Keep Your Feet Feeling Young

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.

Many athletes wear orthotics. From pee-wee sports, through high school, into college, professional to weekend warriors, a properly made custom orthotic will balance the mechanics of the lower extremity and enable the foot to function at peak efficiency. Even when some athletes recognize how an orthotic can be helpful to them, they’re reluctant to try them.

Why is that? Well some feel that it will weaken their foot overall, which isn’t true. Others don’t want to be “restricted” by an orthotic, which is actually the opposite of what it is meant to do. Unlike these people who worry about function, triathletes are often concerned with how practical an orthotic is.

The nature of a triathlon is unique, in that you have to transition from swimming, to biking, into running. While we often think of Ironman triathlons, they do come in shorter distances as well, making participation in a triathlon more accessible. How does an orthotic work in multiple sports and transitioning from one to another.

The swim is an easy one to address. No orthotic necessary. Some wear their orthotics in the biking shoes, many of whom have special orthotics specifically designed for that style shoe. Others choose to not wear their orthotics when they’re on the bike.

If a triathlete uses the same orthotics in their biking and running shoes, then that transition requires them to switch them from one shoe to the other. Otherwise, the orthotics are sitting in the running shoes waiting for them. There are some triathletes who do not want to take the time to put on socks before their run, which I do discourage. But for those where every second counts, it is a time saver.

I had a patient in the office today who is an Ironman triathlete and she uses orthotics in her bike and run. She came up with a great system which she shared with me. She places a velcro dot on the bottom of her orthotic and in the heel of each shoe. She does this for two reasons. First, when she transitions, the orthotic is already in the correct position for her to just slip her foot into the shoe. When she wears her biking shoes, sometimes she doesn’t remove the shoes from the clipped pedals, but rather slips her foot out of the shoe. The velcro helps make sure the orthotic stays in the shoe.

Of course, once your foot is in the shoe on top of the orthotic no velcro is needed since the orthotic won’t slide. This simple system, however, helps enable a triathlete to remove some of the barriers to them wearing an orthotic.

It is that time of year again when all the stores have huge sales to draw customers in to buy products for the holiday season. In a perfect world holiday shopping would be a time of happiness, with cheerful people buying gifts for their loved ones. In reality, however, holiday shopping is usually a frustrating experience consisting of crowded malls, long lines, terrible traffic and overheated stores.

One thing that many people don’t really think about when they leave their homes to go holiday shopping is how much walking they are going to do or how long they are going to be on their feet. Even if you are expecting to be in-and-out of a store because you know exactly what you need, the overcrowded shopping centers and long lines can triple your time spent shopping.

Although you can never know exactly what to expect when you go holiday shopping one thing you can count on is tired feet by the end of the day. The best way to take care of your feet so that they last the length of your shopping experience is to make sure you are wearing the proper shoes and socks.

The best bet when deciding what to wear when going holiday shopping is to choose a comfortable pair of gym shoes and some moisture wicking socks. Make sure you avoid any shoes with a heel or any shoes that are open toed because they put you at a higher risk of spraining your ankle or getting hurt if your foot is stepped on in a crowded store. Moisture wicking socks are also important because they will help to keep your feet dry and blister free when you start getting overheated from the crowded stores.

Holiday shopping can be stressful but by keep your feet happy you are more likely to stay happy yourself. So good luck when you start fighting the crowds in the stores this holiday season. Don’t forget to bring along your gym shoes and a good pair of socks.

Wishing you all the best for a very Happy and Safe Holiday Season!

The holiday season is here yet again. With only a few weeks left before all the holiday madness begins it is time to start thinking about what to put on your holiday wish list for this year. If you are a runner or maybe just someone who will want to run off the extra holiday pounds below are 5 items that everyone will want to have on their list this year.

1) A new pair of running shoes – Let’s face it, running shoes tend to be one of those things many people push off replacing. Whether you are busy preparing for the holidays or if you are just really partial to one pair of running shoes, a new pair of shoes can really help to keep your feet and body injury free. Although experts vary on how often to replace a pair of shoes, a good standard to go by is to replace your shoes every 350 miles or six months, whichever comes sooner.

2) Moisture Wicking Socks – The best pair of shoes in the world won’t be nearly as beneficial without a good pair of moisture wicking socks. Although it may seem extreme to have to pay $5 for a pair of specialty socks when you can get a 5 pack of cotton socks for the same price, socks are one thing you don’t want to skimp on. They help keep your feet and toes stay dry in order to prevent blisters from forming.

3) Nike Fit – I really have to hand it to Nike because the Nike Fit is an extremely helpful tool for runners of all skill levels. This device allows you to track your runs, pace, and states of each workout through a chip in your shoe that can later be downloaded on to your computer to monitor your runs. If Nike isn’t the right shoe for you, there are adapters you can purchase to use the technology with other brands of shoes.

4) Running Utility Belt – If you have ever run a long distance race then you have probably seen those people with the belts around their waist that have little pouches to held various items. This is a great item for people who are long distance runners. The belt is ideal to hold little bottles of water, gel food packs or even your keys or cell phone.

5) Road ID – Although this last item may seem a bit much it is one of those things that it is better to be safe than sorry. A Road ID is an identification bracelet that runners and cyclists wear in case of an emergency so they can be identified. Accidents happen every day between athletes and automobiles, Road ID is a simple way to protect yourself in case anything were to ever happen to you while you are out on a run.

With the holidays being right around the corner don’t forget to add these 5 items to your wish list this year so that you can have the gear you need to run off all those extra holiday calories.

Nike has developed a line of shoes called the Nike Free that has become very popular among long distance runners, track and field athletes, and football and basketball players. Nike Free is unique because it has a special design incorporating new technology that simulates barefoot running mechanics while still wearing shoes. The goals that barefoot running technique strives to reach, and that Nike Free has adapted, is attempting to strengthen the intrinsic muscles of the foot and leg thus preventing long term injuries.

Although Nike Free has become popular among runners there are some important things to take into consideration when deciding to buy these shoes or not.

1) Versions – If you do a little research on the Nike Free you will come to find out that there are actually many different versions of this shoe. The Nike Free can be ordered on a scale of 10.0 to 3.0 with 10.0 being the most supportive shoe and the 3.0 being the least supportive and most similar to barefoot running.

2) Ease into the Shoes – If you have never done any barefoot running, or ran in any minimalist shoes that strive to achieve the same goal as Nike Free shoes, then it is important to ease your way into these shoes. It is recommended to start off running a mile in these shoes and then gradually increasing your distance based on your body’s response to the shoes.

3) They aren’t for everyone – Although Nike is continuously trying to find ways to make small changes and adding versions to the Nike Free to allow the largest population of runners to use them, these shoes still aren’t for everyone. If you don’t run consistently, need extra-cushioned running shoes, or are prone to ankle sprains, I would not recommend these shoes to you. The Nike Free is really built for routine runners with no other major foot problems. Furthermore, barefoot-style running requires significant changes in running mechanics to be successful. If you run in these shoes just as you would in a structured running shoe, you will put yourself at risk for becoming injured.

Nike Free technology has really changed the face of running shoes, opening a whole new vision into what running shoes could do for your feet and body. Although these shoes are becoming increasingly more popular in the running community, these shoes simply aren’t for everybody. Be sure to visit with your sports podiatrist who can help recommend the right shoe for you.

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!

The American Podiatric Medical Association, together with the American Society of Podiatric Sports Medicine, released a position statement for what they referred to as the “barefoot running trend.” I find it interesting that they cite lack of “conclusive research” as their reason for concern, which is the same argument barefoot runners make about the efficacy of running shoes. I have another post on barefoot running coming up soon. Until then…remember I’m just the messenger on this one!

APMA/AAPSM Joint Position Statement on Barefoot Running:
Barefoot running has become an increasing trend, and a possible alternative or training adjunct to running with shoes. While anecdotal evidence and testimonials proliferate on the Internet and in the media about the possible health benefits of barefoot running, research has not yet adequately shed light on the immediate and long term effects of this practice.

The American Podiatric Medical Association, along with the American Academy of Podiatric Sports Medicine, encourages the public to consult a podiatrist with a strong background in sports medicine to make an informed decision on all aspects of their running and training programs.

Deciding to run a marathon is a big decision that must not be taken lightly. Training for a marathon takes a lot of time, dedication, and puts extra strain on your body. If you are on the fence about deciding to train and run a marathon then there are three things you need to take into consideration, your health, your time, and your support system.

The biggest deciding factor in whether or not you should run a marathon is your health status. There are many common medical conditions, such as diabetes, osteoporosis, arthritis, anemia, hypertension, and obesity, which can lead to health complications if you start putting strain on your body. If you have any of these conditions, it is best to consult your primary healthcare doctor before signing up for a marathon training program. You must also take into account your past medical history. If you have a history of lower extremity stress fractures, heel pain, plantar fasciitis or ankle sprains then you will want to make sure that you take all precautions to prevent any of these aliments from occurring again. It is a good idea to talk to your podiatrist to find out what the best running shoe would be for you and if you could be helped by a custom orthotic.

The second thing that you must think about when trying to decide if you should attempt to train for and run a marathon is if you have enough time to properly train for the race. In our fast-paced world most people have trouble finding time to fit in all the activities they already have on their schedule. Training for a marathon is a very time consuming task, especially in the last month of training. You must decide what time of day you are going to fit in runs that can take from 30 minutes to more than 3 hours!

The final thing that is important to consider when deciding to run a marathon is who your support system is. Who is it that most wants to see you finish your race? Most people do not think about this when deciding to run a marathon but it is very important. If you are married and your husband or wife does not support you running the race because it is too expensive or takes up to much of your time, then this is not a positive mental motivator to keep you going. You need your friends and family to be there to support you through your training and the big race day.

Deciding to run a marathon is a big decision. Your health, time, and support system should be taken into consideration when deciding if training for a marathon is right for you. Marathons are very challenging endeavors that simply aren’t for everyone. Do not be disappointed if you decide running a marathon is not for you, but if you do decide to take on the challenge, the best of luck to you!

I’ll admit, there is little more comfortable than a well broken-in pair of shoes. Not just running shoes. I’ve seen men who have had the same dress shoes for the past 20 years. They just keep bringing them in to be resoled. Women, I’ll admit, do rotate their shoes selections a bit more, but there are those one or two favorite that end up being worn more than the rest.

Take a good look at those shoes, though. Are they really “good as new” when you get them refurbished? In most cases, the answer is absolutely not. Unless you are so diligent that you never, ever put a shoe on without using a shoehorn and never once put on your shoes without untying them, then you may be the exception. For everyone else, it’s time to get rid of your dead shoes.

A dress or work shoe, whether a man’s oxford or a woman’s flat, has the majority of the inherent support in the upper. That is the part of the shoe where the foot is housed. This is unlike a running shoe, where the support is in the midsole, which becomes compressed. The upper of a dress shoe will soften with time and no longer will provide support to the foot. The telltale signs are there if you look for them. Often the heel counter, the very back of the shoe, will show wrinkles and softening. In many women’s shoes, especialy flats, you can even see the heel walking right on the back of the shoe!

When you notice that your shoes are so broken down that you’re slipping around in them or walking right on them, it’s a good sign that it’s time to invest in some new shoes. I give you permission…go shopping!

It seems like it has always been a problem. Kids just don’t like to tie their shoes. Sure, it only takes a few seconds, but look at all the time is saved by just slipping them on. Even kids who have Velcro closures on their shoes still don’t undo them…they just slip them on!

A shoe is meant to provide stability for your foot. Tying your shoes daily will make them secure and prevent your foot from slipping around. When a shoe is untied for a period of time and just slipped on and off (you should see the size of some of the knots I see!), the laces loosen and the foot slips around in the shoe. This causes the foot to have to work harder to stabilize itself, often leading to overuse injuries.

Does this really make a difference? Absolutely! I’ve seen kids with infected ingrown toenails because they are hitting the ends of their shoes. Others who developed shin splints because of wearing shoes that are too loose. Still others with Achilles tendon pain or Sever’s disease because they don’t tie their shoes. The more active a kid is, the more important it is for them to tie their shoes well.

The same goes for adults. In fact, I am constantly on the case of my trainer (who tortures me twice a week) for not having his shoes tied. Not such a big deal when he’s working, but I’ve seen him the same way when he’s working out! Think about how much stability your body needs when you’re lifting weights! I’m finally getting through to him after he started feeling some foot pain. Now, I’m a really nice guy so I certainly didn’t tell him “I told you so!” Well….of course I did!

It is important to tie your shoes and to make sure your kids’ shoes are tied every day. If you’re running late, resist the urge to tell them to just slip it on…If you give them permission once, they’ll do it always.

Former, and possibly future, Olympian Paula Radcliffe won the New York Half Marathon on Sunday. This is her first race since the New York Marathon in November and also her first after recovering from bunion surgery. She will assess her progress in the next few days to see if she will pursue the World Championships Marathon in Berlin.

This is great news. One of the most common concerns my patients have when considering bunion surgery is whether or not they will be able to return to running, triathlons, or any other athletic activities. I’m pleased that I’ll be able to point to Ms. Radcliffe as someone who recovered from bunion surgery and rehabilitated several other injuries and has been able to return to a world-class level.

One treatment that is likely helping her at this point is a custom orthotic. An orthotic is a custom insole that supports and stabilizes the lower extremity. It balances the mechanics to remove the forces that deform the foot and cause a bunion. An orthotic allows the foot to work at it’s most efficient and prevents a recurrence of the bunion. I hope that Paula’s doctors have her in a custom orthotic so she can continue to pursue her goals.

I had the opportunity to be invited to Foot Solutions here in Houston to spend the afternoon in residence for a “Doctor’s Day.” I had the opportunity to meet some of their clients who had questions about the best treatment for their feet. Some of my patients came too, to get my opinion on what was the best shoes for them.

Foot Solutions is a national franchise that specializes in quality shoes that supports the foot properly to allow for optimal function. Their shoes range from fashion, to sandals, to therapeutic, to more specialized shoes, such as MBT and Chung Shi. Much of what they provide is complimentary to what I strive to do for my patients at the office. Some of their products diverge from my philosophy, such as their idea of what constitutes a proper custom orthotic.

One of the most exciting new lines of shoes that I was introduced to is a line of handcrafted, custom-ordered, shoes for men from Tauer & Johnson. These shoes offer a large number of different styles and the customer’s choice of leather and sole. The quality is truly extraordinary and very comfortable. Recently, shoe companies have been providing men with fewer choices and the quality is not what it used to be. This now offers men a choice of shoe to suit them and offers a perfect fit.

I will love to return to spend time at the store. It is important for podiatrists to have a shoe store that knows how to properly fit and recommend a shoe. It’s equally important for the store to have a podiatrist to refer to when a shoe alone will not solve the issue.

There are many people out there who cringe at the thought of having to run and, let’s face it, they do so for a good reason, running is a hard sport. I’ve seen track and cross-country teams in Houston wearing t-shirts that say “Our sport is your sports punishment.” Although many people train their bodies to be able to endure the physical requirements it takes to run, it can be quite intimidating to a new runner.

One of the most popular reasons that people start to run is to lose weight. Running is one of the best physical activities you can do to shed a couple of extra pounds in a short period of time. If you are using running as a tool to lose weight, here are some pointers to help you reach your weight lose goal in the most healthy and satisfying way:

1) You are what you eat
One of the most common misconceptions about weight loss is that you can simply lose weight by working out and not changing your diet. This is not true. The best way to lose weight is a combination of diet and exercise.

2) Don’t start off too fast
When people start their weight loss workout routines they tend to be excited and driven in the beginning and are at risk for doing too much too fast. This causes people to tire out, give up, or get injured. Try and write out a workout routine that you can realistically follow without pushing yourself to exhaustion.

3) Make sure you have the right equipment for your workout
When starting to run for the first time it is important to get a new pair of shoes that will give your feet the support they need. Also make sure you get some quality socks that will be able to absorb the sweat from your new workout schedule. There are many other gadgets runners use such as camelbacks, utility belts, absorbent clothing, and sweat bands. The best way to figure out what you will need for your runs is to visit a specialty running store. The employees are often runners themselves and can offer good advice.

Running is a great way to help shed a couple of extra pounds. In order for running to be affective a person must also change their diet, make a realistic workout routine, and have the right equipment that will help them avoid injury.

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!

Many runners have been surprised to take off their socks after a run to notice that one or more of their toenails is turning black and blue.  Many times the bruised toenails can look much worse than they are, but there is actually a simple explanation for this condition.

If a runner does not wear shoes that fit them properly then their feet are able to slide in their shoes.  This can occur if running shoes and too big because the foot will slide around in the shoe and bang up against the front edge.  This can also occur if shoes are too small because the toes begin to jam up against the front of the shoe.  This is why it is so important to get shoes that fit properly in order to prevent the toes front hitting the front of the shoe to hard.

If the nails are turning black and blue from the toes hitting up against the front edge while running don’t be alarmed.  The color change is from micro lesions under the nail from where tiny capillaries have broken.   If you notice this discoloration the best way to get rid of this is to stop running in the same shoes that caused this condition.

Most of the time the discoloration does not cause much discomfort, however, the nail can become infected if it is not kept clean so make sure you wash around the nail to prevent  infection from occurring.  Sometimes if there is enough bleeding under the nail pressure can build which will cause discomfort.  If the nail starts to become painful, then you will want to go to get evaluated by a podiatrist.  The pain either signifies infection or pressure build up from bleeding under the nail, both of which can be easily treated by a podiatrist.

A bruised nail does not automatically mean that you will lose the toenail.  If there is substantial bleeding beneath the nail and a podiatrist relieves that pressure quickly, then the nail can reattach to the nail bed.   Otherwise, the prolonged trauma from the pressure can cause the nail to detach and a new nail to begin forming and growing.   If that occurs, the original, damaged nail will simply fall off when the new nail has progressed.   As long as the nail comes off with no pain or bleeding, there should be no concern.

Bruised nails are a common sign of running shoes not fitting properly.  If this occurs, get new running shoes.   Your best bet is to visit a specialty running store, which has staff trained to properly assess your needs to recommend the right shoe for you and to ensure that shoe fits properly.   If you have any pain with the injured toenail, be sure to get in to visit your podiatrist.

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.

I just got my newest video for my website back from the editor and thought you’d like a sneak preview. It’ll be on my website shortly, but I got it up on YouTube so you can take a look now.

[youtube]http://www.youtube.com/watch?v=GDEFXmIN5Og[/youtube]

A friend of mine emailed me a story about a man from New Zealand who ran coast to coast (of New Zealand that is, barefoot. He figured that if the Kenyans can do it, so can he! Little did I know that there is a whole Barefoot Running subculture. And boy are they serious about it.

In visiting some of their sites, they find ways to explain away everything. Pain on the top of your foot? It’s due to “imprisoning your feet” in shoes. Orthotics? Make you feel better because it just makes the “prison” nicer. We’ll see how open to suggestion they are…I made a few polite comments and will see if the moderator lets them up.

Don’t get me wrong…some people have great mechanics and love going barefoot…maybe even run barefoot. Even if you take out the obvious issues: glass, twigs, gravel, etc. An unshod foot doesn’t have the shock absorption that it needs to run long distances.

If barefoot running has you intrigued, the best option is to give it a try on a very controlled surface, like a high school track. Nicely level with good cushioning. I think that most would put their running shoes back on after one lap around…if they last that long.

Let me know in the comments if you’ve tried barefoot running and your experiences with it.

For more information, visit my website at http://www.tanglewoodfootspecialists.com