Basic treatment of foot problems begins at home. Keep your weight in check. Extra pounds add up to big trouble for your feet. Wear good and proper fitting shoes. If you are not sure ask your doctor, chiropractor, physical therapist or visit a podiatrist. Be cautious of people trying to sell you the latest innovation in shoes and orthotics. If you have true damage to your feet the podiatrist should be the one making your orthotics. Keep your feet clean and dry.

Infectious diseases of the foot can be ugly and debilitating. If you really hurt your foot or ankle the basics apply: rest, ice, compression and elevation. Then get into to see a professional. Rehab involving ultrasound, electric muscle stimulation, taping, adjusting of the joints and muscle strength, gait and balance training are standard. If this fails foot injections and surgeries are available from specially trained podiatrists and orthopedic surgeons.


Back to Top

Hell in Heels

This  article is courtesy of….. Angela Bowen

red-shoes-in-bubble

Fashion trends have pushed the limit of heel height.  AP Photo/Matt Sayles

Let’s face it ladies, every single one of us is likely guilty of owning AT LEAST one pair of heels that give us the firm shapely calves, juicy butt and lofty height we crave while screaming “come and get me boys”. And each and every one of us rues the day a man decided to put a woman in heels as we hobble torn, blistered, swollen and tender for the next day (or three). Common sense should kick in at some point here and cause us to forego the whole lot. We never do, likely never will and really, what harm could there be?

A lot.

The most common issues include blisters, corns, calluses, and bunions and nearly every woman who wears heels for any length of time has at least one.

For those who wear them more regularly problems progress to include ankle sprains, stretched ligaments, chronic pain in the ball of the foot (metatarsalgia), achilles tendonitis and lower back pain due to incorrect posture.

Progress further to women who are never caught dead in flats and ailments include neuromas (benign nerve tumors), loss of arch integrity and “pump bump”. Women who wear heels even on a semi regular basis also run a greatly increased risk of developing osteoarthritis of the knee, contributing a huge number of the 300,000 patients submitted for knee replacement every year. Some of these conditions take as little as one wear to occur. The more sever may take months, years or decades to appear.

How high is too high?

Most experts agree that heels greater than 2 inches in height as well as heels with a width of less than ¾ inch are to be avoided to the greatest extent possible, especially in situations where they will be worn for more than a couple of hours. Podiatrists also recommend the following:

- Wearing flat shoes for walking distances and changing into heels once arriving at your destination.

- Take smaller steps and try to place your heel first, in a gliding step.

- Buy short, chunky heels for all day wear.

- Avoid open backed shoes.

- Avoid pointed toe shoes to allow toes to maintain a natural shape and placement.

- Practice stretching, joint mobility exercises and soak or massage feet to ease the discomfort.

- Lastly, if suffering from pain more than twice a week, seek medical advices, as foot problems get progressively harder to treat as then become chronic.

Also of great concern is the growing number of girls and young women who are being treated for high heel related foot conditions. Girls are young as 10 years old are being treated for compression injuries, ligament and tendon conditions, back and knee pain and can suffer for years to come as a result of these injuries. Sustaining injuries to growing bones and joints can cause developmental restrictions and permanent damage. Growth plates of the knees, feet and hips are typically fused around age 16, so wearing heels, especially very high or narrow heels, can cause serious problems in the future.

Heels are not the only culprits

Flat shoes can be just as harmful as heels. Flat shoes with no support structure, such as slippers, ballet shoes and flip flops, cause different but equally harmful changes in gait and posture. Unstructured flats cause the foot to roll forward and stretch ligaments in the foot which causes incorrect toe alignment and can lead to bunions as well. Flip flops and slings create shuffling rather than walking gaits and (aside from being incredibly obnoxious to listen to) cause poor posture and weakening of core muscles. Shoes with arch support, natural foot shape, heel containment and one half to one inch of sole are recommended for flat footwear.

Options to ease the suffering

Buy shoes that fit. Most women suffer unnecessary pain as a result of wearing shoes up to a size too small. Get fitted at a reputable shoe store and be conscious of the width of your foot, arch height and the swelling that occurs naturally as the day wears on.

Shop in the afternoon or evening after a typical day of activity so that your foot is in the condition in which the most comfort is desired.

Purchase inserts. Dr. Scholl’s makes clear gel inserts and heel guards to prevent every day soreness and rubbing.

Custom orthotics can be costly, but will also greatly improve posture, correct gait and support the arch.

Do not wear shoes you can’t walk in. It doesn’t matter how cute it is, if you wobble for more than a step or two, the heel is too high and/or narrow and begs for injury. And trying to walk but looking like a toddler all over again this way takes away from the feminine grace that is the point of the exercise.

Compromise on heels around two inches in height and ensure a chunky rather than slender heel.

If you simply have to have more height, try a platform or wedge. While this will not alleviate the stress injuries, it will reduce much of the wobbling which can cause traumatic injury. Just get used to the difference in walking in rigid shoes before venturing out into the world.

Back to Top

How Ace put the spring back into Ryan’s step

This article is courtesy of:

ryan jones

ryan jones

THE sports clinic which made a bespoke pair of rugby boots for Wales captain Ryan Jones, has revealed how orthotics can help people with common foot problems.

Using the latest computerised scanning technology, Ace – Feet in Motion, created a tailor-made pair of boots for Jones after discovering his were too tight and causing problems with a nerve in his right foot.

Jones’ metallic blue boots are also fitted with corrective insoles. Orthotics is the branch of medical science which deals with the rehabilitation of injured or weakened joints or muscles through artificial or mechanical support.

It is often used to treat common sporting injuries such as shin splints, knee, ankle, foot and back pain. The most common orthoses are corrective insoles and custom-made footwear which help correct any biomechanical imperfection in the feet.

Ace – Feet in Motion is the official podiatrist to the WRU and has worked with the England cricket team, Elite Cymru and FDSW athletes.

But the clinic, which is based in Cardiff, Swansea and Bristol, also treats musculoskeletal problems in the general public. One of the most common problems affecting daily life are collapsed foot arches – flat feet. The condition that can be inherited or brought on by a weakening of the muscles in the feet because of the stress of supporting excess body weight, ageing, or by the strain of wearing high heels. Collapsed arches are a common cause of back, knee, ankle and foot pain.

Bob Cooper, managing director of Ace – Feet in Motion, said: “Corrective insoles or orthotics can be used to treat a multitude of problems, the root cause of which can frequently be traced back to abnormalities in the biomechanics of the foot. The foot is a complex mechanism involving 26 bones and 33 joints, but we take the correct function of the foot for granted until something goes wrong, at which point, it can affect the entire body.”

Jones was found to be suffering from Morton’s Neuroma – a thickening of the tissue that surrounds the digital nerve leading to the toes. The problem is compounded if a person with wide feet cannot find appropriately fitting shoes.

Andrew James, a podiatrist and clinical director of Ace – Feet in Motion, said: “It’s a very common problem among athletes, who experience constant pain as a consequence, but at present only the elite have bespoke boots made for them to address the problem. One of the functions of Ryan’s special insole is to create more space between the metatarsals. An exceptionally broad boot is then specifically designed to accommodate this feature and the wide foot, thus allowing the pressure on the nerve to be relieved.”

Jones said: “While wearing my regular boots I always felt as though I was walking around with a stone in my shoe because of the pressure they created.”

Back to Top

Common childhood foot problems

Nail Problems:

poor-nail-cutting-result

Children generally do not suffer the same nail problems that adults do, as many changes seen in adult nails are due to the aging process.

Problems with children’s nails are more likely to be as a result of injury.

  • Trauma to the nail can cause discolouration or a blood blister under the nail plate. In some cases the nail may be so traumatised that it will fall off, however providing there is no permanent damage to the cells producing the nail, it should grow back again in time.
  • Nail shape can cause problems if the nail is curved and growing into soft tissue, and an ingrown toenail develops. This is often very painful and can become infected, and can be further aggravated by trauma, and tight footwear.
  • Treatment options can be discussed with a podiatrist and range from regular nail maintenance to surgical options.

Warts/ Verruca pedis

Warts can occur all over the body, but especially on the feet. Warts are more common in children than in adults, and are very contagious and contractable via direct or indirect contact.

What are they?

Warts are masses of benign growths on the skin caused by infection with the Human Papilloma Virus which causes the top layer of skin to overproduce skin cells, producing a hard mass.

Warts commonly occur on the sole of the foot, and may have a black dot in the centre. The normal skin lines will not be present across the wart area, and they are usually painful if squeezed from the sides. It is not uncommon to have multiple warts at one time.

How is the virus that causes warts passed on?

  • The Virus is passed on via close skin to skin contact or even indirect  contact with objects that have been in contact with a wart.
  • Through cuts or broken skin on the feet
  • At public showers or pools where footwear is not worn

How do I get rid of warts?

  • Warts usually resolve on their own within two years, however treatment can speed things up.
  • Speak to your podiatrist about the best type of treatment for you or your child
  • Your podiatrist may suggest any of the following: Salicylic acid treatment, Cryotherapy, Surgery, chemical treatments or alternative treatments.
  • Treatment of warts usually takes both time and patience.

How can I reduce the chance of my child getting warts/ spreading them?

  • Do not allow sharing of shoes, socks, towels or personal items with somebody who has a wart.
  • Avoid spreading warts to other areas of the body by avoiding picking or touching them.
  • Wear footwear in public pools and change rooms.
  • Wear a bandaid over the wart when swimming.


Back to Top