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!

COVID 19 Signs in the TOES of People Without Symptoms

COVID 19 manifestations are now seen in young people, including kids, that are otherwise asymptomatic.   Due to the changes in the arteries and clotting issues, a variety of changes are showing up in the toes.

Discoloration, small sores and even just signs that look like an ingrown nail may be present. Please keep an eye out for these changes in your kids and in younger adults.  It could be a sign that they ARE infected even thought they may not have any respiratory symptoms.

(thank you to the mom's podiatry group for photos with permission).

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!

Resolutions for the New Year: Resolve to Walk!

New Year's Resolutions...................

Resolution #1:  Be more active on this Blog!!

So many people include exercise as a resolution for the new year.  So many people give it up because the exercise they have chosen becomes a hardship either because of cost or complicated new equipment.  In my mind, the best exercise is also the easiest:  Walking.

Walking requires no special equipment other than a pair of appropriate shoes.  Walking requires no cost of membership.  Walking requires no commitment or long term relationship with a gym.  Walking requires you to 1) put on your shoes and 2) Go!

I used to think the same about running.  I loved to run.  I loved the crisp fresh air and the energy I felt when I was out there engaging with the world outside.  And running was easy.  Just put on my shoes and go!  Running became a problem however, when I my knee scope showed significant arthritis.  So instead, walking became the new running.

There are a MILLION websites with info on running, especially with the new year just behind us.  This article is what inspired me to return to this blog after a much too long absence.  There is some great advice here on how to maximize your walking workout.  Walking is the simplest thing you can do to get in shape for the new year!

While I can't promise I will blog weekly, I will try to focus on walking more because I truly believe walking is the answer to many people's quest for fitness.

Today I want to talk about shoes.  While there used to be an entire category of "walking shoes" that I don't think were never intended for fitness walking.  The very best shoes for fitness walking are running shoes.  Running shoes, as opposed to tennis shoes, basketball shoes or even cross trainers allow you to propel in a forward motion from heel to toe.  Running shoes generally have more space in the toe box, provide more support, give padding at the ball of the foot and allow for shock absorption.  I am talking about traditional running shoes, not minimalist runners.

This post isn't intended to discuss the differences in the types of running shoes out there - that is an entirely different topic but the key elements are 1) making sure you have enough arch support if you are a pronator and 2) making sure you have enough shock absorption if you have a high arch foot and 3) its important to see a podiatric physician to determine your foot type and to be evaluated if you should be in custom orthotics before buying new running shoes.   For now, however, make the resolution to walk, find your running shoes and Go!

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!

Frostbite - Should Health Women Worry??

When we think of frostbite in Chicago and other large cities, most people think of the homeless and others out without proper foot protection from the elements.  But working women, especially those who commute downtown, should also be cautious!

So many of my patients commute to the city.  They take the train from Naperville or surrounding western suburbs and walk to their offices from the train.  I can tell you that most of these women are not wearing Uggs as part of their winter foot wear if there is no snow.

Most women tend to wear the same dress shoes and hosiery for their multiple block walks to and from the train - unless they wear sneakers for a previously discussed foot problem.  These shoes, or fashion boots, lack the warmth that winter boots provide and most dress shoes leave a good part of the foot exposed.  This exposure - especially when the temps dip into the teens - can lead to frostbite in some people.

Risk factors include anyone with circulation problems or diabetes but even health women should be cautious if they are smokers, take certain medications or have something called Raynaud's. 

Raynaud's is often associated with some rheumatic diseases (Raynaud's phenomenon), but it can also be present by itself   Raynaud's is fairly common - even my 15 year old daughter has it!  Toes and occasionally fingers get very cold and even turn white when exposed to cold temperatures or other stressful triggers.  It is more common in women and those who live in colder climates.  Even while at home, my daughter's second toe often turns white.

I have my daughter rewarm her toe in warm water or with a warm compress until the normal color returns to her toe; but prevention is the key with women who experience this problem.  Wearing socks (even in the house during the cold months), wearing boots when outside and limiting exposure to the very cold air.  On the really cold days, I recommend to my patients that they take a cab to and from their offices and the train.

Raynauds is a vasospastic problem of the arteries which blocks the blood flow to the toes or fingers.  Risk factors for health women include the use of cold medications that include pseudoephedrine (Chlor-Trimeton, Sudafed) and birth control pills.  Women should not smoke if they have Raynauds - its the perfect and very real reason to give my daughter not to start smoking!