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).

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!

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! 

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 #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.