Keep Your Feet Feeling Young

As I’ve mentioned before in my blog, I’m far from a fashion critic, but my attention was called to pop star Lady Gaga. Her costumes are certainly headed for shock value, but when I saw what she wore to Sting’s Rainforest benefit, I was floored! (Actually the shoes shocked me slightly less than her performing onstage with Bruce Springsteen…never thought I’d see THAT!)

As you can see from her colorful outfit (well, kinda black really) topped off by shoes that have NO heel.  She’s forced to walk on her toes with her heel suspended behind.

These shoes (which by the way, she’s been seen in before) can cause stress on her Achilles tendon, causing it to inflame, and even cause heel pain.  Also, because the pressure is forced to the ball of her foot, she also opens herself to possible stress fractures.

That’s just the issues in her feet!  She also can have pain and problems with her knees and back because of her altered gait and weight distribution.  They’re also a major fall waiting to happen!!

I’m pretty sure her shoes are not going to be mainstream, especially here in Houston, but I’d hope that Lady Gaga is careful of how much she wears her extreme footwear before she starts hobbling around the stage rather than dancing.

I am an unapologetic fan of the Grateful Dead – a Deadhead. I saw them many times before the passing of Jerry Garcia and have seen their many reincarnations and offshoots over the years. Unfortunately, the band rarely comes close to me in Houston, TX so I have to travel to see them. Most recently I took my family to see Furthur, the latest incarnation, in San Francisco for shows over New Years and took friends and colleagues to Fairfax, VA, where I happened to have a meeting. All agree – there is nothing like the unique experience of a Grateful Dead concert. In fact, it’s an experience I try to adapt to my office.

What is your typical experience at a doctor’s office? I know that I often have to wait long past my appointment time and then feel rushed because the doctor is running late. Since I have been in practice, I’ve never wanted to be that kind of office! We schedule our days in my podiatry office based on who is coming in and for what. Our staff is warm and friendly and we’re always happy you chose to visit us. Believe it or not, we will even schedule extra time with some patients who we know like to stay and schmooze! I want your time in our office to be more than a positive one – I want it to be exceptional!

The Dead are famous for each show being unique with a completely different setlist each night. In fact, in their Spring 2009 tour, they went more than the first ten shows without repeating a single song! During a show, their ability to improvise and blend one song into another is legendary. This is also something I adapt into my day.

No two patients are the same and no two conditions present exactly the same. Although I will follow a protocol for a particular issue, such as heel pain, different people will respond to different treatments and will have different results. many doctors will stick to their standards and become befuddled if it doesn’t produce the expected results. It is vital to recognize when a therapy is not working for someone and redirect the focus for that patient. It is just as important to explain to a patient that just because a treatment worked for their friend, it may not be right for them.

It is easy to reconcile my love for the Grateful Dead with being a better doctor to serve my patients. Attending a show also allows me to clear my head and refocus when I return to the office. My next trip is around the corner – I’m off to San Francisco with my friend and travel buddy Wayne to see Furthur and celebrate bassist Phil Lesh’s 70th birthday. No doubt I’ll return refreshed with some new stories to tell.

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!

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.

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.

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]

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!

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.

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.

Even before I can get it on my website, I’d like to debut my first video on You Tube. This is an informative video on heel pain, which I’ve discussed at length through other posts on my blog. For more information and additional videos, visit our website.

Dr. Andrew Schneider

Tanglewood Foot Specialists

http://www.tanglewoodfootspecialists.com

Advanced Care With a Compassionate Touch