Tag Archives: foot care

5 Exercises to Relieve Hammer Toes

2 Oct

Hammer toes occur when the middle joint of the second, third, or fourth toes bends in an upward position, creating a claw-like or hammer look. Hammer toes are not a serious condition, but they can become quite painful, causing shooting pains and discomfort throughout your toes and feet, and soreness where the toe rubs the inside of the shoe. They can develop at any age, even adolescence.

hammer toes hammertoes
There are a number of treatment options for hammer toes, including surgery, but you can also do these 5 exercises at home to reduce your discomfort (but they won’t cure the hammer toe). The reason that normal toes become hammer toes is due to muscles and tendons tightening and pulling the toe into an upward position. Relieving this tension via stretching exercises which pull the muscles in the opposite direction, can work wonders for alleviating pain.

1. Toe Stretch

Sitting on the floor with your legs straight head of you, wrap a bath towel under your toes, and pull towards you so just the toes move. Hold for 30 seconds. This may also be done with your hands.

2. Toe Taps

Sit on a chair and remove your sock. Extend your big toe down toward the floor while at the same time extending the rest of your toes up in the air. Hold for 10 seconds and then lightly tap the floor with your toes 12 times. Then reverse your toe position so the big toe is pointed up and the remaining toes pointing down. Repeat.

 3. Toe Crunches

Sit on a chair barefoot. Place a bath towel on the floor and place the upper half of your foot on top of the towel. While keeping your heel flat on the ground, crunch the towel up with your toes. Release and repeat 12 times.

4. Toe Squeeze

Sitting in a chair, place your foot over your thigh. Slide your fingers in between your toes and squeeze your toes together, as if to pinch your fingers. Release and repeat 12 times.

5. Toe Rolls

Toe Rolls are not pastries – they’re an exercise similar to when you tap your fingers from side to side on a table. Stand barefoot on a flat surface. Lift all of your toes upwards off the ground together, then roll them down one at a time from the little toe to the big toe. Repeat 12 times, then change directions.

Read more about hammer toes and their treatment.

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Getting a Pedicure? Watch out for foot and toenail infections

24 Jul

Sure, you want your toenails to look pretty, especially during sandal season. But any podiatrist will tell you that they see patients nearly every week with foot and toenail infections acquired at a nail salon – viral infections, warts, and athlete’s foot being the main players. Before your next pedicure, you can take a few precautions which will protect you from picking up any hitchhiking bacteria, virus, or fungus that may turn into a serious foot or toenail infection.

PEDICURE HOW TO AVOID INFECTIONS

Don’t mess with the cuticles

Even the most experienced pedicurist will occasionally cut into the cuticles, and that’s a mistake. The cuticle helps anchor the nail to the skin, and should never be pushed back or cut during a pedicure, as that’s when bacteria may enter.

You want your toenails cut into what shape?

If toenails are cut a little too aggressively on the sides, it can lead to ingrown toenails, which as anyone who’s ever had one knows, are absolutely miserable and will certainly not match your other toenails. Pedicurists should cut the nails straight or at a slight curve, along the contour of the toenail, and not down into the corners.

Clean tools, clean surfaces

There’s a chance of acquiring fungus at a salon, too, if the owners aren’t fastidious about disinfecting surfaces and tools. Pumice and emery boards shouldn’t be used more than once, and tools should always be sterilized in between clients, preferably in an autoclave, which uses high pressure steam to kill bacteria and fungus. Non-metal tools cannot be sterilized, so if they aren’t thrown away after one use, every client that follows is at risk.

At the very least, make sure you can see the pedicure tools soaking in that blue liquid called Barbicide, which barbers have used since… well, since at least your grandfather’s first haircut. There’s a required minimum of at least a 10 minute soak in a bacteriacide, according to Environmental Protection Agency guidelines. And UV lights? Not to be trusted for sanitizing. Some salons allow you to bring your own pedicure tools, which is your best protection.

No bubbles, please

Glass bowls for soaking your feet are preferred over fiberglass or plastic – any porous material allows bacteria to hide out. Whirlpool foot baths should be verboten, as the piping feeding the baths can harbor all kinds of bacteria and fungus, which love the warm, but not too-warm temperatures.

Shaved legs and pedicures demand distance

Wait on getting a pedicure for 2 days after you shave your legs. A razor creates microtears in the skin, which bacteria can easily enter, directly introducing them into the legs. This can lead to an infection called cellulitis, which is very serious and may require hospitalization.

And some should never show up for a pedicure

If you’re diabetic, you should think twice about getting a pedicure. One of the unfortunate side effects of diabetes is that sores don’t heal quickly, especially in the feet. Persistently open wounds, even nicks, invite all kinds of bacteria to take up residence, which can lead to a nasty infection in a diabetic foot.

Other people at high risk include those with HIV, those going through chemotherapy, and those who have circulatory disorders or vascular disease. And if you already have an ingrown toenail, avoid pedicures entirely and see your podiatrist for treatment.

We can send toenail fungus on its way with only a few treatments.

If there was a report card for foot care, you’d get an F

11 Jun

Unfortunately, when it comes to foot care, most of you are failing miserably. Well maybe not YOU, because you’re reading this, but everyone else is failing…

foot pain foot health

The American Podiatric Medical Association has released a very illuminating survey on American’s attitudes and experiences concerning their foot health. The results are very surprising to us in some ways, and completely predictable in others, based on the patients we see. Unfortunately, your feet continue to rank low on the list of body parts you consider important to your well-being, and you’re paying less attention to them than you should.

The survey, released in March, shows that 8 out of 10 of you have experienced foot pain at some time in your life. Those of you who’ve experienced foot pain on a regular basis, also report regular issues with other health complications, primarily back pain, eyesight issues (probably diabetes-related), arthritis or other joint pain, weight issues, knee pain, and heart and circulatory disorders.

Half of you said that foot pain has restricted your activities in some way: walking, standing for long periods, exercising, sleeping, going to work, or playing with your children or grandchildren.

You said that you understand how important foot health is, and that consistent or chronic foot pain can indicate other health problems.  You also said that you understand what a complex mechanism the foot is and that a podiatrist is best qualified to treat your foot pain.

However….

You also reported that you have little knowledge of or experience with podiatrists. When a foot problem arises, you’re more likely to visit your primary care physician for help, or try and treat it on your own. But those of you who have visited a podiatrist give them high marks for care and are more satisfied with the outcome than those of you who were treated by your primary care physician.

This last fact highlights a common misperception about the healthcare system – that your primary care physician is some kind of wizard who knows how to treat every conceivable ailment. While we respect our fellow physicians, every MD’s training is different. Primary care physicians are a sort of first line of defense and are trained to identify and treat the most common illnesses and complaints in the population. They’re also trained to flag unusual symptoms and to refer out injuries and disorders which are best treated by a specialist. Yet 60% of you say that you would talk to your PCP about a foot condition before seeking advice from a podiatrist (we understand however, that some insurance plans require this). Hello? Podiatrists know more about foot and ankle injuries and disorders than any other physician. When given the choice, always opt for a specialist.

Shame on you: Only 32% of you report doing foot, ankle, or leg exercises to keep them strong, and only 43% wear proper, supportive footwear (that explains all of the comments/questions on our blog post about why your feet hurt). Speaking of footwear, 71% of women who wear high heels experience foot pain which they directly attribute to wearing high heels. Yet they own NINE PAIR (!).

Unfortunatley, nearly 50% of you experiencing foot pain wait until it’s severe to see a podiatrist. Most of you don’t even consider a visit to a podiatrist for conditions like persistently sweaty or odorous feet, blisters, pain from high heels, hammertoes, problems with your toenails, or even diabetic wound care. Yet each of these conditions can indicate a more serious potential problem or set of problems. Treated early and properly by a podiatrist, your pain and discomfort can be relieved without further complications. In fact, 34% of you said that a podiatrist helped you identify other health issues such as diabetes, circulatory issues, or nerve damage.

But what is up with the fact that only 74% of you report keeping your toenails trimmed?  OMG! What are the other 26% of you doing? Do you have man servants to trim your toenails for you? Or extra long shoes to accommodate your lavishly long toenails?

Click here to read the entire APMA survey.

Flip-Flops Far From Foot Friendly

26 Jul

flip flops feetFlip-flops are omnipresent every summer, but with no arch or heel support, are these foot-shaped pieces of rubber bad for your feet?

When one walks barefoot, the natural biomechanics of the foot are in play. But as soon as we slide into that piece of recycled tire known as a flip-flop, everything changes. We alter our gait because we have to use our toes to grab the flip-flop to keep it from sliding off. We also take shorter strides and turn our ankles inward, which can cause long term ankle and hip problems.

In 2008, researchers at Auburn University actually videotaped students walking in flip-flops and found that because they had to scrunch their toes to hold the flip-flop on when they walked, quite a bit of stress was placed on the plantar fascia (the band of tissue which runs from your heel to the arch). This constant stretching can lead to inflammation and pain along the arch and sole, heel spurs, and tired feet, exactly what the flip-flop wearing Auburn students complained of when they returned to classes in the fall.

The problem is, the flimsy rubber doesn’t flex where our foot flexes, as it’s always in the process of falling off. And those straps at the front can cause serious blisters, too. Because flip-flops offer no real protection to the bottom of the foot, stepping on nails, rocks, and other sharp or irregular objects can easily cause injury.

Those with diabetes who are experiencing poor circulation or a loss of sensation in their feet should never wear flip-flops, as diabetic feet can easily become irritated or develop small wounds, which may become infected, leading to a host of other problems. Those who are obese should also stay away from flip-flops, as added strain will be put on the feet, which may already be affected from the extra pounds.

But we acknowledge that not all flip-flops are created equally. Those at the discount store for a few bucks are definitely out. But those closer to sandals can definitely be a worthwhile buy, because the thicker, contoured soles actually support your arch and heel and offer protection to the bottom of your feet.

The best use for flip-flops? In the gym or pool locker room to avoid getting athlete’s foot. This is the one area that flip-flops win over going barefoot.

Why Your Shoes Are Killing Your Feet

25 Jul

If Doctor Evil was a podiatrist, Mini-Me would be a women’s shoe designer.

high heels

Probably not the best choice for the activity

At times, women’s shoes qualify as instruments of torture.  Most certainly for your back, legs, ankles and feet. Wedges, stilettos, pencil heels, high heels, spike heels, all fall into the category that podiatrists refer to as “cruel shoes”.

Any shoe that lifts your heel off the ground shifts your weight onto your midfoot (ball) or forefoot (toe area). The higher the heel, the more forward the shift, and why the girl who dances all night in high heels has her shoes off before she even gets in the car. You may only weigh 100 pounds, but shifting that weight to a place not meant to carry it can cause significant long-term problems. Even if you failed algebra, that math is easy.

Most common injury caused by high heels over 3 inches: fractures and torn ligaments caused by inverting the ankle (twisting inward).

Besides shifting your center of gravity forward, high heels and wedges provide next to no support for your heel. That spike at the back of the shoe is at times only there to remind you how much you paid for them, how good they make you look and how you’re going to get your money’s worth even if it kills you (or your feet). Since your foot is only secured with a tiny strap, one misstep on a slippery dance floor or wet or cracked sidewalk may cause your heel to slide and your ankle to roll. Next stop – one month in a boot to immobilize your foot while your ankle fracture heals.

But let’s not stop with the shifting of the weight, because these styles offer additional torture. Many feature a pointy toe box, which squeezes the front of your foot so tightly that your toes cry for mercy. The result is bunions, arthritis, and any number of toe problems.

Wearing heels causes your foot to slide forward, redistributing your weight, creating unnatural pressure points and throwing your body’s natural alignment out of whack. High heels have been linked to overworked or injured leg muscles, osteoarthritis of the knee and low back pain. You also risk ankle injuries if you lose your balance and fall off your high heels. – Mayo Clinic.

Women account for ninety percent of the surgeries performed for the most common foot ailments, which is a pretty illuminating statistic. While there’s some debate in podiatry circles about whether footwear or genetics are the actually cause of foot problems like bunions, “pump bumps”, hammertoes, and tight heel cords, there’s no doubt that the high heeled shoe at the very least exacerbates the problem.

Most common injury caused by a platform wedge: Ballet Break. That’s when you fall off the wedge onto the side of your foot, causing a stress fracture.

So what’s a modern woman to do? Nikes and New Balances don’t often match business attire, much less elegant affairs. We recommend that you minimize the amount of time you spend in high heels, wedges, and the like, and don’t buy any heels taller than two inches. The right shoe to wear is the one that causes no pain or discomfort and fits and supports your foot like a glove.

But don’t switch out the high heels for ballet flats or flip-flops, because they can make the situation worse. The lack of support in these “shoes” can worsen conditions like plantar fasciitis. Treat your feet well when you’re young and they’ll treat you well when you’re aging.

Are Your Feet Ready For Summer?

14 Jun

Summer.

The word alone inspires images of swimming, vacations in warm, exotic places, feeling the soft grass underfoot, sticking your feet in a cool stream on a hot day, going barefoot.

How do you feel about that last phrase, going barefoot? Do you have visions of friends and family – even strangers – reacting in all kinds of embarrassing ways when you take your shoes off?

perfect feet

She either has a parent who’s a podiatrist, has never been pregnant, or weighs little more than a feather.

No one’s feet are perfect – that is, no one who’s been pregnant, has walked, run, played, gained weight, lost weight, worn shoes that looked fabulous but didn’t really fit, or in short, lived a life over 30 years. After all, those puppies at the bottom of your legs have carried you through it all, even though you’ve paid little attention to their needs. Heck, you’ve downright abused them at times (can you believe some of those shoes you used to wear?)

Most of us neglect our feet, it’s true. What’s more, we frequently inherit abnormal bone structure, faulty tendons and muscles, or less-than-perfect biomechanics from our parents. Throw all of this together and we frequently end up with bunions, a tendency toward  fungal infections like athlete’s foot or toenail fungus, overlapping toes, crossover toes, corns and calluses, ingrown toenails, premature arthritis, you name it. End result is that we keep our feet covered in public when we desperately want to wear sandals, flip-flops, or roam the world – or even our patio deck – in bare feet.

A regular visit to a podiatrist can solve a lot of your foot hangups. Trained intensively and exclusively in the medical treatment of foot and ankle conditions, a podiatrist can resolve pain, discomfort, and aesthetic issues for most patients without surgery. The first part of a treatment program may include suggestions for changes in footwear, custom designed orthotics, exercises specifically geared to your foot problem, and weight management if necessary. These seemingly small changes can make a big difference to your feet.

So go on – take your shoes off, let your toes hang out, and show the world how beautiful your feet are.

The Truth About Plantar Warts

7 Feb

It’s not a pretty subject, but we need to talk about plantar warts, painful growths which appear on the soles of your feet (the plantar surface). There’s a lot of old wives tales about plantar warts, so first let’s clear up exactly what causes them.

plantars-wartPlantar Warts are noncancerous skin growths caused by the Human papillomavirus, HPV, which produces infections in skin or mucous membranes. While the majority of HPV’s (there are more than 120 identified)  cause no symptoms in most people, some cause warts while other strains cause much more serious health problems. But that doesn’t mean if you get plantar warts you’ll necessarily develop any other conditions.

The HPV that causes plantar warts enters your body through tiny cuts, breaks or other vulnerable sites on the skin of your feet. The warts often develop beneath pressure points, such as the heels or balls of your feet.

“Plantar warts are almost unknown in habitually barefoot cultures and people. This is because walking barefoot for extended periods of time strengthens the skin and keeps it dry… While infection occurs in an estimated 7–10% of the U.S. population, plantar warts tend to affect only 0.29% of people who have never worn shoes” – Wikipedia entry on Plantar Wart

What do plantar warts look like?

A plantar wart is a fleshy, grainy lesion which may grow as large as one inch in circumference, sometimes described as resembling a cauliflower with tiny black spots. Pinpoint bleeding may occur when these lesions are scratched, and they may be painful when standing or walking. Plantar warts may also appear as a callus-like growth over a well defined “spot” on the skin when the wart is growing inward. This usually occurs on the parts of your foot under pressure from standing or walking, preventing the wart from rising above the skin surface. Multiple warts may also grow as a cluster, referred to as a “mosaic wart”.

Plantar warts may create the feeling of having a stone in your shoe and be tender or painful when walking or standing. More typically, pain is felt when pressure is applied from either side of the lesion, instead of the center. In severe cases, plantar warts can cause a change in gait or posture that results in leg or back pain.

How to prevent plantar warts

It may be counter intuitive, but the best way to avoid plantar warts is to go barefoot as much as possible at the appropriate times. Walking barefoot helps to build thick, protective skin on your soles and exposes them to friction when walking or running, which wears off or kills the virus.

The HPV strain that causes plantar warts thrives in the warm, moist environment offered by socks and shoes and the walking areas in public showers, saunas, or changing rooms (such as at the gym or public swimming areas). Wearing flip flops or sandals in these public environments is highly recommended. Also, let your feet dry completely before putting your shoes and socks on, and never share towels, socks or footwear.  Each person’s immune system responds differently to HPV, so not everyone who comes in contact with the virus will develop plantar warts. Even people in the same family react to the virus differently.

Most plantar warts aren’t a serious health concern and may only last a month or two. In this case, they don’t require treatment. However, if plantar warts become painful, you should seek the expertise of a podiatrist for a treatment plan.

Edema: How to avoid swollen feet and ankles

1 Feb

edema swollen feet and anklesAny woman who’s been pregnant knows all about swollen feet and ankles, a condition referred to as edema. But there are many other causes for this swelling too, like long airplane rides, side effects of medication, infections, high blood pressure, kidney disease, liver disease, heart disease, obesity, diabetes, and other health conditions.

Edema is the swelling of body tissues caused by fluid retention. In some cases, this can be a good thing, serving as a defense for your body, as when delivering healing properties to a bee sting. Edema also occurs when you sprain your ankle.

But chronic edema can be at the least uncomfortable and at the worst a sign that you have a more significant health problem.

What causes edema?

Capillaries are the very tiny blood vessels that feed your tissues. Their walls are porous and exchange fluids with the body’s cells at all times – fluids leave your capillaries and an equal amount is reabsorbed. The normal exchange is kept in balance by a number of factors, including the lymphatic vessels. But conditions can arise that cause more fluid to leave the capillaries than can be reabsorbed. The tissues swell up with the extra fluids, which is called edema.

Adding to the problem with the faulty capillary exchange are the kidneys. When fluids can’t escape the cells, the kidneys hold back more sodium and water than usual to compensate for the fluid lost from the capillaries. This forces the rest of your body to increase fluid circulation, which also accumulates in the capillaries. The vessels continue to  release more fluid than they can reabsorb, perpetuatuating the cycle. This is why edema not caused by trauma can last indefinitely.

How can I avoid edema?

One of the most common causes of this imbalance is gravity, or downward pressure. Even though you may be perfectly healthy, if you stand on your feet all day they might become swollen. Elevate your feet above your heart to reduce the effect of gravity, and the fluids are reabsorbed by the capillaries. Similarly, when obese, the downward weight placed on your feet and ankles doesn’t allow this exchange to function properly, and the feet, ankles, and lower legs swell.

Edema is closely related to the health of the circulatory system, and that’s why diabetics so often have swollen feet and ankles, a sign of vascular damage like that caused by peripheral arterial disease or neuropathies. To avoid the conditions that lead to edema,

  • Maintain a proper body weight. Obesity can be a significant cause of chronic edema
  • Exercise regularly, as activity helps the body get rid of excess fluids
  • Elevate your feet above your heart  – this drains fluid buildup from tissues
  • Wear comfortable shoes that aren’t too tight – they may restrict circulation
  • Use your calf muscles to move your feet.   While sitting or laying down, point your toes out, as if you were standing on your tip-toes. Hold. Then point your toes toward the ceiling. Hold. This squeezing of your calf muscles changes the pressure on the capillaries, allowing fluids to be reabsorbed.

Diet can play a big part in avoiding edema

  • Drink plenty of water every day to increase urinary output, preventing fluids from accumulating in your feet and ankles
  • Eat plenty of fresh fruits and vegetables – not frozen, canned, or processed in any way. Fresh produce has a diuretic effect on your body, moving fluids and sodium through tissues, assisting the capillary exchange. The best produce to stimulate fluids are asparagus, celery, garlic, ginger, grapes, green beans, green tea, melons, parsley, tomatoes, pineapple, and leafy greens
  • Ditch the white bread and white rice and choose whole grains like oats, brown rice, and 100% whole grain pastas and breads. Whole grains contain far fewer additives than processed white flour and white rice products
  • Avoid salty foods (sodium), as they help you retain water
  • Avoid processed foods like those that come in a can or box, as most are loaded with sodium

An occasional episode of edema is within the range of normal, especially if you’re otherwise healthy. But if the edema is frequent, contact your doctor, as it could indicate a much more serious health problem.

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