Do Your Feet Look Like This??

So many problems while we are staying at home can arise from not wearing shoes!  Even dry skin and calluses.  Friction and instability of the foot can lead to dryness and calluses of the heels.

There are a MILLION different creams and lotions out there to combat dry skin.  There is even a new foam that will be coming on the market soon that is helpful in repairing the skin layers!  But until then, heavy creams and even some with urea can be helpful in getting rid of dry skin. 

If severely dry, or cracked heels occur, you may need to see a podiatrist.  These cracks can be very painful and can become infected. 


Do not let your heel calluses go unattended!

Women's Feet After Menopause

Does the ball of your feet cause  you pain when you walk or wear certain shoes?   Do you feel that your arch is falling as you get older?  Do you feel that your bunions and hammertoes are becoming more painful?  Is your skin more dry and calloused?  Menopause may be the culprit!  Hormones have major effects on our bodies, including our feet.  Both in pregnancy and after menopause, foot problems develop in many women.

See the article that I was interviewed for here.

Dancing in the New Year! Resolutions Your Feet Will LOVE

As the countdown to the New Year fades and we retire the "special event" heels for another year, it's time to think about what resolutions you can make to start the year on the right foot!

Okay, on the left foot too.  After weeks of holidays and parties, the start of the year is a perfect time to give your feet a rest.  Below are five resolutions to help give them the pampering they deserve.

Give your toenails a breather.
Unless you have a mid-winter warm weather trip planned, January is the perfect time to evaluate the health of your toe nails.  Remove the polish and let the nails breath!  Look for any white spots or yellow discoloration.  Fungus often hides behind the veil of polish and it's important to identify the infection early for the best chance of successful treatment.  Laser treatments, combined with topical treatment, will give you the best odds of getting rid of the fungus in time for summer.

Protect your fascia from the strain and gain!
The plantar fascia is the tissue that lies on the bottom of your feet running from your heels to the balls of your feet.  Strain and stress on the tissue is common with preparations for holidays including extra shopping and cooking. Speaking of holiday cooking, stress is also increased with the weight gain that may come along with it.  Plantar Fasciitis is the common term used for strain of the fascia and presents itself as heel or arch pain.  At home treatments including stretching and wearing shoes with supportive heels but the pain can be stubborn and used to require surgery.  Good news is there are now many new less invasive treatments if your heel pain doesn't go away on its own!

Have your other resolutions be supported by your foot wear!
If you have resolved to be more active, make sure you are wearing the proper foot wear.  Running is the easiest sport to take on but its important to make sure you are wearing running shoes which are designed for heel to toe motion.  Running shoes are also the perfect shoe for athletic walking because they padding and provide ample room for the toes.  Court sports, however, require shoes that allow for side to side motion so tennis shoes have a defined purpose and are not just a type of casual foot wear.  Finally, for those that take to the hoops, basketball shoes are designed with added stability for the ankle.  As you begin your new sport, remember:  foot pain is never normal.  Increased activity can result in stress on the bones and tendons, and ligaments are prone to sprains.  Get checked out if pain remains after a day or two of rest, elevation and icing an injury.

Give your high heels a break.
The best part of winter is that many styles of boots are either flat or with a lower heel.  High heels put constant pressure on the ball of the foot - over seven time the normal pressure with heels as low as three inches.  Wearing shoes with lower heels will allow the balls of the feet (specifically the metatarsal heads) a chance to rebound from the stress and strain that is placed on the soft tissues surrounding the area.  Common injuries to this area due to high heels include bursitis, torn ligaments, displacing the natural padding and stress fractures.

Give your own heels a break.
Winter brings on dry, cracked heels.  Partially due to the dryness of the cold winter air; but also due to friction that occurs on our heels in boots and other shoes that may not provide enough heel support.  Treating dry cracked skin is important before the cracks deepen and develop fissures which may become infected.  I recently read a beauty tip to crush aspirin to use in a lotion.  It sounds crazy but aspirin has acetic acid and acids are used to help get through the dryness.  A much better solution is to treat the skin with a prepared acid-based lotion including those with lactic, salicylic or hyaluronic or glycolic acids.  These lotions and creams will exfoliate the dry skin to different degrees.  As always, be sure to discuss any treatments of the feet with your podiatric physician to make sure they are appropriate - especially if you are a diabetic or have circulatory problems.

Here is to a starting the New Year with Health Feet!

IMPORTANT PEDICURE TIPS!!

We are in full swing of summer now and women everywhere are getting their weekly pedicures or bimonthly!  Best advice if you have callouses is to SEE A PODIATRIST FIRST!

(BTW - toe nails grow slower than fingernails so you do NOT need to have them done with every manicure).




I often have patients saying they "catch" fungus from a pedicure but I honestly think that is not always the case.  Direct infection to the skin of the feet and legs, however is another story.

While not common, there are certainly documented cases where infections occur as a result of transferring bacteria (or fungus) from one person to another.   CBS News just put out this article of a woman almost losing her leg because a contaminated callous shaver was used on her.

So here are my tips for pedicures!

1)  Pedicurists in most states are not allowed to use blades or other callous removers.  If you have callouses that are thick, painful or simply unsightly, SEE A PODIATRIST to have them removed before you have your pedicure!  The benefits to the skin from the pedicure will last much longer if you have the callouses removed properly from a podiatrist.

Pinch Callous

2) Understand that callouses are a result of a structural problem and will continue to develop unless those problems are corrected.  Your podiatrist (podiatric physician) will educate you on the whys, hows and whens that influence your callouses.  Sometimes simply wearing custom orthotics can get rid of that "pinch" callous on the joint of your big toe that many of us seem to have.

3) Go to a salon first thing in the morning when the tools and whirlpools have the least chance of being contaminated.

4) Make sure they are using freshly sterilized instruments, including the nail files!

5) Never shave just prior to going for a pedicure.  This will reduce the risk of bacteria entering your skin if there is a contamination.

Finally - enjoy your freshly painted pink/red/blue/gray toes!!

Stilettos and Cobblestone - do the two work together???

Okay,  I am a little obsessed right now with Meghan Markle but not as much as Google thinks because I keep getting Meghan Markle news links!  But this one was pertinent.  Meghan wears heels on cobblestone in Dublin explores the difficulty wearing heels while walking on cobblestone streets!

I could swear I already wrote an article on this, but can't seem to find it.  The short answer is NO - of course high heels and cobblestones don't mix!  Walking on any uneven surface is difficult but cobblestone surface is uneven, irregular and a mix of contours joined together with sand.   And if you have ever tried walking in sand with heels, you know what additional problems that brings!

So what risks did Meghan take when walking on cobblestone in her 3 inch Sarah Flint shoes (not really stilettos if they are only 3 inches People Magazine)?  She risks spraining her ankles, spraying her foot, sustaining a fracture if she slips and getting those skinny heels stuck in that sand!

What the People article didn't talk about is the problem more women experience while wearing heels in another inconvenient surface:  grass.  They did provide a photo showing the Duchess of Sussex standing in the grass and mentioned that she was able to walk across the park, but the take home message in this instance is simply having those skinny heels sink into the grass!  I KNOW you have experienced that at least once.  in your high heel wearing life time!  Unlike walking on cobblestone, walking on grass while in heels once is certainly enough to make sure you don't make that mistake again.  Seems that getting stuck in the grass is more embarrassing than falling and spraining your ankles!  And who want to clean the mud off the heels while you are out and about all dressed up!

Bottom line - know where you will be walking BEFORE you venture out in those skinny heels!

Recently, Mattel made big news: Barbie's got a brand-new bod.  As a mother (who is more curvy than many), I am excited to know that there are now Barbie doll options other than those that I grew up with - bodies that reflect body types other than those I had always dreamed of having!  While my daughter is too old to benefit from Mattel's attempt to characterize young women more accurately, I know she will share in my excitement of acceptance of multiple body types. 

But what REALLY excited me was to read that Mattel had already modified Barbie with

removable feet so that she could wear heels and flats!

To me, these will always be Barbie's favorite pair of pumps!

How did I miss that news!!  Can you imagine - feet for flats and feet for heels! 

For evening, we would switch out our flexible flat feet to be able to put on high arched feet to have the stability to actually walk from our Ubers to the restaurant for dinner - without worrying that you might fall off your heels or worse yet, be seen wobbling in those heels.

For day time running errands with the kids (as a mom) or for the kids (as a teacher because when I was a kid all my Barbie's were teachers or secretaries), Barbie can kick off those high arch feet which lack shock absorption and put on her more flexible feet to allow proper foot function and rid her of her back pain.   

Or she can put on the feet that are bunion free (bunions BTW - are usually a result of those flexible flat feet) to put on flats that won't hit right across the bunions and cause direct pain.  Or she can put on the feet with a slight arch to make up for the lack of an arch in most flat shoes.

 

The boots, of course provide the best of both worlds, unless Barbie does have a bunion.

 

Then Barbie may need to go to Barbie Shoe Maker to have them stretched until she is ready to have surgery to correct the bunion.  Which of course, would be the best decision Barbie mom, Barbie teacher or Barbie secretary could make to ensure her future foot health and avoid Barbie arthritis in the unlikely event that she ages.




We won't talk about Barbie platforms!

 Now if only we can come up with a Barbie foot to make those sling backs stay on!

 

When Your Feet Still Hurt AFTER You Take Your Heels Off!

High Heels - some people love them, some people leave them.  Most women are like myself, wear them on occasions.  Granted, most women will admit that their feet hurt while they are wearing their heels, but what does it mean if your feet hurt after you take them off?

Pain at the ball of the foot, most commonly felt while wearing high heels, can be more of a problem then direct pressure from shoes.  Wearing heels, even occasionally, can cause tearing in one or more of the ligaments that are on the bottom of the joints located at the ball of the foot.  Pain at the ball of the foot is usually due to inflammation, scar tissue or a partial tear of this ligament.  The pain remains even when wearing flat shoes or without shoes because damage has occurred.

This ligament, known as the plantar plate, is responsible for keeping the toes straight.  When torn even partially, the ligament causes the toe to rotate or displace over time with or without pain.  Even without pain, there are can be swelling on the top of the foot in that region.   But its not just pain, swelling and damage to the ligament that you need to worry about.  It is not uncommon to develop hammertoes because of a disruption of this ligament. 

Treatment for this problem is dependent on when you seek treatment and how much damage there is to the tissue.  Sometimes extended physical therapy and taking the pressure off the ligament can allow the tissue to heal.  Often, using some of the newer forms of regenerative medicine can result in a quicker resolution.  Finally, surgery may be necessary as a last resort.

One thing to caution you on pain in this area.  NEVER have a cortisone injection unless you have ruled out damage to this ligament.  Cortisone, often used for inflammation in the area and/or neuromas in the area can weaken the ligament and cause further damage.

Great - Now I Have Blisters BETWEEN My Toes!!

I read an advice column this past weekend suggesting to wear "toe socks" as a way to avoid blisters between the toes on a woman who recently started a walking program and I take issue with that advice! 

Blisters are a sign of irritation and blisters between the toes would indicate irritation of one toe against the adjacent toe.  Usually, there are bone protrusions on the adjacent toes that cause pressure from one toe to the next piggy.  Hammertoes commonly cause a thickness of the toe joints which can be an  irritant by themselves or with bone spurs on the toe bones.  These bony prominences, when pressed together in tight shoes, cause the body to try to protect itself by creating fluid under the skin.  That fluid turns into a blister and can become quite painful on its own due to inflammation. 

 

Wearing toe socks may seem to give cushioning there is already a blister present but tend to take up even more room in an already crowded space and wearers would find continued walking quite uncomfortable!  Small blisters usually resolve on their own although they may cause a callus over the area.  Blisters that are painful, whether between the toes or elsewhere, need to be relieved of the fluid.  Using a sterile needle to incise the blister on its most dependent location will work, but if any blood is in the blister or any fluid that is not clear comes out, it is time to see your podiatrist.  If any signs of infection are present (swelling, drainage, redness), a trip to the podiatrist is also very important.

 

The best way to avoid blisters is to make sure you are wearing shoes that are wide enough to comfortable fit all five toes!  I often advise my walkers to use running shoes.

 

Removing the bone spurs or correcting any hammertoes that may be present will usually solve the problem once and for all!

I LOVE Kitten Heels

As a woman, a female podiatrist and the American Podiatric Medical Association's expert on shoes, especially women's shoes - I must say that I do NOT agree with the statements made  here in Yahoo this morning about Kitten Heels!  I think they are the perfect alternative to heels for women who want or need to feel dressed up.  The height is perfect and the usually skinny heel is not an issue with sidewalk cracks!  All women know what to avoid walking over when wearing skinny heals - especially in the city where there are all kinds of grate coverings.  I also do not agree that shoes cause bunions, even shoes that pitch the foot forward as stated in this article.  They can aggravate bunions, but its foot type that generally causes bunions.  I encourage patients to wear Kitten Heels every day in my practice due to their modest heel height!

Sarah Jessica Parker - Did She Say High Heels and Cheap Shoes??

I love Sarah Jessica Parker.  I love Sex and the City.  I love high heels.  But do I love the recent comments she made in Net-a-Porter about heels, cheap shoes and foot problems?  No! 

Lets see what they said she said.

Sarah Jessica Parker, we all know, is known for her many years of day to day wearing of beautiful, extravagant and expensive high heel shoes during Sex and the City.  In fact, in the article she said,  "I worked 18-hour days and never took them off."  But during filming of I Don't Know How She Does It, she wore a pair of cheaper shoes that led to her an ankle injury.

So she went to a podiatrist and she said he said, "Your foot does things it shouldn't be able to do. That bone there... You've created that bone. It doesn't belong there."  Is that really what he said?

They said she said that she slipped because the sole of the shoe was not leather.  Certainly a non-slip sole is important;  but, I bet he said that the cost of shoe is less of a factor than the components of the shoe.  I bet he said that a wider heel shoe is a more stable shoe despite the height of the heel.  And I bet he said that a higher heel shoe is a less stable shoe despite the width of the heel.  I am wondering if she said he said anything along those lines.  I bet he did.

Lets think about what she said he said about her bones.  First of all, wearing stilettos for years in your 20's, even if your foot type finds them comfortable, will lead to foot problems in your 30's.  That's what I said he probably said.   That would certainly be what I said had she come to see me.  The shoes do hold your feet in an unnatural position and puts strain on the bones in an unnatural way.  But did he actually say that they caused a specific bone?  I doubt that is what he said.  Maybe that's not really what they said she said he said.

Wearing those sky high heels on a daily basis may cause or contribute to many bone problems such as arthritis, stress fractures, bunions and hammertoes or even cause bone spurs.  Or an even bigger problem is when you wear high heels on a daily basis, your Achilles tendon tightens and shortens and it makes it almost impossible to wear flats!  If her podiatrist had asked Ms. Parker if that was the case, I am willing to bet my most expensive shoes that he said she said yes! 

You may love wearing those heels now; but no matter who you are, Sarah Jessica Parker included, those high heels will present problems down the line if you wear them too much.  

That's all I am saying.

How High is Too High??

After watching the Grammy's and watching so many beautiful women try to walk in their heels - I felt compelled to ask this question!  Well, compelled to give a simple answer.

Too high is when you are not walking properly.  So many of the women I saw presenting or accepting a Grammy were walking with their posture changed, their gait changed and their hips, knees and feet not working as they should!

High heels not only put pressure on the feet but also on the knees and the back.  If you are wearing heel and it does not feel like you are walking heel to toe, standing straight and having your normal stride (length and rhythm of each foot step) - the shoe you are wearing are too high!!

And by the way, platforms are not much better!  Many people thing that the height of the platform negates some of the overall heel height, but I can tell you first hand that you do not have a normal walking pattern when wearing platforms.  Often, walking in platforms does not absorb shock like walking in regular shoes do and back pain becomes a problem.

Shoe Shape vs. Foot Shape

I recently saw a Rachel Ray segment that talked about "foot shape" and how wearing a shoe that is a different shape than your foot can cause deformities such as bunions and hammertoes.  If only it were that simple!

"Foot shape" as referred to in the piece is more a result of the length of your toes.  Some people  have longer second toes and others have a longer great toe.  Either way, you need to fit shoes to the longest toe.  BTW- it is said that those with longer second toes are natural born leaders!

Toe box shape - square, round or pointed -  is only one factor in shoe construction and the way they affect the feet.  Heel height, the cut of the toe box and the point at which the pointed toe shoes curve  are even more important factors!  A pointed shoe that has an extended (faux) toe can be quite comfortable for many women no matter which toe is longer.  Similarly, rounded toe shoes can often cut across the bunion area and be quite a problem.



Finally, I want to make sure everyone understands, shoes do not cause bunions!  Bunions are caused by a combination of foot type, genetics and are influenced by daily shoe wear.  Certainly, if you wore a narrow, constrictive shoe 24 hours a day for years, your foot would take on that shape; but that is rarely the case! 

Why is December the perfect time to take care of your foot problems?

Most active people choose the winter months to have foot surgery to allow them to return to full activity in time for Spring and Summer activities. Walking, gardening, running and even sunbathing are all activities that are enjoyed best after foot problems have resolved.

December is the month this is easiest to take advantage of satisfied insurance deductibles and when patients enjoy the smallest amount of out of pocket expenses.

With online holiday shopping so popular, holiday shopping is no longer a deterrent for foot surgery.

There is nothing like sitting with your feet elevated on a cold winter day with a warm fire nearby! Foot surgery recovery and winter go hand in hand (or foot in foot)!

Don't Let Your Feet Keep You From Wearing High Heels!!

As both a woman who likes to be fashionable and a podiatrist that needs to be sensible, my goal is to help women wear the shoes they want to wear more comfortably!

Recently, FOX32 Chicago interviewed me for a story on cosmetic foot surgery for women who wear high heels. Like almost all podiatric surgeons, I do not consider most foot surgeries to be cosmetic even if the goal is to wear shoes more comfortably. Many women think of correcting bunions, hammertoes and other unattractive foot deformities as cosmetic; but there is usually a structural abnormality associated with those unsightly problems. Insurances almost always cover the correction of foot deformities - even if there is the added bonus of making your feet more attractive!

While FOX32 Chicago initially intended to focus on only cosmetic procedures, my interview clearly shows that when the feet are involved, the definition of what is cosmetic is clearly not black and white. While some newer procedures (such as dermal fillers to the ball of the feet and laser for fungal nails) are not covered by insurance, there are very few purely cosmetic surgeries of the feet.

Function of the foot is always a factor in solving any foot problem. Cosmetic benefits aside, foot surgery is aimed to improve foot function.

My main concern with women is being able to wear fashionable foot wear comfortably and smartly. I believe it is important for any podiatrist to counsel their patients on how to wear high heels safely, how best to shop for shoes and advocates knowing not only your true shoe size but also your foot type before shoe shopping.

Why Some Shoes No Longer Fit

I was getting ready for an upcoming trip and all set to pack my red/black/white floral skirt and my really cute red peep toe pumps that I haven't worn in awhile and slipped them on to make sure they still looked cute. But I got a surprise - they were no longer comfortable!

The fit of a shoe may change for a number of reasons. First of all, anyone with deformities such as bunions or hammertoes may find that shoes are suddenly causing more pressure and tightness around those deformities. This is usually a sign that those deformities are advancing, even if there is no pain associated with them. Custom orthotics made by a podiatrist can help reduce the progression of bunions and deformities.

Swelling of the feet often occurs in the summer months due to the heat. Swelling can tightness in shoes that were once comfortable. Swelling can also be due to a tendon problem or injury and should be evaluated by a podiatrist if persistent. Lower leg swelling that is continuous can be due to systemic problems, vein problems or even kidney or heart problems and should be evaluated by your primary care physician.

And finally, foot size can change as we get older. Pregnancy can cause the ligaments and tendons of the foot to stretch which may make the foot longer. The tendon that holds the arch commonly becomes stretched, torn or injured in people that have a flexible flat foot or are overweight. It is very important to see a podiatric physician if you develop pain in the arch with or without swelling!

So, I went shopping to set to find comfortable black sandals that I could wear with multiple outfits and I ended up finding really cute red sandals. Happy Day - red shoes make me happy!! It quickly became a really happy day when I saw the price of those red shoes!!

Resolution#11: Don’t believe rumors and don’t be afraid of the unknown

If foot surgery is recommended to you, there is no reason to panic. Foot surgery is designed to not only treat existing conditions, but to prevent further ones as well. Foot surgery rarely requires you to be off your feet for more than a few days, although some surgeries may require you to either have a cast or use crutches for up to several weeks. Our patients find that pain is usually mild after foot surgery, if at all. Our surgeons have the education, training and experience you want in a physician! When performed by either Dr. Marlene Reid or Dr. Lawrence Kosova, your feet and ankles will be in good hands!

Resolution #9: Clear out that fungal infection once and for all!

2011 brings much good news for fungal nails! New laser treatments are now being used to attack the fungus within and beneath the nails and are showing great success and Family Podiatry Center is the first (and one of the only) offices to offer it in the western suburbs! It’s no longer necessary to decide if the anti-fungal pills are worth the risk – laser treatments for fungal nails will change the way we look at our toe nails!

The laser we are using is a dual wave length laser that acts by destroying the fungal cells within the nail and the skin beneath the nail. The results we have been seeing are dramatic. The advantage for this laser is that you only have to treat the nails that have the fungus so it is more economical than outer options.

Resolution #8: Walk for fitness but make sure you have the right gear

Walking is the easiest fitness program you can create but you need the right gear! A good pair of walking or running shoes that compliments your foot type is essential. Many people also benefit from custom orthotics that are like eye glasses for your feet. Custom Orthotics made by a podiatrist are prescribed based on your foot type, problems you are having and the amount of control you may require to keep your feet working their best. At Family Podiatry Center, orthotics are used to control progressive deformities such as bunions and hammertoes, relieve stressed tendons and to prevent additional injuries.

Orthotics can be made from a foam impression (the least accurate method), a plaster cast (the most traditional method) and the way that Family Podiatry Center makes them, from a computer analysis of the way you walk (the most advanced and accurate method). The computer analysis can be used for all types of orthotics - sport, dress or even sandal orthotics!

Patient satisfaction for both our dress and sport orthotics has never been higher! Typically, people relate that they can't believe the difference and can't imagine walking without their orthotics.

Resolution #7: Give your toes a break

Hammertoes are deformities of the digits (toes) that cause them to bend or curve. They can be flexible or rigid and often cause pain, corns or bursitis on the tops of the toes. Severe hammertoes can even cause problems at the ball of the foot and make walking difficult with or without shoes. Changing your shoes can help give them more room to sit comfortably, but often surgery is necessary to “break” the toes to allow them to lie straight to avoid these problems.

When is it time to have your hammertoes corrected? Unlike bunions, hammertoes can be put off as the surgery usually involves destroying the joint sp it is not so necessary to try to preserve the joint. However, that being said; hammertoes are progressive and if treated early, it is possible to save the joint if treatment is during the flexible state.

Resolution #6: Take advantage of new technologies

So many new technologies now exist for treating everything from chronic pain to heel pain to flat feet to lasers for fungal nails.

Stay tuned for more info on lasers for fungal nails in the upcoming weeks!!!!!