Keep Your Feet Feeling Young

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!

Have you ever noticed the rubber mat behind the cash registers at departments stores? Why are they there?

To answer this question I suggest you stand on one sometime. You’ll find a huge difference in your feet, knees, and back almost immediately. Many retail employees have realized that their hard surfaced floors are punishing. To make matters worse, the sales associates have to wear high heeled shoes that are equally punishing!

The rubber mat is there to absorb the shock of standing on a hard surface and moderate the effect of the “ground reactive force” coming back up into the foot. The problem is some high-end stores find it low-class and unsightly to have these mats visible, much to the detriment of their employees.

A few years ago, a nearby upscale department store here in Houston replaced their wood floors with marble. They looked exquisite! Wood has some flexible properties that helps to absorb some shock. The problem was that marble is hard and unforgivable. Associates had to wear dress shoes and were being crippled. Of course, who would cover up marble with a rubber mat?

There was a steady stream of employees coming through my office. I put some in orthotics in order to stabilize the feet and ultimately it made them better able to manage the pressures. I did appeal to the management of the store and convinced them to provide rubber mats in select areas where they were not so obvious to the public, much to the relief of their sales associates.

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?

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.

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.

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.

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 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.