Keep Your Feet Feeling Young

Your feet are your foundation…Your base of support. When your base of support isn’t stable, it causes an effect to your posture. This instability can directly affect your ankles, knees, hips, and back. According to an article published in the Daily Mail this week, flat feet can account for regular, severe headaches.  Even migraines!

In fact, expert say that as much as 25% of migraine headaches are caused by issues with posture.  The weakness in the feet causes the muscles in the lower limbs to contract for longer periods of time.  The signals from the overloaded muscles can overwhelm the brain.  This causes the blood vessels within the brain to become inflamed and sufferers are left with a pounding pain from it.

In my Houston, TX podiatry practice, I see this quite often.  People are referred every day with back pain, hip pain, knee pain, and, yes, even headaches that have no other causes than postural issues.  What I look for in these patients are how their feet are managing pressures.  By taking a weight-bearing x-ray, one taken while standing, I am able to look at the bone structure and how the foot manages while bearing weight.  By watching you walk, I’m looking for the height of the arch, the angle the foot bears weight in, and how the heel rolls with each step.

While there is surgery that can correct a severely flat foot, I recommend it rarely because of the very long recovery.  A more conservative approach involves making a custom orthotic.  An orthotic is a custom insole with addresses the cause of the instability.  When properly made with a comprehensive biomechanical exam, an orthotic provides stability and efficiency to the feet and legs.  This will cause the muscles that are working overtime to be able to calm down to a more normal level.  This would quickly solve any postural conditions that created those painful headaches.

If you’re ever told that “nothing is wrong” when you’re suffering with pain, ask your doctor to watch you walk.  Relief may be just a referral to a podiatrist away.

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.

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.

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!

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.

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.

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.

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.

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.

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.

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.

[youtube]http://www.youtube.com/watch?v=dfv8jqtDxnU[/youtube]

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.

[youtube]http://www.youtube.com/watch?v=UCFV8tlRNTg[/youtube]

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