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!

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.

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!!

 

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.

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!