Making Sure Your Shoes Stay Put!

We all love shoes!  Heels, platforms, mules and wedges - it doesn't matter as long as they make our legs look great and make the outfit!  But it's important to make sure they fit properly.

I was walking down Oak Street the other day and spotted this very fashionable young woman and while I was admiring her outfit, I happened to notice that her heels were flying off her shoes!

If you look at her right heel, you will see that her shoe is not supporting her right leg - the heel is falling toward the inside of the shoe!  The 4" platform creates a dangerous ledge that can easily cause significant damage if she were to slide even slightly off that shoe.

Given she is almost 50% off the shoe, this woman is at great risk to literally falling off her shoe (especially if she hits the sidewalk crack wrong).    She is at risk for not only injuring her ankle bones and ligaments, but also for tearing the main tendon that is responsible for supporting her arch.  Injury of this tendon could cause chronic pathology and the damage could it impossible for her to wear her shoes of choice later in life.

Please make sure you test your shoes fully before you purchase any new shoes.  Get off the carpeted area and really walk a test run before committing to that really great pair of shoes.  Unless they are what Oprah once called "dinner shoes" and aren't meant for walking.

What Actually is a "hairline fracture" Mr. President-Elect?

President-Elect Biden suffered a foot injury while playing with his dog “Major” over the recent holiday weekend.  Mr. Biden was diagnosed with a hairline fracture of the middle and lateral cuneiforms which are located in the center region of the foot.  While this type of fracture is not usually associated with tripping over one’s dog, he will likely be in a walking boot or shoe for several weeks.

What is a “hairline fracture”?

Hairline fractures are actually “stress fractures” where the bone fractures or cracks under excessive stress and are common in the weight bearing bones of the foot.  They are usually caused by constant and repetitive stress and strain to the bone.  Stress fractures may occur from overuse, repetitive athletic activities and even due to bone alignment and foot deformities. High impact sports such as basketball, running and even ballet place someone at risk for a stress fracture.  

The treatment for stress fractures is to rest the bone and control the abnormal forces on the bone.  This may mean a cast, a walking boot or surgical shoe.  Healing will be monitored with x-rays and by the improvement of clinical symptoms.  It often takes a bone four to six weeks to heal enough to withstand forces placed on it.  If a bone were to be subjected to similar stress too early, it could easily refracture.  Generally, we tell patients to plan on at least 8 weeks without athletic activities after a stress fracture.  There are ways to speed up healing of bones as well as soft tissues but immobilization is always necessary to some degree.

While President-Elect Biden was transported presidential style to his doctor for a foot injury, all YOU have to do is contact Family Podiatry Center to be seen for an urgent same day or next day appointment.  And while Mr. Biden needed to go to a second facility, the physicians at Family Podiatry Center are the MOST qualified to evaluate, diagnose and treat all your foot and ankle injuries!  Podiatric physicians are specifically trained in all thing’s feet – giving you the best and most appropriate care rather than first seeing a general or even a general orthopedic physician or physician assistant first.  At Family Podiatry Center, we have in-office x-ray and diagnostic capacity so you will most likely get an accurate diagnosis on your first visit!

Don't be Scared to Take Care of Your Health Needs even with Covid-19 Still Present!

"I can still bear weight, so it must just be a bad bruise" said my friend when she sent me this photo of her painful, swollen and bruised foot resulting from a pancake griddle catastrophe over a week ago!  So many things wrong with this statement!

First of all, just because you can bear weight doesn't mean there isn't a fracture.  Some bones of the foot and ankle do not bear weight so they may not be very painful when you stand on them.  Some bones fracture where the tendons attach so they may only be painful when you walk, not when you stand.  And some bones break in places that are only vaguely painful.  BUT if there is an injury that has swelling and bruising after a week, you must get an x-ray to rule out a fracture!

Cute Sandals!

Why do you need to rule out a fracture if there is no pain you ask?  Because not all fractures will heal properly on their own, especially in the feet because your feet support your full body weight and are subject to many different forces.  Because some fractures may not heal at all if they are in an area that does not have adequate oxygenation.  Because some fractures heal in abnormal positions that will affect the function of your feet (and ambulation) down the road.  So don't wait!

Yes, we are all worried about contracting Covid-19, but many podiatry offices are open for urgent and essential needs.  Injury is considered an essential health care need.  So PLEASE see a podiatrist if you have an injury, especially one that results in swelling for more than a few days!

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!

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!

 

The PERFECT Wedding Shoes

I happened to notice the shoes that this bride was wearing in this photo - granted, the article was about the wedding couple being photo bombed by a group of naked bike riders in Philly (they do that in Chicago too); but my attention immediately went to her shoes!

They are the perfect height for dancing, smiling, kissing and walking down the aisle!  However, if you absolutely must have a higher heel for walking down that aisle with your very tall groom; take the following precautions:

1) Have a second pair of shoes with a lower heel.  That's what I did.  My husband is a foot taller than I am and I didn't want all the photos to make is so obvious.  I had one pair for the ceremony and one pair for the rest of the evening.  I had the dress hemmed to accommodate both at a sort of in-between length.

2) Practice and rehearse - not just at the rehearsal!  While you are not going to break in those heels, you can at least get used to wearing them if you start wearing them around the house for short periods of time weeks before the wedding.

3) Put pads in those shoes to take pressure off painful spots.  Nothing like your painful feet keeping you from smiling on the happiest day of your life (hopefully) so far.  You may need to experiment with the pads but better yet, take the shoes to a podiatrist and see how he or she can help you reduce pressure points while wearing them.

4)  Walk slowly.  I have known brides that are in such a rush to the alter and from the alter that I would swear that they were wearing roller skates.  Walking slowly will help you keep your balance and have a more normal gait despite any crazy heel height you wear.

5)  BE CAREFUL!  Especially if you are not used to wearing four, five or six inch heels.  It is very easy to literally fall off your heels.  Nothing worse than having an ankle sprain and not being able to dance to "your" song.

Now that I have your feet covered - its someone else's job to help you figure out your hair issues!

SNOW!! More Dangerous than Ice!

Most people  think of ice when they think of the dangers of winter.  While our office receives emergency calls due to slips and falls from the ice all winter long,  we see even more foot problems that become symptomatic from walking on snow!

 

While walking the uneven surface of snow laden sidewalks, drives and alleys, many existing problems worsen.  Many people feel that they are more protected wearing snow boots but in reality snow boots give a false sense of security because most snow boots don't provide any ankle stability.  And the continued fashion of Uggs and similar boots cause people with all foot types to have problems in the winter!

 

 If you find yourself feeling unstable while walking on the uneven snowy surfaces or have pain on the outside of the foot just below the ankle bone, you may be experiencing an inflammatory problem called Sinus Tarsi Syndrome (STS).  STS is very common in people with more flexible feet and is often misdiagnosed as an ankle sprain.  If you have fallen or sprained an ankle and the emergency room treatment or that provided by your primary doctor doesn't seem to help, it is very possible you have STS.  STS can be caused by an injury but just as frequently can be caused by a foot that has excessive motion.  Flexible flat feet are feet that lose their arch height when you bear weigh.  STS is probably one of the most common misdiagnosed causes of pain to the foot or ankle because the joint involved, the sinus tarsi, is very close to the ankle and it is often confused by a doctor who does not specialize in the foot and ankle.

 

To diagnose STS, the joint is isolated and injected with local anesthesia to confirm that at the pain is coming fro that joint.  Since treatment for STS consists of injections of cortisone into the sinus tarsi, it is added to the initial diagnostic injection.   STS, in its early form, is an inflammatory problem and responds quite well to one or a few of cortisone shots.  Treatment also consists of controlling the flexible foot type and the excess motion by using custom orthotics or the placement of a stent within the sinus tarsi to block the excessive motion.

 

However, as time goes on and the problem is ignored, the tissue within the joint becomes thickened and almost like scar tissue and may not respond as well to the injections. If the injections fail to help, we will often order an MRI to confirm the diagnosis and to evaluate the tissue within the joint.  Surgery, either arthroscopic cleaning of the joint or opening the joint to clean out the thickened tissue.  The surgery is not very invasive and allows return to work and activities quickly.

 

Like many foot problems, the key is to treating the problem early before the problem becomes chronic.  Remember - foot pain is never normal!!