Tag Archives: high heels

Pain in the ball of your foot could be Morton’s Neuroma

30 Jul

Does it feel like you have a pebble in your shoe between your 3rd and 4th toes?

Perhaps you have occasional shooting or burning pain in the bottom of your foot?

Do your 3rd or 4th toes occasionally sting or feel numb?

Any of these could be symptoms of Morton’s Neuroma, a painful thickening of the tissue around the nerves that lead to your toes.

mortons neuroma

Morton’s Neuroma is also known as Morton’s metatarsalgia, Morton’s neuralgia, plantar neuroma, or intermetatarsal neuroma. It typically has no outward signs, such as an obvious lump – only discomfort and pain on the bottom forefront of your foot or toes. Technically, a neuroma is a benign tumor of a nerve. Fortunately, a Morton’s neuroma isn’t a true tumor, but simply a thickening of fibrous tissue. If left untreated however, the neuroma can lead to permanent nerve damage.

How Morton’s Neuroma forms

Abnormalities in the anatomy of the foot, aggravated by injury, irritation, or wearing pointy shoes or high heels, compress and irritate the nerve that passes under the ligament connecting the toe bones in the forefoot. In response, the nerve enlarges and develops a nasty lump. It most commonly develops between the 3rd and 4th toes, and appears in women 10 times more often than in men. Those people who have bunions, flat feet, hammer toes, or unusually high arches, are prime candidates for developing Morton’s Neuroma. So are those athletes who perform on courts or hard surfaces – runners will notably feel the pain when they push off from the starting line.

Symptoms of Morton’s Neuroma

  • Feeling of having a pebble in your shoe
  • Burning or stinging pain and numbness in the area between the 3rd and 4th toes
  • Pain intensifies with activity and subsides with rest
  • Symptoms rarely appear at night

Causes of Morton’s Neuroma

Abnormality in foot biomechanics, aggravated by:

  • High heels, shoes that are too tight, or shoes that don’t fit correctly. This footwear can put pressure on the toes and ball of you foot, aggravating the nerve.
  • Sports that put unusual stress on your toes, like rock climbing, or snow skiing, or high impact aerobic sports like running or basketball.

Treatment of Morton’s Neuroma

  • Change your footwear. Swap high heels for flats, and wear shoes with a square toe box which will not constrict the movement of your toes. This lets the bones spread out, taking pressure off the nerve, and allowing it to heal.
  • Custom orthotics or pads may be worn inside your shoes. A podiatrist at PA Foot and Ankle Associates will customize an orthotic for you which will take pressure off of the sensitive area. This speeds healing by lifting and separating the toes, taking pressure off the nerve.
  • Steroidal injections can be used to reduce pain and inflammation in the affected area.
  • Over the counter anti inflammatory medicine like advil or aleve can be used to control pain, along with ice and rest.
  • If these treatments fail to relieve your symptoms, surgery may be recommended.

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.

What’s that bump on the back of my heel?

14 May

If you’ve noticed a lump right above your heel that’s red and sore and gets worse when you walk or run in shoes, you might have Haglund’s Deformity, also known as “pump bump”.

haglunds_deformity_pumpbumpIt’s remarkable how the combination of heredity and footwear can cause so many foot problems.

In a normal foot, the Achilles tendon attaches to the back of the heelbone (calcaneus). Between the heelbone and the tendon is a bursa, a sac of tissue that allows the tendon to easily slide against the bone when your foot moves. If you’ve inherited Haglund’s Deformity, your calcaneus is shaped differently – you have a prominent bump underneath the attachment of the Achilles tendon. If you went barefoot all the time, you wouldn’t even notice it. But when you wear shoes with hard backs which rub at that exact spot (like high heels and dress shoes), the prominent bump squeezes the soft tissues between the bone and the back of the shoe. Eventually the bursa becomes inflamed (bursitis), causing swelling and thickening of the tissues. This makes the problem worse, creating significant heel pain.

“Pump bump” is most common in young women who wear pumps. But unusually high arches can also be the cause of the problem, as the heel bone is tilted backwards into the Achilles tendon. This causes the uppermost portion of the back of the heel bone to rub against the tendon, creating constant irritation. As a result, a bony protrusion develops and the bursa becomes inflamed. A tight Achilles tendon can also be responsible for this condition, as can a tendency to walk on the outside of the heel.

The good news is that “pump bump” can almost always be relieved without surgery.

Treatment of “Pump bump”

  • Change your footwear to shoes without hard backs or high heels
  • Over the counter anti inflammatory medication like advil (Ibuprofen) or aleve (naproxen)  to relieve pain and inflammation
  • Ice the sore area to reduce inflammation
  • Stretching exercises to relieve tension from the Achilles tendon
  • Orthotic devices and shoe modifications
  • Heel pads to protect the sore area
  • Foot may need to be immobilized

How to prevent “pump bump”

  • Wear appropriate shoes and avoid high heels and pumps
  • Wear arch supports or custom orthotic devices prescribed by your podiatrist
  • Avoid running on hard surfaces
  • If symptoms are present, avoid running uphill and consult a podiatrist

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.

My second toe looks like a claw-do I have a Hammer toe?

21 Jun

At any age, including adolescence, your toes can develop a deformity called hammertoes (hammer toes), which many patients refer to as looking like a claw. That’s because the middle joint of the second, third, or fourth toes bends in an upward position, creating the claw-like or hammer look. Mallet toe is a similar condition, but affects the upper joint of a toe.

hammertoe illustration

Hammer toes and Mallet toes are usually not a serious condition, but can become painful as the bent joint rubs against the inside of the shoe, causing irritation, corns or calluses. Hammer toes may also cause occasional shooting pains throughout the toes or elsewhere in the foot.

Just like bunionsHammer toes are usually the result of wearing too-tight footwear. They can also be caused by a muscle imbalance of the foot, even in children. Foot muscles work in pairs to straighten and bend the toes. If your toes are jammed inside footwear that’s too tight, or if the foot has a biomechanical defect, the muscles tighten and cannot stretch out.

How your shoes cause hammer toes
tara reids hammertoes

These are the feet of TV and film star Tara Reid. Notice the hammer toes. Perhaps she should give up the footwear that’s causing the problem.

Shoes that narrow toward the toe create the illusion that your foot is smaller, but the narrow toe box forces the smaller toes into a bent upward position. This makes the toes rub against the inside of the shoe, creating corns and calluses, aggravating the toes further. Additionally, a high heel forces the foot forward and down, squeezing the toes against the front of the shoe, which increases the pressure and the bend in the toe. Eventually, the toe muscles become unable to straighten the toe, even when barefoot.

Treatment for Hammer toes

The first step in hammer toe treatment is to wear shoes that fit correctly and don’t cramp your toes. Shoes should have a nice, wide toe box that leaves room for your toes to move-if you can’t wiggle your toes in them, don’t wear them. I would also recommend a period of physical therapy with stretching exercises to make the toe muscles more flexible. Over the counter toe straps, cushions or corn pads are available which may also provide relief. If these treatments don’t produce results, custom orthotic inserts can be created. If that still doesn’t provide enough relief, there are surgical procedures which can release the muscles in the affected toes.

If you discover changes in your foot that don’t appear normal, call PA Foot and Ankle Associates for a thorough diagnostic exam. We’ll create a custom treatment plan for you and closely monitor your progress until your condition is relieved.

How do I know if I have a bunion?

24 May
Bunion is one of the most common conditions treated by a Podiatrist. They are most frequently seen in women and can be caused by wearing narrow-toed, high heeled footwear, but are frequently an inherited trait.

In fact, podiatrists sometimes treat bunions in multiple generations of the same family.

What is a bunion?

A bunion is an abnormal, bony bump that forms on the joint at the base of your big toe. It’s caused when your big toe pushes up against your other toes, forcing the big toe joint in the opposite direction, away from the normal profile of your foot. Over time, the stress enlarges your big toe joint, pushing the big toe even further against your smaller toes and causing pain. Bunions frequently form in early adulthood and worsen with age, especially if accompanied by arthritis.

Who is most likely to develop a bunion?

You’re a good candidate for bunions if:

  • Either of your parents had bunions
  • You’re a woman (women have a 50% chance of getting bunions)
  • You’re a woman who is or was a dancer
  • You suffered a foot injury at any point in your life
  • You wear tight, narrow, high heeled hoes
  • You have arthritis in your feet
How do I know if I have a bunion?

Look at your feet. On a normal foot, the big toe should point straight ahead and you should be able to draw a relatively straight line from your heel to your big toe.

If you see a bump – an outgrowth – on the side of your foot just below the joint of the big toe, you most likely have a bunion forming. It’s probably pretty small if you just discovered it, but eventually this bump may enlarge, forcing the big toe towards the smaller toes. If so, you’ll begin to experience pain in your foot and the skin over the bump will become swollen or irritated from the pressure of your shoes. You may even see noticeable marks on the side of your shoes as the bunion wears through.

Another type of bunion is called a Tailor’s Bunion, also known as a Bunionette. This is a smaller bump that forms on the outside of the foot towards the joint at the little toe. A Tailor’s Bunion is created when the little toe moves inwards towards the big toe and is usually caused by footwear that is too tight.

How do I relieve bunion pain?

Bunion pain can be relieved by wearing wide shoes to reduce the force on your toes. You can also add padding on the inside of the shoe over the bunion area. At drug stores, you can find toe spacers that will separate the big toe from the second toe to keep them from rubbing. If the pain continues, or if the bunion becomes worse, surgery will be needed to straighten the toe and remove the bunion. This surgical procedure is called a bunionectomy.

When should I call a podiatrist about my bunion?

A surgeon performs a bunionectomyWhen you first notice a bunion, you should contact your podiatrist for an evaluation. He or she will make an initial diagnosis, monitor your condition and make recommendations for treatment. Initial treatments may include custom orthotics (inserts in your shoe which are custom formed to your foot), bunion splints, bunion regulators, bunion cushions, ice, and rest.

If your pain persists or the bunion enlarges, a bunionectomy may be required.

How do I reduce my chances of getting a bunion?
  • Don’t force your feet into shoes that don’t fit
  • Choose shoes that comfortably conform to the shape of your foot
  • Choose shoes with wide insteps, broad toes and soft soles
  • Do not wear shoes that are too tight or sharply pointed
  • Do not wear shoes that have a heel higher than two inches
  • See your podiatrist on a regular basis

If you suspect you have a bunion or are experiencing any kind of foot pain, make an appointment today with PA Foot And Ankle Associates for a thorough diagnosis.

Morton’s Neuroma

2 Feb

Acrylic platform shoes.

Have you found yourself sitting down to take off your shoes looking for a rock in your shoe only to find nothing there? Or what about the times when you are wearing one of your favorite pair of high heels and suddenly feel a burning shooting pain in the ball of your foot and your toes begin to sting. I imagine that you kick off your shoes as quick as you can hoping to find some relief. If you said yes or nodded your head to any of these symptoms you may be dealing with a Morton’s Neuroma.

Morton’s neuroma is found around the ball of the foot, most commonly around the third and fourth toes. Some describe it as a burning, tingling, stinging, a rock or a bunched-up sock in their shoe. A Morton’s neuroma is described as a thickening of the layers of tissue that surround the nerves that run to your toes. The exact cause of the thickening is not known, but most often is seen due to irritation. Some common causes of irritation can be from a tight-fitting shoe, high heels, or repeated movements in the foot like running. These elements may initially cause damage to the nerve and the constant use of your feet continue to irritate the area and the nerve. Most often when you look and rub your foot you may not see or feel anything strange, but you definitely feel the pain.

Some things relieve the pain, such as removing the tight shoe, icing, or rubbing the foot. However, there is usually no better treatment than seeing a Podiatrist about the problem. You may say that you can deal with the pain and wait for it to go away, however the pain from a Morton’s neuroma usually gets worse with time.

Your Podiatrist may recommend a couple of different treatments for a Morton’s neuroma such us: special shoe inserts (orthotics), wearing wider shoes, padding to the area, medications to block the nerve pain, injections to calm the inflammation and of course the last resort would be surgery.

Call us today to make an appointment to take your pain away. With our help we can get you back on your feet, back to your favorite activities, and back to enjoying life.

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Protect Your Ankles While You Run

18 Oct Yi Jianlian of Nets sprained ankle
Most adults have had an ankle sprain at some point in their lives. You landed wrong trying to dunk, or while running, your foot came down right in the middle of that hole you never saw. Your ankle bent over and the pain made you see stars. Forget about putting any weight on it, as you’ll feel the sting of pain immediately.
Yi Jianlian of Nets sprained ankle

Yi Jianlian of the Nets sat out four games due to a sprained ankle

What exactly is a sprain?

A sprained ankle occurs when your foot lands improperly, your weight placed on the outside edge of your foot, shifting it sideways, which causes your ankle to bend or roll beyond its capacity to do so. This stretches and/or tears the ligaments in your ankle. Usually, your ankle and the surrounding tissue in your foot will begin to swell immediately.

It’s essential for your ankle’s healing that you do not try to “fight through the pain” and continue your activity on the sprained ankle. Doing so may injure it very seriously, requiring corrective surgery. Immediately rest, ice and elevate your ankle and make an appointment to see your podiatrist to check for any torn ligaments.

But sprains don’t strictly occur during athletic events, because wearing very tall high heels can be hazardous also. If you get the heel caught in the crack of a sidewalk  or some other obstacle, your heel may slip sideways and all of your weight will land on the side of your foot, resulting in a sprained ankle for fashion.

To learn more about ankle sprains see the ankle sprains or sports injuries pages at the East Penn Foot and Ankle Associates website. If you have suffered an ankle sprain, contact East Penn Foot and Ankle Associates for an immediate appointment and examination so you can quickly get back on top of your game. Our phone number is 610-432-9593.

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