Keep Your Feet Feeling Young

Even here in Houston, TX, where winter means we put on a light jacket, many are glued to the TV watching the Winter Olympics in Vancouver. The athlete’s focus and dedication is inspiring and we’re disappointed to see it come to an end after eighteen days of competition. I’ve overheard kids ask their parents for a snowboard, even though there is no place to use it in Houston. This is what the Olympic games are all about.

On February 12th, 2010, at the Opening Ceremony, a moment of silence was observed in honor of Nodar Kumaritashvili, a Georgian luge slider who died in a training run on the Vancouver luge track. The moment was a chilling reminder to all the athletes from around the world that were there that night that many of the winter games aren’t without risk.

The Winter Olympics separate themselves from the Summer Olympics by the high level of risk involved with many of these sports. Running, swimming, and track and field do not even compare to luge, ski jumping, alpine downhill skiing, and half pipe snowboarding in respects to real danger to the athlete. Many people watch the winter games and feel a rush of sheer thrill because the athletes are doing things that seem crazy to some and near impossible to others.

Nodar Kumaritashvili participated in a sport that few have the opportunity to ever try, luge. Luge is a sport in which a person lays on their backs on a luge, which is an aerodynamic sled, and speed down a half enclosed ice tube at speeds in excess of 90 miles per hour. If an athlete makes any mistakes the end result is almost always life threatening, as what was the unfortunate fate of Nodar. The luge track is also used for bobsledding and skeleton and can be just as dangerous for these sports as well.

Although many winter games are noted for their extreme speeds and heights, this does not mean that caution should be avoided in order to increase these two factors. Many athletes and experts commented that the Vancouver luge track was simply too fast and therefore dangerous. Unfortunately nothing was done to fix the track until it was too late and Nodar was fatally killed. Hopefully this 21 year old Georgian luge sliders story will help to caution and improve safety protocols for more winter sports so that the amazing athletes from all over the world will be as safe as possible for future winter games.

The main thing that really separates the Winter Olympics from the Summer Olympics is the extreme danger that many of these sports present to the athletes. With events such as Alpine downhill skiing, luge, ski jumping, and skeleton, athletes find themselves going at speeds over 90 mph, being at heights of over 50 feet, and traveling in the air over the length of a football field.

The one thing that many of the winter sports have in common is the athlete going from extreme heights to ground level in a matter of seconds. Even if the athlete is on skis, a snowboard or figure skates, the amount of pressure that is put on the foot and ankle during landing can be disastrous if anything goes wrong.

It’s not only landing from a height that is challenging for winter athletes but also the conditions they are forced to land in. Take pairs figure skating for example; female skaters are thrown in to the air spinning and then attempt to land on one leg wearing a 1/8 inch blade. The physics of these throws makes them very hard to land and if not done properly can lead to terrible ankle sprains or fractures.

Although many of the Winter Olympic sports put athletes at high risk of injury, only some of these sports are prone to increased ankle and foot injuries due to the different types of equipment and protection that are used. Figure skating is a winter sport with one of the highest incidences of ankle sprains, while skiing and snowboarding offer more protection to the ankle due to the heaver barrier provided by the boots.

The Winter Olympics are truly amazing to watch because these athletes participate in sports that are not as commonly accessible to everyone as are sports in the Summer Olympics like running or swimming. Although these sports may seem cool to watch it is important to remember that they are trained athletes and that injuries are very common to not only beginners but also to Olympians.

For some reason, treatment for an ingrown toenail is scary. People who have gone through major surgeries without a problem cower at the prospect of having an ingrown toenail cared for…why is that?

For some, there’s personal experience that plays into it.  How many of us were threatened by our mothers that if we didn’t cut our nails correctly they would become ingrown.  We didn’t know what that meant, but it sure sounded bad!  Some even got an ingrown toenail and was treated by their pediatrician who gave them what seemed like hundreds of injections in the end of the toe and it took forever to heal (incidentally, which is similar to the reason I fear the dentist to this day!).

The oddest explanation I heard from a patient in my Houston, TX podiatry practice just this week.  She was a very pleasant new patient to my office, but was petrified about what I was going to do to her.  I promised her that I wouldn’t hurt her and kept my promise.  She left smiling and couldn’t believe there was no pain.  She did tell me that her fear of a toenail procedure stems from the 70’s television series The Incredible Hulk starring Bill Bixby and Lou Ferrigno.  She told me that the ONLY time he was in the hospital was when he had a toenail torn away.  Now, I’m not well-versed enough to know the episode, or even if it’s true, but I certainly never have heard a more random reason to fear an ingrown toenail.

As common as the fear is, also common is the relief after the procedure.  Without fail, people feel that it is never as bad as they pictured in their mind.  The procedure only takes a few minutes and, other than an injection to numb the toe, the procedure is entirely painless.  In fact, the relief is immediate.  If you have been suffering with an ingrown toenail…Don’t Wait!!  Come in to see what it will take to provide you instant relief.  I guarantee it’s not like you think i will be.

To enter our contest to win fantastic foot health products, become a fan on Facebook!!! Drawing will be tonight at 9 pm Central

This past Wednesday at the 2010 Vancouver Winter Olympics Lindsay Vonn finally captured the Olympic gold, despite a serious shin contusion. Vonn had been forecasted to win the Alpine Skiing Ladies’ downhill event for months leading up to the Olympics until a disastrous injury on February 2nd in Austria left everyone wondering if she would even compete. Vonn reported that she suffered from a severe contusion to her right shin in practice that left her unable to even put on her tight ski boots for days. Being a downhill racer, the shin is one of the most devastating places a skier can get an injury due to the tightly fitting boots that puts pressure around the area.

Vonn took it easy for the weeks following the accident and decided to go to the Vancouver games to test out the course and decide if she would compete. Lucky for her nasty weather conditions pushed back her first event a couple of days leaving Lindsey more time to recover.

When the race finally took place, Lindsey felt healed enough to compete at full strength. Vonn was able to edge out fellow United States athlete Julia Mancuso for the gold. At the medal ceremony an uncharacteristic emotional Vonn was seen teary eyed as the US National Anthem played and the American flag rose. Vonn reported that emotions ran especially high for this event due to her injury that she thought might have cost her all the years of training leading up to the event.

Lindsey Vonn has won countless races throughout her career but has never been able to medal at the Olympics until now. With 4 more events to go for Lindsey at these Olympic games, including the Ladies’ Super Combined, Ladies’ Super G, Ladies’ Slalom, and Ladies’ Giant Slalom fans wait to see if she will continue to capture gold or if her injury will start to take its toll on her body. The refreshing news is, that after winning the gold, and asked about the upcoming events, she responded that she reached her goal – an Olympic gold medal and she was just going to enjoy her moment.

To enter our contest, become a fan on Facebook!!! Drawing will be tonight at 9 pm Central

To enter our contest to win fantastic foot health products, become a fan on Facebook!!! Drawing will be tonight at 9 pm Central

This week the pairs figure skating competition took place at the Robson Square Arena at the 2010 Vancouver Winter Olympics. After a close competition Shen Xue and Zhao Hongbo of China managed to capture the gold. Although the competition was close with silver going to Pang Qing and Tong Jian, also a Chinese pairs team, and the bronze medals going to the German pairs skaters Aliona Savchenko and Robin Szolkowy, spectators could not help but cheer for Shen and Zhao due to their amazing history together.

Shen and Zhao have been to four Olympics together winning bronze in 2002 and 2006 but could never quite get the gold medals they always wanted. The pair got married in 2007 and retired after they won their third world title but shortly after this career move they decided they needed to try once more for the gold medals they could never quite reach.

Part of the reason that the pair has never been able to surpass their bronze medal status until this year is because Zhao’s ruptured his Achilles tendon right before the 2005 world championship. Zhao was forced to take the entire season off from skating to heal and could not return to the sport until weeks before the 2006 Olympics. Although Shen and Zhao were able to capture the bronze that year it still took years for Zhao to completely recover from the Achilles tendon rupture.

In the end Shen and Zhao finally got their gold after 18 years of competitive pairs figure skating. I’m sure Zhao questioned if he would ever skate again after his terrible injury but this story really shows that if you want something enough and really work for it anything is possible…..got to love the Olympics!

To enter our contest, become a fan on Facebook!!! Drawing will be tonight at 9 pm Central

The Snowboarding Halfpipe event became an Olympic event in 1998. It was the beginning of the traditional Olympics embracing the less traditional X-games. Derived from skateboarding, snowboarding was slow to be embraced by ski slopes. In fact, there was much animosity between skiers and snowboarders. Some ski areas actually banned snowboarders from their facilities.

Today, more than 97% of ski areas embrace snowboarding. Half of those have special areas specific for snowboarding, including rails, jumps, and halfpipes.

Injuries most commonly associated with snowboarding include fractures of the wrist and ankles. The best way to avoid injury is to use proper form and protective equipment. Snowboarding boots should be well-fitted, with toes snug in the end of the boot to minimize movement.

The Gilden Tree Exfoliating Foot Scrub is a creamy, deep-cleansing scrub that leaves skin sensuously soft and velvety. This scrub is wonderful to use – whipped, so it spreads easily, creamy enough to be moisturizing on its own, and with very even, gentle pumice to exfoliate dry skin on feet and body. It’s made with with Certified Organic Aloe Vera, but with a cream base, not soap so it leaves skin softer and more moisturized.

To enter our contest, become a fan on Facebook!!! Drawing will be tonight at 9 pm Central

Even with the increased popularity of snowboarding, Alpine Skiing continues to be the most popular snow sport. Although it is often criticized as being dangerous, in truth only 3 in 1000 skiers are injured participating in the sport. Fatalities are extremely rare, although are usually high profile when they occur.

About 50% of skiing injuries occur in the lower extremity, with the knee being the most common area of injury. The knee injuries most commonly occur due to faulty bindings that do not release properly. Newer bindings do help to protect the knee from injury better.

Most ski injuries are ligament sprains. Soft tissue bruising and joint injuries are the next most common injuries. Skiers have half the rate of fractures (broken bones) that skiboarders do – about 17% compared to 34%. “Boot top” fractures of the tibia and fibula at the top of the ankle where either the binding fails to release as it should, or the skier unexpectedly enters softer snow and the skis slow down but his momentum carries him forwards leading to the injury.

Today’s prize for our Winter Olympics Facebook Contest is Orthogel Advanced Cold Therapy Pain Relief Gel. It is a topical pain reliever and anti-inflammatory that is perfect for any aches and pains that you may feel once you get off the slopes.

To enter our contest, become a fan on Facebook!!! Drawing will be tonight at 9 pm Central

To many of us, Luge may seem to be a silly sport. Growing up in the northeast, we would bring our sled to the school hill and sled down. Sometimes, we’d go on a toboggan run. But luge is something else entirely.

The luge sled is on sharp blades going down an ice track, approaching speeds of 100 mph. Small movements of the driver will shift the balance and steer the sled. 64% of injuries with the luge are crash related, resulting in fractures. The others are muscle strains, often in the neck. I, of course, want to recognize the tragic death of Georgian luger Nodar Kumaritashvili on a training run in Vancouver. Our prayers go out to his family and teammates.

Today’s prize for our Facebook giveaway contest is Barefoot Botanica Cracked Heel Repair Cream. It is a deep penetrating cream that actively soothes and repairs dry, cracked, damaged skin and heels.

It dissolves away dry and callused skin and moisturizes the underlying healthy skin. Feet and heels quickly feel and look good again! Cracked heels are a common foot problem that frequently causes pain, bleeding, and infections.If treatment is not initiated early, not only can the pain become intense, but the cracks and fissures may bleed. Once bleeding occurs, the skin is prone to bacterial infections and athletes foot.

To enter our contest, become a fan on Facebook!!! Drawing will be tonight at 9 pm Central

Cross country skiing is the Winter Olympics equivalent of track.  With different distances and uneven terrain, and of course long flat devices attached to the feet, the biomechanics is different from the running gait.  Where in running, we strive to minimize the amount of time the foot is in contact with the ground, as we’re faster in the air, cross country skiers look for a fast glide.

Because of the extra weightbearing and the increased amount of contact with the ground, we see overuse injuries most predominantly occur with cross country skiing.  Plantar fasciitis, Achilles tendonitis, and shin splints are the most common.  Again, like running, heel pain has to be dealt with both in the summer running season and the winter cross country season!

Of course the presentation of heel pain from cross country skiing is the same as in running, typically a sharp, stabbing pain in the back or bottom of the heel, most commonly occurring first thing in the morning.

One of the most popular items in our Houston office is today’s prize for the Winter Olympics contest.  The TheraBand Foot Roller is used to provide temporary relief from pain associated with plantar fasciitis, heel spurs and tired feet. Patients with plantar fasiciitis can use the roller as a device to stretch the plantar fascia and increase flexibility. Those experiencing soreness from tired feet will find the massaging benefits of the roller pleasant and therapeutic. In all applications, the Foot Roller can be chilled or frozen to help reduce inflammation.

To enter our contest, become a fan on Facebook!!! Drawing will be tonight at 9 pm Central

It’s Valentine’s Day…a day for love!  We reach out to our wives and husbands, boyfriends and girlfriends, and express our love to them.  Great for the flower and chocolate industry!!

It’s also a great idea to shift the focus to loving ourselves.  Too often, in our pursuit of caring for those that we love the most, we start neglecting our own health and well being.  This goes for every aspect of our health, but foot health is something that usually is a low priority in particular.

In my Houston, TX podiatry practice, I see people everyday who can’t take their foot pain anymore.  When I ask them how long they have had it, the answer is commonly “months” and even “years.”  This is unacceptable.  We’ve all heard that if your feet hurt, you hurt all over, then how can we function with pain in our base of support.  It exhausts us to be in pain and affects our work life, recreation, and even our love life.  Waking up with a sharp, stabbing pain in the heel, and then managing your entire day with it takes too much out of you for one day, never mind more than that!

The good news is that your podiatrist can usually quickly and easily manage the pain you are in.  In most cases we are able to provide relief almost immediately!  Don’t suffer with your foot pain.  Your feet are responsible for too much of your enjoyment and productivity!  Love each other, but don’t forget to love yourself too!

Happy Valentines Day!

Some may think that the Biathlon is not so practical…cross country skiing along with rifle target shooting, but it’s pretty entertaining to watch. Not only that, cross country skiing truly provides a full-body workout and the athletes must be in optimal condition. Plus they must stop and calm enough to be sharpshooters.

The most common injuries associated with the biathlon are similar to running injuries, namely medial-tibial stress syndrome, also known as shin splints, and Achilles tendinitis.

Today’s foot product for the winner of our Facebook fan contest is Corganics Topical Relief Analgesic Cream. Corganics Relief is a deep penetrating topical pain reliever that provides quick and effective relief!

Relief™ is formulated with a powerful blend of traditional medicines, each containing the purest herbal extracts such as L-Arginine, MSM, Eucalyptus Oil, Vitamin E, and Menthol.

To enter our contest, become a fan on Facebook!!! Drawing will be tonight at 9 pm Central

Short Track Speed Skating became an event in the Winter Olympic Games in 1992. The events, for both men and women, include 500 m, 1000 m, 1500 m, and a relay. Injuries most commonly associated with Short Track Speed Skating include lacerations below the knee, with skaters cut by their own skate blades or those of a competitor, and ankle fractures. Be sure to watch American superstar Apolo Anton Ohno!

Today’s product is one of our most popular!  Biofreeze (also known as “liquid crack” by patients) is a pair relief gel which provides an anti-inflammatory effect.  It’s perfect to rub on any area of pain, whether it be in your ankle after you take off the skates, or your neck, back, shoulder, knees…anywhere!

To enter our contest, become a fan on Facebook!!! Drawing will be tonight at 9 pm Central

Today, over 5000 athletes and officials from over 80 countries are gathering in Vancouver for the 2010 Winter Olympic Games.  Not as popular as the summer games, the winter games feature a multitude of sports played on ice and snow.

During the course of the winter games, I will highlight different sports and injuries related to the lower extremity.  I’ll also feature a product from my online doctor’s store to give away.  Because of the drying nature of cold weather, I think it’s appropriate for our first featured product to be:

Gilden Tree Foot Creme which is a serious, but gentle foot cream that almost magically helps to heal and soften feet, Gilden Tree’s Healing Foot Cream is extremely rich and gentle. Keep a jar on your bedside table and use it nightly for softer, healthier feet and legs. Made with a Certified Organic Aloe Vera base, instead of water. Thick, rich and very creamy, you’ll love the way it feels and smells. It is remarkably healing – even on very dry, damaged skin, and always one of our best-selling products – try it and find out why.
To enter our contest, become a fan on Facebook!!!  Drawing will be tonight at 9 pm Central

…you just might win!!

Each day of the Winter Olympics, beginning with Opening Ceremonies tonight through Closing Ceremonies on Sunday February 28, we will be choosing one of our Facebook fans to receive a FREE product from our online store. Become a fan by clicking the link at the bottom of this post, or visiting our Facebook page.

Tanglewood Foot Specialists

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With the 2010 Vancouver Winter Olympics quickly approaching, I start to think about all the amazing athletes that will be competing at these games. It is amazing the speed, agility and climate that these athletes perform under. I am not only amazed at the talent that the athletes at the winter Olympics possess but also how well they perform considering the impact they are putting on their feet.

When it comes to the winter Olympics the first thing that you have to remember is that these athletes are performing in cold conditions. Whenever it is cold outside your body attempts to keep itself warm by constricting the superficial blood vessels in the extremities to push more of that warm blood to your vital internal organs. This is why when it is cold outside you are more likely to get frostbite on your toes, fingers, ears and nose then any other area of your body.

Since winter sports are played in cold conditions athletes are forced to make sure they have thick socks on their feet to make sure that they stay as warm as possible. The problem is that many winter sports require athletes to wear shoes that are tight and awkward and do not always go well with thick bulky socks. For example, if you are a skier, then you know that you want to keep your feet warm in your ski boots but need to make sure that the socks will stay in place. All skiers know that if your socks develop a small wrinkle in them while you are skiing then you are in for some terrible blisters and even bruises on your feet and shins.

The last thing that amazes me about the winter Olympics is the way many of these sports put amazing amounts of pressure on athlete’s feet. Think about figure skating, downhill skiing or ski jumping. All of these winter sports take you from standing still to extremely high and dangerous speeds in just seconds. They also can thrust you into the air and require you to land on your feet in uncomfortable and unstable shoes. For this reason the winter games only allows the best of the best to compete because these games can be down right dangerous, leading to twisted ankles, broken feet, concussions and even death!

When you watch the winter Olympics this February keep in mind how much pressure and torque these athletes are putting on their feet while you are cheering them on and you will be even more amazed then ever before at how talented these athletes really are.

We are running a contest during the 2010 Winter Olympics.  Beginning with the Opening Cereomony on Friday, February 12, we will be drawing one “fan” from our Facebook page to receive a high-quality foot health product from our online store.  To enter, just become a fan on Facebook.

Join us now at www.facebook.com/HoustonPodiatrist

Dr. Mehmet Oz is a MD who has been a fixture on Oprah Winfrey’s show and recently started his own talk show that focuses on explaining medicine in a way that the general public can understand. On one of his recent shows he explained how a person’s foot structure can affect their entire body. He showed the audience that there are three main foot types: high arch, normal arch and low arch.

On the show, he showed that there are two quick ways to determine what type of foot structure you have. First you can lay some paper down dip your feet in water and then take a couple of steps on the paper. In a normal arched foot you will be able to see the heel and toe of your foot as well as most of the arch. In a person with high arches their foot print will only show the ball and heel of the foot. A low arch, or flat foot, would look like a paddle.

Dr. Oz also explained that by looking at the bottoms of your shoes you can also get an idea of what your foot type is. The bottoms of your shoes will wear out in the areas where you apply the most pressure. If you have a low arch then the inside of the shoe will be worn down more quickly. However if you have a high arches the outsides of your shoes will wear out more easily.

Dr. Oz did an excellent job of quickly explaining that by having either a high arch, low arch or normal arch your body is more prone to getting different problems. For example if you have a flat foot (Pes Planus) then you are more a risk for developing heel pain and biomechanical deformities, such as bunions or hammertoes.

Although Dr. Oz only skimmed the surface of foot structure and related problems this helps give you an idea of how structure can really affect function. If you have more questions regarding what kind of foot type you have and if your foot structure is causing your health problems then, as Dr. Oz recommends, you should visit your podiatrist.

Tomorrow is one of my favorite days…Super Bowl Sunday! Always bittersweet since, as a big football fan, it also indicates the end of another football season. I’m hoping it’s a good game between the Indianapolis Colts and the New Orleans Saints. Not a fan of either team and I don’t have a particular aversion either….so I’m hoping I get to see a good game here in Houston.

One thing that I’m following is the Indianapolis Colts’ defensive end Dwight Freeney’s severe right ankle injury. Now, I wouldn’t play on it and wouldn’t advise my patients to do so either, but professional sports is a different story. They professionally beat their bodies up and push them to the limits for our entertainment and get paid royally to do so. So it certainly is possible, even though he hasn’t participated in any recent workouts, that he probably will play in tomorrow’s game.
From what I read, he sustained a grade 2-3 ankle sprain, which is a complete tear of some of the ligaments that support the ankle. This leads to severe pain and swelling and a very significant instability in his ankle.  Of course, with anti-inflammatory medication, possibly a cortisone injection, taping, and bracing, he can be pieced together to play.

Of course, there is some very real risk to him playing as well.  Without good sensation in his ankle, he will not be very sure-footed and his speed and reaction time will be affected.  Also, there is the good possibility of worsening his injury, rupturing the remaining ligaments that are supporting his ankle.  In fact, he is putting his career at risk, but so is every football player when they walk on the field.  Best case scenario, after the game, he will be immobilized followed by physical therapy to restore strength and balance. Worst case would be surgery to stabilize his ankle, again followed by physical therapy

If you twist or sprain your ankle, get it examined immediately.  Ligaments do heal, but are quick to heal in a stretched position that will provide less stability in the long run.  Even for moderate sprains, studies have shown that a period of immobilization is best to ensure more complete healing of the injury.

One of the most common issues I see in my Houston, TX podiatry practice is ingrown toenails. This is one that spans the ages – from very young children to senior citizens.

Ingrown toenails form for different reasons. In children, the nail sometimes is wider than the nail bed and the edges embed into the skin, which becomes red, inflamed, painful, and often infected. As we mature, the nails can naturally curve, which can cause them to grow in. Incorrect cutting of the nails can also cause and ingrown toenail to form.

If you believe that your nails are beginning to ingrow, do NOT perform “bathroom surgery.” In most cases this will cause the situation to worsen and increase the pain and infection. I have seen patients in the office after using tools such as razor blades and pliers to “remove” the nail, only to end up with a bloody mess.

For some reason, ingrown toenail surgery is particularly feared. In truth, it is pretty easy. the only uncomfortable part of the procedure is an injection at the base of the toe for anesthesia. After waiting a few minutes for the toe to become numb, the procedure itself takes about two minutes and is entire without pain. Only the small piece of nail that is growing into the skin is removed and the rest remains untouched. If there is any infection, it is cleared and a bandage is applied. In most cases, there is no pain when the numbing wears off.

The next time you think your nail may be ingrown, visit your podiatrist for this quick and easy procedure. It is much simpler than taking matters into your own hands.

There are several systemic diseases that podiatrists will often diagnose before your primary care doctor due to how those particular diseases present. One of these disease that podiatrists are likely to diagnose before any other doctor is gout.

Gout is caused by elevated uric acid levels in your body that precipitates to form little crystals that deposit in your joints, tendons and surrounding tissues. This occurs often after having a high protein meal or when you may be dehydrated. (After the upcoming Super Bowl, I’ll see lots of gout attacks from too much wings and beer in my Houston podiatry practice!) The most common joint that gout affects is the big toe (contributing to over 75% of all gout attacks). When someone is experiencing a “gout attack” they have severe pain in their big toe which becomes red, tender, hot and swollen. When an individual experiences a gout attack it is so painful that even the weight of sheets on the big toe can make someone scream!

Due to the intensity of pain that is associated with a gout attack, people are forced to go to a doctor to help alleviate the pain. If someone is experiencing a gout attack for the first time and it manifests in the big toe they are likely to go to their podiatrist because they likely think they have broken their toe. This is one reason why podiatrist can be the first person to diagnose you with gout.

Although it is usually a chronic disease that will randomly come back over the years, there are many medications and lifestyle changes that can be made to help control gout from attacking again. If you even experience a gout attack visit your podiatrist. He can prescribe medication to alleviate the pain quickly. Sometimes, a cortisone injection will help and other times he may refer you to a rheumatologist. There are few physicians better equipped than a podiatrist to handle a painful attach of gout.

I am a HUGE Disney fan! Keeping up with road races, I’ve always been intrigued by the “Goofy Challenge” which is when a marathoner completes the Donald Duck Half Marathon on Saturday and the Mickey Mouse Marathon on Sunday for a 39.3 mile experience. My friend Barry Tobias completed his first Goofy Challenge and was good enough to share his thoughts of training and the race itself:

There’s a reason they call it the Goofy Challenge. Every January Disney World hosts the Mickey Mouse Marathon weekend. For those who are willing to step up to the challenge, you can sign up to run both the Donald Duck ½ on Saturday and the Mickey Mouse full on Sunday. In all seriousness, it’s not that goofy of an idea. After running a number of marathons it was clear that breaking any speed records is beyond my ability, additionally pursuing goals of ironman races still needs a bit of time to transition into, and ultra-marathons…well that’s just crazy! The goofy run seemed to be the right ‘next move’.

Somehow I was able to convince my running buddies to sign up with me and months later training started. Like all marathon training, I have found that training with friends is the key to success, if not more so for the goofy challenge. I took my typical 16 week training plan and moved the medium mid-week run to the day before the weekly long run. The biggest challenge we faced was dragging ourselves out of bed early on both weekend days to run. Surprisingly, only the first couple back-to-back runs were bad. Amazingly enough our bodies got used to this schedule pretty quickly and after the third or fourth week we were physically comfortable with this schedule. The one noticeable difference in these runs was that the long one was not as fast as they were when they were the only weekend runs we did. Our medium runs we’d run at our normal pace and then on the long run back off about 20-30 seconds/mile, which seemed to help a lot. Honestly, the slower run was probably more of a natural response from our bodies than a mental decision to slow down. Of course, our best runs were those that were cut short and ended at IHOP instead.

The actual race itself was “memorable”. As most of those in the southern states dealt with the Arctic freeze by staying in bed, we (along with 17000 other people each day) spent it waiting to run. As we stayed at a Disney resort, we had to be on the bus and over to the start area by ~4am for a 5:50am start. Saturday we spent the 2 hours sitting under ponchos getting nailed by sleet. The run itself was not bad, although only ~2 miles were through Disney parks, the majority was spent in parking lots and streets. I believe what made the runs so much easier than expected was keeping the mentality that “Saturday’s run was nothing but a training run and we did that every week, so no biggie.”

Sunday was slightly better in that there was no sleet or rain. Unfortunately the temperature was quite colder. Sitting around huddling under mylar blankets that we got after the ½ marathon run, we shivered our way through 30 deg F weather, only to have the temps drop to ~27 (plus wind-chill that came near the end of the race) during the run. It was so cold that by the time we got to the water stops, the PowerAde drinks were icing over and all the spilled water at the water stops turned the streets into an ice rink. The full marathon took us through ~4-5 miles through all four Disney Parks, entertainment by a number of Disney characters and music kept us going. Mad props have to go out to the spectators and volunteers who all battled the cold to support our runs. The last mile through EPCOT was run to the theme song of the Olympics, which is the greatest song that exists to put some kick into very tired muscles. Overall I think Disney did a very good job organizing the race (sans the cold and lack of heat lamps). I’m still trying to decide if shaking hands with former President Bush at Houston’s 23rd mile or high-fiving Goofy at the end of 39.3 miles is more memorable.

It may have been goofy, but running the Goofy Challenge was a great experience. If anyone is looking for a step up in challenges after a marathon, I highly recommend it. 39.3 miles in two days seems daunting, but with some slight modifications to one’s training schedule and of course, good friends to keep you company, it is worth taking on that challenge. And if that still isn’t enough, may I suggest dressing up in a full blown costume of your favorite Disney character, you’ll be the most popular runner out there…and it may keep you warmer!

-Barry Tobias (4:21:12)

Congratulations to everyone who participated in and finished the Houston Marathon and Half Marathon today.

The most vital piece of equipment for any runner is the running shoes. Proper fit is essential. Some rules of thumb:

1. You should have approximately the width of your index finger between your longest toe and the end of the shoe. For those who’s second toe is longer, be sure to size appropriately.

2. Always size your shoes towards the middle or end of the day. Also be sure to wear the socks you usually wear with those shoes and always stand when checking for the proper fit.

3. If you end up with black toenails, don’t automatically size up the shoes. If you wear improperly fitting shoes, your arch will not correspond to the arch of the shoe and the shoe won’t break properly.

4. Be sure to buy your shoes from a specialty running store (at least for your first fitting). Most are staffed by runners who are knowledgeable in proper fitting. Locally, I recommend Fleet Feet or Luke’s Locker. Look out for good specials on shoes however. Today i found a fantastic sale on Asics running shoes at Sports Authority. Buying online also works as long as you’re familiar with the shoe style and how it fits you. Never try a new style online. It’s worth paying a bit more for expertise.

If you’re unsure of the right style shoe for you, or the proper fit, visit your podiatrist for more guidance.

For more information: www.tanglewoodfootspecialists.com

Pain. Everyone seeks to avoid it. No one likes physical pain. We choose our relationships and hope to avoid emotional pain. Generally speaking we seek a life without pain…

…then you get your wish and realize that you miss it.

That’s exactly how millions feel who are suffering from peripheral neuropathy. Peripheral neuropathy is a condition that commonly affects people with diabetes. It can also be caused by a result of chemotherapy, alcoholism, autoimmune disorders, and a host of other conditions that we may not even know about.

So why does it happen? That answer’s not so simple. Neuropathy as a complication of diabetes is caused by microvascular disease. That’s the small vessels that branch of from the main pipeline arteries. They stop sending blood, which carries oxygen and nutrients, to the nerves and they begin to fail. So how do we correct this? Not easily. If that’s the reason, sometimes the individual needs a procedure to restore circulation. Other times, when the main circulation is in good shape, there may be other modalities. I use a therapy called MicroVas which is a non-invasive treatment that stimulates the microvascular circulation to reverse diabetic neuropathy. Does it work? Often yes, sometimes no. It depends on the individual. But I am pleased to say that the therapy has help many people effectively reverse the numbness in their feet and legs.

For other conditions, the cause of neuropathy is unclear. If we don’t know the cause, then it’s really hard to find a solution. I’ve tried MicroVas therapy for neuropathy caused by other conditions and have found it much less effective.

So big deal, why is this so important. Well, think about your reaction when you touch a hot stove. Your reflex is to quickly draw your hand back because your brain reacts to the pain even before you can feel it. And if you had no pain? You’d get a pretty nasty burn.

Now think about your feet. We wedge them into shoes every day. What if your shoes didn’t fit? The average person would take them off and figure out why. If you had no pain, you’d keep walking. What if you had a pebble in your shoe. Again, the pain would cause you to take care of it. If you were walking barefoot and stepped on a piece of glass? You see where this is going…

People with diabetes will not feel these minor injuries and can develop sores, blisters, and skin ulcers. These ulcers can become infected easily, spread to the bone, and cause major problems. More than 60% of non-traumatic amputations is due to complications from diabetes. This is why all people with diabetes should be familiar with a podiatrist. I routinely tell my diabetic patients that they should check their feet daily before they go to sleep and call me if they see anything that wasn’t there the night before. I tell them that I’d rather they call me and it be nothing than let it go and let it develop into a problem.

The research documents that a comprehensive foot care program can reduce the rate of amputations in people with diabetes by 45%-85%. With those numbers, you should run (carefully) to your podiatrist’s office. It’s the first step in keeping you walking for years to come.

For More Information: Peripheral Neuropathy
Microvas Therapy

This weekend I had the great pleasure of taking my 4 year old daughter, Daniella, to Disneyworld. You have to understand, I’m a huge Disney fan, but this trip was unique for me…it was my first princess trip. Growing up in a family of boys, such things were foreign to me. But seeing her in her Cinderella dress taking pictures with her idols was truly something else. (I’ll see if I can post a photo…you’ll fall in love too.)

One of the highlights of the trip was a new ride based on the Toy Story movies. The ride itself was fantastic! But of particular note on this posting was the line…a really long, long, long line. We snaked around the queue for about 75 minutes, 30 of which had me carrying my sleeping daughter. During the wait, I had a chance to observe hundreds of people and the relative misery they were in. For such a happy place, there sure were lots of weary-looking people: Shoes being kicked off and rubbed…bandaids being put on blisters…ibuprofen being popped like candy.

For such a trip, you’d do well to train. Train? Exercise? For a theme park? Absolutely! Most people do not do the amount of walking involved in one day at a theme park in an entire week! Does anyone randomly decide to start standing in place for 75 minutes to see what it feels like? No! Has anyone considered how far it is from Space Mountain to Splash Mountain? I can’t tell you how often people come into the office and tell me about their terrible foot pain that has been present and ignored for 2 months and, by the way, they’re going to Disneyland tomorrow and I must make them feel better.

So before the trip, start taking long walks as a family. Don’t call it exercise. Start slow (breakfast pace), increase speeds slightly (catch the monorail pace), or full on race walking (need to be first in line pace) and you’ll find that your days in the “Happiest Place on Earth” will indeed be happy.

www.tanglewoodfootspecialists.com

Well, the simple answer is “maybe.” First lets work on some definitions. The insole that comes in your running shoe is a “sock liner.” No matter what the shoe salesman says, it offers minimal support. The support and control of a running shoe comes from within the shoe itself. Anything you buy off the shelf at a pharmacy, shoe store, or sporting goods store is an “insole.” It does provide generic arch support. It is often a first step in solving foot issues.

That brings us to an orthotic, which is a custom insole made from a mold of your foot. That mold will be when your podiatrist wraps plaster around the foot, has you step in foam, or stand or walk on a computer force plate. There are differences as to what’s the best method but that’s for another post. An orthotic is only right for the person for whom it is made. It’s important to only get a custom orthotic from a doctor, who will provide an appropriate examination. Shoe stores that have “custom” orthotics are not using proper methods to design these orthotics and even may be using a computer to choose a generic insole and charging 10x more than they should for it. I’ve even found shoe stores charging more for a generic insole than I do for a custom orthotic!

In the evaluation for a custom orthotic, I take measurements of your foot, ankle, knee, and hips during a biomechanical exam. I also take x-rays when you are standing to examine the bone structure in detail. Lastly I watch you walk barefoot so I can get a true view of your mechanics. Based on the exam, I formulate a prescription to make the orthotics correct your mechanics to make you walk as efficiently as possible.

A custom orthotic is always right if you have any sort of foot deformity, such as bunions or hammertoes. A properly made orthotic will help to eliminate the forces that caused these deformities and stop them getting worse. This could help you to avoid surgery down the road. Serious athletes at any level should consider a custom orthotic if they have any pain during the activity. Taking a chance with a generic insole may make your condition worse.

Of course, there is a time and place to try an off-the-shelf insole. For mild foot pain, shin splints, or pain in the front of your ankle, try getting an insole from a specialty running store, which will provide some good support. An insole of this type should cost about $30-$40. If it’s more than that, just say no!!

For more information, visit www.tanglewoodfootspecialists.com

Most men can sit this one out…

Ladies, I am not here to tell you to not wear polish on your toenails. I’ve tried, I’ve lost, I’ve given up. I do understand that when a woman wears an open toed shoe or sandal, they enjoy having polish on their nails. I get it!

But now it’s November. It’s chilly here in Houston (for Houston) and outside of Houston it’s downright cold. Women are wearing closed shoes and boots, but guess what? The nails are still being polished!

Most nail polishes contain formaldehyde, a carcinogenic chemical best known for preserving cadavers. On a toenail, the formaldehyde dries and damages the nail. Polish remover has acetone, which is popular for removing adhesives and paint. Also damaging for the nail. This damage can leave the toenail susceptible to fungus infections. Most of you have seen the dry white flaky condition of the nail when your polish comes off. In fact, people often come into the office concerned that it’s fungus. No, it’s just damage from the polish.

It’s time to take a vacation. While the closed shoes season is here, give your nails a chance to recover by not wearing polish. That’s right…no polish. What’s that? Just a base coat? Well clear polish is still just as damaging. It’s not the color that does it, it’s the polish itself.

Well is there any good polish? The answer is yes. There are polishes sold in some stores that are without formaldehyde. By most reports, they are inferior. There are also “healthy” polishes that contain vitamins, tea tree oil, and wheat protein. These are better for the nails and have antifungal properties. Even so, no polish is still better than this.

If you’re on vacation, go crazy, wear polish for the week if you’re wearing shoes that will show your toes. But otherwise, treat the nails right and get them ready for next sandal season.

If you would like to know more about the “healthy” polish, click here.
For more information about nail problems, visit www.tanglewoodfootspecialists.com

I had an opportunity to sit down with the store manager and shoe manager of Luke’s Locker, a specialty running store here in Houston. The partnership between a good running store and their clients is a vital one. They’re the ones that stay on top of the new shoe styles, monitor changes and “upgrades” and can best identify when a shoe is not appropriate for a particular runner.

Staying on top of changes in running shoes is tough. Most shoe companies will “upgrade” a shoe as often as twice a year. Why the quotes? Well an upgrade may end up being an entirely redesigned shoe with a new last but with the same name. While it may have been the right shoe for you at one time, it no longer may fit right once it was updated.

Most podiatrists are unable to keep up with the constantly changing variety of shoes. Since I see lots of runners, triathletes, and other athletes, I do my best to stay abreast of changes, but I often refer to the experts. A specialty running store has knowledgeable managers who educate their salespeople as to the appropriate shoes for foot types. Some even bring in podiatrists and other experts into their stores to run workshop for their sales staff and even for their customers.

A properly fitting shoe is vital to foot health in general, but especially if you’re involved in an exercise program. Proper shoes can not solve all foot problems (otherwise I’d be out of business) but they’re an important step to providing the environment that will be most helpful in healing many foot issues.

To learn more about how running effects the feet, visit www.tanglewoodfootspecialists.com
To find a location for Luke’s Locker, visit www. lukeslocker.com

Everyone with diabetes should know that their feet are at risk. They also should realize that their risk increases exponentially as their blood sugar rises and their diabetes becomes uncontrolled. That being said, despite this knowledge, many people with diabetes do not take control of their disease like they should. I sometimes sound like a broken record when I speak to my diabetic patients about this, but I’m currently dealing with a situation that serves as a good reminder to me as to why I have to keep insisting that my patients remain vigilant against complications of diabetes.

It’s a story of a very, very nice man who I saw first in my wound clinic. He had a seemingly minor ulcer beneath his left foot. We talked about the proper dressings, the need to keep the pressure off of the area, etc. Everything I would normally discuss in these circumstances. He did admit that his diabetes was not in great control, but he was working at it. In fact, a test later showed that his diabetes was not close to being in control!

A short time later I got a call at my office from his wife that she was concerned with the appearance of his foot. I had him come to my office immediately and found a rapidly deteriorating, infected foot. I admitted him to the hospital and operated on him to drain the infection, but it was not enough. A few days later I had to remove more tissue and amputate a toe. This all happenned in a short time frame of approximately 10 days.

Uncontrolled diabetes puts many of the body’s systems at a deficiency. Of particular note is it’s effect on the immune system, putting the diabetic’s limb at a greater risk of infection and decreases the ability of the body to heal. For these reasons, I insist on the following routine to everyone with diabetes in my practice, from the “borderline” cases to those under poor control.

Along with diabetes often comes neuropathy, a decrease in sensation in the lower extremity which fails to alert the brain when a normally painful condition occurs. It is vital that people with diabetes inspect their feet daily. I suggest a 30-60 second inspection of the top and bottom of the feet, as well as between the toes. What you’re looking for is any change from the day before. Any redness, cracking, bleeding, or pus is worthy of concern and a phone call to the podiatrist. If you cannot see the bottom of your foot, a spouse or child can help you. Otherwise, a mirror can be helpful. My patients are routinely told that I’d rather they call me and it be nothing than have them wait and postpone treating a problem.

For more information about diabetic foot care, visit www.tanglewoodfootspecialists.com
For more information about an easy to use illuminated mirror for foot inspections, click here

Holiday shopping is not easy on the feet. Not only are you trekking from store to store, but if you have a long list of gifts to buy. What you had hoped would take hours ends up taking days. At the end of the day, you bring home a few unwanted gifts of your own: foot pain and blisters.
The average person takes about 8,000 to 10,000 steps a day, especially when on the hunt for that perfect gift. To help you stay on your feet, here are five holiday fixes:
1. Massage your feet. This will help release tension, increase circulation and rejuvenate the skin.
2. Soothe your soles. Soak your feet for at least five minutes in a container filled with warm water. Pat dry and apply lotion to hydrate your feet.
3. Elevate legs. Lift your legs above your heart while lying down to help reduce swelling.
4. Rotate ankles. Cup the foot under the back portion of the heel to brace the foot and leg; turn slowly at the ankle five times. This loosens the ankle joint and relaxes your feet.
5. Point your toes. While standing, do toe raises, toe points and toe curls for five seconds; repeat 10 times. This alleviates toe cramps and strengthens calf muscles.
When you get home, reward yourself by pampering your feet. After all…you deserve it. Visit our website for some great suggestions as to creams, exfoliants, and soaks to get your feet ready for their next outing. For more information on solving foot pain, visit www.tanglewoodfootspecialists.com.

Throughout my years of practice, I have seen many patients wonder if a particular device or product is available and where to get it. They then proceed to go online and buy one for everyone they know because it’s a “miracle” cream/splint/support/etc. To save you some time searching, I’ve compiled the top five stocking stuffers that will make your family and friends smile as they pamper their feet.

1. Keep Calluses Soft…
Callex Ointment thins and softens calluses and dry, cracked heels. Its natural plant enzymes selectively exfoliate dry, cracked, thickened and scaly skin while its petrolatum base retains natural skin moisture. Callex is free of acids, mineral oil, colorants and lanolin and may also be used on sport, brace and work-related calluses. Callex significantly reduces the severity of foot calluses, dry or flaking skin and heel cracking.

2. …then Keep Them Gone!!
To help remove the softened dead skin, the Foot Buffer Pro is a podiatrist recommended buffer sponge system. One side is infused with a combination of healthy ingredients including glycerin gel for a gentle skin cleanser, skin softening olive oil and shea butter, Vitamins A & E for anti-oxidant protection and healing botanicals to freshen the feet. The other side is excellent for gentle exfoliation of loose, dry, scaly or flaky skin on the heels, soles and sides of the feet. The Foot Buffer provides a “spa-like” treatment to tired feet. A real “pick-me-up” at the end of a long day!

3. The BEST Foot Pad Around
I’m not a big Dr. Scholl’s fan, however they had a great product out several years ago called the cushlin callus cushion. It was a reusable silicone callus cushion that provided relief to the ball of the foot when the natural padding had eroded away. The problem that Dr. Scholl’s experienced was that they were TOO good. They lasted for months, their product sat on shelves, and in their infinite wisdom, they discontinued it. Along comes Dr. Jill’s, a company owned by a podiatrist, to fill in the void. Her Ball of Foot Callus Cushions takes a great product and improves on it. These purple pads are reusable and provide excellent cushioning to calluses beneath the foot, prominent bones due to lost fat padding, and pain from neuromas.

4. How About a Foot Facial?
With the Gilden Tree 4-Step Healthy Feet Kit you can soak, scrub, moisturize and protect those tired feet and rejuvinate them for the next day. This kit contains everything you need for healthier, more beautiful feet! Gilden Tree’s focus on Healthy Feet means that every product is effective and natural. This kit is a sampling of their best products – Softening Spa Soak, Exfoliating Foot Scrub, Healing Foot Cream and Shea Butter Balm. Great on cuticles, nails, elbows, and other dry skin. It’s a marvelous gift, and perfect for home pedicures or for travel. Scented with Kiran Forest, a captivating blend of fresh green botanicals.

5. It’s Time for a Safe Pedicure
Every year…maybe twice…there are horrifying stories about people getting limb-threatening infections from pedicures. The truth is, that salons are poorly regulated and often cut corners in disinfecting their equipment properly. By bringing your own equipment, you know that it only is used on you. The SOS Safe Salon Pedicure Kit provides everything you need for your pedicurist to provide a germ-free pedicure. It includes all natural tea tree and lavender Sole Savior Essential Moisturizing Oil, professional grade cuticle nipper, nail clipper, cuticle pusher and curette cleaner, nail brush, nail file, and two sets of toe separators. After the initial purchase, keep everything in good supply with the Pedicure Refill Kit, which will replace everything in the pedicure kit and includes a carrying case.

The holidays are a time for reflecting on the year past, but looking forward to a healthy year ahead. I hope that these suggestions will provide your loved ones with happiness and comfort for the coming year.

You just started a new workout program and everything aches. You’d like nothing better than to soak in a warm bath to soothe those muscles. Is that the right thing to do?

You were out for a walk, stepped in a hole, and twisted your ankle and now it’s bruised and swollen. Do you use ice or put a heating pad on it?

This is one of the most common questions I receive. It’s also one of the more common things that people do incorrectly. It does make sense…heat on something for a long time makes it feel good. Ice becomes uncomfortable after having it on for a few minutes. So heat should be better, right?

As it turns out, ice is universally better for acute injuries and even some chronic ones. Ice serves as a natural anti-inflammatory and functions to constrict the blood vessels, thereby reducing the blood flow to the injured area. Blood carries in it factors responsible for inflammation. Having less of these present minimizes the swelling, bruising, and pain associated with inflammation. The sooner you apply an ice pack to a sprain or strain, the sooner it can do its job reducing pain and swelling. For chronic problems such as low back pain or muscle spasms, ice whenever the symptoms start up.

You do need to take some precautions with ice, thought. Never put ice directly on the injury…always wrap it in a towel first. Only keep ice on for 20 minutes and then take a break for at least 40 minutes. After 20 minutes, you lose the efficacy and can damage the soft tissues.

Heat does have its place, also. Heat increases blood flow and restore movement to injured tissue. Heat can also help pain and stiffness in joints, such as the resulting pain from osteoarthritis. Heat shouldn’t be used on a new injury, however, since the increase in blood flow will cause an increase in swelling and pain and can cause more harm than good. When you apply heat, use it for 20 to 30 minutes and then take a break.

If you have diabetes, please remember that your sensation may be diminished in your hands and feet. You should check the heat of the pad with an area that has full sensation, such as your elbow. You also need to make sure that you only apply cold for the recommended period of time and stop if you notice any change in color to the area.

With any injury, a never-fail way to treat yourself is with RICE: Rest, Ice, Compression, and Elevation. If it’s not feeling better then make sure you call your local physician. For more information, be sure to visit www.tanglewoodfootspecialists.com.

I’m pleased to announce that our website has been updated with new information on the topic of wounds. As I’ve mentioned before in this blog, chronic wounds are one of the leading cause of amputation in people with diabetes. In fact, an article by The Times in the UK stated that diabetes is responsible for 70% of lower-limb amputations. It has surpassed landmines as the leading cause around the world.

It’s important to understand the risk factors, causes, and treatment of wounds. Visit our website for more information, as well as a series of informative videos on this topic.

I recently read a blog post (you can check it out here) focusing on Victoria Beckham’s (aka Posh Spice of Spice Girls fame) bunions. The claim was that she was tired of the bunions and didn’t want surgery because of her inability to wear high heels after surgery. She wore a simple night splint and the bunion disappeared in a short period of time.

A bunion is often perceived as a bony growth on the side of the foot. It is, however, the bone behind the big toe shifting out towards the side of the foot. The surgical correction usually involves breaking that bone, shifting it over, and securing it with a screw or pin. While there are bunion deformities that are due to soft tissue contracture, it is the minority.

I often use bunion splints as postoperative aids. I have not had the experience of a bunion be “cured” simply from a device such as this (for an example of a night splint, click here). It can, however, help with some of the deformity and resulting pain.

As for Ms. Beckham, the pictures shown on the site are hardly evidence that the bunion has disappeared. For her sake, however, I hope she chooses her shoes more sensibly so the bunion does not worsen. Otherwise, surgery may end up being her only option.

If you’d like to learn more about bunions, their cause, and treatment, including an informative video, visit our website.

If you’re a sports lover like myself, you’re hearing more and more that athletes are out with a “high ankle sprain.” You especially hear about this in basketball and football where you have lots of feet being planted on the ground and pivoting. So what’s the difference between a high ankle sprain and your average, run of the mill ankle sprain?

A traditional ankle sprain, or twisted ankle, most commonly involves damage to the ligaments that connect the bones in the legs, the tibia and fibula, to the bones in the foot. This type of injury will cause swelling on the outside of the ankle, and often bruising will be seen. The best initial treatment for this is applying the “RICE” principle: Rest, Ice, Compression, and Elevation. Taking anti-inflammatory medication can also help. If the pain is not significantly better in the first 24-36 hours, you should visit your podiatrist.

A high ankle sprain is an injury to the ligaments that connect the two bones in the legs, the tibia and fibula. They’re called “high” ankle sprains because the injury occurs above the ankle level in the lower leg. These injuries are tougher to diagnose because the symptoms are usually more dull than their more traditional components and present with little or no swelling. Treatment for a high ankle sprain also includes the “RICE” principle. If the pain does not improve quickly, visit your podiatrist. Some sports figures who have had high ankle sprains include Tom Brady of the New England Patriots, Terrell Owens of the Dallas Cowboys, and Dirk Nowitzki of the Dallas Mavericks.

For those who habitually sprain their ankles, exercising with an ankle brace is important. The more one sprains the ankle, the easier and more likely future sprains are to occur. A wide array of ankle braces and supports can be found in our store.

For more information, visit our website.

Babies, both infants and toddlers, have unique issues when it comes to their feet and footwear. An infant’s feet is essentially developmental in nature. The baby lifts up his feet and looks at these crazy things in front of his face. He explores his feet and toes and wonders what they may do. He moves them around and wonders who is making them do that.

As the baby progresses to crawling, they become more functional, to propel him across the floor. He then proceeds to pull himself up and, for the first time, bears weight on them. Then come those wonderful first steps. It’s amazing that all this occurs in about the first year of life!

In order for a baby to be able to get a grasp of the weightbearing process, it’s important that he has full sensation to their feet. A baby needs to feel the pressures in his feet, known as proprioception, to learn how to balance. Shoes with a real sole do not allow the baby to properly feel his feet. I’m not talking about booties or socks, but those really cute, tiny, Converse All-Stars.

You can take the smartest person…let’s say a pediatrician (who really knows better)…tell them that their infant should not be wearing shoes yet and their response would invariably be “I know…but they’re so cute!” or “I know…but they match his outfit!” I’m all for cute baby’s and all, but let’s not effect the kid’s development!

Also, babies are rapidly growing creatures. A sock or soft bootie allows the foot to expand and grow as it should while allowing the baby to feel the ground. Keep those patent leather black Mary-Janes off of the girls! Keep those baby Nike’s off of the boys!

Once the baby starts to take some steps, it’s okay to put a shoe on him. When you do, make sure that you put on one with a flexible sole. Rigid soles are not appropriate for a new developing foot!

One thing is for certain. Once your child starts to walk, if you find that he sits down often, complains that their feet hurt, or would rather crawl then walk, they might be experiencing a true problem with their feet or ankles. If this is the case, be sure to visit your podiatrist to check them out!

For more information about pediatric foot problems, including an informative video, visit our website.

When it comes to basketball, the risk of spraining an ankle is constant. Quick breaks, starts, stops, pivots, and, of course, jumps. Whenever an ankle is sprained, there is always ligament damage. The time out of the game will depend on the extent of the damage. You’d expect that a sprain resulting from a jump would result in more damage from simply rolling the ankle. All we know is that McGrady’s ankle was sprained in practice.

The Rockets announced that McGrady was a game-day decision to play tonight’s game, which leads me to believe it’s not so severe. Hopefully T-Mac will be back soon and stay healthy along with Yao and Artest to make this a great season.

Although the title specifies running shoes, I’m writing this with all types of athletic shoes in mind: tennis shoes, walking shoes, sneakers, aerobics shoes, basketball shoes, etc. The principle is generally the same. For brevity, lets just refer to them for the most part as running shoes.

We all know that running shoes do not last forever. Most people, however, continue to wear them well after their useful life has ended. Most commonly in my office I’ll have people tell me that their shoes are three years old BUT (insert excuse here…). Some of my favorites, it fits my feet perfectly (meaning it’s broken down), the heel is worn out just how I like it (meaning it has a hole inside the shoe), new shoes just bother me (meaning that I’ve worn these for so long, the support is too different at this point), and my favorite: They still look new.

Yes, they still look new. When all you do is run on the treadmill, use the elliptical, and some stationary bike, and your shoes never see the light of day, of course they look new. What’s problematic is the part you don’t see.

The support and function of a running shoe has little or nothing to do with the overall appearance of the upper part of the shoe or even the sole. It’s the midsole, the portion of the sole that is largely invisible from the outside, that has the most function and limits the useful lifetime of a shoe. With every stride, the midsole compresses and, with time, loses the majority of its support. For runners, I estimate the useful lifetime of a running shoe at approximately 350 miles. This amount may be slightly shorter for heavier runners and slightly longer for lighter ones. For those who really don’t run regularly, or partcipate in other sports and activities that can’t me measured by mileage, your shoes should be replaced every 4-6 months, depending on the frequency and level of the activity.

So start keeping track of the life of your shoes. Dedicate a pair of shoes (or more) exclusively for exercise to get the most out of its useful life. Keep a tally of the mileage in your running journal, or even on the side of the shoe in pen. Write the date of the shoe on the tongue or the outsole of the shoe so you really know how old it is.

Whenever you are involved in serious exercise, minor injuries are inevitable. You must do everything in your power to minimize them. Wearing the proper shoes is one simple way to help you along.

There was an article a month or two ago about the future of the printed Yellow Pages. It’s a well-established fact that fewer people consult the Yellow Pages for information and are increasingly turning to the internet. Truthfully, my books at home go directly into recycling.

I came across an interesting blog entry about Matthew Upson, a British soccer player, about a novel use for the Yellow Pages:

…Upson simply had to get fit, find a way of curing a mysterious calf injury that wrecked the beginning of his Upton Park career.

Running out of options, he finally phoned up a specialist in South Africa he’d heard about on the grapevine, a kinesiologist who, as it turns out, deploys an unusual method to construct the orthotic inserts that realign the body when placed inside someone’s shoe. “He uses the Yellow Pages to build them up and then wraps them in masking tape,” Upson explains, removing a wedge from his training shoe to let me have a look. “Taking out just one page would knock you off balance. That’s how delicate it is. He’ll gradually reduce the number of sheets as my body realigns itself. Now I fly him over whenever I need to see him. Before, I was constantly overusing my calf because my body was so far out of line. One side of my jaw was cracking, my neck was hurting, one groin was constantly tight. It all adds up to a pretty cloudy picture of how I was moving. I think it started after my cruciate operation at Arsenal. When you start running again, you’re bound to protect that side a bit. It’s only natural.”

I’d have to wonder how durable such an orthotic device would be!!!

Visit our website to learn more about non-Yellow Page orthotics…

Ok…it’s really hard to comment on these. When I first saw the boot only pictures, I thought it was on a hansome cab horse in central part. I do know that Sarah Jessica Parker likes to push the fashion envelope, but in this case it was a misstep (no pun intended).

So are they the boot version of flip flops? No…they’re much better than that. In fact, I can’t say from a function standpoint why I don’t like them. You have socks with each toe separated, running shoes that look like gloves…why not boots that look like mittens? Or horse hooves? Guess that’s why I’m not in fashion!

A friend of mine emailed me a story about a man from New Zealand who ran coast to coast (of New Zealand that is, barefoot. He figured that if the Kenyans can do it, so can he! Little did I know that there is a whole Barefoot Running subculture. And boy are they serious about it.

In visiting some of their sites, they find ways to explain away everything. Pain on the top of your foot? It’s due to “imprisoning your feet” in shoes. Orthotics? Make you feel better because it just makes the “prison” nicer. We’ll see how open to suggestion they are…I made a few polite comments and will see if the moderator lets them up.

Don’t get me wrong…some people have great mechanics and love going barefoot…maybe even run barefoot. Even if you take out the obvious issues: glass, twigs, gravel, etc. An unshod foot doesn’t have the shock absorption that it needs to run long distances.

If barefoot running has you intrigued, the best option is to give it a try on a very controlled surface, like a high school track. Nicely level with good cushioning. I think that most would put their running shoes back on after one lap around…if they last that long.

Let me know in the comments if you’ve tried barefoot running and your experiences with it.

For more information, visit my website at http://www.tanglewoodfootspecialists.com

People with diabetes are typically at a disadvantage in many ways. For one, they typically have a decrease in circulation which ends up in a diminished capacity to heal. Second, they often have a decrease in sensation that makes it difficult to know when there is a particular problem with the feet.

In my office, I usually give my diabetic patient a “fire and brimstone” speech about how they can lose their feet if they don’t take care of them. This is easy for me to say, but the truth is many of these people find it difficult to bring their feet up close enough to inspect them. There are several new innovations to allow the person with diabetes to keep an eye on their feet.

Pictured above is the Insight Foot Care Scale that has become recently available. It has a mirrored surface that allows the bottom of the feet to be visible. It will sell for approximately $99 and is a great tool to help people monitor their feet on a daily basis.

Another option, which is a bit less expensive, is an illuminated mirror that can be used in the same manner. The mirror is adjustable and is another good tool to keep the feet healthy.

Both mirrors will allow the people to check their feet for any new breaks in the skin, infection, calluses, or anything that may put the feet at risk. If any of these things are seen, your podiatrist should be called immediately. Remind the office that you’re diabetic and think you have a problem.
The mirrored scale is not yet available, but will be soon. You can purchase the Illuminated Mirror by clicking HERE.

There was a report today that Girl Scout cookie sales are down about 20% and the economy is to blame. Everyone seems to be cutting back these days and even the Girl Scouts are feeling it.

But maybe it’s not the economy…maybe people realize that they don’t need five boxes of Thin Mints in the house. Maybe the citizens of America have realized that their waist sizes are expanding and it has to stop…and their starting with the Tagalong patties. Perhaps the diabetics of the land are realizing that the temptation associated with Caramel deLites are too much to overcome and just stopped buying them.

Could it be possible that Americans are taking responsibility for their health? Keeping their blood sugar under control. Trying to lose the holiday weight from the last five years. Taking the stairs instead of the elevators. Walking instead of driving. Trying to take less medication rather than making medication the answer.

Unfortunately…it’s probably just the economy.

Generally speaking, our feet hurt. With that understanding, there is a huge market for products that claim to end the foot pain. Some work, others do not. Some even can cause worse problems.

Today I’d like to start with a rule of thumb I use often in the office…if you can compare it to a kitchen utensil, you should not be using it on your feet! If you look at a foot product and immediately can think of a practical use in the kitchen, stay away!!

The first item I’d like to discuss is the popular Ped-Egg. To the untrained eye (and even to the trained eye) you can’t help notice that the product strongly resembles a cheese grater. Now I know that most of you would not think about getting your fine box grater from the kitchen cabinet and work on your calluses, right?

In the same vein are the many products known as a callus shaver or callus planer. This is a “safety” metal device with a razor blade embedded to take off the top layer of skin. Strongly resembles a cheese slicer. The words “bathroom surgery” come to mind.

A safe alternative to these callus products are a multitude of products designed to safely remove calluses. A Pummice Sponge is an inexpensive and effective means to remove the callus. Best used in or after a bath or shower, the Pummice Sponge will safely remove the top layer of hard, dead skin. Another solution is the Gilden Tree Footscrubber and Callus Remover, which works much the same way.

For more foot care solutions to manage corns and calluses, visit our online Foot Care Store.

There’s always so much talk about treating diabetes and reacting to the disease. Warnings like “watch your blood sugar or you’ll lose your eyesight” or “if you don’t take care of your feet you’ll lose them.” True, but who ever thinks about PREVENTING diabetes? Sure, Type 2 diabetes is often weight dependent and that’s one way. But you have a unique opportunity to help prevent diabetes in others…and it’s FREE.

A School Nutrition bill has been introduced in congress. The Child Nutrition Promotion and School Lunch Protection Act (HR 1324) will improve the nutritional value of foods in schools. There has been a dramatic rise in the number of overweight children causing an alarming increase of cases of Pediatric Type 2 Diabetes. It’s frightening that Type 2 Diabetes, often referred to as “adult onset” has become such an issue in children.

Please click this link to visit the website of the American Diabetes Association and complete a form to send a letter to your representative. It takes less than one minute, but can have a dramatic effect on the future of diabetes in our country.

Please Take Action!!

To learn more about Diabetes, and its potentially devastating effects, visit our website.

Are your heels hurting? The statistics say there is a good chance. According to a recent survey from the American Podiatric Medical Association (APMA), heel pain is the foot ailment that affects Americans most—16 percent of the population regularly experiences it.

When you pound your feet on hard surfaces while playing sports, or wear shoes that irritate sensitive tissues, you can develop heel pain. Many people try to ignore the early signs of heel pain and keep performing the activities that are causing the problem. But when you continue to use a sore heel, it can quickly get worse and become a chronic condition, leading to more problems.

While it is a common misconception that heel spurs are to blame, the most frequent cause of heel pain is plantar fasciitis. With this condition, too much running or jumping can lead to inflammation of the tissue band (fascia) connecting the heel bone to the base of the toes. The pain is generally centered under the heel and may be mild at first, but tends to flare up when you take your first steps after getting up in the morning, or resting for a period of time. Plantar fasciitis is often successfully treated with custom orthotics, injections, prescription medications, physical therapy and immobilization. However, the longer you have untreated pain, the more difficult it is to find relief.

There are other causes of heel pain, however. Other possible causes can include:

• Achilles Tendinitis. This condition is often caused by tight calf muscles, bone spurs, age, injury and primary tendonitis. If left untreated, this can also develop into tendon rupturing and a more chronic problem called tendonosis, which involves adhesions and scar tissue formation.

• Fat Pad Thinning. Age, obesity and walking on hard surfaces can all cause fat pad thinning, which occurs on the fleshy ball of the heel of the foot. Treatments for the condition may include soft insoles and soft-soled shoes prescribed by a podiatrist.

“Heel pain is generally the result of faulty biomechanics that place too much stress on
the heel bone and the soft tissues that attach to it,” said Dr. Ronald D. Jensen, APMA
president. “If pain and other symptoms of inflammation—redness, swelling, heat—persist, you should limit normal daily activities and contact a podiatric physician immediately.”

To avoid heel pain, always wear shoes that fit well and wear the proper shoes for each activity, not wearing shoes with excessive or unevenly worn heels or soles, and stretch
the heel well before exercising. Fortunately, if detected early, heel pain can be successfully treated with several noninvasive treatment options.

For more information about heel pain, visit our website.

Ask the casual reality show observer which show would end up with more foot and ankle injuries. I’m sure many would think Survivor, right? After all…malnourished on a remote area. Physical challenges abound. Catch your own food…sounds logical, right?

Turns out Dancing with the Stars has them beat by a landslide. Over the several seasons, Dancing with the Stars boasts the following:

• Misty May-Treanor: ruptured Achilles Tendon (after successfully winning an Olympic Gold unscathed)
• Susan Lucci: Sprained Ankle/Stress Fracture
• Lance Bass: Broken toe
• Jewel: Fractured tibia
• Kristi Yamaguchi: Ankle injury
• Brooke Burke: Injured foot
• Karina Smirnoff: Ankle sprain

Now compared to foot and ankle injuries from Survivor:

• (staring up and whistling)

So how can we explain this. Quite simply, actually. Dancing is a sport. It requires discipline, practice, and a high level of fitness. So like any sport, it’s going to carry with it a wide variety of injuries. Couple that with taking celebrities who are not professional dancers and putting them through the rigor of training for the dance routines with their professional partners that they are not prepared for.

Look who are the most successful to date: Sports stars…Kristi Yamaguchi, Emmitt Smith, Apolo Anton Ono. And the favorites this year? Shawn Johnson (Olympic Gold Medal Gymnast) and Lawrence Taylor (Super Bowl Winner). As in all sports, conditioning and training still are the key to excellence.

I had an experience yesterday that almost moved me to tears. In December I wrote about a gentleman who was incredibly close to losing his leg, if not his life (Here’s the original post). Within a short time frame of days, he went from having a “minor” ulcer treated to a major infection of the foot which ended up with him losing two toes, but has retained the functional foot. Before the first operation, I had a conversation with the infectious disease physician caring for him who was insistent that my surgery was futile and he needed an amputation above his knee to save him. The patient and I discussed this and agreed that we wanted to try anyway.

During the first operation, I experienced an infected foot like I’d never seen before, even in my training. It was very apparent that the surgery didn’t get rid of the infection like it should have. A few days later, another surgery with a toe amputated. The following week a third surgery with a second toe amputated. Then the miracle…

His fever dropped to normal, all the color came back into his face, his appetite returned. He looked healthy. He made a commitment to his wife, me, and most importantly, himself, to take this horrible time in the hospital and take charge of his diabetes. He did everything right to lower his blood sugar to normal levels. We sent him for Hyberbaric oxygen treatments which helped the residual minor infection to resolve and started to promote healing. As he was discharged, we put a negative pressure “VAC” dressing on his foot to further promote healing.

Our initial hope was to get the wound to the point that we could use a skin graft to close it. Yesterday, that changed. He is doing everything right, including being vigilant about controlling his diabetes. The bottom of his foot is close to healing on its own…without a skin graft! This is ideal, since that would make the skin much thicker and would minimize the risk of breaking open again. Thinking where we were just a few short months ago, I’m staggered to think that soon he’ll be back to wearing shoes and even back to work with two functioning feet.

Good thing we decided not to take the easy way out by amputating the leg, don’t you think?

No, this isn’t doing the “Time Warp!” I’m more interested in my runners who come in complaining about foot, ankle, shin, knee, or hip pain ON ONE SIDE. Here in Houston, TX we have major drainage issues, so all of our streets are banked.

So when runners come into my office, they have done online searches and have a million reasons why they are hurting. They have bought all sorts of supports and liniments to make them feel better…but they don’t seem to work. They come in complaining of their IT band hurting, or some shin splint pain on one side and expect me to run a whole barrage of tests to tell them in a high-tech way why they hurt and how to solve it. Then, after I listen to them, I ask the most important question:

What surface are you running on?

Invariably I’ll hear an answer that they’re running on the side of the road, or another similar uneven surface. I watch as they brace to hear a lecture on how “asphalt is a terrible surface” or “never run on concrete.” Instead I ask my next question:

Where on the road do you run?

This is a loaded question…I know pretty well that they’re not running in the middle of the road (if they were, there would be bigger problems than limb pain). They’re, of course, running harmlessly on the side of the road. A-ha!!

When someone runs on the side of a banked surface, like the local Houston roads, they are essentially creating a leg length difference. This will cause the two feet to function very differently. One limb is going to compensate by attempting to lengthen and the other is going to shorten. A significant imbalance will result and can cause a variety of pains. My great wisdom for these runners?

Take a step to the left…

That’s all? That’s what they came in for? Well…yes. Sometimes a simple change makes a huge difference. By running on a more even surface, it allows for a more stable and even base and doesn’t overwhelm the mechanics. My advice is to not take time off. Nurse the injury with ice and some anti-inflammatory medication, and be more aware of where they’re running. I ask them to call me in a week to tell me how they’re doing.

The results are amazing! A small adjustment like this causes the lower extremity to even up and makes a huge impact on the biomechanics. The pain gradually improves with essentially no time away from training!

Peripheral Neuropathy is a condition where the nerves lose their ability to conduct efficiently and ends up with either numbness in the lower extremity or persistent pain and burning. Too often, those suffering with peripheral neuropathy had been told that there is little or nothing that can be done. Fortunately, as time progresses, there is a continually better understanding of this condition and an improvement in treatments. We will outline the four most effective.

1. Microvascular Therapy: It has been well documented that even in cases where the main arteries are bringing adequate blood flow down the limb, the microvascular circulation, the small tributaries, are not as well functioning. This is particularly true in people with diabetes. Microvascular therapy is achieved through a unit similar to a physical therapy modality. The unit is distributed by Neurovasix and is called Microvas. It is a non-invasive treatment not requiring any medication and has no side effects. The treatment involves a digital wave that causes angiogenesis, the reperfusion of capillaries, which brings more oxygenated blood to the nerves. Patients often feel a dramatic increase in sensation. Some cases report full resolution of peripheral neuropathy symptoms. It has been well documented that people with diabetes suffer from microvascular deficiency and is the primary cause of neuropathy. For that reason, microvascular therapy is much more effective in people with diabetes. You can find more information on Microvas therapy on our website.

2. Benfotiamine: A bioactive form of Thiamine, Benfotiamine, is a nutrient that is deficient in many people suffering with peripheral neuropathy. A common brand name of Benfotiamine is Neuremedy. Thiamine, Vitamin B1, is essential for the nervous system to function properly. It is difficult to maintain adequate levels of Thiamine through diet alone. Benfotiamine works to nourish the nerves and reverse the effects of peripheral neuropathy. After taking Benfotiamine, people can notice a change in their peripheral neuropathy symptoms anywhere from several days to two months after first taking it. For those who it is effective for, it is important to continue to take the supplement. Benfotiamine has been used in Europe since the 1960s and has been proven to be safe and effective. For more information about Neuremedy, visit our website. Neuremedy can be purchased online here.

3. Topical Analgesics: When it comes to peripheral neuropathy, much focus is spent on the oral pharmaceuticals to manage the discomfort. These medications, Neurontin, Cymbalta, Lyrica, and others are often prescribed and heavily advertised on television. These medications are often effective, but the side effects can be debilitating. So many people overlook a topical analgesic. If someone’s neuropathy presents as a constant burning pain, why not put out the fire? Now not all analgesics are created equal and each should be used at the proper time. If someone is feeling that burning pain, you don’t want to counter that with a topical that will make the feet burn more! Put out the fire with a topical analgesic that provides a cold, soothing sensation. The most popular of these products is called Biofreeze. Biofreeze contains Ilex, an herbal extract of a holly shrub in South Africa. Biofreeze provides a cooling sensation. Beware of “Icy” topical that have a heat component afterwards. For a neuropathy that presents with a numbing effect, then a heat component works better. Capsin, and other ointments that contain capcaisin, provides a burning sensation that stimulates the nerves and can moderate the numbness. No matter which is appropriate to use, please be sure that you wash your hands afterwards. If you touch your eyes…ouch! Biofreeze is available for purchase at many podiatrist’s offices. More information on Biofreeze can be found on our website.

4. Shoes are Important! With all the discomfort with peripheral neuropathy, it probably is best just to go barefoot, right? WRONG!! For one, the feet must be protected. If someone with peripheral neuropathy has a decrease in sensitivity, as most do, then that person is putting their limbs at risk by not wearing shoes. A foot that does not have full sensitivity cannot be expected to feel what it steps on. This will, at best, cause a lack of balance and, at worst, cause a foreign body to embed into the foot, which can become infected and lead hospitalization or amputation. When looking for a shoe, the sole is most important. A sturdy rubber sole is the best way to protect the foot from foreign objects. If enclosing the foot proves to be too uncomfortable, a looser fitting shoe or sandal can work well also.

It is true that nothing will help everyone. But someone who suffers from peripheral neuropathy will tell you that even a slight reduction in pain may let them get to sleep at night and be more productive during their day. Most cities have support groups and resources for peripheral neuropathy. It is definitely worth going, hear experts speak about it, and network with other people who understand how you feel.

Are your heels hurting? The statistics say there is a good chance. According to a recent survey from the American Podiatric Medical Association (APMA), heel pain is the foot ailment that affects Americans most—16 percent of the population regularly experiences it. As high as 1 in 4 people will experience heel pain in some way.

When you pound your feet on hard surfaces while playing sports, or wear shoes that irritate sensitive tissues, you can develop heel pain. Many people try to ignore the early signs of heel pain and keep performing the activities that are causing the problem. They feel that eventually the pain will go away on its own. But when you continue to use a sore heel, it can quickly get worse and become a chronic condition, leading to more problems.

While it is a common misconception that heel spurs are to blame, the most frequent cause of heel pain is plantar fasciitis. With this condition, too much running or jumping can lead to inflammation of the tissue band (fascia) connecting the heel bone to the base of the toes. The pain is generally centered under the heel and may be mild at first, but tends to flare up when you take your first steps after getting up in the morning, or resting for a period of time. Plantar fasciitis is often successfully treated with custom orthotics, injections, prescription medications, physical therapy and immobilization. However, the longer you have untreated pain, the more difficult it is to find relief.

There are other causes of heel pain, however. Other possible causes can include:

• Achilles Tendinitis: This condition is often caused by tight calf muscles, bone spurs, age, injury and primary tendonitis. If left untreated, this can also develop into tendon rupturing and a more chronic problem called tendonosis, which involves adhesions and scar tissue formation.

• Fat Pad Thinning: Age, obesity and walking on hard surfaces can all cause fat pad thinning, which occurs on the fleshy ball of the heel of the foot. Treatments for the condition may include soft insoles and soft-soled shoes prescribed by a podiatrist.

Heel pain is most commonly due to instability in the patient’s mechanics. This leads to the plantar fascia ligament pulling on the heel bone and causing inflammation to occur. Often, an off-the-shelf arch support can help to prevent the pulling and limit the inflammation. Other times, a more custom orthotic device is necessary to more completely correct the faulty mechanics.

To avoid heel pain, always wear shoes that fit well and wear the proper shoes for each activity, not wearing shoes with excessive or unevenly worn heels or soles, and stretch
the heel well before exercising. Fortunately, if detected early, heel pain can be successfully treated with several noninvasive treatment options. Not only that, heel pain is resolved with non-surgical treatment in greater than 95% of cases.

It was reported that while on a trip to Africa to tour orphanages to possibly adopt another child (admirable), Madonna had exercise equipment flown in. While on the treadmill, she flew off the back of it and twisted her ankle. The pain was enough to have her writhing in pain and forced her to cancel her tour. Fortunately, she will be able to take her newly adopted daughter home this weekend.

Ankle sprains are often written off as minor injuries, although there is very often torn ligaments involved. If it is not addressed in a proper fashion, the ligaments will heal in a stretched position, leading to future ankle instability.

A recent study had shown that a sprained ankle addressed quickly with immobilization fared much better than others that were not well-addressed. No surprise! Immobilization maintains the ankle in a stable position and allows the ligaments and other damaged tissues to heal well.

As with many sports injuries, the RICE principle applies: Rest, Ice, Compression, and Elevation. To run on a sprained ankle is only doing you a great disservice. The long term damage that can be done by not resting after an injury can dramatically increase the likelihood of future injuries.

Ice will help to reduce and limit inflammation and swelling. This will also minimize the pain involved. The rule of thumb for icing is 20 minutes on and 40 minutes off. Compression can be as simple as a using an ACE bandage or elastic ankle brace. That, along with elevation, helps to also moderate swelling and provides stability to the ankle.

I’m sure Madonna will be back in good marching order shortly (or she’ll hire people to carry her around). One has to think though, wouldn’t it have just been easier to go outside for a run?

I was reviewing the post about Madonna falling off of her treadmill and started thinking of the multitude of injuries I see due to the perceived safety of a treadmill. True, the surface of a treadmill does absorb shock, but there is a major natural pitfall with using a treadmill.

When you run – for real, with real forward progression – you are in control. As you tire, what happens? You slow down, of course! Not so on a treadmill. We typically set a speed and stick with it the whole way, for better or for worse. Some can maintain that steady pace, but most can not. As we tire, we’ll naturally shift the upper body forward and the running gait will be more unnatural. What will happen? The anterior muscle group of the lower extremity (the front of the leg) will be overworked, as will the Achilles tendon. Then comes the pain…shin splints most commonly along with Achilles pain.

So what do you do to stop it? Well, just slow down! Not by a lot…every so often, maybe after the first third of the run or walk, lower the speed by 0.2 mph. This will allow for the natural fatigue of your body.

If you wait too long and start to feel some discomfort, drop the speed even more, by as much as 0.5 mph to even a full mph. Then, depending how you feel, slowly increase your speed. If the pain persists, be sure to visit your podiatrist sooner than later.

A treadmill is not meant to be a passive experience. Be sure to listen to your body and make appropriate adjustments along the way.

Today has been promoted as “One Day Without Shoes” by TOMS, a shoe company that believes in a one-for-one philosophy. For every pair of TOMS shoes that is purchased, one is sent to a child in need. Now, on this blog, I’ve been an advocate for wearing shoes…not going barefoot. But this is a fantastic cause and worthy of your attention. Supporting this company and this cause will allow thousands of children to be able to protect their feet with shoes.

These are the facts:

Unfortunately this program doesn’t have an associated event in Houston. I’ll hope to help organize one the next time.

To learn more about this fantastic company and their efforts visit their website.

People with diabetes are hammered with things they shouldn’t do. Always high on the list is not to go barefoot. We always tend to over-analyze such recommendations, often to our own detriment.

In our own house? Well, yes. I’ve pulled all sorts of crazy things out of people’s feet. Pet hair, pins, staples, glass, a toothpick. No joke! Some, of course, knew that the foreign body was in there…it really hurt! There are those with diabetes who don’t have any sensation due to peripheral neuropathy. These folks can step on a foreign body and not have any idea. They may notice bleeding on the carpet or in their shoe and find out that way. For others it can be days or more before they discover the problem.

The most universally accepted place to go barefoot is the beach. No problem, right? Wrong. Let me count the ways…

First of all, sand gets very, very hot. For those who have full sensation in their feet, they’ll realize it and will protect their feet with shoes, flip-flops, Crocs, etc. For those who don’t have sensation, they will have no idea about the heat of the sand. Severe burns can (and believe me often do) result. If you have any decrease in sensation, always protect your feet on the beach.

Add the heat of the sand to the multitude of foreign body’s unique to the beach. Seashells can be sharp and cut into the foot easily. Coral and other natural growth can scratch and do the same. This is more dangerous than your household foreign bodies. On the beach, there are bacteria that you won’t find anywhere else. So along with the danger of simply stepping on something and not feeling it, you can add the risk of infection which, of course, is exacerbated by the diabetes depressing the immune system.

So the take home message is, always be careful and always protect your feet. You need to always think about where you are and what dangers may be lurking. Even in a comfortable situation, like a day out at the beach, being proactive in protecting yourself will always keep the memories of the day pleasant.

British marathoner Paula Radcliffe lately has been plagued by injuries. In fact, she had to pull out from this weekend’s London marathon after breaking a toe. She since has had bunion surgery and is hoping the realigned foot mechanics will end her long stream of injuries. After running the marathon for the Beijing Olympics just four months after breaking a leg, she is focused on her 2012 goal of medaling in the London Olympics, her home city.

A bunion is an enlargement of the great toe joint. It, however, is not from a growth of bone, but rather a shifting of the first metatarsal bone due to unstable mechanics. The forces causes the great toe to shift towards the second to and the metatarsal bone to shift out of alignment. Bunion surgery, when necessary, realigns the relationship of the bones, but does not alter the underlying mechanics that caused the bunion in the first place. If left uncontrolled, the bunion can return over time and can even require a second surgery.

The best way to balance the lower extremity is with the use of a custom orthotic. An orthotic redistributes the mechanical pressures, permitting the feet to function as a more stable unit. This allows for more a more efficient gait in walking and running. It also helps to moderate the deforming forces that caused the bunion in the first place.

In 2012, Paula Radcliffe will be 38 years old. It is not unheard of for a woman of 38 to win Olympic gold in the maraton. Constantina Dita of Romania won the Beijing marathon this past summer at the same age. Lets just hope that Paula is able to rehabilitate and resume her training, injury free, while taking all the necessary precautions to allow her body to function at peak performance.

One of the first things a woman thinks after she gets engaged is what she wants to look like on her wedding day. Many women realize that they need to start exercising and dieting in order to achieve the look they want for there special day. Some women even go so far as buying their wedding dresses in smaller dress sizes so that they have to lose weight to fit into it!

Many women, such as the celebrity singer Fergie, try to lose weight for the wedding by taking up running or walking. Many celebrities are seen dropping ten or even twenty pounds in weeks but the thing that many people don’t think about is that these people have personal trainers spending countless hours with them to ensure they are exercising properly and getting the correct nutrition so that they can lose weight without hurting themselves in the process.

For all of us who cannot afford to have a personal trainer wake us up every morning to whip us into shape, here are some hints on how to start an exercise regime that won’t leave you limping after a week.

1. Don’t do too much too fast

It is important to gradually ease your body into an exercise program. If you are working off of a base in which you don’t work out at all then start off with running 3 times a week for 20 minutes.

2. Get the right equipment

If you don’t exercise much to begin with then it is probably time for you to invest in a new pair of running shoes. It is important to have one pair of shoes that are dedicated to running and one pair that you use for other everyday activities.

3. Take care of your feet

Make sure you are wearing the correct footwear when exercising. If you are wearing shoes that are too tight, or that don’t give you the right support then you can get a number of foot aliments that will prohibit you from continuing your “race to the altar”.

Everyone wants to look good on their wedding day. Running is a great exercise to shed a few pounds, as long as you ease yourself into it and take care of your feet and body.

I previously discussed Victoria Beckham (aka Posh Spice) and the questions that have been posed about her bunions. Does she have them? (Yes) Did she have surgery? (No) Did she get rid of her bunion without surgery? (Definitely not!) Click here to see the original post.

As you can see in the photo, Ms. Beckham has started wearing shoes that are too big for her, so her bunion can be comfortably accommodated. While on the surface this seems like a good idea, it certainly can cause other issues.

When a closed shoe, such is the one in the photo, is worn, it is meant to have a nice snug fit. The way it is fitting Victoria, there is lots of motion that will come from it. For one, her heel not only is sliding up and down, which can most certainly cause a painful blister to form, but the heel will also rock back and forth during the course of a step. This rocking motion will put forces on the back of the heel that can also cause blistering. The pressure can also impact the back of the heel bone, causing a bone spur to form. This is known as a “pump bump” or Haglund’s deformity. If it becomes bad enough, it may also need surgery.

Wearing a shoe too large has biomechanical effects as well. The Achilles tendon is forced to work too hard, which can cause it to inflame. The muscles on the front of the leg and top of the foot will also work too hard, which can cause hammertoes to form.

It seems that, in the short term, the shoes are a good fit and the bunion does not hurt her. In the long run, she may be looking at creating new situations that may also need to be treated surgically in the future. Victoria…find shoes that fit!!

Seriously…that was a real question that one of my patient’s was asked on her Facebook page. No, it wasn’t a joke. She mentioned that she was going to see the Podiatrist and her friend responded “What’s that? An iPod doctor?” I’m stunned too!

He’s not alone though. I remember traveling by bus from New York to Philadelphia for my interview. The guy who sat next to me asked what I was going for and I told him and interview for Podiatry. He then spent the next hour telling me how much he loved kids. Podiatrist, pediatrician, close enough, right?

So…just in case you want to bring me your iPod or that I’ll help your kids with their ear infection (I do treat kids’ foot problems, though). Here’s my explanation:

A podiatrist is a doctor that specializes in treating all disorders of the foot and ankle. After college a podiatrist attends four years of school and then a hospital-based residency program. Podiatrists treat children, my youngest patient is under one year old, and also treat adults into their geriatric years. In my practice, I’ll see the marathon runner who has developed pain due to overtraining and poor mechanics. I’ll see the person with diabetes who has an open wound due to pressure. I take care of warts, ingrown toenails, athlete’s foot, and infections. If someone steps on a tack, I’ll be here to take it out. If you suffer with bunions, hammertoes, or a neuroma, I can do the surgery to get you feeling better. If you have flat feet, I can fit you for a custom orthotic so you won’t even think about it. Break a bone? No problem, come on in and I’ll x-ray it and get you fixed up.

Get it now? Simply put, a podiatrist is the premier physician to handle any foot or ankle problem. To learn more, order my FREE book “One Step Ahead: The Foot Owner’s Manual” by clicking here.

By the way…I am pretty good with an iPod too!

Running is one of the most popular means of exercise around. The reason is, it’s easy and accessible! We have our feet, there’s road outside our door…all you need to do is step outside. National Running Day is a national initiative whereby many of the major organizations within the running industry are joining forces in an unprecedented unified effort to nationally and locally promote running.

There will be cities around the country hosting organized runs for all ages and levels. Houston, TX is definitely a participant and the Chevron Houston Marathon is a sponsor. If you do not live in or near a participating city, that’s no problem! Just go outside and run!

Don’t run alone either!! Run with your husband or wife, boyfriend or girlfriend, fraternity or sorority. Run with your kids or run with your parents. Run with your dog (dog’s love to run with you.) Run around your block, go to a park and run, or run on a high school track. It doesn’t matter where…it doesn’t matter with who…just get out and go!

For more information, visit http://www.runningday.org

As the Houston summer quickly approaches, so do those long summer days with the scorching hot sun and humid conditions. If you are a runner this means that you are going to have to prepare yourself to bear the heat if you want to keep up the pace during the summer months. One of the most important aspects of running, no matter what time of year it is, is staying hydrated. I can still remember my high school cross country coach telling the team that training doesn’t end when you leave practice but continues with everything you put in your body because this will affect your run tomorrow and the next day. He would say that you can tell if you are drinking enough water if you are urinating clear. Back in those years I thought this was a silly analogy to be teaching high school students but thinking back on it now it was actually a very clever way to tell if I was truly drinking enough fluids to keep up with the toll I was taking on my body with each run.

There are many other ways to make sure you stay fully hydrated during hot and humid runs. Many runners choose to wear camelbacks, because they are relatively lightweight and don’t require you to stop if you want a sip of water. There are also many fuel belts on the market that allow runner to wear a belt that holds containers for water or juices.

It is important to consider that sometimes water is not the best choice in hot circumstances because you are not merely losing water when you run but also essential electrolytes. Alternatives such as Gatorade, Vitamin Water, and PowerAid are great products that help to keep you hydrated and replenish your electrolytes.

When you run in the heat you also sweat more. Make sure you wear socks that are made out of a material that can wick the increased perspiration away from your feet. If you wear cheap cotton socks you will have a greater risk of developing blisters.

However you choose to help quench your thirst and dodge the heat while running in the summer months always keep in mind that you must be especially in tuned with your body during this time. Don’t push yourself to hard. If you start feeling heat cramps, dizziness, or lightheadedness coming on stop immediately and seek shade and water.

Another foot injury plagues the Houston Rockets. In Friday night’s playoff game against the Lakers, center Yao Ming suffered what was believed to be an ankle sprain. The next day, it was announced that the injury was, in fact, a hairline fracture. Although not displaced and requiring no surgery, the injury will require a full 8 to 12 weeks of rehabilitation before Yao can play on the foot again. This is the end of Yao’s season. Hopefully the Rockets can continue to move forward with their playoff ambitions.

Yao’s left foot has been plagued with various injuries. A stress fracture in his foot almost forced him to miss the Beijing Olympics. When repeated fractures such as this occur in the foot, often a custom orthotic is necessary. An orthotic will stabilize the mechanics and redistribute the pressures so no one specific area has an undue load on it. This most commonly will stop future fractures from occurring.

For basketball players, an additional level of support is sometimes needed. An ankle-foot orthotic not only redistributes pressures in the foot, but also helps to provide support to the ankle. I hope that during Yao’s downtime, his trainers and physicians will reassess his biomechanical control so he can stop having these injury-plagued seasons.

I am on a plane returning home to Houston, TX from visiting Denver with my buddy Wayne to see The Dead perform. This is the latest incarnation of the Grateful Dead (Editorializing: It is ridiculous that all major tours don’t come through Houston, the fourth largest city in the USA!). The show was amazing – worth the trip! But as has always been typical with the scene – The Dead, Phish, String Cheese Incident, etc – shoes are optional.

For the uninitiated, the pre-show parking lot scene is a big part of the experience. Thousands of people going through a traveling bazaar selling t-shirts, posters, jewelry, and more. Looking around, I’d say about 10% of those walking around were barefoot. As a podiatrist, I notice these things! I also notice the considerable amount of broken glass on the ground, as well as other hazards. Stepping on this would likely need immediate treatment, antibiotics, and a tetanus shot. Not to mention risking missing the show!

Once inside, the percentage of barefoot attendees increased. Dancing on the floor and in the seats of the arena on the hard concrete. Although the dangers from outside are less (but not entirely absent) you now have people in close quarters dancing to the music. Trust me, you don’t want a 200 pound guy accidentally stepping down on your bare foot!

The concrete floors also provide a significant amount of shock when dancing. The force of your body weight on your feet is one thing, but the force coming up into your foot from the concrete is another. A rubber sole of any sort will help to moderate that shock.

I intend to be at many more concerts. I’m sure I’ll notice the same things at the next one. Just be careful, take care so you can enjoy the show comfortably and safely.

Just as I finished writing about Houston Rockets star center Yao Ming being sidelined with a broken left foot, Vegas screeches to a halt with the news that Lance Burton has canceled weeks of shows because he broke his right foot on stage. That must have been some magic trick!! This is the first time, however in 15,000 shows that he has broken a bone. Maybe Yao should have Lance over for drinks to learn his secret.

Oh, yeah…it’s magic, not basketball…that might be it too. For those looking to visit the Monte Carlo Hotel, Lance Burton’s Vegas home for 13 years, he plans to be back after June 3.

Year after year, Americans are putting themselves at increased risk for diseases. For a few years, Houston, TX had the dubious title of most obese city in the country. That’s not what anyone wants to be know as! It is well known that 30 minutes of sustained activity at least three times a week dramatically reduces the risk for these diseases.

Here’s some eye-opening statistics:

• More than $127 million is spent annually nationwide on medical expenses related to juvenile obesity
• Healthcare expenses and losses in productivity related to problems from obesity costs Americans in excess of $100 billion a year
• 300,000 deaths per year are related to problems associated with obesity.
• Inactivity and poor diet is on the verge of overtaking smoking as the number one cause of preventable death
• Children ages 10-15 who are overweight have an 80% chance of being an obese adult at age 25
• Only 25% of children get 30 minutes of physical activity each day
• Juvenile and teen obesity rates have doubled in the past 20 years

Running is the easiest and most accesible exercise out there. We all know how to do it. No training necessary. All you need are running shoes (although there are those that debate if shoes are necessary). Just step outside and go! Once you start the routine, it’ll just get easier.

It’s tough to go to Walgreens, Target, CVS, or Walmart without passing by a display for the Ped-Egg. Reviews are usually glowing that their feet feel incredibly soft after treatment. When I look at it, I see one thing…a cheese grater.

I have an iron-clad rule in my practice, if you look at a product, and you think….”man, that would be great to zest a lemon or grate cheese, you should NOT use it on your body”…especially your foot!

The Ped Egg is actually a series of sharp blades that grate away hard skin. The problem is, you need to go by feel, not sight. How do you know you’re getting too close? You feel the pain, see the bleeding, etc. OUCH!! What if you can’t feel the pain? Some people with peripheral neuropathy do not have enough sensation to feel when you have gone too far. Again, these are BLADES! You don’t want a pedicurist coming at you with a sharp blade, why would you want to yield one blindly?

Calluses can be well treated with a variety of creams, callus pumice stones and files, and pads. You can find a variety of these products on our online foot care store. Remember, you wouldn’t want to use something like the slide the kid is about to go down, right? You’d never do that…don’t do it with your feet either!!

When a new product comes to market, look at it with a critical eye and think “is it really something good to use on my feet?” Let your gut guide you!

You wake up one morning and it hits you like a ton of bricks. A sharp, stabbing pain in the bottom of your heel. As you start trying to walk it may progressively ease up…but if you sit for a period of time, there it goes again! Welcome to the not-so-exclusive club of Plantar Fasciitis. You are in good company – approximately 25% of adults will experience heel pain at some time.

The plantar fascia is a ligament that attaches to the heel and extends through the arch. Due to an injury, or just longstanding biomechanical imbalance, the attachment of the fascia to the heel becomes inflamed. In order to appropriately manage this, both the inflammation and the mechanics must be addressed.

Treatment of inflammation is a modification of the ‘RICE’ principle: Rest, Ice, Compression, and Elevation. In the case of plantar fasciitis, ice is most helpful. Anti-inflammatory medication is also useful. In extreme cases, an injection of cortisone can be used to quickly manage the inflammatory process.

Without mechanical control, all the anti-inflammatory measures will be for naught. Initially this can come in the form of a taping or strapping to splint the plantar fascia ligament. An off-the-shelf supportive insole can be used as well. In many cases a custom orthotic device will best serve to neutralize the pathological mechanics adn best prevent a reoccurrence of plantar fasciitis.

One thing that needs to be mentioned is that plantar fasciitis is not a sign of aging. On the contrary, it is a syndrome of activity. In my Houston practice, I have treated patients with plantar fasciitis who are as young as in their 20’s. Don’t assume it will go away on its own, however. Be sure to visit your podiatrist to get you out of pain as quickly as possible!

The weather is starting to get cold. Even here in Houston, TX, we have days with cold weather and, yes, some freezing conditions. Don’t just assume it is business as usual! Although this weather forces many runners indoors onto tracks and treadmills, some prefer to remain outdoors.

There is nothing wrong with running in cold conditions but if you do you must make sure you take the proper precautions to take care of your feet. Here are 5 tips for running in cold and wet conditions:

1) Wear quality waterproof socks

Everyone knows that shoes can make a huge impact on the health of your feet, but socks are just as important. Make sure that you have a good hardy sock, not any of those thin shear cotton socks because they don’t help get rid of the moisture on your feet fast enough in wet conditions.

2) Bring an extra pair of socks

If you are going to run a race in cold or wet conditions then consider bringing an extra pair of socks that you can put on immediately before the race begins. This will ensure that your socks are fresh and dry.

3) Try Using Waterproof shoes

Many shoe companies now make shoes that are either partially waterproof or completely waterproof. They help to keep your feet dry which will help prevent blisters from forming.

4) Try to stay indoors as long as possible before the run

The longer you stay outside in cold weather the greater chance you have of get frostbite on your toes or other areas of your body. Try to limit the time spent outside to as little as possible. If racing in cold conditions try and find a warming tent to stand in for as long as possible before your race.

5) Avoid running in slush, puddles, or deep snow

Always try to take the cleanest path possible on your runs even if this means going a little out of your way. Trust me it will pay off at the end of the run because when your feet, shoes or socks get wet you have a great chance of getting frostbite or blisters.

Frostbite is serious business. However if you ensure that you do all you can to prepare for the cold weather, you should still have an enjoyable and successful run.

This is a direct quote from one of my patients this morning.  She is a woman in her seventies, suffers from bunions, hammertoes, and unrelenting peripheral neuropathy.  She is always looking for the newest and greatest remedies that  can offer her to eliminate her pain.  She is, however, unwilling to relinquish her high heels.

I’ve experienced this commitment to shoes before.  Years ago, I treated a retired principal who was in her nineties.  Each visit she would walk into the office in her high-heeled Ferragamos while holding on to her walker.  Over time, her feet progressively swelled over the course of the day.  It reached a point that the shoes were actually causing the skin on the toes to break down and form ulcers.  When I got the nerve to tell her that the shoes are hurting her and it was necessary for her to switch, she replied “I have always been a 6.5 AAA shoe size and always will be…and Ferragamo is a fine shoe.”  I never saw her again.

People are passionate about how they appear, but it is important that passion does not cause them any harm.  If your favorite shoes are causing pain or problems to occur, it’s time to find a new favorite.

After having a child many women want to lose their baby weight so they look for activities that they can do to shed some pounds but still spend time with their little bundles of joy. Jogging strollers are a great option that allows just this.

Whether you are new to stroller jogging or if you have been doing this for years there are a few things that you need to keep in mind in order to keep your body out of harm’s way. First, it is important to remember that even if you are an experienced runner, starting to exercise with a jogging stroller is an entirely different experience. You are no longer pumping your arms to help propel you forward. This means more power must be derived from your legs and feet, thus putting more pressure on them as well.

Secondly, your posture is going to change because when you are pushing the stroller your back hunches slightly. If you are not used to this position, then expect to be sore the first couple of times you start stroller jogging.

Third, expect different muscles and areas of your body to ache more than they normally would in your pre-baby running days. When running with a stroller you are positioning your body differently and adding an extra pushing motion which will cause different muscles to be worked. Also, if you have put on some extra weight then you must keep in mind that you are putting more weight onto your feet which may cause them to hurt more then usual. I would recommend buying a new pair of running shoes when you first start out. Using old running shoes from before baby, when you were running ten to twenty pounds lighter than now, causes the pressure points to shift causing your feet to blister.

Getting back into shape is an important step for any mother to take after she has a child. The better shape you are in, the easier you will find being able to keep up with your children. Just remember to start out slow when you first begin to exercise again. Take in to consideration all the things your body has been through recently and don’t get frustrated if you get tired quickly, this is to be expected for the first couple of weeks when beginning a workout routine.

Schools are letting out and summer vacation is coming up.  As you’re developing that checklist for your trip, be sure to add one thing:  Visit your podiatrist.

In a typical day, I’ll see lots of patients who have just got home from a trip and are lamenting the fact that they didn’t come in for a foot checkup before they left.  On Day 3 of their trip a callus or corn started to act up…Pain!  A tiny bit of heel pain becomes a major issue from walking in the airport.  The little nothing becomes a big something.  You get the picture.

A visit to you podiatrist can give you piece of mind, especially with the investment of a big trip.  Headed to Europe?  Those hard, uneven stone roads will make a small twinge become an unbearable pain quickly.  A cruise?  Even if you don’t think you’ll get off of the ship, they’re HUGE and require lots of walking.

The sooner you address your foot issue, the quicker it can be resolved.  A small pain is much easier to address than one that gets out of control.  After three to four days of pain, chances are it is not going away on its own.  Save your vacation…address the pain…see your podiatrist first!

I saw a commercial yesterday for Dr. Scholl’s For Her Smooth My Sole. Much flashier commercial than the low budget Ped Egg. Nicer looking product. And a name you can trust, right?

WRONG!

Beverly Hills 90210’s Jennie Garth is recovering from a broken foot. She’s the next in high profile celebrity injuries. What is particularly interesting about her story, however, is how uneventful it really was. Reports are that she was home and carrying her baby. She went to answer the door, stumbled, and twisted her foot which led to the break. Is there anyone reading this who honestly can saw they’ve never done something similar?

It doesn’t take much to break a bone. Sometimes a quick twist of the ankle is enough to cause a major fracture in the foot. Walking to the bathroom in the dark and tripping over the kids’ toys. Knocking the toe on the furniture. It has happened to us all. Because of that, it’s very easy to dismiss it as something that will go away quickly.

But what if it doesn’t. Some of these injuries can become quite serious. A twisted ankle, for instance, can lead to a fracture of the base of the fifth metatarsal bone. If this fracture is not immobilized quickly, it can displace and require surgery to get it healed. Even a broken toe should be examined with an x-ray to make sure it is not displaced. If it is, it is important to address it before it starts to heal on its own or the treatment later on will become more complicated.

It sounds like Jennie is getting the treatment she needs. Let’s learn from her good example and take care of our minor injuries…before they become major ones.

There are many walking fundraiser events these days that truly tests a person’s endurance. The Houston area hosts several of these events every year. One of the most popular examples is the two and three day breast cancer walks in which you can walk the distance of almost two marathons. The way most of these events work is you walk all day, sleep in a tent overnight, and then get up the next morning to keep walking. While causes like breast cancer really strike a cord with people there are a couple of things that people must keep into consideration when taking on a challenge like this so that they can prevent getting hurt.

1. Listen to your body, not your mind:
Many times when people are walking or running for a cause they get very emotionally involved in their drive to finish the race. It is important to listen to your body. If it hurts, stop!! Just because you don’t finish a race or event does not mean you are letting someone down or that you don’t care about the cause.

2. Just because you are a runner doesn’t mean you are a walker:
There are many runners out there who attempt to do one of these long walks and find themselves more sore then after they run…this is natural. Walking uses different muscles than running, so it is like your body is starting a new exercise routine that it is not used to.

3. Don’t be afraid to stop for aid:
At all of these events there are always medical and podiatry tents to care for race-day injuries. One of the most common injuries seen when walking long distances is blisters. If you stop at a podiatry tent, there are many trained medical volunteers who are there to help drain your blisters and bandage you up so that the rest of your race will be more comfortable. It also prevents further trauma that can cause infection.

Walking for a cure is one of the most emotionally gratifying things you can do. Just make sure that if you attempt a walk with a distance longer than you’re used to that you know what to expect. Listening to your body and stopping for help if you need it, even if you are an experienced runner, should not be a blow to your athletic psyche.

Judge Sonia Sotomayor, who was recently nominated by President Obama to be an associate justice on the Supreme Court, tripped at Laguardia Airport while trying to catch a flight back to Washington today. Once on the plane, she realized that she needed treatment and was taken to an ambulatory hospital in Washington for treatment. She is now using crutches as she continues her meetings with senators on the path towards her confirmation.

This is another example of an everyday activity gone bad. Last week, actress Jennie Garth stumbled in her home and broke her foot. Now we see how something simple as walking through the airport can have significant consequences. No, I’m not going to comment that she should have gotten to the airport earlier so she didn’t have to rush (trust me, I’m not one to criticize that!). I do commend Judge Sotomayor for seeking care quickly…most do not.

The ankle has several ligaments on both sides to stabilize the joint. There are also several tendons traveling down all sides of the ankle. When an ankle is twisted, most commonly the supporting ligaments are damaged. This is known as an ankle sprain. Occasionally, however, the ligaments or tendons can pull off a piece of bone, which is an ankle fracture. The ankle bones may also fracture without a direct pull of the soft tissue.

Both fractures and sprains will be painful, with swelling and bruising noticeable. The idea that if it is broken or fractured you won’t be able to walk on it is not true. The only way to tell is to get an x-ray, available quickly and painlessly in all podiatrists’ offices. No need to go to the hospital for this, unless, of course, you’re in the running for the Supreme Court.

The type of sock that you wear when you run is crucial to the comfort and health of your feet. It is important that you are running in the right type of socks that can stand up to whatever weather condition you may be running in. If you are running in cold conditions you will want a sock that will keep your feet dry and warm. In warmer conditions you want a sock that can keep your feet dry and cool. If you are a trail runner you will want a thicker more durable sock If you are a short distance runner you are going to want a more lightweight sock.

During the summer months, when it is warm outside, you sweat more when you run. It is very important to have a sock that has certain characteristics to deal with the heat. You must be certain that the sock is able to wick away this extra perspiration from your foot; otherwise you will acquire excess moisture against your skin that will cause blisters to form.

The most crucial factor on deciding which type of sock to wear during these warm months of the year is the material of the sock. You want to stay away from anything that is made of mostly cotton. Cotton is a great lightweight material but does not dry quickly. Cotton socks absorb the moisture from your feet and remain damp. This can cause blisters to form from the rubbing of the wet socks against your feet as you run. Some better materials for socks to use during warmer conditions are polyester, acrylic, and CoolMax. These synthetic materials are more expensive than cotton socks, but they really stand up to the heat. These materials will help to wick away your perspiration while keeping your feet cool and blister free.

Another thing to consider when buying warm weather running socks is to look at the design of the sock. A good running sock is made up of two layers. The inner layer of the sock should help to wick the moisture away from your feet and the second outer layer should remove the water from the first layer and aid in evaporation. This design will keep your feet as dry as possible so blisters will not form.

Runners are so concerned about running in the right shoe, they don’t give much thought to their socks. The next time you go to purchase running socks, make sure that they check what the sock is made of and its design. All socks are not created equal.

I was reading an article in the UK Daily Mail entitled “Check Out Your Bunions While Buying Your Onions” this morning and I was intrigued. It described a podiatrist who has set up clinic in a grocery store a couple of days a week. Would this work here in Texas? If people are too busy to go to the podiatrist, should podiatrists just station themselves to where the people are?

This model is not unfamiliar to the US. Several years ago, WalMart was exploring a partnership with podiatrists in their stores. That program ended up fizzling. You will find, however, walk-in clinics popping up in Walgreens, CVS, WalMart, and other stores and pharmacies. They are often staffed by a nurse practitioner or physician assistant to administer minor treatment or prescribe medication for an illness. They are marketed to people without insurance, but the convenience is attractive to many.

Podiatry, along with other specialties, require specialized and expensive equipment. For optometry, stores like WalMart and Target seem to have realized that the investment in this equipment is worthwhile. I don’t think the same will hold true for podiatrists. Having a podiatrist in these types of situations will be providing fairly limited services, like caring for toenails, corns, and calluses, such as what was described in the article. If someone truly required more advanced foot care, such as treating a diabetic ulcer or bunion surgery, a visit to the office will still be best.

Word has gotten out that Yao Ming did not get great news about the broken bone in his foot at his six week checkup. The bone does not seem to be healing properly, although he has no pain. He still is laid up and won’t be playing for the Chinese national team. It remains questionable when he’ll be ready to play for the Houston Rockets.

According to the article that I read at ShanghaiDaily.com, a bone scan done recently shows the fracture as still unhealed. I happen to know who Yao’s doctor is, so I certainly trust his assessment. I think the story gives a false impression, though. A bone scan is a test that shows bone activity. It is great because it’s sensitivity can pick up fractures and other bone issues that may be hard to see on a plain x-ray. A problem, though, is that it is so sensitive that it can still give a false positive signal for things like arthritis, past surgeries, and old fractures. I would expect to still see the fracture on the bone scan.

It certainly is possible for the fracture to not heal quickly, especially on a big guy like Yao. Bone has a blood supply…it’s living tissue. Some areas of bones have a greater blood supply than others and if the fracture occurred in a weaker area, it likely has a poorer supply. This can cause a condition known as avascular necrosis. This is a deterioration and non-healing of the fracture site due to a poor blood supply. Often, the use of a bone stimulator can be helpful for this. A bone stimulator is a device that sends waves to the bone to stimulate blood flow and bone healing. It is a non-invasive device that works well to get a bone to heal faster and stronger.

A bone stimulator is not just for professional basketball players, it is covered by most insurance companies and can be prescribed by your podiatrist.

UPDATE 6/30/09: As more details emerge, the first article had it wrong…while he might have had a bone scan, the determining test was a CT scan. This is a much more appropriate test and would be able to assess the status of healing of Yao’s fracture. It seems like it’s possible that he’ll miss much or all of next season. I’m hoping he’ll be able to have this fracture ultimately heal without surgery. With all the surgery Yao has already had, another could really damage his career.

Athletes foot is a fungal infection, known as Tinea Pedis, that grows in damp sweaty environments. This is a common condition that occurs in many runners that can be very irritating to deal with. The infection commonly causes itching, stinging, and burning between toes, as well as peeling, cracking and blistering skin on the feet. This fungal infection is common in runners as well as many other athletes (hence it’s name) because of the environment it grows in.

The fungus that causes athletes foot can be found on damp contaminated surfaces such as in locker rooms, bathrooms, and pool areas. It is also contagious, so if a family member has the infection, it can remain on surfaces to infect others. Athletes foot grows rapidly between toes since it is a moist and warm area. Runners who pick up athletes foot will then put on socks and shoes and run causing an even more ideal environment for the fungus to grow in since your feet become even more warm and sweaty. Add to that the hot and humid weather in Houston, TX and you have the ideal circumstances for the fungus to thrive.

There are a couple of things you can do to prevent getting athletes foot. Always wear flip-flops or shower shoes when bathing in public facilities and in bathrooms that you share with someone who has athletes foot. Whenever you get out of the shower or pool make sure you dry between each toe to eliminate excess moisture that Athletes foot can thrive in. Do not wear all-cotton socks because they cause your feet to be damp when they sweat. Buy socks made of a synthetic fiber that are thoroughly able to wick away any excess fluid, such as CoolMax and DryMax.

If you get Athletes foot there are over-the-counter antifungal products, such as Lamisil cream, to treat the infection. To treat the infection, begin by washing your foot, making sure to wash and dry the areas between the toes. Apply a thin layer of an anti-fungal medication to the affected area as directed on the label. Most over-the-counter anti-fungal medication can take up to two weeks to heal completely. If you are not sure which medication to use, or if the over-the-counter medication is not working, contact your podiatrist.

You should also be sure to treat your shoes. Having fungus in your shoes will cause you to reinfect yourself after the Athletes foot has cleared up. Spraying your shoes with a disinfectant spray, such as Mycomist, will allow the fungus to be controlled and will help to prevent the infection for reoccurring.

A blister is a small pocket of fluid contained in the outer layers of the skin. A blister is caused by irritation of the skin from excessive rubbing, burning, freezing, chemicals toxic to the skin, or infection. It can contain blood, serum, or pus within it. If you are athlete you are probably very familiar with blisters. They commonly appear at places that get repeated irritation. The location of blisters depends on the activity you are doing. If you are a golfer, weight lifter or baseball player the most common places to get blisters are on your hands, a skier or snowboarder on your shins or lower legs, and a runner or walker on your feet.

Once people realize that they have a blister the most common issue is not knowing what to do. Do I pop the blister or do I leave it alone? Some people say don’t pop a blister because it can get infected and it will just get worse. Other people say pop a blister as soon as it forms otherwise it will keep getting bigger. I can see why there is confusion as to pop or not pop a blister because there is a little truth in both of these statements. As far as what a trained health care professional will tell you, such as a podiatrist, it is better to pop the blister, but doing it in a clean and sterile manner. If you need to drain a blister because you are going to continue the type of activity that caused the blister, follow the following guidelines to do it safely

1) Gather the following supplies: washcloth, soap, sterile needle, gauze, antibacterial ointment, Band-Aid

2) Clean the area over and around the blister with a washcloth, soap and water.

3) Carefully hold the sterile needle in your dominant hand and gauze on your non-dominant hand. Puncture the blister on the side then immediately apply pressure over the blister with a gauze pad until you have drained all the liquid from the blister. Be sure to leave the “roof “ of the blister intact.

4) Properly dispose of the needle and gauze pad.

5) Apply a thin layer of topical antibacterial ointment to the area where the blister was located.

6) Put a Band-Aid over the area to help prevent infection.

7) Figure out what caused the blister to form and find a way to stop the irritation from continuing. This will prevent additional blisters from forming.

Blisters are common occurrences, especially in active people. Most blisters are easy to treat but if you feel uncomfortable treating it on your own, or think that your blister may be infected, contact your local podiatrist for a professional opinion.

We all have those things we come across and say “I should have thought of that!” A few years ago, when in the exhibit hall for the Houston Livestock Show and Rodeo, I had such a moment.

Among all the tractors, ranch supplies, hot sauces, and other vendors you’d expect, I came across a guy selling insoles. The product was much more supportive than one you would find in a pharmacy but a far cry from a custom orthotic. Plus, knowing his audience, he had some that would fit into western boots.

As with most conventions and exhibit halls, there is a ton of walking on hard concrete floors. Surely the number of attendees with foot pain increases as the day wears on, and there the vendor is to provide instant relief at a premium price…Genius!

As you head off to such a conference, go prepared with either some good insoles, such as Powerstep or Superfeet. If you are already experiencing foot pain, see your podiatrist for relief before you go and do all of that walking.

I had the opportunity to attend my friends’ children’s high school graduation this week. The school is a small private school in Houston, TX with a graduating class of 17. It was an inspiring ceremony and I wish my best to all graduates this commencement season.

Of the female graduates, almost all of them were wearing the highest heels I have seen. It hurt me to watch as they walked across the stage to receive their diploma. People ask me what i think of such shoes. My answer is “They’re great for business!” At some point these young ladies will have foot issues and I’ll be there to treat them.

The most common injury that comes from wearing high heels is a Morton’s Neuroma. This is an inflammation of the nerve that travels between the metatarsal bones and provides significant pain in the forefoot.

Treatment for a Morton’s Neuroma can include anti-inflammatory medication, cortisone injections, custom orthotics, and nerve sclerosing injections. A recent study appearing in the Journal of the American Podiatric Medical Association also showed the effectiveness of shockwave therapy (ESWT)on neuromas, previously used only on heel pain. There is also surgery to remove the painful nerve, of course as a last resort.

Wearing high heels occasionally is unlikely to provide problems. Habitual use, however, can cause significant trouble. Moms…be sure to tell your daughters…they won’t listen to us dads!

I just got my newest video for my website back from the editor and thought you’d like a sneak preview. It’ll be on my website shortly, but I got it up on YouTube so you can take a look now.

I’d like to introduce everyone to my 8 year old son Ariel. Ariel has been wearing orthotics since he was four and is incredibly diligent about making sure he transfers them from shoe to shoe. Today, however, he forgot and found his feet to be aching. Of course, when we were walking home he said…Dad, should you blog about me forgetting to wear my orthotics? I thought we’d do one better and make a short video withfoot him telling everyone in his own words.

The videos just got up on the website, so I can’t call this one a sneak preview.

This video discusses the use of a custom orthotic to control the biomechanics of the lower extremity. When we deal with the multitude of foot and ankle injuries, mechanics plays some role. From heel pain, to neuromas, to chronic ankle sprains, controlling the mechanics with an orthotic is the best long-term investment to keep those injuries from reoccurring. To learn more about the use of orthotics, visit our website.

Shin splints is one of the most common injuries that connects runners all over the world. Also known as medial tibial stress syndrome this aliment can be very painful and irritating to deal with as a runner. Here are some facts you need to know about shin splints to educate yourself about what they are and how you can help to alleviate them.

What are Shin Splints?
Shin splints are an irritation on the front of your lower leg that manifests as pain, swelling and soreness. The pain is caused by muscles pulling on the shin bone called the tibia. This happens due to overworking and overloading the muscles and bone (tibia) load of the lower extremity.

What causes Shin Splints?
Shin splints are caused by physical activities such as running. Certain motions can make an athlete more prone to getting shin splints. These motions are: running on uneven surfaces, not wearing the proper running shoes, running on hilly surfaces, and frequently stopping and starting during activity. The contour of your feet can also affect the probability of acquiring shin splints. People with flat feet have a much greater chance of getting shin splints because it causes the muscles on the shin to pull harder on it.

How do I heal Shin Splints?
The best way to heal shin splints is to rest from the activity that caused them to appear. This treatment is not always feasible (or desirable) so there are some other things that can be done to lessen there severity. These include icing the area for 15 minutes 5 times a day, getting new running shoes that properly support your feet, and taking over the counter medication that also has a anti-inflammatory agent to reduce swelling. Providing support with an appropriate insole or custom orthotic can also provide the biomechanical support and control needed to reduce the pull of the muscles and prevent the pain from returning.

Shin splints are a very common obstacle that many athletes have to overcome. Just because you have shin splints does not mean you need to stop a sport or activity that you love. If the information above does not help to alleviate the pain then you may want to consult your podiatrist for further treatment.

A sprained ankle is one of the most common injuries of the lower extremity, with approximately 8 million people spraining an ankle each year. Also known as twisting or turning the ankle, it can happen as a result of playing sports, running on uneven surfaces, or just walking along. The foot turns in on the leg, which can lead to a stumble, trip, or fall.

There are some interesting statistics that show that people who sprain their ankles will injure them again in the same way up to 80% of the time. Why does one injury put someone at such major risk of repeating the injury?

Studies have shown that many people who have a tendency of spraining their ankle have poor balance. This can be demonstrated by standing upright (have something close to hold on to) and standing on one foot. The more wobbly you feel, the better the chances are that you will sprain an ankle, often repeatedly. This can be remedied by some simple exercises to increase the strength of the muscles. Again, stand on one leg and try not to wobble. Hold that position for one minute and repeat on the other leg.

Why does balance training help someone from repeatedly turning their ankle? As an ankle is sprained, the supporting ligaments are injured. They do heal, but in a stretched position. There are receptors in the ligament that are damaged also, which provides feedback to the brain about the position of the joint. This feedback becomes faulty with persistent injury and the balance suffers as a result.

While ankle supports and braces are helpful to provide stability to the weakened joint, pursuing a regimen of exercise to increase the balance is particularly helpful. This can be as simple as standing on one foot and balancing when you are brushing your teeth every day. If you want a greater challenge and result, there are a number of balance boards and mats available.

There are many dedicated female runners who become pregnant and are faced with the decision of taking the next 9 months off from running or continuing to run while pregnant. There are varying opinions out there about how much exercise a woman should or should not do during pregnancy. This can be confusing for a woman who is looking for a clear cut answer. The reason for the ambiguity is that there is no absolute “yes or no” answer to if a women should continue to run during pregnancy. The answer depends on the health, level of running a women usually does, and difficulty of pregnancy of the women.

One thing that most experts on this subject agree on is that women should stay active during their pregnancy as long as they do not overexert themselves. If you are a long distance runner, then you are going to need to tone down your training schedule because any stress or strain you put on yourself will also be put on your child. It is also important to remember to never let yourself become overheated because when you overheat so does you baby. If you live in a hot climate, such as Houston, then you are going to have to consider moving indoors for your runs. Runners do love, and even depend on, their routine. Pregnancy, however, requires some of your routines to change.

There are also many side effects of pregnancy that may limit a woman from running certain speeds, distances, or even running at all. During the first trimester, women commonly feel morning nausea which may prevent those who are used to running in the morning from continuing their morning running routine. During the second and third trimesters, the feet also can become swollen which can prevent women from running. Women should not attempt to run away the swelling in their feet because this may overwork the heart as it attempts to pump the excess fluid against gravity while also keeping up with the stress of running.

Running is a very important part of many women’s lives. It is important for pregnant women to know the facts about running while pregnant in order to keep their body and their baby’s body safe. It is also important to communicate with your doctor and podiatrist about running during pregnancy so that they are well informed of your physical activity during pregnancy so they can best inform you of any side effects you may experience.

As parents, we always want the best for our children. Did you know that most of our kids are wearing shoes that are too small? Don’t feel too bad, it happens to us all (yes, even your friendly neighborhood Houston podiatrist).

We are conditioned to our own adult feet, which are no longer growing. We wear our shoes until they die, and often well past their demise. We buy shoes out of desire, but not necessity. Kids are different.

The feet of children are rapidly growing and developing and need room to do so. But don’t give them too much room. The old days of buying shoes with “room to grow” were just our parents trying to stretch the usage of the shoes. Don’t do that! Kids need shoes that fit them properly, just like you do.

What do you look for when you are buying shoes for children? First of all – keep shoes off of your infant! Babies who are not yet walking should be barefoot or wearing socks or soft booties…nothing more. Oh, and I don’t care if they are so cute or match the outfit. Keep them off! Babies need to explore their feet for proper development and feel what it is like to stand and balance barefoot. They need that natural feedback, so let them have it.

I’ll relent a bit once the kid starts walking. The shoe, however, needs to be flexible. If you push up under the toe area while holding the shoe, the shoe should flex upwards with minimal resistance. Toddlers’ feet also do not need any arch support, so don’t look for shoes that have it.

This changes between ages 3 and 4 when you may notice some in-toeing, out-toeing, toe walking, or excessive stumbling. Children this age don’t have the ability to compensate for biomechanical forces and issues like adults do. Their pediatrician may tell you that the child will grow out of it. Even so, what most commonly happens is that kids just develop the ability to compensate for those biomechanical forces and the mechanics lead to problems down the road. Identifying issues early and putting a child into a custom foot support, called an orthotic, when needed will allow the kid to develop around a more mechanically correct position. Because of this, the correction that an orthotic device provides to a child may become permanent.

Also at this age, kids start wearing shoes that are more familiar in appearance you your adult shoes. Many athletic shoe companies will make sizes for children. You should also buy a shoe according to the activity, just like you do for adults. For instance a running shoe for kids who enjoy running (not playing, I’m talking about running). The rule of thumb is to have about a half-inch between the longest toe and the end of the shoe.

Your child’s feet are crucial to their happiness. Kids are built to go nonstop – bundles of energy to run, jump, play, and climb. If you see your kid sitting out during a game, or refusing to walk when you are out shopping, don’t chalk it up to laziness. First check to see if the shoes are too small. If they’re not, consider taking the child to a podiatrist to see if there is anything more you can do to get your child active once again.

This just in…

Yao Ming has decided that the best way for him to repair his broken navicular bone in his left foot is to have surgery. The plan is to use a bone graft to fix the fracture and surgically lower his arch to reduce the stress on his foot. This will keep him out for the entirety of next season with the Houston Rockets.

This is probably, in truth, the best option for Yao. Most elite athletes are treated with surgery because it provides the most stable, quickest, an most complete repair. Yao’s fracture is different because the navicular manages a large amount of the transfer of weight from the ankle to the foot. It is an irregular bone with irregular joints so it’s repair can be unpredictable.

Based on his treatment thus far, it seems that Yao is doing his best to heal completely and, hopefully, make it back to the basketball court. I hope he will end up in a good pair of biomechanically sound orthotics afterward to best balance his feet to prevent future injury. I wish him a complete and speedy recovery.

I have written before how impressed I often am with specialty running stores. Tonight I have the opportunity to visit the Luke’s Locker location in Katy, TX, a suburb of Houston, for a reception sponsored by Asics. It was a very informative evening and I had the opportunity to visit with Sarah Balboa, the shoe manager at the store.

In speaking with Sarah, it is clear that she is passionate to stay on top of the features of every shoe she stocks in the store. She is committed to provide her clients with the best fitting and most functional shoe for that person and their particular foot type and mechanics. She takes the time to watch the customer walk without shoes so she can recommend the appropriate shoe, while taking into consideration what activity the person will do as well as if an orthotic is being worn and, if so, what type.

As a podiatrist, this is crucial for me to know. I treat serious athletes and I need to know that I am sending them to a store where the staff will take the time to devote to them to ensure they function at the highest level. As I’ve said before in a previous post: Running Stores Know Runners. I have lots to stay abreast of and, try as I might, there are so many changes in running shoes. Some companies update and change as often as three times a year!

So while it’s easier sometimes to pull a shoe off a shelf at Academy or Sports Authority, and even easier to order online, there is no substitute for going to a store like Luke’s Locker where the staff is well trained and their mission is to provide you with the equipment you need to keep you running at peak performance.

Many runners have been surprised to take off their socks after a run to notice that one or more of their toenails is turning black and blue.  Many times the bruised toenails can look much worse than they are, but there is actually a simple explanation for this condition.

If a runner does not wear shoes that fit them properly then their feet are able to slide in their shoes.  This can occur if running shoes and too big because the foot will slide around in the shoe and bang up against the front edge.  This can also occur if shoes are too small because the toes begin to jam up against the front of the shoe.  This is why it is so important to get shoes that fit properly in order to prevent the toes front hitting the front of the shoe to hard.

If the nails are turning black and blue from the toes hitting up against the front edge while running don’t be alarmed.  The color change is from micro lesions under the nail from where tiny capillaries have broken.   If you notice this discoloration the best way to get rid of this is to stop running in the same shoes that caused this condition.

Most of the time the discoloration does not cause much discomfort, however, the nail can become infected if it is not kept clean so make sure you wash around the nail to prevent  infection from occurring.  Sometimes if there is enough bleeding under the nail pressure can build which will cause discomfort.  If the nail starts to become painful, then you will want to go to get evaluated by a podiatrist.  The pain either signifies infection or pressure build up from bleeding under the nail, both of which can be easily treated by a podiatrist.

A bruised nail does not automatically mean that you will lose the toenail.  If there is substantial bleeding beneath the nail and a podiatrist relieves that pressure quickly, then the nail can reattach to the nail bed.   Otherwise, the prolonged trauma from the pressure can cause the nail to detach and a new nail to begin forming and growing.   If that occurs, the original, damaged nail will simply fall off when the new nail has progressed.   As long as the nail comes off with no pain or bleeding, there should be no concern.

Bruised nails are a common sign of running shoes not fitting properly.  If this occurs, get new running shoes.   Your best bet is to visit a specialty running store, which has staff trained to properly assess your needs to recommend the right shoe for you and to ensure that shoe fits properly.   If you have any pain with the injured toenail, be sure to get in to visit your podiatrist.

There was an article in the July 23 edition of the Wall Street Journal about Cankles, which is a word used to describe thick or fatty ankles. It is a combination of calf and ankle and is not usually used in a flattering way.

It seems that now that all other areas of the body have been firmed and sculpted, the ankles are getting their due. The article states that Gold’s Gym declared July to be “Cankles Awareness Month” with workouts devoted to the ankle. Even with their Cankles-busting workout, though, it may not show much improvement.

For those who just don’t want to give up on those perfect-looking ankles, plastic surgeons are advertising liposuction for ankles to remove the fatty deposits. The concern is that there can be trauma to the surrounding vessels and tendons that squeeze through the ankle to enter the foot. There are also people who are finding temporary relief by applying Preparation H hemorrhoid cream to their ankles.

Your ankles are meant to be functional. In many cases the heftier ankles are due to the formation of the achilles tendon lower than usual, so what you see is the muscle belly. In those cases, toning your ankles may even make them seem larger! Before you do anything to affect your ankles, or any other part of your body, be sure to discuss it with your physician. Also take a long look objectively and see if it is really something that you need to do. In most cases, it’s just not worth it.

An orthotic is a vital piece of equipment for those who wear them. They provide support and comfort when running and playing sports. They also help people get through their day outside of sports and exercise.

One of the biggest misconceptions is that orthotics should only be used for exercise and athletics. This couldn’t be further from the truth! The function of an orthotic is to provide support to the foot to allow the lower extremity to work more efficiently. For that reason, wearing them only for exercise puts you at a disadvantage.

Muscles have memory and enjoy consistency. If you only wear an orthotic for exercise, that only accounts for 10% of your day…maybe even less! Think about it this way: Let’s say you could only use your car 10% of the time, but you had to walk the rest. You’d be pretty tired, right? So think about your feet and legs only being allowed to work at peak performance for that same short time.

To make it easier to wear an orthotic throughout the day, they can be made to fit an athletic shoe, dress shoe, women’s high heels, western boots…anything where the heel is closed in. For those who enjoy a more open shoe, some sandals, such as Bite, can accommodate an orthotic. Other sandals, such as Birkenstock and Naot, can be custom made with an orthotic built in.

There are many factors that determine the useful lifetime of an orthotic. The first is the material the orthotic is made from. In my Houston podiatry practice, the orthoses we fabricate are made a firm plastic material. Because this material is durable and wears very little, the orthotic generally lasts about four to five years. Softer materials, such as cork, leather, and foams, will deform with time and has a much shorter lifespan of one to three years, depending on how it is constructed.

Another factor is your activity level. A marathon runner is harder on their feet than a “weekend warrior.” The foot is dynamic and must change with every step and manage forces. So the foot changes with time and those who are more active notice quicker and more dramatic change. This will require a change in orthotics sooner, simply because of a change in mechanics.

Finally, there are other issues that will cause an orthotic to be replaced. A major joint replacement, such as a knee or hip, will alter the mechanics of the lower extremity significantly enough to warrant a new orthotic. Generally, I wait six months for the joint to “settle in” until I move forward with evaluating for a new orthotic. Many women see changes in their feet and mechanics during and after their first pregnancy. This will occasionally require a reevaluation for new orthotics.

And let’s not forget about our household pets. If your puppy chews up your orthotic – we’ll need to replace them then too!

There are many people out there who cringe at the thought of having to run and, let’s face it, they do so for a good reason, running is a hard sport. I’ve seen track and cross-country teams in Houston wearing t-shirts that say “Our sport is your sports punishment.” Although many people train their bodies to be able to endure the physical requirements it takes to run, it can be quite intimidating to a new runner.

One of the most popular reasons that people start to run is to lose weight. Running is one of the best physical activities you can do to shed a couple of extra pounds in a short period of time. If you are using running as a tool to lose weight, here are some pointers to help you reach your weight lose goal in the most healthy and satisfying way:

1) You are what you eat
One of the most common misconceptions about weight loss is that you can simply lose weight by working out and not changing your diet. This is not true. The best way to lose weight is a combination of diet and exercise.

2) Don’t start off too fast
When people start their weight loss workout routines they tend to be excited and driven in the beginning and are at risk for doing too much too fast. This causes people to tire out, give up, or get injured. Try and write out a workout routine that you can realistically follow without pushing yourself to exhaustion.

3) Make sure you have the right equipment for your workout
When starting to run for the first time it is important to get a new pair of shoes that will give your feet the support they need. Also make sure you get some quality socks that will be able to absorb the sweat from your new workout schedule. There are many other gadgets runners use such as camelbacks, utility belts, absorbent clothing, and sweat bands. The best way to figure out what you will need for your runs is to visit a specialty running store. The employees are often runners themselves and can offer good advice.

Running is a great way to help shed a couple of extra pounds. In order for running to be affective a person must also change their diet, make a realistic workout routine, and have the right equipment that will help them avoid injury.

I usually only write about local Houston sports stories, but I found this one particularly upsetting and tragic. A star defensive end from USC and first round draft pick, Kenechi Udeze had to retire from the Minnesota Vikings due to unrelenting foot pain caused by peripheral neuropathy from chemotherapy. Udeze was diagnosed with acute lymphoblastic leukemia in 2008 and missed the entire season, although determined to return to football.

One side effect to some forms of chemotherapy is peripheral neuropathy. This can result in a numbness or persistent pain in the feet or hands. Chemotherapy, although effective in eliminating rogue cancer cells, is also detrimental to many healthy cells as well. Several years ago, when musician Melissa Etheridge was fighting breast cancer, she was noticing numbness in her fingertips. As she was unwilling to sacrifice her ability to play the guitar she sought alternate ways to treat the cancer. Thankfully she was successful in beating the cancer.

Peripheral neuropathy is most commonly associated with diabetes, however it is a common effect of a number of illnesses, medications, and treatments. Unfortunately it is caused by a number of different factors, so one treatment will not be successful in all cases. In fact, there are many cases of peripheral neuropathy that cannot be treated effectively at all.

To date, the only treatment that I have found that is successful in limiting peripheral neuropathy pain caused by chemotherapy is Neuremedy. It is a medical food with a bioactive form of vitamin B1 that helps to nourish the nerves. It is available in the offices of many podiatrists as well as online. Neuremedy does not interact with any other medication and has no side effects.

I wish Kenechi Udeze the best in his continued fight against cancer and hope that he ultimately finds a way to limit his pain and return to the football field where he belongs.

I have been a fan of the Houston Texans since the team started. I’ve been at almost every home game and love watching them. I don’t get nearly as frustrated as some others by past seasons. You see, I grew up a fan of the New York Jets. Yes, the Jets are the team that passed up Dan Marino for Kenny O’Brien. If that’s not frustrating, I don’t know what is.

Being a Jets fan all these years, I’ve learned a few things. One of those things is never predict that this year will be THE year…at least not publicly. I wish my Texans learned the same thing. All reports from the team, unofficially, and certainly the press have been hyping this team as our first playoff team. Even before the first snap of preseason!

Well, Tuesday’s workout saw two injuries of starters that can have a significant impact on the team. Center Chris Myers suffered a high ankle sprain on a play that Coach Gary Kubiak called sloppy. This will keep him out indefinitely, but he hopefully can return during the season. It all depends on the extent of he injury and how quickly he is able to rehabilitate. Starting Cornerback Jacques Reeves fractured his fibula in a collision with Andre Davis during another play that also sounds pretty sloppy. He’ll be out six to eight weeks.

Fortunately both players will not need surgery, but it is a major hit to the Texans expectations for their season. No one wants to see them healthy more than I do…I’m ready for a winning season and I’ll be there watching and cheering them on.

It’s a familiar sign, especially on fast food restaurant doors: “No Shirt, No Shoes, No Service (No Kidding).” Well in a Burger King in Sunset Hills, MO they certainly weren’t kidding! A mother was threatened with the police being called because she did had no shoes on her 6 month old baby. At six months old, of course, the baby is certainly not walking and likely not crawling. Even if she was, I suspect that her mom wouldn’t have her crawling around the dirty floors of the restaurant.

I hope that everyone reading this already realizes how ridiculous this is! The reason shoes are required in restaurants is not because of a health code, but rather to limit the establishment’s liability in case something is stepped on. Certainly shoes are dirtier than bare feet! And flip flops are permissible, so the exposure of a foot can’t be the issue.

The baby’s mom is absolutely correct. She stated in the St. Louis Fox Station’s report, that the baby didn’t even own shoes. At six month’s old, I should hope not! Baby’s at that age developmentally need access to their feet. Plus, as the baby is learning to stand, cruise, and walk, she will need the sensitivity of the soles of her feet to provide feedback to learn how to balance. At most, the baby can wear socks or very soft booties.

Once her baby starts to walk unassisted, shoes can then be used. When they are, however, they must still have a very flexible sole to allow for proper function of the foot. So, to answer a very common question, there is no age at which a child should start wearing shoes. It all depends on the baby, when she starts to walk, and the developmental milestones. Even if they are the cutest shoes, and they match the outfit perfectly, keep them off the baby. She’ll have plenty of time for shoes once she’s walking.

Have you ever heard the saying “You are what you eat”?? There is some truth to this statement especially when it comes to runners and other athletes. What you eat can strongly affect the outcome of your daily runs. Not eating enough can leave you lacking energy and feeling fatigued early in the run. There are a couple of things to keep in mind about how much and what to eat before a run.

If you run in the morning, make sure you eat something before your run because the food you digested from the night before is mostly gone by the morning and won’t provide with you with the energy you need to sustain you through your workout. If you are not a big breakfast person then consider eating something that is easily digestible and over 200 calories about 30 minutes to an hour before your morning run.

Men and women runners both need to make sure they are getting enough calcium in their diets, but this is especially true for women. When you run you put stress on your bones which cause them to need to remodel. If there is not enough calcium in your body then stress fractures may form. Some foods that are great options to make sure you get an adequate amount of calcium in your diet are dairy products like milk, yogurt, and cheeses. Although taking a calcium supplement may be a good option for some, the best way to get calcium is from food.  This is because you also require Vitamin D to absorb calcium into your body. Calcium and vitamin D tend to be found in many of the same dairy products.

The types of food you eat also will affect your running performance. In our society, there is a negative stigma against carbohydrates. For runners, however, carbohydrates should be your best friend. When you exercise your body creates fuel by breaking down the food that you eat. Carbohydrates are the most readily accessible food group to be broken down to use as fuel. After carbohydrates, the next most important food group to make sure you get enough of if you are a runner is protein. Running puts a lot of strain on your muscles and causes micro tearing in the muscles to stimulate muscle growth. Protein is needed to repair the micro damage to muscles in order to allow muscles to grow.

Of course, it is important to stay hydrated.  Especially in warm climates, such as Houston, the body cannot function properly if you do not consume enough water.  Be sure to drink throughout the day and during your run.  If your urine is not pale in color, you are not drinking enough fluids.

All runners need to pay special attention to what they eat. Having a healthy and balanced diet that is tailored to running can really help boost the performance and energy of a runner.

I had the opportunity to be invited to Foot Solutions here in Houston to spend the afternoon in residence for a “Doctor’s Day.” I had the opportunity to meet some of their clients who had questions about the best treatment for their feet. Some of my patients came too, to get my opinion on what was the best shoes for them.

Foot Solutions is a national franchise that specializes in quality shoes that supports the foot properly to allow for optimal function. Their shoes range from fashion, to sandals, to therapeutic, to more specialized shoes, such as MBT and Chung Shi. Much of what they provide is complimentary to what I strive to do for my patients at the office. Some of their products diverge from my philosophy, such as their idea of what constitutes a proper custom orthotic.

One of the most exciting new lines of shoes that I was introduced to is a line of handcrafted, custom-ordered, shoes for men from Tauer & Johnson. These shoes offer a large number of different styles and the customer’s choice of leather and sole. The quality is truly extraordinary and very comfortable. Recently, shoe companies have been providing men with fewer choices and the quality is not what it used to be. This now offers me a choice of shoe to suit them and offers a perfect fit.

I will love to return to spend time at the store. It is important for podiatrists to have a shoe store that knows how to properly fit and recommend a shoe. It’s equally important for the store to have a podiatrist to refer to when a shoe alone will not solve the issue.

Former, and possibly future, Olympian Paula Radcliffe won the New York Half Marathon on Sunday. This is her first race since the New York Marathon in November and also her first after recovering from bunion surgery. She will assess her progress in the next few days to see if she will pursue the World Championships Marathon in Berlin.

This is great news. One of the most common concerns my patients have when considering bunion surgery is whether or not they will be able to return to running, triathlons, or any other athletic activities. I’m pleased that I’ll be able to point to Ms. Radcliffe as someone who recovered from bunion surgery and rehabilitated several other injuries and has been able to return to a world-class level.

One treatment that is likely helping her at this point is a custom orthotic. An orthotic is a custom insole that supports and stabilizes the lower extremity. It balances the mechanics to remove the forces that deform the foot and cause a bunion. An orthotic allows the foot to work at it’s most efficient and prevents a recurrence of the bunion. I hope that Paula’s doctors have her in a custom orthotic so she can continue to pursue her goals.

A bunion is a common foot deformity that presents as a bump on the inside of your great toe joint. Especially in warmer climates, such as Houston, where people tend to wear open shoes year-round, people with bunions become concerned about the appearance. When they put on a closed shoe, the pressure on the bunion can cause a sharp, stabbing pain.

Most people think a bunion is a growth of bone on the side of the foot, but in most cases this is incorrect. A bunion is formed by the rotation of the first metatarsal bone which is caused by mechanical forces. This bone shifts over and causes the great toe to move over towards the second toe. This can even cause the great toe to push up the second digit, forming a hammertoe.

The worse and more painful the bunion becomes can require surgery. This often involves the bone being surgically fractured, repositioned, and repaired using a tiny screw. Needless to say, the recovery is involved, since the bone must heal. The good news is that bunions do not form overnight and steps can be taken to prevent their progression once they are noticed.

A bunion typically does not form because of bad or tight shoes, although they can contribute to them. The potential for developing a bunion is hereditary. If a parent or grandparent has a bunion, it puts you at greater risk for developing one yourself. This is because you inherit the mechanics that causes a bunion to form. So when you notice a bump on the side of your foot beginning to form, see a big callus on the side of your great toe, or start seeing your great toe drifting towards your second toe, that is the time to take action.

An orthotic is a custom insole or shoe insert that works to correct the mechanics that causes a bunion to form. By addressing the forces that cause a bunion deformity, an orthotic helps to neutralize them and redistribute them across the foot. The orthotic essentially fools your foot into functioning more efficiently and stops the bunion deformity from progressing.

To have an orthotic made properly, a podiatrist should perform a biomechanical examination to learn what forces are coming into your foot from the lower back, hips, knee, and ankle. A gait analysis is often performed to see how the foot functions when walking. Ultimately a mold of the foot is taken with plaster or fiberglass while holding the foot in a stable, neutral position. It is from this mold that the orthotic is fabricated.

The orthotic will do much more than prevent bunions from progressing! By making your feet, which are your base of support, more stable, it takes the pressure off of the knees, hips and back. In fact, many people who suffer with knee and back pain find that an orthotic removes the pressure and relieves the pain.

Bunions will reach a point where orthotics will no longer help and surgery may be your only option. The sooner you visit with a podiatrist, the more likely you will be to prevent a bunion from becoming worse and, hopefully, will be able to avoid surgery altogether.

President Barack Obama has received some significant criticism in the last couple of weeks for some comments he made related to his health care plan. He suggested that doctors stand to make $30,000 for an amputation. This number is not even close, as it consists of the entire hospital stay. According to an article by the Associated Press, the surgeon’s fee is a small fraction…often less than $1,000. But President Obama is correct in assuming that we need a better focus on preventative diabetic foot care.

By far, the most cost effective way to treat diabetic foot complications is to prevent them entirely. Believe it or not, once a complication occurs, such as a foot ulcer, the costs increase exponentially. Once an ulcer forms, it can cost up to $8,000 to treat…$17,000 if it becomes infected! Spending a significantly lower cost to prevent an ulcer from occurring is most certainly ideal!

How can we prevent a diabetic foot complications from forming?  First, every person with diabetes should form an association with a podiatrist for routine foot checkups.  These checks will help to monitor circulation down the legs and into the foot, nerve sensation, and assess risk factors for formation of ulcers and wounds.

Since wounds primarily form in areas of pressure, managing that pressure is incredibly important.  Even Medicare has recognized the value in shoes with insoles that will prevent those pressures from causing problems and cover a pair of shoes and several pair of insoles each year.  The insoles are made of a soft material that redistributes the weight and alleviates areas of pressure.  We, as do many podiatrists, carry lines of diabetic footwear.  Those who do not will refer you somewhere that does.

You can’t rely on the podiatrist alone to keep you healthy.  I always recommend that my patients with diabetes perform a quick foot check each evening before bedtime.  What they look for is anything that wasn’t there the day before:  redness, bleeding, pus, etc.  For those who cannot pick their feet up to see the bottom, a wonderful mirrored scale is available called the CheckPoint scale.  Its mirrored surface allows you to easily view the bottom of the foot for daily inspection.  This way if you notice a problem, you will know it is no more than 24 hours old.

Experts say that diabetics need the right care to keep their limbs.  I couldn’t agree more with that statement.  There will always be factors that put diabetics at greater risk of developing foot problems, being vigilant in controlling your blood sugar while watching for the smallest sign of a problem, will tip the scale in your favor.

Sneaking right under the wire…before the month is over…our August newsletter is available online.   If you subscribe, you should have it in your inbox shortly.  If not, visit http://su.pr/1yG3ZU to download it and previous issues.  You can subscribe by emailing news@tanglewoodfootspecialists.com

This month, we highlight a new treatment for damaged and fungal toenails called KERYflex.  We are among the first in Houston to offer this innovative treatment for nail restoration.  The result is a healthy looking nail that can be shaped and polished  .  I’ll post more about it soon!

There was a comment on my blog asking me about my profession and what I do. I’m going to open that up to what podiatrists do in general and how caring for an often neglected body part saves lives. I’m further spurred on to write this by the irresponsible remarks by Rep. John Shadegg (R-AZ) made on Neil Cavuto’s Fox News Channel Program. He lumped Podiatry in with aromatherapy and acupuncture, calling them an “esoteric demand that most people don’t have or don’t need.” I won’t place judgements on the other slighted professions, but I do have strong feelings about Podiatry.

Most people are fortunate to be born with two feet. Unlike shoes, which wear out after a period of time, these feet must last a lifetime. The average person takes thousands of steps each day and walk the circumference of the Earth twice over their lifetime. Your car needs routine maintenance every few thousand miles. Shouldn’t the same be true of your feet.

When something goes wrong with your feet, who is there to fix them? Family practice physicians and internists often prescribe medication. Many orthopedists look to correct the problem with surgery. Podiatrists look for the root of the problem…the underlying biomechanical deficiency…and treat the cause of the issue, not just the effect.

I can talk all day about what we do…people coming into our offices in miserable pain and leaving feeling relieved that there is a solution. The Podiatric profession is responsible for technological improvements in surgical technique, biomechanical correction, such as orthotics and bracing, that have benefited many. Talk to someone who had foot surgery 25 years ago and another who had one recently and you’ll find two very different experiences.

The greatest contribution, in my opinion, is the contribution of Podiatry to the care of diabetics. We just can’t quantify how many feet and legs have been saved by the direct and indirect influence of a podiatrist. While many are quick to amputate a toe, foot, or leg that is deemed unsaveable, the podiatrist will do everything possible to save the limb. New wound dressings are constantly coming to market, one better than the next, which podiatrists have helped develop. New wound healing therapies are developed with the research by podiatrists. New products are developed to help keep the diabetic foot healthy so these wound dressings and therapies are never needed.

These developments do not just benefit the podiatric profession. I’m proud to have colleagues like Dr. David Armstrong, Dr. Larry Harkless, Dr. Jon Steinberg, and so many others who travel around the country and world educating physicians of all types about the latest techniques and research to save diabetic limbs. Not to mention the thousands who are walking on two feet due to their research, teaching, and development.

So, Congressman, I’m happy you have two healthy feet. I’m glad you’ve never awoken with a sharp, stabbing pain in your heel. I’m thrilled that you’ve never known the fear of losing a limb or the elation of knowing that you’ve “only” needed two toes amputated, but still have a foot to walk on. But just know, that when you do need a podiatrist, you’ll be pleased that this “esoteric demand that most people don’t have or don’t need” is here to help you.

I like to see heart…I really do. But, when your job is not on the line, and you have a history of injury…is a risky scramble the right thing to do in a PRESEASON game?

Well, that’s exactly what happened last night in Reliant Stadium when the Texans played Brett Favre and the Minnesota Vikings.  I’ll admit, I don’t usually go to preseason games, but since both starting teams and quarterbacks were going to play at least the first half, the fact that it was Monday Night Football, and I’ve been pretty starved for football, I’d give it a chance.

Fortunately, it seems that Schaub’s ankle sprain is not serious.  After scrambling to the sideline (nice play, although I don’t agree with it) he limped slightly going back to the huddle.  After throwing a touchdown pass later in the drive, he really was limping as he was leaving the field.  Halftime came and went and Schaub did not return to the game.

Any twisted ankle can damage the three ligaments on the outside.  They are there to support the ankle.  The ligaments can either be stretched or torn when this happens.  Studies have shown that immobilization provides the best environment for the ankle sprain to heal.  For mild sprains, however, good quality elastic ankle support usually suffices.

As with any acute injury, a great way to manage the swelling and pain is through the RICE principle:  Rest, Ice, Compression, and Elevation.  This especially holds true for ankle sprains, since they can swell pretty quickly.  Don’t write off a sprained ankle as something that is minor…it is usually the annoying “minor” issues that linger.

I hope Schaub shows the same heart when he plays in the regular season…but he better stay healthy!!

The terrain that an athlete runs on is critical to not only their performance but also to the health and maintenance of their bodies. You might be surprised at what running on a different terrain can do to your body. When it comes to the type of surface that you run on, the most important factor is the amount of shock absorption that the terrain provides. Now just because something is super shock absorbent does not mean it is the most ideal running surface. For example, many people like to run on beaches because it is a very soft surface, but it also takes much more energy to run on sandy surfaces because you sink into the sand as you run. Therefore, there is a cost-benefit ratio to running on very shock absorbent surfaces, on one hand they provide a softer surface for your feet to land on but on the other hand they require more energy to run causing you to get tired more quickly during your run.

More traditional running surface materials are concrete sidewalks and asphalt streets. If you have the choice, the asphalt streets are actually a better option because they are softer on impact compared to concrete sidewalks. You may not be able to feel a difference when running on the two but over long distances, your body will certainly be able to feel the difference.

Besides the material that a running surface is made of, another factor that makes a difference while running is if the terrain you run on is slanted or banked. Running on a banked surface in one direction or another is common because many roads and pathways in Houston are designed this way to help them drain properly. The problem with running on a banked surface is that you get an uneven distribution of force and work that is put onto each leg. The leg that is lower bears more weight and does more work than the leg that is more uphill. If you know you are running on a slant then one thing to consider is make sure you are running on an out and back run route and not a circular path. If you are running in a circle then the same leg is always bearing more weight and doing more work than the other leg. If you run out and back then one leg does more work on the way out and the other leg does more work on the way back. By the end of your run your legs have taken on the same workout which will minimize the chance of injury.

The composition and contour of the surface you are running on is very important to the health and performance of a runner. Making a conscious effort to run on a flat surface that has the optimal shock absorption is important to consider on every run.

It seems like it has always been a problem. Kids just don’t like to tie their shoes. Sure, it only takes a few seconds, but look at all the time is saved by just slipping them on. Even kids who have Velcro closures on their shoes still don’t undo them…they just slip them on!

A shoe is meant to provide stability for your foot. Tying your shoes daily will make them secure and prevent your foot from slipping around. When a shoe is untied for a period of time and just slipped on and off (you should see the size of some of the knots I see!), the laces loosen and the foot slips around in the shoe. This causes the foot to have to work harder to stabilize itself, often leading to overuse injuries.

Does this really make a difference? Absolutely! I’ve seen kids with infected ingrown toenails because they are hitting the ends of their shoes. Others who developed shin splints because of wearing shoes that are too loose. Still others with Achilles tendon pain or Sever’s disease because they don’t tie their shoes. The more active a kid is, the more important it is for them to tie their shoes well.

The same goes for adults. In fact, I am constantly on the case of my trainer (who tortures me twice a week) for not having his shoes tied. Not such a big deal when he’s working, but I’ve seen him the same way when he’s working out! Think about how much stability your body needs when you’re lifting weights! I’m finally getting through to him after he started feeling some foot pain. Now, I’m a really nice guy so I certainly didn’t tell him “I told you so!” Well….of course I did!

It is important to tie your shoes and to make sure your kids’ shoes are tied every day. If you’re running late, resist the urge to tell them to just slip it on…If you give them permission once, they’ll do it always.

It’s a question I get often in my Houston, TX office…from patients and non-patients alike. Why do I want to work with feet all day? I believe that there is no greater satisfaction than when someone comes into my office with pain and leaves pain free, or confident that they are on the road to recovery.

American Podiatric Medical Association (APMA) produced a great video that really answers this question well. Take a look and let me know what you think.

In rehearsals for Dancing With the Stars, Tom DeLay, former congressman from a suburb of Houston, TX, suffered a foot injury. Originally thought to be a stress fracture, it was later announced that it was a “pre-stress fracture.” I was amazed to hear this. After several years of school, residency, and practice, I’ve never encountered such a thing.

So what do you do when you come across something new…you Google it! So I did and guess what? Everything that pops up has to do with Tom DeLay! Well that’s the trend now…Pre-Diabetes, Pre-Hypertension…we’ve become too afraid to label someone with what they’ve got. So you end up with patients telling you: I’m not diabetic…I’m pre-diabetic as they eat a cupcake.

It is probable, however, that Mr. DeLay has a biomechanical situation in his feet that increases the pressure beneath the metatarsal bones. This can set the stage for a stress fracture. He should be managed with a custom orthotic device to allow the pressures to be redistributed. This way, no one area will have undue pressure beneath it. If he does develop a stress fracture, then it is a problem. If he continues to dance, the stress fracture, or a “hairline” fracture, can develop to be a full fracture which can require surgery to repair.

I’m sure Mr. DeLay’s getting the best treatment. He should…he’s got one of those lifetime congressional health plans we’ve heard so much about! Keep on dancing Tom!

Today is the first day of fall and the Falls Free Coalition has dubbed today National Falls Prevention Day.  Accidental falls are a major health problem among the elderly in the United States.  One in three people over age 65 fall each year.  Many falls result in hospitalization.  Ten percent of elderly people who fall have serious injuries resulting.  These include fractures, joint dislocations, and severe head injuries.

As a podiatrist in Houston, TX who treats a fair number of elderly patients, the results of falling is far more than physical alone.  There are significant emotional and psychological effects as well.  An unwillingness to venture outside, fear of falling again, changes in a person’s gait, and an overall “aging” affect are commonly noticed after a fall.  It is important to identify these factors as well.  Falls can lead to depression which can have a devastating effect on the elderly person.

What can you do to help prevent falls? Starting an exercise program is a great way of lowering the chances of a fall. Especially helpful are exercises that increase balance and coordination. You should also review all of your medications with your doctor. There are some medications and other combination of medications that can cause drowsiness and can cause a fall. You should also have your eyes checked once a year to be sure you eyesight is as good as it can be.

Making your home safer also is helpful in preventing falls. Remove things that can be tripped over, such as books, area rugs, and shoes. Putting grab bars in areas that can be slippery, such as the bathroom and shower, as well as using non-slip mats are helpful. Also, wearing shoes inside and outside the house can help with stability and minimize the chance of falling.

It is impossible to prevent falls entirely, but taking some steps can certainly help to reduce the chances. If you or your loved one does have a fall, be sure to get checked out, no mater how minor it seems. The quicker you get something taken care of, the less chance it can be a problem later on.

How can a Houston, TX podiatrist’s office offer a “Cash for Clunkers” program? Well don’t bring your old gas guzzler. The government ended that program!

What we’ll do is trade in your old, worn, beat-up orthotics or insoles and evaluate you for brand new orthotics. The useful lifetime of a custom orthotic is usually three to five years. This varies based on the material used to construct the orthotic, your weight, and your activity. The truth is, your mechanics change. You may have started a new exercise program, gained or lost weight, or suffered an injury…all of which will impact your mechanics. As mechanics change, your current orthotics will not provide the stability that they once did.

Of course, off-the-shelf insoles need to be replaced much more often. Because of the soft, flexible material, they will deform and no longer be supportive.

So now is a great time to replace those worn-out orthotics and insoles. Give us a call and tell us that you “have a clunker to trade in” and you’ll receive up to $50 off a new pair of custom orthotics. The money comes right off the cash balance of the orthotics once we hear from your insurance company. If your clunker wasn’t made by our office? No problem! You can take advantage of this program even if you’ve never been to our office before.

If you’ve recently gotten one of our custom orthotics that are working great and it’s not time to replace them, think about a second pair. It’s perfect for dress shoes, high heels, western books, bike shoes, or just for the convenience of having another. If this is something you need, let us know and we’ll give you up to $25 off the cash balance.

Contact our office at 713-785-7881 today to take advantage of this program. Unless Congress votes to fund the program longer, it will end on October 31, 2009. For more information about custom orthotics, visit http://tanglewoodfootspecialists.com/serv/ortho.htm

Plantar Fasciitis is one of the most common foot injuries…common in all level of athletes. Well America, you have good company. Super Bowl MVP Eli Manning of the New York Giants had a MRI confirming the diagnosis today. He left the game, clearing the way for former Houston Texans QB David Carr to take over.

Here’s the kicker…Eli may not be ready to play on Sunday. Truly amazing! Why? Because so many of my patients ignore heel pain until it gets unbearable and here is the HIGHEST PAID player in NFL history who may have to sit out because of it. Imagine, someone getting paid millions of dollars to play football and here I have people not willing to miss a run or two to get better.

Plantar fasciitis, what Eli is suffering from, is an inflammation of the plantar fascia ligament where it attaches to the heel bone. The pain is usually a sharp, stabbing pain when you first get up in the morning and after sitting for a period of time. It is very treatable with conservative measures. In fact, surgery is rarely needed. Anti-inflammatory medication, ice, night splints are all great first line treatments for heel pain.

Once you get plantar fasciitis under control, it may come back. To prevent that from happening, you should invest in custom orthotics. An orthotic mechanically balances the feet and lower extremity to manage the excess pulling that causes the inflammation.

So sitting out on Sunday may be the best treatment for Eli if he’s not 100%. More likely, however, is that they’ll give him a cortisone shot in the heel, tape him up, and send him to play. The lesson to learn is, if you have any pain in your heel, don’t wait…be like Eli…identify the problem, treat it quickly and aggressively, so you don’t have much down time at all. To learn more about heel pain, visit our website.

As I mentioned in a previous post, Tom DeLay was injured with what was considered a “pre” stress fracture of both feet…a term that really doesn’t exist. Well friends, it became a true stress fracture in his feet and he is forced to quit the competition.

Stress fractures are common injuries and often found in athletes, including dancers. In the case of Mr. DeLay, who was taking up dancing for the first time (I suspect), he probably took on more than his body was conditioned for, a primary cause of injury. If you are planning on starting a running program, for instance, and decide that your first run will be a charity 10K, you have not conditioned your body to bear that stress. As a result, you put yourself at risk of injury, including stress fractures, sprains, strains, and tears.

Good luck to Mr. DeLay in recovering. His treatment will likely consist of immobilization for a period of time.  Afterwards, he should be fitted for a custom orthotic to balance the forces to prevent an injury like this from happening again.   I hope he continues his athletic endeavors when he heals, with the proper conditioning to go along with it.

A stress fracture is a small incomplete crack in a bone that is due to repeated stress in an area in the body. 95% of stress fractures develop in the lower extremity and account for 10% of all running injuries. Stress fractures are a common injury in runners because of the repeated motion that runners go through over thousands of steps.  Stress fractures commonly occur in runners when they have too many miles on their shoes, change the surface they run on, or change the intensity level of their workout.

The symptoms of a stress fracture are tenderness over a localized area, pain when you put weight on the affected limb, and slight swelling around the area. Runners who are most prone to getting stress fractures are women with amenorrhea (loss of menses) because of the role estrogen plays in strengthening bones, thinner athletes, and people who are not getting the proper nutrients to replenish their bones.

It is important as a runner to make sure that you are getting the proper nutrients to keep your bones strong in order to avoid developing stress fractures. It is recommended that you get 1000 mg of Calcium per day and 200 IU of Vitamin D per day, as well as maintaining a Body Mass Index (BMI) of at least 18.5 or higher and a body fat level of at least 14%. All of these factors will help insure that your bones have the right nutrients to sustain themselves even through daily running stresses.

If you think that you may have a stress fracture then the first thing to do is to decrease the amount of exercise you are doing. It is also important to go see your doctor or podiatrist so they can take an x-ray of the site. X-rays are not always able to detect a stress fracture and a bone scan may be required. Although stress fractures can be frustrating to an athlete who is in training, it is important to listen to your doctor’s instructions to modify your workout routine or you may create a more severe injury that may require surgery and more time away from your sport.

Deciding to run a marathon is a big decision that must not be taken lightly. Training for a marathon takes a lot of time, dedication, and puts extra strain on your body. If you are on the fence about deciding to train and run a marathon then there are three things you need to take into consideration, your health, your time, and your support system.

The biggest deciding factor in whether or not you should run a marathon is your health status. There are many common medical conditions, such as diabetes, osteoporosis, arthritis, anemia, hypertension, and obesity, which can lead to health complications if you start putting strain on your body. If you have any of these conditions, it is best to consult your primary healthcare doctor before signing up for a marathon training program. You must also take into account your past medical history. If you have a history of lower extremity stress fractures, heel pain, plantar fasciitis or ankle sprains then you will want to make sure that you take all precautions to prevent any of these aliments from occurring again. It is a good idea to talk to your podiatrist to find out what the best running shoe would be for you and if you could be helped by a custom orthotic.

The second thing that you must think about when trying to decide if you should attempt to train for and run a marathon is if you have enough time to properly train for the race. In our fast-paced world most people have trouble finding time to fit in all the activities they already have on their schedule. Training for a marathon is a very time consuming task, especially in the last month of training. You must decide what time of day you are going to fit in runs that can take from 30 minutes to more than 3 hours!

The final thing that is important to consider when deciding to run a marathon is who your support system is. Who is it that most wants to see you finish your race? Most people do not think about this when deciding to run a marathon but it is very important. If you are married and your husband or wife does not support you running the race because it is too expensive or takes up to much of your time, then this is not a positive mental motivator to keep you going. You need your friends and family to be there to support you through your training and the big race day.

Deciding to run a marathon is a big decision. Your health, time, and support system should be taken into consideration when deciding if training for a marathon is right for you. Marathons are very challenging endeavors that simply aren’t for everyone. Do not be disappointed if you decide running a marathon is not for you, but if you do decide to take on the challenge, the best of luck to you!

I’ll admit, there is little more comfortable than a well broken-in pair of shoes. Not just running shoes. I’ve seen men who have had the same dress shoes for the past 20 years. They just keep bringing them in to be resoled. Women, I’ll admit, do rotate their shoes selections a bit more, but there are those one or two favorite that end up being worn more than the rest.

Take a good look at those shoes, though. Are they really “good as new” when you get them refurbished? In most cases, the answer is absolutely not. Unless you are so diligent that you never, ever put a shoe on without using a shoehorn and never once put on your shoes without untying them, then you may be the exception. For everyone else, it’s time to get rid of your dead shoes.

A dress or work shoe, whether a man’s oxford or a woman’s flat, has the majority of the inherent support in the upper. That is the part of the shoe where the foot is housed. This is unlike a running shoe, where the support is in the midsole, which becomes compressed. The upper of a dress shoe will soften with time and no longer will provide support to the foot. The telltale signs are there if you look for them. Often the heel counter, the very back of the shoe, will show wrinkles and softening. In many women’s shoes, especialy flats, you can even see the heel walking right on the back of the shoe!

When you notice that your shoes are so broken down that you’re slipping around in them or walking right on them, it’s a good sign that it’s time to invest in some new shoes. I give you permission…go shopping!

I am confronted on a daily basis with men and women who think their toenails are ugly.  Especially here in Houston, where open-toed shoes and sandals are commonly worn year-round, people are embarrassed to expose their toes.

Damage to toenails can be caused by a number of factors.  Fungal toenails are common, due to Houston’s heat and humidity and shoes harboring the fungus.  Even after treatment, the disfigurement of the nails can remain.  Trauma is another major cause – stubbing a toe, being stepped on, or dropping something on your toenail can cause permanent damage.  Runners and other athletes develop a condition appropriately called “runner’s toenails” due to the impact of the toes against the end of the shoe.  Sometimes the trauma could cause the nail to no longer grow or be missing altogether.

No one – women and men alike – enjoy others seeing gnarly toenails.  Acrylic false nails were available for fingernails but most find them uncomfortable in shoes.  They also suffocate the toenails, causing more damage.

I was introduced to a product that I didn’t think existed – KeryFlex.  It’s premise:  a healthy and comfortable toenail replacement that acts and feels like a natural toenails.  It can be shaped and polished, just like a real nail too!  KeryFlex uses a flexible resin to reconstruct a new toenail in place of a nail that is damaged or missing.  Hard to believe?  I thought so too, but I spoke to doctors in the northeast that have been using it and they told me that their patients love it!

Our office was one of only two podiatrists in Houston trained to provide KeryFlex.  So far, everyone loves it!  the procedure is completely painless and requires no laser or surgery.  It only takes about 20 minutes and you’re ready to go!

To learn more about KeryFlex, visit www.fixmytoenails.com or call us to schedule an appointment

November is National Diabetes Month and the American Podiatric Medical Association’s “Diabetes is a Family Affair” campaign is in full swing.  Information about Diabetic foot health can be found on television morning programs, magazines, and newspapers around the country.  Even NASCAR is getting involved.

In honor of November’s Diabetes Awareness Month, NASCAR driver Erik Darnell, who is managed by Hall of Fame Racing, will sport the Diabetes is a Family Affair  logo on the side of his #96 Ford Fusion race car throughout the month.

The Diabetes is a Family Affair campaign encourages those with Diabetes to discuss the disease with their family.  Diabetes has reached epidemic proportions and is commonly passed down from parents to children.  If diabetes is detected and treated early, many complications, such as foot ulcers, can be avoided and may prevent a foot or leg amputation.

Nearly 11% of people over age 20 have diabetes and that increases to 23% in those over 60.  60-70% of those with diabetes have some form of nerve damage, known as peripheral neuropathy, which increases the chances for amputation.  Diabetes accounts for 60% of non-traumatic lower extremity amputation and if one limb is amputated, there is a 50% chance that the other limb will be amputated.

Every person with diabetes should have a strong association with a podiatrist.  Recognizing risk factors early will prevent future diabetic concerns.  In fact, a comprehensive foot care program can reduce amputation rates by 45-85%.  To learn more about Diabetes and it’s affect on the feet, visit our website.

The American Podiatric Medical Association, together with the American Society of Podiatric Sports Medicine, released a position statement for what they referred to as the “barefoot running trend.” I find it interesting that they cite lack of “conclusive research” as their reason for concern, which is the same argument barefoot runners make about the efficacy of running shoes. I have another post on barefoot running coming up soon. Until then…remember I’m just the messenger on this one!

APMA/AAPSM Joint Position Statement on Barefoot Running:
Barefoot running has become an increasing trend, and a possible alternative or training adjunct to running with shoes. While anecdotal evidence and testimonials proliferate on the Internet and in the media about the possible health benefits of barefoot running, research has not yet adequately shed light on the immediate and long term effects of this practice.

The American Podiatric Medical Association, along with the American Academy of Podiatric Sports Medicine, encourages the public to consult a podiatrist with a strong background in sports medicine to make an informed decision on all aspects of their running and training programs.

Nike has developed a line of shoes called the Nike Free that has become very popular among long distance runners, track and field athletes, and football and basketball players. Nike Free is unique because it has a special design incorporating new technology that simulates barefoot running mechanics while still wearing shoes. The goals that barefoot running technique strives to reach, and that Nike Free has adapted, is attempting to strengthen the intrinsic muscles of the foot and leg thus preventing long term injuries.

Although Nike Free has become popular among runners there are some important things to take into consideration when deciding to buy these shoes or not.

1) Versions – If you do a little research on the Nike Free you will come to find out that there are actually many different versions of this shoe. The Nike Free can be ordered on a scale of 10.0 to 3.0 with 10.0 being the most supportive shoe and the 3.0 being the least supportive and most similar to barefoot running.

2) Ease into the Shoes – If you have never done any barefoot running, or ran in any minimalist shoes that strive to achieve the same goal as Nike Free shoes, then it is important to ease your way into these shoes. It is recommended to start off running a mile in these shoes and then gradually increasing your distance based on your body’s response to the shoes.

3) They aren’t for everyone – Although Nike is continuously trying to find ways to make small changes and adding versions to the Nike Free to allow the largest population of runners to use them, these shoes still aren’t for everyone. If you don’t run consistently, need extra-cushioned running shoes, or are prone to ankle sprains, I would not recommend these shoes to you. The Nike Free is really built for routine runners with no other major foot problems. Furthermore, barefoot-style running requires significant changes in running mechanics to be successful. If you run in these shoes just as you would in a structured running shoe, you will put yourself at risk for becoming injured.

Nike Free technology has really changed the face of running shoes, opening a whole new vision into what running shoes could do for your feet and body. Although these shoes are becoming increasingly more popular in the running community, these shoes simply aren’t for everybody. Be sure to visit with your sports podiatrist who can help recommend the right shoe for you.

I occasionally have new patients come into the office after visiting an “orthotic store” with three or four pair of off-the-shelf insoles. These unscrupulous stores prey on the emotions of people who are in pain. These victims drop over $1000 on insoles that may provide temporary relief, but ultimately don’t help them. What’s worse, they could buy similar products from a late-night infomercial for $39.99…and they’ll DOUBLE your order!

When that patient comes in to see me, they’re dismayed that they can get a biomechanically corrective custom orthotic for LESS than what they already shelled out…with better results. They were told that they needed a different pair for running shoes, walking shoes, dress shoes, golf shoes, etc. How many pair of orthotics are really necessary?

When children require a custom orthotic, one pair is always enough. That orthotic should be made so it can be moved to any shoe the child wears. You’d be surprised that most kids take ownership of wearing their orthotics and are careful to wear them regularly…and not lose them.

Men usually can also get away with one pair of orthotics. The truth is, there’s not much structural difference between a men’s dress shoe and an athletic shoe. Men who wear specialized footwear, such as western boots or bicycling shoes, do get additional pair of orthotics to wear in them.

When it comes to treating women, most end up with two pair of orthotics. A woman’s dress or work shoe and an athletic shoe are very different. For that reason, an orthotic that will fit into an athletic shoe will be too bulky for a dress shoe. Conversely, an orthotic for a dress shoe would be too narrow and flexible for an athletic shoe.

Of course, there are many who elect to purchase multiple pair of orthotics for convenience. Under our “Cash for Clunkers” program, we are offering an additional $25 off of our already reduced price for additional pair of orthotics. If you have an old pair of orthotics or insoles that need replacing, we’ll perform a comprehensive biomechanical examination to evaluate you for new orthotics with up to $50 off your final cash balance.

To learn more about “Cash for Clunkers” for orthotics, check our our September and October FREE newsletters. Act quickly…to qualify for these discounts, you must call for your appointment by November 30, 2009!

Diabetes is reaching epidemic proportions with statistics staggering about the number of foot complications.  In observance of American Diabetes Awareness Month, I’ve decided to publish a video that I recorded about the steps that people with diabetes should take to ensure that their feet stay healthy for a lifetime.  Enjoy!

Today, my eleven month old son Jonah had surgery to put tubes in his ears.  Since he was essentially dealing with two straight months of ear infections, there’s no doubt he’ll have relief.  When we were giving the medical staff his history, we were asked a few times if he was walking yet.  Both of my older kids were walking at this point, but Jonah isn’t yet.  He’s cruising, but not walking.  That’s totally normal and my wife and I are certainly not worried, but the questions made me think…is there a correlation?

The middle and inner ear is responsible for balance.  The vestibular system, sharing some bones that allow for hearing, controls the balance.  The vestibular system consists of three semicircular canals, which contain sensory hair cells that are activated by movement of inner ear fluid.  As the head moves, hair cells in the semicircular canals send nerve impulses to the brain by way of the acoustic nerve. These nerve impulses are processed in the stem of the brain and in the brain’s cerebellum as coordination and balance.

When someone, often a child, has persistent ear infections it causes a buildup of pressure and thickening of the fluid in the inner ear.  This can cause the fine hairs within the ear canal to not function optimally and can cause dizziness and balance issues. When the fluid thickens, is infected, or has a buildup of pressure, tiny tubes are inserted through the ear drum to relieve this pressure and allow the vestibular system to function more normally.

So far, Jonah’s been out of surgery for six hours and he’s still not walking.  It will be interesting to see if in the coming weeks his balance improves and he takes those first steps.  Otherwise, we’ll just be happy with better night sleeps, no ear infections, and an interesting topic to write about.

UPDATE 11/30/09: I’ll admit that I wrote this post as theoretical at first, but I will report that Jonah took his first unassisted steps six days after getting the tubes put in.  He’s getting more confident in his balance and it is clear to me that the pressure buildup in his ear had much to do with his not having walked before the surgery.

The holiday season is here yet again. With only a few weeks left before all the holiday madness begins it is time to start thinking about what to put on your holiday wish list for this year. If you are a runner or maybe just someone who will want to run off the extra holiday pounds below are 5 items that everyone will want to have on their list this year.

1) A new pair of running shoes – Let’s face it, running shoes tend to be one of those things many people push off replacing. Whether you are busy preparing for the holidays or if you are just really partial to one pair of running shoes, a new pair of shoes can really help to keep your feet and body injury free. Although experts vary on how often to replace a pair of shoes, a good standard to go by is to replace your shoes every 350 miles or six months, whichever comes sooner.

2) Moisture Wicking Socks – The best pair of shoes in the world won’t be nearly as beneficial without a good pair of moisture wicking socks. Although it may seem extreme to have to pay $5 for a pair of specialty socks when you can get a 5 pack of cotton socks for the same price, socks are one thing you don’t want to skimp on. They help keep your feet and toes stay dry in order to prevent blisters from forming.

3) Nike Fit – I really have to hand it to Nike because the Nike Fit is an extremely helpful tool for runners of all skill levels. This device allows you to track your runs, pace, and states of each workout through a chip in your shoe that can later be downloaded on to your computer to monitor your runs. If Nike isn’t the right shoe for you, there are adapters you can purchase to use the technology with other brands of shoes.

4) Running Utility Belt – If you have ever run a long distance race then you have probably seen those people with the belts around their waist that have little pouches to held various items. This is a great item for people who are long distance runners. The belt is ideal to hold little bottles of water, gel food packs or even your keys or cell phone.

5) Road ID – Although this last item may seem a bit much it is one of those things that it is better to be safe than sorry. A Road ID is an identification bracelet that runners and cyclists wear in case of an emergency so they can be identified. Accidents happen every day between athletes and automobiles, Road ID is a simple way to protect yourself in case anything were to ever happen to you while you are out on a run.

With the holidays being right around the corner don’t forget to add these 5 items to your wish list this year so that you can have the gear you need to run off all those extra holiday calories.

As Thanksgiving quickly approaches it is time to reflect on all that we have to be thankful for in our lives. Most people will give thanks for their Family, their jobs and most importantly their health. If you are someone who has issues with your feet or ankles and have been into a podiatrist’s office lately then I’m sure one of the things you may be thankful for this Thanksgiving is your Podiatrist! Whether you have lower extremity related problems or not, here are five reasons to be thankful for Podiatrists this Thanksgiving.

1) Diabetic Feet – One fact that many people don’t realize is that of the 23.6 million Americans or 7.8% of US citizens that have been diagnosed with diabetes, podiatrists are one of their primary doctors that they visit on a regular basis. Diabetic feet are a tricky and sensitive issue that podiatrists deal with on a daily basis. Diabetics over time may develop neuropathy which is a loss of sensation which in diabetics starts in the toes and moves up the leg. Podiatrists work especially hard with diabetics to make sure they are extra careful about their feet or they can develop potentially life threatening ulcers or infections.

2) Children’s Feet – Children make up a large segment of a podiatrist’s patients. Something that might surprise you is that podiatrists can work with children as young as 6 months old in order to try and correct any deformity of the lower extremity. One common example is children with club feet. Although this deformity can look devastating to a concerned parent, podiatrists work with these children over the years to literally straighten them out. Other common conditions, such as in toeing, out toeing, toe walking, plantar warts, and ingrown toenails are also addressed often.

3) Bunions – A bunion is a bony protrusion commonly located on the base of the big toe. If you have ever had a bunion you can attest that these deformities are annoying and at times painful. Fortunately there is a very common surgical procedure that podiatrist perform called a bunionectomy that can correct this abnormality. If a bunion is caught early, simply wearing a custom orthotic can prevent surgery altogether!

4) Warts – Most people will contract a wart at some point in their life. Podiatrists have the leading edge technology to take care of them if they develop on your feet. Podiatrists even will give you different options for treatment, such as medication or treatment with a laser.

5) Nail and Skin infections – This is a wide category but a very important one to be thankful that there are podiatrists to help treat and cure these infections. One of the most common infections that podiatrists treat is onychomycosis. This is a fungal infection of the nail that can spread if not treated properly. The important thing to remember is that many nail and skin infections can look very similar. It is important to get a podiatrists opinion if an infection develops on your feet.

We often don’t think about our feet until a problem occurs. This Thanksgiving, make a commitment to yourself to visit with your podiatrist and make sure you stay on the road of proper foot health.

As Diabetes Awareness Month comes to a close, I wanted to post another video on a related topic. I’ve been using Neuremedy in my practice for about a year. It is a medical food that is a soluble and bioactive form of Thiamine, which is Vitamin B1. Diabetics and others suffering from a type of nerve damage known as peripheral neuropathy have been found to have a thiamine deficiency.

My suggestion to my patients is to try a two month course of Neuremedy. There are no side effects or interactions with other medications. If after the two months, your neuropathy symptoms have decreased, then continue taking Neuremedy. If not, then stop taking it. What I’ve found is that many who stop it after two months realize that there has been a positive change and restart it within two weeks.

Neuremedy can be purchased through your podiatrist…we always have it available in the office. You can also purchase it online at http://www.buyneuremedy.com.

For those who follow my blog, you know that I’ve discussed Victoria Beckham’s bunions before.  You can read those posts here and here. Apparently there is renewed interest in her bunions, seemingly triggered by her returning a pair of shoes at Barney’s in Beverly Hills.

Rarely photographed without VERY high stilettos on, the rumors are that her aversion to having surgery to correct her bunion has to do with not being able to wear heels for several months after the surgery. It seems as if she’s tried everything, but continues to hold out hope that applying ice and stretching will help the bunions go away. Beckham admitted to a reporter from the UK’s Daily Mail, “Part of the reason I wear such amazing shoes is to take the eye away from my horrid feet.” Such a vicious cycle!

The sad news for Posh, however, is that the bunion deformity is a bone that has rotated, not simply an inflammation. The surgery she will need will surgically fracture the metatarsal bone, shift it over, and repair it with a pin or screw. She will need to wear a special post operative shoe for about two weeks afterward and likely won’t return to her fancy shoes, realistically speaking, for two to three months after the surgery…no doubt an eternity for someone who picks up her children in the most fashionable shoes. While the shoes likely contributed to the bunions, there is likely a strong heredity factor as well.

I wish there was a magic potion or lotion that could be prescribed for a bunion, but there is none. Wait until Victoria hears that a custom orthotic is suggested after surgery to prevent the bunion from coming back!

I’ll admit that it’s cute, but three year old Suri Cruise, the daughter of Katie Holmes and Tom Cruise (aka TomKat) should not be wearing high heels at this age.  Too often, parents fall into the “but it’s cute” trap.  Parents of non-walking infants will put shoes on their babies because they match the outfit.  Both little girls and boys enjoy dressing up in their parent’s shoes around the house.  To actually wear a high heeled shoe when out…that’s another story.

Suri is probably the most photographed child in the world, thanks to her two superstar parents.  Many photos show her in these silver dancing shoes with high heels.  When asked about Suri in the shoes, her mother stated that it’s every girl’s dream to wear such shoes and who is she to stop her?  Will all due respect, you’re her mother.  Of course you want her to be happy, but you also want her to be healthy and wearing such shoes can certainly impact that.

It’s true that the shoes Suri is wearing is probably an appropriate size.  Just because they make such shoes doesn’t mean they should be worn constantly.  In this case, the shoes are ballroom dancing shoes.  Of course Suri can wear them when she’s taking dance lessons for an hour or so, but the photo doesn’t look like a lesson.

Wearing a high heel at such a young age can cause shortening of the Achilles tendon.  This can happen in adults too, but is much more likely in kids.  If this happens, there will be undue stress on the back of the heel, where the tendon attaches, and can become a painful condition known as Sever’s disease, or calcaneal apophysitis.  It is an inflammation of the growth plate on the back of the heel bone causing sharp heel pain.  As she grows older, the shortened tendon will lead to compensation of the rest of the foot, causing the foot to become unstable and pronate.  This will put her at risk for developing bunions and hammertoes in the future. She is already at risk for these deformities, since her mother suffers from bunions and hammertoes already.

Why put Suri’s future health and happiness above her 3 year old desire to wear the shoes all day.  Katie and Tom, show Suri how much you love her by limiting her time in her favorite shoes to an hour a day.  She’ll thank you for it in the long run.

It is that time of year again when all the stores have huge sales to draw customers in to buy products for the holiday season. In a perfect world holiday shopping would be a time of happiness, with cheerful people buying gifts for their loved ones. In reality, however, holiday shopping is usually a frustrating experience consisting of crowded malls, long lines, terrible traffic and overheated stores.

One thing that many people don’t really think about when they leave their homes to go holiday shopping is how much walking they are going to do or how long they are going to be on their feet. Even if you are expecting to be in-and-out of a store because you know exactly what you need, the overcrowded shopping centers and long lines can triple your time spent shopping.

Although you can never know exactly what to expect when you go holiday shopping one thing you can count on is tired feet by the end of the day. The best way to take care of your feet so that they last the length of your shopping experience is to make sure you are wearing the proper shoes and socks.

The best bet when deciding what to wear when going holiday shopping is to choose a comfortable pair of gym shoes and some moisture wicking socks. Make sure you avoid any shoes with a heel or any shoes that are open toed because they put you at a higher risk of spraining your ankle or getting hurt if your foot is stepped on in a crowded store. Moisture wicking socks are also important because they will help to keep your feet dry and blister free when you start getting overheated from the crowded stores.

Holiday shopping can be stressful but by keep your feet happy you are more likely to stay happy yourself. So good luck when you start fighting the crowds in the stores this holiday season. Don’t forget to bring along your gym shoes and a good pair of socks.

Wishing you all the best for a very Happy and Safe Holiday Season!

A bunion is a common foot deformity that many Americans have to deal with during their lifetime. Currently, podiatrists are the leading health care professionals for caring for this deformity. Bunions are a very unique foot problem with a specific population and appearance which you will see from the seven facts below.

1) Bunion Definition – A bunion is a bony enlargement of the bone and surrounding soft tissue of the base of the big toe. This makes your foot look like you have a bump on the inside of the base of your big toe and also causes the tip of your big toe to angle toward the second toe.

2) Who gets Bunions – Bunions are more common in women. Bunions are also more common in western countries, with as much as 30% of the population of people of western countries having bunions. Interestingly, studies have shown that people from countries where shoes are not commonly worn by most citizens have a lower incidence of bunions then western countries, suggesting that bunions may be due to the shoes people wear. Bunions are also more common in older people, with a greater incidence of bunions with age.

3) Bunion Genetics – Many studies have shown that there seems to be a genetic link for acquiring bunions. This means that if someone in your immediate family has a bunion you have an increased chance of getting a bunion then the general population.

4) Bunion Symptoms – There are many symptoms that may lead people to think they have a bunion but the most common symptoms are as follows: A bony protuberance on the base of the big toe, red callused skin over the protuberance on the inside of the big toe, pain over the joint with the protuberance that worsens with pressure, and the tip of the big toe pointing toward the second toe.

5) Shoes leading to Bunions – It has been shown that narrow shoes, cowboy boats or high heel shoes can lead to bunions. This may explain why bunions are more common in women and also why they are more common in western countries where high heel shoes are more commonly worn.

6) Diagnosing a Bunion – If you think that you have a bunion and present with the symptoms above that indicate a bunion then go to a local podiatrist to have a bunion diagnosed for sure. A podiatrist will have a good idea if you have a bunion just by sight but they will also x-ray the area to confirm the presence of a bunion.

7) Bunion Surgery – If a bunion is so painful or so enlarged that it interferes with your quality of life then a treatment option is to get a bunionectomy. A bunionectomy is a surgical procedure commonly performed by a podiatrist that helps to straighten out the big toe.

As with all problems, the sooner you catch it the easier it is to treat. Don’t simply assume that surgery is required for a bunion. Bunions in very early stages can be controlled with non-surgical means that may even prevent the need for surgery in the future! The best thing you can do is visit with your podiatrist to see what the best options are.

When we think of a bunion, we usually think of a large bump forming on the side of the great toe joint. Bunions can also occur on the top of the same joint, however, but for different reasons.

When a bunion occurs on the side of the foot, it is due to biomechanical forces that cause shifting and rotation of the first metatarsal bone. These forces are usually inherited. A bunion on top of the foot is known as a “dorsal bunion.” A dorsal bunion is due to excessive mechanical force causing damage to the joint, such as a sprain or hyperextension injury such as turf toe.

When this joint is injured, it leads to a bone spur forming on the top of the head of the first metatarsal. This spur limits the smooth gliding of the joint, with an abrupt blockage of motion. Repetitive motion causes stress and inflammation to occur, which continues the growth of the spur.

Pain from a dorsal bunion can come in different forms. As the spur enlarges, a solid bump forms on top of the joint. This can become painful due to pressure from shoes. Pain can also be due to activities that require more motion than is available in the joint. Tennis, golf, basketball, and running, especially on hills, are some such activities. A deal breaker for many women is when they are forced to limit their heel height, when the spur limits too much motion.

Treatment for a dorsal bunion varies and is based on when treatment is sought. Early treatment involves prescribing a custom orthotic to biomechanically stabilize the foot. This increases the available motion around the joint and helps to limit the forces that continue to damage the joint. In cases that are already more progressed, surgery to remove the spur and remodel and decompress the joint may be necessary.

Of course, as with any injury, treating it sooner will lead to much quicker control of the problem. Time only allows for continued injury to the joint. If you are in pain, be sure to give us a call today!

Many athletes wear orthotics. From pee-wee sports, through high school, into college, professional to weekend warriors, a properly made custom orthotic will balance the mechanics of the lower extremity and enable the foot to function at peak efficiency. Even when some athletes recognize how an orthotic can be helpful to them, they’re reluctant to try them.

Why is that? Well some feel that it will weaken their foot overall, which isn’t true. Others don’t want to be “restricted” by an orthotic, which is actually the opposite of what it is meant to do. Unlike these people who worry about function, triathletes are often concerned with how practical an orthotic is.

The nature of a triathlon is unique, in that you have to transition from swimming, to biking, into running. While we often think of Ironman triathlons, they do come in shorter distances as well, making participation in a triathlon more accessible. How does an orthotic work in multiple sports and transitioning from one to another.

The swim is an easy one to address. No orthotic necessary. Some wear their orthotics in the biking shoes, many of whom have special orthotics specifically designed for that style shoe. Others choose to not wear their orthotics when they’re on the bike.

If a triathlete uses the same orthotics in their biking and running shoes, then that transition requires them to switch them from one shoe to the other. Otherwise, the orthotics are sitting in the running shoes waiting for them. There are some triathletes who do not want to take the time to put on socks before their run, which I do discourage. But for those where every second counts, it is a time saver.

I had a patient in the office today who is an Ironman triathlete and she uses orthotics in her bike and run. She came up with a great system which she shared with me. She places a velcro dot on the bottom of her orthotic and in the heel of each shoe. She does this for two reasons. First, when she transitions, the orthotic is already in the correct position for her to just slip her foot into the shoe. When she wears her biking shoes, sometimes she doesn’t remove the shoes from the clipped pedals, but rather slips her foot out of the shoe. The velcro helps make sure the orthotic stays in the shoe.

Of course, once your foot is in the shoe on top of the orthotic no velcro is needed since the orthotic won’t slide. This simple system, however, helps enable a triathlete to remove some of the barriers to them wearing an orthotic.

It’s about that time of year again when people start making New Year’s resolutions to help bring about positive changes in their lives. Although people may have a wide variety of New Year’s resolutions, the majority of people focus their resolutions around weight loss, health, and personal care. Some of the most popular New Year’s resolutions made every year actually also can help to keep your feet healthy and happy throughout the New Year. The following are three New Year’s resolutions that will help your general health as well as your feet.

1) Weight Loss – This by far must be the most common New Years resolution. With obesity at an all time high more people then ever are trying to drop some weight in 2010. What you may not realize is that if you are currently overweight or even obese all of this extra weight is being placed on your feet. The extra weight on feet that are built for a body that should be 25, 50 or more pounds less then what you currently weight will cause your arches to depress and ligaments to become more stretched out, ultimately leading to major foot pain. Don’t be surprised when you drop some pounds this New Year if your feet stop hurting as much!

2) Smoking – Another very popular New Years resolution is to quit smoking. If a person successfully quits smoking they will help to decrease their risk of lung cancer, emphysema, yellowing teeth as well as many other factors, but one of the most important to podiatrists is they will stop harming their arteries. When you smoke you are increasing the rate of artery clogging. When you clog your arteries you first begin to see the effects in the smallest arteries like the ones that supply your toes. Smokers commonly have poor circulation in their feet and can even lose hair on their digits due to the lack of blood flow. By quitting smoking for the New Year you will help to restore blood flow to your toes.

3) Stop drinking – Besides smoking, alcohol is one of the most abused drugs in the United States. Many people know they have an alcohol problem and set dates for them to cut back or quit cold turkey starting in the New Year. Cutting out the booze will help prevent you from developing peripheral neuropathy of your toes and also decrease your chances of developing clots in your legs.

Whatever your New Year’s resolution is this year just remember to be realistic about your expectations. Small steps to improve your health really can go a long way to improve your quality and longevity of life.

With the start of a New Year and the end of all the holiday parties and family get togethers people start to focus on getting themselves in shape and healthy for 2010. Keeping your feet healthy in 2010 will definitely help to keep you happy for the year. Below are ten facts you should know about your feet in 2010 in order to keep your body health and happy the entire year.

1) Structure – The standard foot has 26 bones and 2 sesamoid bones which are small, irregular bones under the base of your big toe.

2) Flat Feet vs. High Arched Foot – Flat Feet (Pes Planus) is a condition in which you have less of an arch on the bottom of your foot. There are 2 types of flat feet: rigid and flexible. A rigid flat foot is the type that commonly leads to further biomechanical problems. High arched feet (Pes Cavus) is when you have an increased arch which may require you to need good support in your shoes to prevent them from hurting.

3) Diabetic Feet – If you or someone in your family has diabetes then make sure that they monitor their blood glucose levels closely. It has been shown that uncontrolled blood glucose levels can lead to peripheral neuropathy, numbness or nerve pain in the feet and legs, and ulcerations of the feet.

4) Smoking and Feet – Smoking can lead to many terrible side effects but one that many people don’t know about is peripheral arterial disease (PAD). Smoking decreases the circulation of blood to your feet leading to loss of hair on the extremities and can also result in loss of sensation.

5) Athlete’s Foot – If you are an athlete of any kind then one thing you should always be trying to avoid getting is athlete’s foot, which an infection of the foot caused by a fungus. Of course, you don’t really need to be an athlete to get this. To avoid getting athlete’s foot it is important to wear moisture wicking socks while you workout to prevent your feet from getting too moist. It is also important for everyone to dry their feet thoroughly after they get out of the shower.

6) Nail Fungus – Nail fungus can be cosmetically troubling due to the ugly discoloration of the toe nails. If you think that you have nail fungus it is important to go to a podiatrist who can provide you easy ways to eliminate it.

7) Bunions – A bunion is when the tip of your big toe points toward your second toe causing a bump on the inside of your foot. Bunions can be caused by a person’s inherent foot mechanics and is often inherited. It is important to seek medical help as early as possible if you have a bunion to prevent it from getting worse and requiring surgical correction.

Weight and Feet – With an ever increasing incidence of obesity in the US population, a link has been discovered between foot pathology and weight. The more you weigh the greater incidence of developing diabetes, plantar fasciitis, and osteoarthritis.

9) Shoe Gear – What kinds of shoes you wear is very important to the health of your feet. Avoid wearing high heels and flip flops at all costs as they do not properly fit and support feet and try and wear gym shoes with good arch support as much as possible.

10) Plantar Fasciitis – This is one of the most common foot pathologies. Plantar fasciitis is irritation and swelling of the thick tissue of the bottom of the foot. It most commonly presents as heel pain and may occur in conjunction with a heel spur. Most cases are well managed with medication and custom orthotic devices.

Your feet are the base that supports your entire body. Make sure that you keep your feet healthy in 2010 in order to ensure that your can do all the activities you are looking forward to this year.