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.

Foot pain is common. At some point most people will experience pain or discomfort in their foot. While much of the time this is due to a direct foot issue, it sometimes can be because of instability elsewhere in the lower extremity. If left untreated, this can lead to pain in the ankles, knees, hips, back, or even your rear end. So my title can be taken literally or figuratively.

A literal “pain in the rear” due to unstable mechanics comes in a condition known as Piriformis Syndrome. The Piriformis muscled lies deep to the gluteal muscles and the sciatic nerve passes right beneath or through it. It functions to move the thigh away from the body’s midline and externally rotates it. Piriformis Syndrome is a condition in which the piriformis muscle irritates the sciatic nerve. This causes a pain deep in the buttocks and can even cause symptoms of Sciatica, a referred pain down the leg. The pain is generally made worse by sitting, squatting, or climbing stairs.

The primary cause of Piriformis Syndrome is biomechanical in nature. Overpronation of the foot can ultimately lead to the formation of this syndrome. It is essential that this be addressed with the use of a custom orthotic to prevent recurrence of the issue. Treatment also involves a stretching regimen and physical therapy. In resistant cases anti-inflammatory medication can be used and a cortisone injection may also help.

Speaking more figuratively, any pain in the foot has the ability to become a pain in the butt! From an ingrown toenail, heel pain, and Achilles tendon pain to something like a simple painful corn, foot pain can make everyday activities painful and laborious. I see it daily in my Houston, TX, podiatry practice – people waiting weeks, months, or even years for their foot pain to go away. There is no reason to wait so long!

The quickest avenue to eliminating the pain in your foot is by visiting your podiatrist. A podiatrist can simply diagnose the cause of your pain and offer solutions to quickly resolve it. Many people I treat are stunned how quickly the pain resolves…all regretting that they waited so long! Most find that the difficult part of solving their foot pain taking charge and scheduling the appointment.

Who would have thought that a foot doctor could treat the pain in your foot that’s become a pain in your ass? Both at the same time!

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.

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.

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

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.

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!

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.

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!