Thursday, December 17, 2009

Heels and Uneven Floors do NOT Mix!

I was in Las Vegas last weekend and had to walk from the hotel to the convention center. The path for the 20 minute walk was a floor that was uneven, shinny, super smooth and made to look like cobblestone. It was TORTURE! Certainly not designed by a woman or even with women in mind. I struggled with each step of my kitten heels (1 1/2 inch) and worried about all the women that tried to walk this walk in real heels!

It brought me back to my trip to Prague and the cobblestone streets which were even difficult to navigate in sneakers!

I think its time more women designed walk ways, shoes and maybe even cities!

Thursday, December 10, 2009

Those Skinny Heels

I have dreamed of skinny for years.

Skinny legs, skinny thighs - but never again of skinny heels! I recently slipped while wearing a pair of skinny heeled shoes (not too high, mind you) and sprained my knee. Okay, I'll admit it - I actually slipped TWICE before deciding not to wear them again!

The thinner the heel, the more unstable the shoe, regardless of the heel height. Slipping on smooth surfaces is an easy thing to do. Wider, chunkier heels can be just as appealing as the skinny heels and a lot safer to walk in.

If you must wear that favorite pair of shoes that happen to have a skinny heel, please make sure the very bottom of the heel is not worn out as this will really cause you to slip! Have your shoe maker replace the heel and ask them to use a slightly thicker material in the process. Your knees will thank you later!

Monday, November 16, 2009

Platforms - Are They Better Than Heels??

I just answered a post on which asked this exact question. The answer is yes, and no.

Platform shoes do give you height without some of the problems of heels, but platform shoes have their own set of problems. The human foot is meant to go through a specific pattern of walking called the gait cycle. Shoes should allow normal gait unless there is a specific reason not to allow normal gait.

Normal gait includes the foot bending at the ball of the foot to allow propulsion of the body forward. The toes work in conjunction with the rest of the foot to stabilize while moving forward. Many people with arthritis find that normal propulsion is painful if their joints at the ball of the foot are arthritic. For these people, we recommend shoes that limit motion in that area.

Most of us do not have significant arthritis and have no reason to not allow that normal motion. Any shoe that does not bend at the ball of the foot does not allow normal motion. Most platform shoes fall into this category.

Platform shoes that are made of rigid materials stop the foot from its regular function and force the tendons and muscles to work abnormally. This can cause some muscles to be over used and others to be under used. Tendon pain, inflammation and irritation can occur if this is allowed for an extended length of time. If shoes worn on a regular basis cause the toes to grip the shoe excessively, hammertoes can even develop!

Listen to your feet. Foot pain is never normal and any shoes that cause pain or discomfort when wearing them or immediately afterwards should not be worn for any length of time.

Friday, November 13, 2009


I am always answering questions about shoes so I thought it was time that I began to write about shoes and how they can help or hurt your feet.

Lets start with everyone's favorite shoes - High Heels!!

High heels are simply not good for your feet! True, women with higher arches can wear them more comfortably and with more stability, but down the road they can cause problems at the ball of the feet. Torn ligaments, inflammation and stress fractures can occur from constant high heel use. Heels over three (3) inches put seven times the pressure on the ball of the foot and that pressure wears out the normal tissue. Many women as early as their late 20's start having problems at the ball of the feet.

I am realistic, however, and know women are going to continue wearing heels. So here is what you need to do:

1) Alternate your heel height daily, even if its from a 4" heel to a 3 1/2" heel. That will change the force on the bones daily.

2) When trying on shoes, get off the carpeted area. You want to see what type of padding the shoe itself gives - not the padding the carpet has!

3) Never wear a shoe that you feel unstable in. Many women sprain their ankles when they wear heels that are too high for them

4) Try to find a heel that is wide if you feel unstable.

5) Go for the kitten heels! Same look as heels but without the dangers

6) Height is an illusion! Stand tall, throw your shoulder back and go for the 1 1/2" heel instead of the 3" heel!

Next up - platform shoes!!

Friday, November 6, 2009

Subtle Injuries That Can Be Devastating

I had a patient on Monday that had the most severe arthritis that I have seen in a very long time. She told me that 18 years ago, she injured her foot in a step class and that the doctor at the time suspected a stress fracture but never found it on x-ray.

This woman had an injury to the middle of her foot that is very often missed by general doctors, emergency room doctors and even radiologists. It is a disruption of what is called the Lisfranc's Joint. It involves many joints across the middle of the foot and if it goes untreated when it first occurs can cause severe arthritis years later.

It is VERY important to see a podiatric physician anytime you have a foot injury or foot pain. Looking at this woman's current x-rays not only showed the arthritis but clearly indicated that this subtle injury had occurred. A podiatric physician would have been able to detect the problem at the time of injury. This woman is now left with severe pain, limited activities and a total change in life style.

Wednesday, September 9, 2009

I was just interviewed about neuromas and thought I would write about them.

Each toe has four nerves that supply sensation - two on top and two on the bottom. The bottom nerves of adjacent toes are actually formed by a larger nerve that splits into two at the ball of the foot. Sometimes, the point at which the split occurs gets irritated and inflamed. As a result, the nerve tissue enlargs becomes a nerve tumor. That is a neuroma.

Anything that irritates the nerve can cause a neuroma. Pressure at the ball of the foot from high heel shoes and having high arches are two of the most common causes. Arthritis and bone spurring around the joints that make up the ball of the foot can also cause irritation.

The symptoms of a neuroma can vary greatly depending on the stage of the neuroma development. Early symptoms may simply feel like you are walking on a stone or a lump in the area. More typical symptoms are numbness, tingling or even pain to the two adjoining toes. It is common to have these symptoms at rest or while in bed.

Anything that causes pressure to the area will worsen the symptoms. High heeled shoes put direct pressure on them and narrow shows pinch the neuroma also producing symptoms.

Foot pain is NEVER normal. All too often, people ignore their pain with the hopes of it going away. When pain increases in intensity or is present more frequently or changes in its nature - you are overdue to see your podiatrist! An examination is usually enough to test for a neuroma, but your podiatric physician may also recommend a diagnostic ultrasound or MRI to confirm the diagnosis.

Relieving the pressure on the nerve tumor is the key for conservative treatment. Changing shoes, wearing less narrow and lower heeled shoes can make a big difference. Often, a podiatric physician will use pads and more permanent custom shoe orthotics to control the pressure on the ball of the foot and control any abnormal motion of the foot.

Neuromas can certainly become a chronic problem. Like any inflammed tissue, if the nerve tissue continutes to be inflammed continue to enlarge and will change to include scar tissue and adhesions. Like most foot problems, it is very important to treat this early in its course. Often the nerve tumor can grow to the point that every step becomes painful.

Thursday, July 23, 2009

What's up with the Media's Interest in Cankles???

The term "cankle" is not a medical term, diagnosis or medical condition. It most commonly refers to thick ankles. The width of these ankles make it difficult to distinguish the normal anatomy of the muscles, tendons and bones of the lower leg. People come in all shapes and sizes and thick ankles may be due to obesity, pregnancy, conditions causing chronic ankle swelling or may simply be hereditary. Exercise directed at the muscles of the lower leg may help define the muscles and thereby reducing the nondescript appearance.

It is however, important to differentiate ankles with this persistent thickness in anatomy from those that develop the condition suddenly or even gradually. Many systemic conditions can cause gradual swelling of the ankles (examples include kidney disease, venous disease and heart disease) and certainly trauma can cause acute or sudden swelling. A deep vein thrombosis can also cause a swollen lower leg and ankle.

A podiatric physician, also known as a podiatrist, should examine any new swelling or thickness to rule out injury, trauma or damage to the tendons in the leg and ankle. Two very common tendons that would cause thick ankles are the Achilles tendon and the posterior tibialis tendon that supports the ankle and arch. Ankle sprains, both old and new, cause thickness around the outside of the ankle. Swelling of the ankles and lower leg is treated frequently by podiatrists using a soft cast, known as an unna boot.

It is also common for women beyond their forties to develop fatty ankles due to fat deposits around and below the ankle. Often, these deposits put pressure on the nerves and can be problematic.

Monday, July 20, 2009

Feet: The Good, the Bad and the Ugly

When is Foot Surgery Simply Cosmetic and When is it Medically Necessary

Women – feet – shoes- they are a natural triad, a trinity to some and a piece of modern day life.

Women – feet – shoes- a passion many women have. I hesitate to say most; but certainly many women are fixated on their feet almost as much as their shoes. Most of my female patients evaluate and critique their feet as they would any other body part. Many women feel embarrassed to show their feet and I can’t tell you how many women have told me that they feel as if they are going to the gynecologist when they have to take off their shoes!

Many foot problems are unsightly. Hammertoes produce crooked toes. Bunions and other deformities cause disfigurement. Masses of fat tissue generate bulging of the ankles. Problems with the arch tendon can produce flat feet. Fungus cause thick toe nails.

Many unsightly foot issues become medical problems. Long toes can result in jamming in shoes and eventually produce hammertoes, pain at the ball of the foot and even tearing of ligaments. Deformities such as bunions and hammertoes can cause arthritis. Fat deposits become symptomatic with irritation of the nerves. Flat arches can instill pain, fatigue and tearing of the arch tendon. Thick nails can cause infection.

While most foot problems are hereditary, shoes certainly have a role in the affect they have on our daily lives. This is especially true for women. Women love shoes - although I can’t say that shoes love women! Many shoes inhibit the natural motion of the feet and can contribute to the development of deformities and other foot problems. Nonetheless, women love their shoes and most women will simply not give up the style, look and elegance that their carefully selected shoes provide!

Health feet, desired shoe wear and daily life styles represent a trinity to the sole of many women! Podiatric physicians that are sensitive to these three aspects of life can assist women in making the right choices to satisfy the heart, body and sole!

Treating foot problems is a challenge for many primary doctors, but podiatric physicians are trained in the biomechanics or function of the foot. The weight we bear and steps we take everyday directly influence the conditions, abnormalities and appearance of our feet. And because we walk on our feet, many foot problems are progressive. Usually, conservative treatment is enough to balance these factors and render our steps pain free, but often surgery is needed to correct a problem and/or prevent future problems.

Foot surgery, when performed by a qualified podiatric surgeon, is safe and usually uncomplicated. Foot surgery, of course, carries the same risks that other elective surgeries have, but most surgeries involving the foot get you back on your feet within weeks if not days. Foot surgery is performed for all different problems including those that cause unsightly conditions.

Despite their shoe wear, women are entitled to feet that are healthy, feel good and look great! It is the job of the treating podiatrist to determine which treatments will be most successful. Treatments may involve surgery and it is important to understand the risks. Surgery has a role in the management of foot problems associated with foot structure, shoes and daily life style. Foot health is intimately tied to foot structure and when it comes to the feet, it is often difficult to separate the truly cosmetic procedures from those that are medically necessary.

Cosmetic Foot Surgery

I was recently interviewed by the Chicago Tribune on cosmetic foot surgery. The reporter, Dawn Trice, spent almost an hour interviewing me and she really came to understand the effects of biomechanics, weight and walking on the feet! Many conditions that seem to be "cosmetic" such as long toes, really do have medical consequences.

Check out the article and let me know what you think!

Saturday, July 4, 2009

Ankle Pain - Not What You Think!

Most people associate ankle pain with an ankle sprain - pain at the outside of the ankle. But does anyone ever experience pain along the inside of the ankle?

Gradual or occasional pain behind the ankle bone on the inside of the ankle could be the start of a serious problem with the tendon that supports the arch. Many women, as they enter their 40's, begin to have excessive pressure on the posterior tibialis tendon, the strong tendon that helps hold up the arch.

Extra weight, increased activities, flat feet, and shoes with a lack of arch support all contribute to this problem. If untreated and allowed to progress, the tendon can become inflammed, tear and even rupture. This is one condition that pays to treat it early on!

Treatment differs depending on the stage of progression it is in, but will always include reducing the stress on the tendon. Pain or discomfort may be present but one common sign is that your arch seems to have "fallen."

I should know! Not only do I treat Posterior Tibial Tendon Dysfunction (PTTD), but I have started to show signs of it as well!!

Tuesday, June 2, 2009

Heel Pain Keeps Walking In!!

Heel pain remains the #1 complaint we see in our Naperville Podiatry Office - Family Podiatry Center.

Check out this video I did for the APMA on a new treatment.

Topaz for heel pain

Thursday, March 26, 2009

Have Heel Pain???

Be sure to tune in to the Real Women on Health - an internet Radio show - this Saturday morning at 9:30 EST. I will be speaking on how to treat and take care of those painful heels. See below!!

Dr. Marlene Reid
Private Practice Podiatric Physician & Surgeon
Spokesperson, American Podiatric Medical Association

Get the inside scoop and become your own best wellness advocate!

Grab your morning coffee or tea, and dial in to join us at the virtual roundtable with Kelley Connors, host of RealWomen on Health! radio show and Dr. Marlene Reid, Women's Foot Health Care specialist to talk about

what a pain in the....heel! (find out what the pain is...and what it's not!)
When: Saturday, March 28 @ 9:30 am EST - 10 am EST
How to participate in the live chat and radio show on the internet:

1. Go to and register yourself prior to the show.

2. After you are registered, and prior to the start of the show, go to the show page found at http://www.blogtalkradio/realwomenonhealth.

3. To call in and listen: dial (646) 929-2625. However, this is a New York number. Local/long distance charges from your phone company will apply.**

4. If you live outside of NY, select the "Click to Listen" button on the show page, during any live show. This is free. When you want to talk to the guest or host, you select "Click to Talk". For this, you need a headset plugged in your computer. Otherwise, just text chat with the others online!

5. To ask a question via text chat, simply type in your question or comment!

6. Should you decide not to use text chat, that's OK too. Just listen in.

How to obtain the show if you can't join live:

1. Go to and register yourself into blogtalkradio.

2. After the show has finished live, go to

3. You can download the show to iTunes to listen to it, and then to your mp3 player.

The beauty of Podcasting with BlogTalkRadio, is that we give you options. If you can't listen live via the computer, you can listen via the telephone. If you can't listen live at all, then you can download it to your computer, your iTunes, or you can just stream it from the Show Page of the episode you want to listen to.

Do you have questions you want us to know in advance? Submit your questions to

No computer available or internet just died? Just dial-in for Audio: (646) 929-2625.

What is RealWomen on Health! About?
RealWomen on Health! is the only talk radio show on the internet that creates a network of support for women around such areas such as sexual health, pelvic health, the change before the change, menopause transitions, caregiving, working women and stress, women's heart disease, weight management, evidence-based complementary medicine, mid-life transition and navigating the healthcare system.

Interesting, informative and entertaining guests of the show include women who have written research-based books, women's health leaders from around the world, women's health film producers, and female health entrepreneurs who are in service to help women a proactive and knowledgeable approach to health and wellness.

So join us this Saturday, March 28th at 9:30 am EST to chat with us at our virtual roundtable.

Be Well,

Kelley Connors, MPH

Monday, February 2, 2009

Snow or Ice at Your Feet: Pick Your Winter’s Worst Enemy

As many of us continue to get pounded with this winter’s weather AND our friend the groundhog predicts six more weeks of this weather, its time to stop and think about your safety on the snow and ice. We have all heard about the dangers of walking on ice, but there are also hazards of walking on snow.

Many of the dangers are obvious. Ice can cause slips and falls which can result in ankle sprains, fractures and other types of injury. The emergency rooms are filled with problems associated with unexpected trauma due to falls from ice. Most women don’t need to be told that it is not safe to wear heels or unstable shoes on icy sidewalks. Walking on ice requires patience, sturdy boots and awareness of your surroundings. Acute ankle injuries are very common in the winter and when it happens, there is no question about it! A fresh injury to the ankle causes pain and swelling and can lead to months of aggravation.

So what about walking on snow? As I walked my dog the last few weeks over snowy banks and neglected sidewalks I realized that we hardly ever talk about the risks specific to walking on the uneven surfaces of snow. Uneven surfaces require strong, responsive tendons and ligaments and are easy to navigate if you have physically fit ankles that have never been injured. However, not everyone can claim to have “virgin” ankles that have never suffered a sprain. Many people have what we call chronic ankle instability that is due from an improperly treated sprain.

The ankle has an outside component and inside component. When most people suffer an ankle sprain, they injure any or all of the three ligaments on the outside of the ankle. It is very common for people to either ignore the problem or seek treatment from an emergency room that is often inadequate. Proper treatment is very important and involves reducing the swelling and immobilizing the ankle immediately after the injury to allow the ligaments to repair in their proper position. Failure to heal in their natural position causes the ligaments to be stretched out, weak and unable to perform their function which is to stabilize the ankle. Re-injury of the ankle occurs easily when the ligaments are stretched. Scar tissue develops and the ligaments no longer have the structure to do their job. Many people with this problem relate that their ankles sprain easily or “give out” often.

The uneven surfaces and varying heights of snow present the perfect opportunity for unstable ankles to give way to re-injury. This type of injury occurs no matter what shoes you are wearing, even stable snow boots. Many people don’t even realize that the injury is occurring because it is unlike the acute ankle injury that occurs with ice. Pain may or may not arise; but is often dull and not likely to alert you to the injury that occurred. The ligaments continue to tear, scar and weaken as this type of repetitive injury continues.

The best advice for treatment of ankle injuries is to have them properly treated when they occur to avoid problems later on. Podiatric physicians will offer either conservative treatment or surgical treatment depending on the severity or situation. Chronic ankle instability can be treated conservatively with ankle braces; but may require surgery to put the ligaments back in the correct position.

Protect your ankles this winter. If you have weak ankles, it is important to remember that walking on snow requires the same careful attention that walking on ice requires. Try to avoid the uneven peaks and valleys of the snow drifts and matted down snow piles on those neglected sidewalks this winter has given us! If the groundhog was right in his prediction, it is going to be a long six weeks for your ankles!

Thursday, January 1, 2009

Keep Those Heels From Cracking!!

While countless women maintain their pedicure routine during the winter months, problems with dryness and callus build up can continue to be a struggle for many. Prevention is the best medicine when it comes to heel calluses and understanding why they form can help prevent them from forming and possibly developing into serious cuts or fissures that can even cause infection.

Dry, cracked heels can be as much of a problem in the winter as in the summer. Dryness and friction are the two biggest causes for calluses, dryness and cracking of the heels. Friction occurs most in the spring and summer when women tend to wear open backed shoes that allow the heels to have extra motion and friction within the shoes; but dryness of the winter air can produce dry, cracked heels just as bad as in the summer. Other causes of heel calluses include systemic conditions such as diabetes and thyroid problems.

Even your foot type might be contributing to heel calluses! Many women (and men) have what is called a flexible flat foot. This foot type looks has a nice arch when there is no weight on it but loses some of that arch when standing. This flexibility is caused by excessive motion called pronation and can cause friction on the outer rim of the heel. Friction due to pronation or excessive motion due to backless shoes causes the body to produce a hard skin or callus to protect itself.

If left untreated, calluses thicken as your body continues to produce callus for protection. The thickened skin often cracks in to deep cuts called fissures which can be very painful as the cuts dig into the nerve endings in the skin. These lacerations can even bleed, develop fungus or become infected.

Prevention is important and involves only a few minutes of care each day to be effective. Applying lotion daily to the heels is important to replenish the moisture. If you do tend to produce heel calluses and you do not have diabetes or circulation problems, a daily exfoliation with a pumous stone or foot file will help keep the problem in check. Special lotions that have urea can be recommended by your podiatric physician.

If your heel calluses are more than just a rough layer, a podiatric physician will be able to safely remove the build up. It is never recommended to use a razor or blade on your self, especially for the heels. It is very difficult to remove the hard skin safely by one’s self and it is equally important to leave a layer of roughness that we all need for a little protection. A pedicurist or other non-medical person should also not be using a razor or knife; however a podiatrist can do this safely and with medical care. In fact, the visit to the podiatrist would most likely be covered by health insurance. Your podiatrist can also diagnosis any flexible flat feet problems and prescribe and produce custom made orthotics to help control the abnormal motion causing the calluses.

These days, women want to keep their feet as well manicured as their hands and heel calluses can be a hurdle to overcome. Calluses should be removed by safe and effective means and may require a visit to the podiatrist. Often, one treatment can remove the calluses and then preventative measures ensure they will not return. Even with our feet stuck in boots all winter, smooth, soft heels should be a goal year round!