Foot Articles on the Web

Here is my pick of the latest, greatest foot, ankle and podiatry related articles on the web:

Pregnancy is a bundle of joy, but not for your feet! Podiatrist Scott Kilberg has written a great review of the effects of pregnancy on our feet. Check out Foot Problems During Pregnancy and for more from Dr. Kilberg, visit his blog My Aching Foot.

Shin splints eventually affects just about every runner and Podiatrist Andrew Schneider has written a good synopsis on this common problem. His blog also has some of the best writing about our feet and ankles that you can find. Check out Dr. Schneider’s superb writing and and learn about shin splints HERE.

Bunions are among the top podiatry problems we see. Podiatrist Jennifer Feeny has written a good review – Bunions: A Pain in the Foot. Her blog can be found HERE. If you want to know when a Bunion is Not a Bunion, check out Dr. Marybeth Crane’s article HERE.

If you want to dance, you may have to pay the piper – or the podiatrist! Dance takes a toll on the feet. For a great introduction to foot pronation and how it can be the cause of your knee pain, read Lisa Howell’s How to Understand Overpronation and Knee Pain If You Have Flat Feet.  

Speaking of Flat Feet, there is a basic introduction to flat feet and Choosing the Best Running Shoes at the Running Shoe Guru.

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Our feet take a beating.

We put in long hours, walking an average of seven to ten miles a day.

We tread on artificial surfaces such as asphalt, concrete and tile, often carrying a briefcase, purse, baby or laptop—and for some of us all four!

And with each step two to three times our body weight comes down on our feet, not to mention the strain of jogging, stair stepping or high impact aerobics.

So what can you do to keep your feet healthy, beautiful and strong enough to make it through the day?

I hear this question often as a podiatrist and more often from female patients, which doesn’t surprise me, since women experience four times more foot problems than men.

Fortunately, both men and women can do simple, inexpensive things to care for their feet, and when your feet feel great, your whole body will too. Consider the following five ”musts” for healthy, beautiful feet.

1. Use a good moisturizer

The skin of your feet is increasingly prone to drying out as you age. Dry skin is not only ugly but can crack open and possibly become infected, especially in diabetics or those with poor circulation. A good moisturizer can soothe dry skin.

The secret to finding a good moisturizer is not by price; more expensive doesn’t mean better.

Read the ingredients and avoid products with alcohol or alcohol derivatives.

Generally, lotions contain alcohol to make them absorb faster, but the alcohol hinders the product’s ability to moisturize your skin.

The best dry skin products tend to be creams without alcohol. These are gooier and absorb slowly, so I recommend applying them just before going to bed.

2. Keep your feet dry

This may seem to contradict using moisturizer, but dampness around your feet, specifically between your toes, can be a breeding ground for bacteria.

When washing your feet, be sure to dry them well, especially between the toes.

Towels can pick up bacteria or fungus, especially if they are damp or dirty, so wash them often with bleach or hot water and never use the towel that dried your feet on the rest of your body or face.

A good tip to keep feet, and especially toes, free from moisture is to use a foot powder enriched with zinc or menthol, or even both. A sprinkle a day will not only keep toes from perspiring, but also lessen odor.

3. Beware of nail polish and acrylic nails

Men can skip this tip, but women should heed it. Nail polish and acrylic nails trap moisture, increasing the chance of fungus infecting toenails, causing the nails to thicken and turn yellow or, in severe cases, black.

Toenail fungus can also infect the surrounding the skin and in some cases, particularly when the person is diabetic or has poor circulation, can lead to the loss of a toe or even the foot.

Some women who notice their toenails beginning to darken or yellow from fungus cover the nails with polish to hide them; ironically, this only makes the problem worse.

Am I saying you shouldn’t wear nail polish or acrylic nails? Not at all. Nail polish or acrylic nails can cheer up the ugliest of feet, don’t cost a lot and are generally among the safer pleasures for your feet.

When using nail polish or acrylic nails think of them like a dieter having a scoop of ice cream: occasionally it is okay, but not every day.

If you have a special event, feel free to wear nail polish or acrylic nails; just remove the polish or fake nails when you get home. The more your nails can “air out” the better.

4. Wear sensible shoes

This seems obvious, but many people choose style over comfort (one study showed that 88 percent of women have at some point knowingly squeezed their feet into shoes that were too small).

Like eating that fattening scoop of ice cream, wearing Jimmy Choos or other stylish shoes occasionally, for brief periods usually won’t cause problems.

However, wearing ill-fitting shoes too often can cause the toes to crunch up, possibly causing permanent deformities, pinched nerves, corns, calluses or other problems.

People with diabetes or poor circulation need to be especially careful, as these problems can result in serious infections.

The secret to making sure shoes fit properly is to shop for them late in the day when your feet are likely most swollen.

When you walk in the shoes you try on, try to avoid the soft, plush carpet found in most shoe stores. If you’re in a mall, leave the shoe store and walk on the mall’s tile floor.

Most importantly, if shoes hurt in the store they will hurt when you get them home–a shoe should never need to be “broken in.”

5. Check your feet daily

The last tip to taking care of your feet is more common sense than secret. Check your feet every day.

It’s amazing how many people don’t look at their feet; or if they do see a problem or have pain, they shove their foot into a shoe and try to forget about it.

When examining your feet, watch for any blisters, redness, swelling or open sores, and be sure check between the toes as this is a common area for infections to start. A good way to see the bottom of your feet is to use a mirror.

If you find a foot or ankle problem, see a podiatrist promptly.

Most foot and ankle problems are easy to take care of when caught early. The biggest complaint I hear from my patients is, “I wish I had come to see you sooner.”

Your lifetime of healthy, beautiful feet

Your feet work hard all day long, and they need a little care to remain strong.

When you use these tips to take care of your feet, they can be healthy, beautiful and ready to carry you anywhere.

To learn more about podiatry, podiatrists, and podiatric medicine, visit the website of the American Podiatric Medical Association

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There is a new buzzword in foot care: Orthotics. The science of treating deformities and abnormalities in the musculo-skeletal system – traditionally associated with ungainly corrective footwear – has been given a high-tech makeover.

Now, off-the-shelf or custom-made insoles worn in shoes to correct the gait (walking style) and support weakness in the foot are created using the latest in computer scanning technology. Available from £15 at High Street foot clinics, the great thing about them is no one can tell you’re wearing them.

Experts also say that orthotics could be the answer to curing leg, knee and even lower back pain.

Delicate: Damage in the feet can make itself felt in other parts of the body

Do you need orthotics?

Some estimate that the distance we travel on our feet every ten years is equivalent to the Earth’s circumference. So the 26 bones and 33 joints that make up each foot take a pounding over the course of a lifetime.

And given that between one and two times a person’s entire body weight is

absorbed to as much as three-and-a-half times when running, it is hardly surprising they are susceptible to injury.

‘Feet are fairly delicate structures,’ says consultant podiatrist Simon Costain of the Gait & Posture Centre in Harley Street. ‘Damage may be painless in the foot but felt elsewhere in the body.’

For instance, collapsed foot arches – also known as flat feet – which can be inherited or brought on by weakening of the muscles in the feet through sustained strain caused by wearing high heels, ageing and weight gain, are a common cause for knee pain.

‘The condition can cause the heel to turn outwards at the ankle,’ says Costain. ‘This misalignment can result in painful grinding of the knee. We can track even further up the body, to lower back pain caused by the feet.

‘For example, leg length inequality can cause a tilt in the pelvis – if the legs are functionally different because of a collapsed arch in one of the feet, we can use orthotics.’

Therapy often centres on treating pain caused by walking with high or flattened arches, and problems caused by overpronation or oversupination – the way the foot rolls inwards or outwards through a step to distribute impact throughout the foot.

‘Our feet are like shock absorbers, and the ability to roll inward or outward is essential,’ says Costain.

Difficulties begin when there is too much or too little pronation or supination, or if it happens at the wrong time when walking.

By creating extra support underneath specific parts of the feet – lifting the ankle a few millimetres, for example – insoles, made of foam rubber or carbon fibre, rebalance the action of the foot and correct other mechanics of the gait.

Walk away from your sore feet

Orthotics are frequently used by footballers, rugby players and runners – but their uses go beyond the playing field. They can be used to treat a range of common medical problems, experienced by one in five of the population.

These include metatarsalgia (pain in the ball of the foot, sometimes caused by dropped metatarsals where the bones we use to push off when we walk become misaligned) achilles tendonitis (soreness of the large tendon that connects the back of the ankle to the calves) and plantar fasciitis (a painful condition caused by tearing and inflammation of the tissues around the ligaments that connect the heel to the front of the foot).

Tibialis posterior pain, also known as acquired flat feet, causes pain on the inside of the ankle as a result of the collapse or rupturing of the muscles that hold up the arches.

Costain says: ‘Moving from high heels to flat shoes often provokes this kind of pain but an orthotic can be worn in either or both type of shoe to help alleviate the problem.’

Costain says that about 70 to 80 per cent of patients referred to his clinic by GPs can benefit from orthotics and estimates that they could also help up to 70 per cent of the general population to treat or prevent injuries or improve the efficiency of the gait.

‘Not enough people use them,’ he says. ‘The analogy we use is with racehorses – most have orthoses put on before each race and they would not run without them.’

Screen test: A scan can reveal feet are the cause of many problems

Pinpointing the problem

While gait analysis is increasingly available in sports shops and gyms, Michael O’Neill, from the Society for Chiropodists & Podiatrists, says prospective wearers should undergo a full gait analysis with a trained podiatrist or other medical expert (see below).

‘A full analysis will include watching how someone walks, from their neck and shoulder to arm swing, knee function and leg swing, rather than just the foot,’ says O’Neill. ‘From there, we make a temporary device and subsequently make improvements once we know we are on the right track.

‘We can use orthotics to control problems, improve the way the foot works and change its mechanics.’

Custom-made orthoses are created by taking plaster casts of the foot, but specialist clinics increasingly use cameras and lasers to map a three-dimensional image.

Ready-made insoles can also be bought. However, Jimmy Walsh, of fitness chain Runners Need, says: ‘Off-the-shelf insoles can help sportsmen and women who have already been diagnosed with overpronation or supination, but prescribing orthotics really requires a trained medical professional.

‘There are some trainers that help remedy these problems and some off-the-shelf insoles such as Sorbothane, Sofsole and Spenco have an orthotic function and will take more impact out of the foot when running, but they won’t correct the gait.’

So, what’s the next step?

Your GP can refer you to NHS podiatry services, however simple orthotic insoles are available from chiropodists, with more specialised appliances costing from £75 to several hundred pounds from clinics.

‘I’d never say orthotics are the magic bullet,’ says Costain, ‘but very often they prove to be extremely helpful in a range of ways.’

And O’Neill argues that orthotic therapy will work only as part of a wider package.

‘A person’s mobility, stretching regime and muscle balance are all as important. Orthotics on their own won’t work.’

Scan that reveals secrets of the sole

During gait analysis, a practitioner – usually a podiatrist, osteopath or chiropractor – takes a detailed medical history, including any specific complaints such as pain in the foot or elsewhere in the body. This is followed by a physical examination of the foot to check for any abnormalities.

‘The GaitScan pad has thousands of pressure sensors linked to a computer which shows on a screen the distribution of pressure across the feet,’ says Dr Roger Reid, a chiropractor at London’s Body 4 Life Healthcare.

‘Red shows most pressure, and blue the least. Pressure should be evenly distributed across the sole. The patient first stands still on the pad, where an uneven distribution of pressure could indicate a musculo-skeletal problem such as different leg lengths or misaligned hips.

‘After this, the patient walks across the pad a number of times. Problems with pronation – the rotation of the foot – would show up as uneven pressure during this part of the scan.’

If needed, the scans, above, can be used alongside a mould of the foot which is sent to a specialist orthotic manufacturer that uses CadCam technology.

‘This uses cameras and lasers to scan the surface of the mould and is the most accurate way of capturing the anatomy of the foot,’ says Pat McGonigle, of Pegasus Orthoses, who create orthotics for Chelsea Football Club and the Royal Family.

‘This is then used together with patient-specific information about sex, age, weight, height and medical problems, to create a 3-D computer model of an orthosis, which can then be manufactured.’

Running insoles cured my painful shins

Relief: Katharine Vile wears orthotics for high arches

Literary agent Katharine Vile began using orthoses after experiencing severe shin pain.

‘I was suffering from soreness in the lower leg, and found I was in pain just standing up and walking. It was even stopping me wearing my favourite heels. I enjoy running but it got so bad in February this year that I had to stop exercising. Friends suggested I look at orthotics,’ says the 38-year-old.

Katharine visited a physiotherapist who discovered that she had high arches, a common inherited condition in which the arch of the foot is higher than average, often requiring supporting insoles.

‘High arches often mean the feet are very poor shock absorbers and they can lead to pain in the knee, lower back and the arches themselves,’ says Simon Costain.

The orthosis is built up under the arch of the foot to help take the weight of each step as it is distributed through the foot. Treatment was simple – the physiotherapist prescribed orthoses to use in her running shoes. They cost about £70.

Katharine says she noticed an improvement almost immediately.

‘Within a couple of days I could feel the difference. Now, when I’m standing, my feet are flat rather than falling in on themselves,’ she says.

She was able to return to running and has found that she no longer suffers leg pain when wearing her everyday shoes.

‘The physio suggested I should wear them in my other shoes.

‘I like wearing high heels and I know it would help, but just wearing them in my running shoes has helped and the pain has gone, so I think I can get away with it.

Dr. Nirenberg’s Comment:

This is an excellent article. Numerous scientific studies have shown poor foot structure can cause not only back pain and problems, but also ankle, leg, knee and hip pain. In patients where these problems are related to weak, unstable, or flat feet, I have had good success alleviating their pain with custom made arch supports (orthotics).

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Bunions, Flat Feet & Weak Ankles

Most of us don’t think about our feet until they hurt.

Even then, we limp around hoping the pain will go away. But with two to three times our body weight pushing down on each foot with every step, it usually doesn’t.

Fortunately, you can do a few things for relief.

1. Wear Only Great-Fitting Shoes

In one study, 88% of women admitted that at some point they knowingly squeezed their feet into shoes that were too small.

Further, as we age, our feet tend to become larger, but most people insist on wearing the same shoe size they wore years ago.

In addition to making sure your shoes fit properly, make sure they have a good arch support and that the heel counter—the area that wraps around your heel—is firm and strong.

2. Feet Need Exercise, Too

I can hear the couch potatoes now:  “My feet get enough exercise.”  Perhaps, but walking to the fridge or standing in line at McDonald’s isn’t exactly exercise.

Most people agree our entire body needs exercise, but few people think about keeping their feet in shape.

Yet, with the average person walking over a hundred thousand miles in their lifetime, feet need all the help they can get.

Foot exercises tone, stretch, and strengthen feet, while alleviating fatigue, soothing soreness, and increasing blood flow.

3. Take the Plunge

Nothing soothes sore, aching feet more than a relaxing footbath.

You can use a bathtub or plastic basin, or for some serious relief, I recommend buying a massaging footbath.

Make sure the water is warm, not hot (I’ve seen patients soak in water so hot they received second-degree burns).

Add good quality bubble bath to the water; and for those who are not diabetic or have poor circulation, adding Epsom salts is great, too.

4. Moisturize Your Way to Healthier Feet

Good moisturizers can sooth dry, irritated skin.

The secret to finding a good moisturizer for your feet is not by price; more expensive doesn’t mean better.

Read the ingredients and avoid products with alcohol or alcohol derivatives—the best dry-skin products tend to be creams without alcohol.

These are gooier and absorb slowly, so I recommend applying them just before going to bed.

5. Nailing Down Nails

Caring for your nails will go a long way in helping to alleviate foot problems.

Long, jagged, and thickened toenails can catch on socks or pantyhose, dig into adjacent toes, or suffer injury by pressing against the inside of our shoes.

In my practice, I have seen unkempt nails lead to blisters, infections, ingrown toenails, and even gangrene.

When trimming your toenails, follow the contour of the toe and avoid cutting into the corners. Smooth any rough edges with a nail file.

Final Thoughts on Aching Feet

Caring for your feet is your responsibility. However, when problems don’t go away, become serious, or if you have diabetes or poor circulation, get professional help and see a podiatrist.

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