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What is Gout?

8 Jan
big toe with gout

Big toe joint inflamed from gout

“I just kind of woke up one morning, stepped out of bed, took one stride toward the bathroom and ended up giving a high falsetto scream, like a six-year-girl, flopping to the floor, [and] grabbing my left big toe.”

That’s how David Wells, legendary pitcher for the New York Yankees and Toronto Blue Jays described his first encounter with Gout. Yes, it will make a grown man cry.

Once thought to be a disease of the upper class, Gout can affect anyone.

It starts with purines

Purines are part of the chemical structure of our genes. They are found in all of your body’s cells and in most foods, but they’re especially high in organ meats, asparagus, mushrooms, herring, dried beans, peas, and anchovies.  As the cells in food are digested, so are the purines, which eventually break down into uric acidic. Uric acid is a key component of our blood and necessary for a properly functioning vascular system.

Normally, uric acid dissolves in the blood, passes through the kidneys, and exits the body via urine. But in some people, uric acid is not discharged correctly, and levels remain too high. Gout occurs when this excess uric acid crystallizes and builds up around the joints, causing inflammation, swelling, and severe pain. It usually first appears in the joint just below the big toe, the same spot where bunions develop. In some cases, small lumps can be seen around the joint, which are actually deposits of uric acid crystals called tophi.

Gout is classified as a form of arthritis, causing pain, swelling, redness, a hot feeling, and stiffness in the affected joint. Besides appearing in the big toe joint, it can also affect your arch, ankle, heel, knee, wrist, fingers, or elbow.

toe joint with gout

How can I avoid gout?

Gout appears more frequently in men than women, but it’s still a bit of a mystery why some people with high uric acid levels (hyperuricemia) develop gout and others don’t. But there are certain factors that science recognizes as contributing factors:

  • genetic predisposition – an enzyme defect which makes it difficult for your body to break down purines
  • being obese or overweight
  • a diet high in alcohol consumption, especially beer
  • a diet high in purine-rich foods
  • extremely low calorie diets
  • rapid weight loss
  • overuse of aspirin
  • overuse of the vitamin niacin
  • chronic kidney disease
  • long term use of diuretic medicines
  • medicines taken by transplant patients
  • high blood pressure
  • psoriasis
  • tumors
  • surgery
  • myeloma
  • hemolytic anemia
  • lead poisoning
  • hypothyroidism
Symptoms of Gout
  • Severe pain –  and a hot feeling in the affected joints, accompanied by redness and inflammation, most commonly first appearing in the big toe (podagra)
  • Red skin – the area around the joint may become red or purple, appearing similar to an infection
  • Fever
  • Stiffness in the joint
  • Pain may subside – an untreated gout attack can last for a week or more, and then fade
  • Itchy skin – as the gout subsides, the skin around the joint may start to itch and peel away (peeling skin is one of the ways your body sheds the extra uric acid)
  • Small lumps (tophi) – appearing around the elbows, hands, or ears

Some patients experience no symptoms, which unfortunately may develop into chronic gout.

Gout symptoms come on very suddenly, and many times during sleep, as in David Wells’ story. If you experience sudden and intense pain in your big toe, or anywhere else in your foot or ankle, make an appointment with your podiatrist immediately for a thorough evaluation. If you leave gout untreated, it may become much worse.

For more information on gout, see the National Institutes of Health page

Most Common Foot and Ankle Injuries For Runners

4 Jan

foot and ankle injuries for runnersFew sports make one feel better than running: the challenge to go the next mile, to better your speed, to increase endurance. There are also few exercise programs better or more natural than running, except for perhaps swimming (gets the edge because of low impact on joints and it uses every single muscle).

But as all of us runners know, a foot injury can put us out of the game for days, weeks, even an entire season. According to the Rice University Sports Med Web,

“…studies show that experienced runners have about the same rate of overuse injuries as beginners. It is not that experienced runners never learn. Certainly some do not and constantly run, and rerun, into the same injury pattern. However, it is likely that a larger percentage cure one injury then develop and improve until they stumble into the next. This is probably because as one area gets stronger the stress load is subsequently re-applied elsewhere. Injuries, thus, tend to march along what is referred to as the “kinetic chain”.  Each runner, however, tends to march to the beat of a different drummer. The specific location for an overuse injury is determined by a multitude of factors (e.g., genetics, previous injuries, training factors, etc.)… Knowledge and early warning are a runner’s best friends.”

Did you get that part in the middle? Strength conditioning doesn’t bring every muscle and tendon along at the same rate and the weaker parts tend to get injured. And it’s different for every runner. Here then, is a list of potential foot injuries you may experience when running. Forewarned is forearmed.

Heel Area Injuries

The most common source of heel pain for runners is Plantar Fasciitis, an overuse injury that inflames the fascia on the bottom of the foot. Pain is usually felt in the heel, but may also be felt in the arch. This may heal on its own with rest, ice, and pain medicine, but persistent pain indicates an injury that needs medical treatment.

Pain in the heel may also indicate a Calcaneal Stress Fracture, a thin crack in the heel bone. This is a more serious injury that needs attention from a podiatrist.

Pain from Achilles Tendon injuries typically appears in the heel area, but also may be felt behind the ankle. Mild pain could be the result of irritation of the tendon, but severe pain may be due to a full-on tear (rupture) needing surgery.

Bottom of the foot injuries

On the bottom of your foot, in the area commonly called the “ball” of your foot are the sesamoid bones, located just behind the big toe. The tissue surrounding these tiny bones can become irritated from overuse, a condition called sesamoiditis. Additionally, the bones may actually fracture. Pain can be anywhere from “just hurts a little” to “I can’t even take a step without screaming”. Just as with Plantar Fasciitis, minor pain can be treated with rest and anti inflammatory pain meds, but more significant, persistent pain needs the attention of a podiatrist.

Top of the foot injuries

If you feel pain in the top of your foot, right about at the halfway point, you might be experiencing Extensor tendinitis, an inflammation of the tendons that run along the top of the foot.

Pain in the top of the foot can also be due to a metatarsal stress fracture. The metatarsals are the five long bones in your foot that connect with your toes.

Toe Area Injuries

If you’re experiencing a “pins and needles” sensation between your 3rd and 4th metatarsals near your toes, you’ve probably irritated the interdigital nerve. This is called Morton’s Neuroma.

If you have a sore or discolored toenail, you may be experiencing a subungal hematoma, which happens when your toe is constantly jammed against the inside of your shoe. This action leads to bleeding underneath the nail, creating the discoloration. Buy running shoes that fit properly.

Ankle Injuries

You usually know it when you’ve sprained your ankle. The tissue around your ankle discolors, and the joint is stiff and painful. This injury is not to be taken lightly – you should always have a sprained ankle thoroughly evaluated by a podiatrist. Sprains treated incorrectly (or not at all) may not heal sufficiently and are notorious for re-injury, weakening the ankle and leading to arthritis after middle age.

Soreness (without discoloration) on the inside or outside of your ankle could be inflammation of the Posterior tibialis tendon or the Peroneal tendon. With these injuries, pain may also be felt along the outside or inside of the foot.

Treating tendinitis and minor irritations

Treatment of a sore area with minor pain should always start with a period of rest, ice and anti inflammatory pain meds like aleve. When and if the pain subsides, don’t jump right back in to the same running routine, because you’ll probably injure the same area once again, but this time more seriously. A damaged tendon is a weakened tendon and needs to be reconditioned before placing maximum load on it.

To recondition the muscle or tendon, start with simple stretching exercises. If there is any pain at all while stretching, the injury is not yet healed and needs more rest. Only start running again when there is absolutely no pain in the damaged area. Warm up with proper stretching exercises and start with a light routine to get the foot and ankle working correctly again. Slowly increase speed and distance.

Whenever foot and ankle pain persists, or is severe, you should seek the attention of a podiatrist for a thorough evaluation and proper treatment. Take good care of your feet and you’ll still be able to run marathons into your 80’s. But much slower, of course…

 

What is a Plantar Plate injury?

7 Dec

It’s very common for an athlete to suffer a Plantar Plate injury due to the stress placed on their feet and the frequent over extension of their toes.

plantar plateThe plantar plate is a thick ligament on the underside (plantar) of your foot, running along the first joint of each toe. Its purpose is to act like a support cable and protect the head of the metatarsal (toe bone) from pressure and injury and to prevent the over extension of the toe by hindering the joint from bending upward beyond the normal range of motion. It also keeps each toe stabilized to prevent them from drifting out of their normal alignment, which is referred to as a “splayed toe”. The plantar plate is also called the volar plate, volar ligament, or plantar ligament.

During walking or running, your toes naturally flex upward. At the same time, your body weight – all of it – is supported by the bones in this part of the foot and the plantar plate.  The plantar ligament is a relatively small structure, so you can see how easily it might be damaged.

Injury to the plantar plate is usually caused by overuse, such as from running; obesity, which puts too much body weight on the ligament; or wearing high heeled shoes too often which locks the forefoot into a flexed position and requires the plantar plate to carry all of your body weight.

pierre garcon's plantar plate tear

click for a larger view

Damage to the plantar plate can be chronic and include a lengthening or partial tear of the ligament. The most serious form of plantar plate injury is a total rupture of the plate, when the ligament tears completely and leaves no link between the foot bones (metatarsals) and toe bones (phalanges). Severe damage to the Plantar Plate is frequent in professional sports, as seen most recently by Pierre Garcon of the Washington Redskins.

Symptoms of Plantar Plate injury

If you’ve damaged your plantar plate, you may experience mild to severe pain and swelling under the ball of the foot, extending toward the toes (most commonly the 2nd or 3rd). Some swelling and redness may be visible on the top of your foot, and one or more of your toes may be splayed or clawed. You may also have a sensation of numbness or “burning pain” in your toes, or a feeling like you’re walking on the bones of your foot.

Treatment of Plantar Plate injury

Fortunately, the most common injuries of the plantar plate can be resolved without surgery, and one or more of the following will be suggested by your podiatrist:

  • Icing the injured area
  • Anti inflammatory medications like aleve or advil to reduce pain and inflammation
  • Strapping the toe into a downward position to align it in order to help the tendon heal
  • Custom orthotics
  • Off-loading body weight via felt padding in shoes
  • Footwear modifications
  • If your case is severe, a special boot or shoe to keep weight completely off the ball of your foot

See: Photos of surgery to repair plantar plate tear

MicroVas Therapy Heals Diabetic Peripheral Neuropathy

28 Nov

*** PA FOOT AND ANKLE ASSOCIATES NO LONGER OFFER MICROVAS THERAPY

MicroVas, also known as Micro Vascular Therapy or MVT,  is one of the treatments used by PA Foot and Ankle Associates to relieve the symptoms of Peripheral Neuropathy in the feet. In most cases, but not all, this condition results from diabetes.

What is Diabetic Peripheral Neuropathy?
diabetic peripheral neuropathy microvas

click for larger image

Neuropathies are the most common side affect of diabetes, occurring in up to 50% of patients. A neuropathy can appear in any part of the body, affecting any organ, the muscles, or sensation, but most often affects the feet and legs, followed by the hands and arms. Symptoms may appear suddenly or may develop slowly over a period of years.

Symptoms of diabetic peripheral neuropathy include:

  • Tingling or burning sensation
  • Sharp pain which may be worse at night
  • Difficulty or pain when running or walking
  • A “heavy” feeling in your legs
  • Numbness in the extremities
  • Reduced ability to feel pain
  • Reduced ability to feel changes in temperature
  • Extreme sensitivity to touch
  • Lack of sensation when touching an object
  • Muscle weakness
  • Ulcers, infections, deformities, bone pain, joint pain in the foot
  • Feeling of wearing stockings or slippers when feet are bare

Peripheral Neuropathy may take years to develop in a diabetic patient, or it may be present at the time of diagnosis. If you’ve been diagnosed with Type 1 or Type 2 diabetes, it’s essential that you’re tested regularly for symptoms of Peripheral Neuropathy to avoid the additional complications which can develop.

What is the MicroVas treatment?
microvas treatment diabetic peripheral neuropathy

A patient undergoing MicroVas Therapy

MicroVas was originally developed by the U.S. military to treat hypothermia in Navy SEALS. It’s a non-invasive treatment which uses electronic impulses to cause muscle contraction and relaxation cycles to stimulate circulation in the capillaries (the tiny blood vessels near the skin surface).  This increased capillary blood flow raises the oxygen level in the tissues in order to promote healing in the nerves and muscles which have been damaged.

Blood flow in the capillaries and the tissues they feed is compromised in many diabetic patients because persistent high blood sugar causes vascular damage and nerve damage, and with the vascular damage comes decreased blood flow to the surrounding tissues. When blood flow is reduced, gas and fluid exchange is reduced, which allows toxins to build up in the tissues, causing further damage. MicroVas stimulates blood flow in these regions to remove toxins, speed healing, and restore balance and proper function.

MicroVas treatments are administered in our office, take roughly 45 minutes each and there are no complications. How many treatments are required will depend on the severity of your condition and will be determined by your podiatrist.

More information on diabetic neuropathy

More information on MicroVas treatment

Another NFL WR down: Redskins’ Pierre Garcon’s mysterious foot injury

18 Oct

Lately, we’ve been posting about quite a few NFL athletes (and more than a few wide receivers) benched with foot and ankle injuries: Hakeem Nicks of the Giants; Santonio Holmes of the Jets; Matt Forte of the Bears; Terrell Suggs of the Ravens. Now, another wide receiver is sidelined: Pierre Garcon of the Washington Redskins.

In the 2011 offseason, Garcon was signed to a 5 year contract for $42.5 million. Thus far, he’s only played in the season opener and a handful of plays since then, due to a mysterious injury of his right foot sustained in game 1 against New Orleans.

pierre garcon washington redskins

At first it was thought Garcon had a case of the dreaded turf toe, but when that was ruled out, an MRI was ordered. Monday, Redskins coach Mike Shanahan revealed that Garcon has an inflamed capsule underneath the joint of his second toe. “That toe is quite sore,”  Shanahan said. “You could see when he’s pushing off when he goes downfield he’s just not anywhere close to full speed.”

Garcon’s injury is called capsulitis. The capsule is the fluid filled outer covering that joins two bones to make a joint. There are five of these joints in each foot, joining the metatarsals to the toe bones (phalanges). The capsule under the second toe, where Garcon is reported to have his injury, is the most common capsule to become inflamed.

Those who suffer this kind of injury will generally report pain, swelling, redness, and a feeling like they’re walking on a stone. If left untreated, painful calluses may develop. Capsulitis can be difficult to diagnose because of other related structures in the forefoot that can also become inflamed from biomechanical problems. It is frequently misdiagnosed as bursitis.toe capsulitis location

Why do so many wide receivers suffer foot injuries?

1. Wide Receivers demand a lot of their feet

Anyone who’s watched an NFL game knows that a wide receiver frequently pivots sharply when he turns to catch the ball. He  sometimes precedes that action with a fake motion in the opposite direction to shake off the man covering him. This position also requires very significant, sudden bursts of power (jumping and sprinting). The lateral motion and quick power is extremely demanding on every part of the foot and ankle and one step in the wrong direction, or one bad landing after making the catch, and the foot, toe, or ankle twists sharply, causing a sprain, irritation, or fracture. And that doesn’t even include a teammate or opposing player accidentally landing on your foot. Often, the injuries are an accumulation of overuse, as in plantar fasciitis, or achilles tendonitis.

2. The playing surface: synthetic vs natural turf

An additional problem is the playing surface. Eleven NFL teams now use a synthetic turf called FieldTurf in their stadiums. While  it requires no irrigation or cutting, synthetic turf is responsible for more athletic injuries because it doesn’t have the same “spring” as grass. Grass and soil actually give a little bit underfoot, allowing a player’s foot to properly twist and turn, whereas synthetic turf does not.

In one of three NFL injury studies, researchers found that National Football League players were significantly more likely to injure their legs and feet on FieldTurf than on grass. According to Elliott Hershman, MD, of Lenox Hill Hospital in New York City, “NFL players were 27% more likely to sustain a lower extremity injury when the game was played on artificial FieldTurf instead of the real thing”.  More specifically, “there was an 88% increased risk of an injury to the anterior cruciate ligament (ACL) and a 32% increased risk of an eversion ankle sprain (when the ankle rolls too far inwards) when playing on FieldTurf”, Hershman reported at an American Academy of Orthopaedic Surgeons meeting.

University of Missouri turfgrass expert Brad Fresenburg has done comparative tests on natural turf and synthetic turf. Fresenburg says that these tests show “increased potential pressure on joints and bones from the inability of a fully planted cleat-wearing foot to divot or twist out, an action that releases force. The traction on synthetic turf is much greater”, he said. “Most people see [divots and ripped out grass] as damaged turf. I like to say those divots are a sign that the field is doing its job – yielding to the athletes’ cleats.”

Garcon described his ongoing foot injury as frustrating, and is determined not to let himself get discouraged by the healing process. He also understands that he risks another setback if he returns to action before he’s fully healed.  “It does suck not being able to play, but you can’t sit around and mope about it,” said Garcon. “I need my toes to be 100 percent… If it’s not 100 percent, I can’t really give it any power or force.”

With Garcon out, first-year pro Aldrick Robinson is expected to take his place. Robinson was a sixth-round draft pick out of Southern Methodist University in 2011 and played on the Redskins’ practice squad last season.

What is Turf Toe?

21 Sep

turf toe diagramTurf Toe is considered a relatively minor sports injury, but it can be quite painful. Known as a Metatarsophalangeal joint sprain in medical jargon, turf toe is basically an injury to the joint and connective tissue between the foot and the big toe.

Most commonly associated with football players who play on artificial turf, it also affects athletes in other sports including soccer, basketball, wrestling, and gymnastics.  Turf  toe is usually the result of jamming the big toe into the ground, bending it backward beyond its normal limits, or repeatedly and forcefully pushing off the big toe as one would do when running or jumping. Many NFL players routinely have their toes taped before games to prevent this injury.

According to Russell Warren, a professor of orthopedics and the team physician for the New York Giants,

“I see it in linemen—particularly the ones on the ends of the line. If that player gets overpowered and his knee is down on the turf and his foot is out behind him, and he falls back on his foot or somebody else falls on it, smashing the toe into the ground and hyperextending it.

“The wrenching motions cause inflammation—swelling and stiffness—of the joint where the toe attaches to the rest of the foot, leading to difficulty moving the toe. We’ll turf toe in football illustrationoften try to reduce the swelling and get movement in the joint back by icing the injury or treating it with ultrasound—which stimulates the tissue and causes increased blood flow to the area to speed healing. If motion around the joint is lost, turf toe can become a chronic problem, sidelining some players for up to a month.

“In extreme cases, players can tear ligaments at the joint between the toe and the foot, sprain the joint or injure cartilage underneath the toe, separating it from the bone—by cracking or splitting it. In rare cases, two little bones on the balls of your feet behind the big toe called sesamoids—which are like little knee caps—can stiffen and begin throbbing or, worst-case scenario, fracture.

“If a player gets turf toe—and we don’t make any protective changes—the chance of him sustaining stress fractures and breaks in his foot increases. To protect against re-aggravating the injury, we’ll get them firmer shoes or put a thin, steel plate in the bottom of the shoe to take some of the flexibility out of the tip of the shoe.

Turf Toe symptoms

You know you have turf toe when there’s pain, swelling, and limited joint movement at the base of one of your big toes. The symptoms usually develop slowly and get worse over time. But if it’s caused by a sudden forceful motion, sometimes a “pop” can be felt and the injury will be immediately painful, with symptoms worsening inside of 24 hours.

Turf Toe treatment

It typically takes two to three weeks for turf toe pain to subside. In order to give your toe time to heal, the foot must be rested and the joint protected from further injury. The basic treatment for turf toe is the simple and reliable R.I.C.E.: Rest,Ice, Compression, and Elevation.  Your podiatrist may recommend an over-the-counter anti-inflammatory/pain reliever such as ibuprofen (Advil) or naproxen sodium (Aleve), and may tape or strap the big toe to the toe aside it, or immobilize the foot in a cast or walking boot.  In severe cases, surgery may be necessary.  Physical therapy may be recommended after immobilization to re-establish range of motion, strength, and conditioning of the injured toe.

One goal of treatment should be to evaluate why the injury occurred and to take steps to keep it from re-occurring. Your podiatrist may recommend wearing shoes with better support to keep the toe joint protected from excessive bending and force, and may also recommend using custom designed orthotics. A physical therapist or a specialist in sports medicine can also work with you on developing training techniques to help reduce the chance of re-injury.

Unfortunately, turf toe often returns and can reduce the long-term function of the big toe joint. Arthritis of the big toe is quite common in those who suffer repeated turf injuries or trauma to the big toe joint.

The facts about Arthritis in the foot and ankle

12 Sep

Roughly 40 million people in the United States are suffering from arthritis symptoms at any given time. Most are over 50 years old, but arthritis can affect the joints in the foot or ankle at any age.

One-quarter of the bones in our body are in our feet and each foot has 33 joints. Any of these can be affected by arthritis.  Downward pressure from our body weight wears out the padding in our feet and wears out the cartilage in our joints until bone rubs on bone, inflaming the joints and causing pain. And it doesn’t help that we typically gain weight as we age.

One of the side effects of arthritis is the cascading effect. If you have pain in your ankle or foot, you change the way you walk. But when you change the way you use your feet, you also change the way you turn your ankles, knees, hips and spine. For instance, to reduce the pain in your foot, you might pronate (tilt your foot to the inside). This will cause cartilage in the ankle to degenerate, causing you to pronate more, further wearing out the cartilage. Weakness in the ankle will then cause stress on the knee joint, forcing the knee to turn in, resulting in a non-alignment of the knee, which can degenerate the outside of the knee joint. So when the foot isn’t aligned, it affects everything, and if you already have arthritis in these joints, it gets much worse.

To slow these additional issues, see a podiatrist at the earliest symptoms of arthritis, so they can establish a baseline and take pain management steps to avoid further damage to your body. The early signs of arthritis include pain or tenderness in the joint; stiffness or reduced motion; swelling; and difficulty walking due to joint pain.

The most common forms of arthritis in the foot and ankle are:

Post Traumatic Arthritis

ankle arthritisThis type of arthritis typically develops after an injury to the foot or ankle. Remember that day you fractured your foot when you were 25? You’ll feel that pain again when you’re about 50, especially if you fractured one of the joints. This type of arthritis is similar to osteoarthritis and may develop years after a fracture, sprain, or ligament injury. An injured joint is seven times as likely to develop arthritis, even if it’s properly treated.

Osteoarthritis (Degenerative arthritis)

osteoarthritis of foot

Joints are formed by two bones which are held close together by ligaments and an outer covering known as a joint capsule. In order for the joints to move freely and without pain, the ends of the bones are covered in a softer material called cartilage and the lining of the joint capsule produces a lubricating substance called synovial fluid.

In arthritis, the cartilage starts to crack and erode, resulting in bone rubbing on bone. The body responds by creating extra bone at the edges of the joint to try and stop movement and thus symptoms. This is why arthritic joints often become enlarged.

This degeneration of the joint results in inflammation, swelling, and pain. Osteoarthritis progresses slowly and the pain and stiffness it causes worsens over time. Because the ability of cartilage to heal itself decreases as we age, elderly people are most likely to suffer from osteoarthritis. Other contributing factors are obesity and a family history of the disease.

Rheumatoid Arthritis
rheumatoid arthritis feet

Severe rheumatoid arthritis

Rheumatoid arthritis is a systemic inflammatory disease where the patient’s own immune system attacks and destroys cartilage in many parts of the body. Unfortunately, the exact cause of rheumatoid arthritis is not known, but researchers believe that some people have genes that make them more susceptible. Women are three times as likely to suffer from RA than men are.

RA is much more erosive to the cartilage than Osteoarthritis, to the point that the bone is sometimes eroded completely, causing the joint to totally collapse. The disease typically begins with joints being swollen, warm, painful and stiff, particularly early in the morning on waking or following prolonged inactivity. Gentle movements may help to relieve symptoms. As the disease progresses the inflammatory activity leads to tendon tethering and erosion and destruction of the joint surface, which impairs range of movement and leads to deformity.

How your podiatrist relieves arthritis pain

Initial, non-surgical podiatric treatment may include

  • Pain relievers and anti-inflammatory medications to reduce swelling
  • Shoe inserts (orthotics), such as pads or arch supports
  • Custom-made shoe, such as a stiff-soled shoe with a rocker bottom
  • An ankle-foot orthosis
  • A brace or a cane
  • Forefoot supports such as gel toe caps, gel toe shields, and gel toe straighteners
  • Physical therapy and exercises
  • Weight control
  • Steroid medication injected into the joint
  • Footwear with a wider toe box

If pain persists, surgical management may be suggested.

More information on the symptoms and treatment of arthritis can be found at  the Mayo Clinic website and Arthritis.org.

Is the pain from high heels worth the fashion statement?

25 Jul

I was recently asked by a journalist to comment on how high heels wreak havoc with women’s feet. I know how you like a beautiful pair of pumps, but I have to be honest with you – feet damaged by those instruments of torture will keep me in business until I decide to retire.

How exactly do high heels damage your feet?
high heeled foot and leg xray

Note the unnatural angle of the foot, ankle and leg

When you wear high heels, your foot points downward, with the majority of stress placed on the forefoot (see the pic). The more you subject your feet to this position and stress, the more likely you’ll be to develop bunions, corns, calluses, pinched nerves (neuroma), hammertoes, and pain in the foot called metatarsalgia. Not only that, but the position of your feet in heels also affect your calf muscles, effectively shortening them. When these muscles are shortened, you have less power pushing off the ground when you walk. That’s why your legs get so tired in heels.

If that weren’t enough, the Achilles tendon also is shortened in this position, which can lead to a condition called Insertional Achilles Tendonitis, an irritation of the tendon where it inserts into the heel bone, causing heel pain.

But wait, there’s more…

With all of that pressure and squeezing at the front of the foot, you can also develop toenail issues, like ingrown toenails, nail infections and toenail fungal infections. Not to mention the occasional sprained ankle when that heel gets stuck in the pavement.

What can I do to relieve pain from high heels?

The first step in recognizing a problem is admitting there’s a problem. So first say out loud, “Pain from footwear is not normal”. Repeat 3 times to make it stick.

Here are a few ideas on how to relieve your high heel pain

lady gaga in heels

Lady Gaga will need an entire team of podiatrists when she hits middle age

  • Don’t be a slave to fashion – swap high heels for flats as often as possible
  • Avoid high heels with pointy toes – there’s no room for your feet in there
  • If you have wide feet, buy wide shoes
  • If you have pain in your feet when you wear high heels, try using a gel insole or metatarsal pad for extra comfort
  • Visit my office for an exam, where I’ll tell you to stop wearing high heels

High heels can also cause pain in your ankles and back, including pinched nerves. So if you have pain anywhere that you believe might be related to your high heel habit, switch to flats right away and whenever possible, wear athletic shoes to give your feet additional support and comfort.

Then visit Allentown’s top podiatrists for a thorough examination to make sure you don’t have long lasting problems with your feet.

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