Keep Your Feet Feeling Young

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!!

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.

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.

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.

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.

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.

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?

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.

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.