When it comes to shoes, there are usually two types of people: those who buy too many pairs and those who avoid buying shoes at all costs. But did you know that shoes are not just about looks – the shoes you choose can have a huge impact on the health of your feet. How?

Each time you move or walk, your legs will carry twice your total body weight with each step you take. The right shoes will provide your feet with the necessary cushioning and support and at the same time they will be comfortable. On the other hand, shoes that do not fit properly can contribute to injuries such as shin splints and Achilles tendon pain, corns, ingrown nails, or posture problems and low back pain.

Our podiatrist have the following tips to keep in mind when buying new shoes:

1. Have adequate space

Make sure there is a gap of 1.5 cm between the toe and the toe of the shoe. Wrap your toes to make sure they have enough room to move – they may not feel pinched. In some cases (for example, if your shoes are leather) it may take a long time for the shoes to take off, but in general, the shoes should be comfortable, even if they are new.

2. Test shoes before buying

Trying on shoes is important, especially if we have access to an online store these days. We can order shoes based on our normal size from online, although it should be noted that not all brands make the same size. So it’s important to physically go to the store and choose the shoes you like and try them on.Before wearing shoes regularly, try them on different surfaces to see how they feel when walking. Put on your new pair of shoes at home for a shorter period of time than you put on for a longer period of time. 

3. Shop in the afternoon

Did you know that at the end of the day, your legs are bigger than in the morning? Buying shoes later gives your feet plenty of time to expand naturally and you will find a pair that fits you. As we age, our arteries become incompetent, which means they can no longer carry fluid in the circulation, causing fluid to build up in the feet. Many elderly patients with swollen feet and ankles can often benefit from buying shoes when their feet are more swollen. The foot fits so well in the shoe and the patient will not feel uncomfortable when they are tight.

4. Get Proper fitting

The easiest way to find out if a shoe is too big or too small is to find out how big the toe is. There should be a gap about the width of a toe between the toe and the toe of the shoe.

Another way to check this is to slip your toe between the heel of the foot and the heel of the shoe. There should be enough space on your finger to fit properly. If your finger slides quickly into the left area, you should drop half the size, while if it clicks firmly, go half up.

If your shoes are too tight, they are likely to scrub and this friction can cause blisters, so it’s best to have some room to move. The ball of your foot should fit snugly against the widest part of the shoe and the heel should allow the heel to slip slightly. Slipping on the heels will not cause blisters if you break the shoe slowly.

If a pair of shoes seems too tight, try half the size of the shoes, because you won’t have to buy new shoes in the hope that they will last longer over time.

Shoe sizes may vary by brand and style, so you may need to change your shoe size from time to time. If you try on the shoes and they fit well, then the size of the label theoretically does not matter. If your shoes are obviously too big, then you should not wear them, because bad shoes can lead to foot problems, as we mean, and it is important to take care of your feet.

5. Make sure your feet are supported

The inserts help provide extra cushioning and support and add strength. It can also help alleviate back and hip problems. inserts can be used to reduce unnecessary knee movement and more effective shock absorption. ​​One of the most common painful conditions the inserts help alleviate is the plantar fasciitis. 

There are several types of over-the-counter inserts. They are available at a retail pharmacy. Some over-the-counter orthoses are made of soft materials that immediately dissipate when you step on them – you want to avoid them. Instead, use those that are made of polymer plastic or hard plastic because they are stiffer and offer more support underfoot. 

In order for the inserts to really help with your foot pain, you need to provide strong support that adapts to the contours of your feet. It starts by determining the height of your arch. You want different top cover thicknesses depending on whether you prefer thick removable insoles along their entire length, thin removable insoles along their entire length or no distortion eliminated.

The most important thing for foot care is to find the right solution for you – if you get the right product, you will know! Simply adjusting your slippers can change how your feet feel after a long day of standing and walking for hours.

​​Meet our podiatrists, who can help you find shoes that suit your type of foot and your daily activities. We can also perform biomechanical analysis of gait and also make custom orthoses based on your foot type to provide you with the support you need for pain free walking. We have two offices conveniently located in Whittier and Bellflower. An appointment is usually also available on the same day.

Some foot problems are more common than others– learning about the signs and reasons for those conditions allows you to keep away from doing extra damage on your feet as you grow old.

Here are 5 not unusual foot issues for the ones over 60 and a way to treat them.

Plantar Fasciitis

Plantar fasciitis is the condition where the pain is present at the heel bone and often extends up to and around the arch.  It happens due to inflammation at the junction of the bone and soft tissue interface.  Also occurs due to repetitive motion, starting new activities, and recent weight gain.  Most plantar fascia pain is self-resolving, meaning patients should feel relief with home remedies and some conservative treatments such as icing, stretching, changes in shoewear, use of NSAIDs, etc. A cortisone injection into the fascia may be required to relieve inflammation and pain and allow the patient to resume normal activities. When pain does not improve, we must consider alternative options, such as extracorporeal shock wave therapy, which includes the use of high-energy sound waves to target the tender area under the foot. The high frequency of sound waves generates an area where the inflammation can begin to heal. This method has the advantage of requiring no incisions and having a very high patient satisfaction rate. This method has the advantage of requiring no incisions and patients could start walking immediately. Another treatment option for non-healing plantar fasciitis pain is fasciotomy, which involves making a small incision and cutting the fascia’s most medial band. This approach has a rapid recovery time and a high success rate, however, the patient is expected to be non-weight bearing in a cast for a few weeks. 

Bunions

Bunions arise when the joint of your big toe shifts out of place due to pressure, resulting in a bulging, bony bump on the big toe. Small bunions, known as bunionettes, can form on the fifth toe, even though they are most common on the big toe joint. You’ll know if you have a bunion because you’ll see (and feel!) swelling, redness, or discomfort around your big toe joint, thickened skin underneath your big toe, and calluses on your second toe as a result of overlapping and persistent foot pain. Treatments such as over-the-counter pain relievers and anti-inflammatories, bunion pads and splints, and comfortable shoes can help in the short term, but If bunions are uncomfortable, the only method to get rid of them is to get surgery. Bunions do not always require surgery. Patients who have continuous discomfort that interferes with their day-to-day activities are more likely to require surgery.

Corns and Calluses

Corns and calluses are often used interchangeably, but there is a distinction between the two. A corn is a thickened skin circle that appears on the toes, between the toes, and on the tips of the toes. A callus is a hard, scaly area of skin that grows on the balls of the foot or the back of the heel and is usually yellow. 

Improperly fitting shoes are the most common cause of corns and calluses. Shoes that are too tight can pinch the foot; shoes that are too big can rub the foot; and some styles, particularly high heels, can put excessive strain on certain areas of the foot. If over-the-counter creams and treatments don’t work, consult your podiatrist, who can safely remove a corn or callus (don’t try to shave it off yourself!).

Osteoarthritis

It is sometimes known as “wear and tear arthritis,” the most common type of arthritis, characterized by the loss of cartilage in joints. It can strike anyone at any age, but it is more common in women, those over forty, and those who have suffered serious joint injuries. Swelling, discomfort, and stiffness in the joint, as well as difficulty walking or bending the joint, are all indications of osteoarthritis. As far as the foot and ankle are concerned, the most common location of arthritis is the big toe joint, ankle joint, and subtalar joint.  Often the arthritis is so advanced that the patient is not able to achieve the normal range of motion due to a loss of cartilage.  When that occurs pain becomes persistent.  Anti-inflammatory medicines are usually the first line of defense, but custom orthotics (shoe inserts) and physical therapy may be required in some cases. In severe circumstances, surgery may be required.

Achilles Tendinitis

This inflammatory condition causes intense pain in the tendon that links the heel to the calf and is most usually caused by overuse of the leg muscles. Often a tight heel cord is responsible for many other foot problems. Patients with Achilles tendonitis will present with discomfort or swelling in the back of their heel, tight calf muscles, and difficulty walking are all symptoms. Patients may also present with a prominent bony growth at the back of the heel which causes pain when wearing shoes. Your doctor will gently touch the affected area during the physical exam to assess the location of pain, soreness, or swelling. He or she will also assess your foot and ankle’s flexibility, alignment, range of motion, and reflexes. Tendinitis is a condition that normally responds well to self-care. Your doctor may recommend different treatment options if your signs and symptoms are severe or persistent. Anti-inflammatory medications, physical therapy, and avoiding activities that irritate the condition may be recommended. If the pain persists after six months, surgery to repair the tendon and possibly stretch the calf muscle may be necessary.

Podiatrists are doctors that specialize in treating foot and ankle problems. They play an important role in managing patients who require routine foot care, particularly those with diabetes and impaired circulation. Podiatrists go through rigorous training in academic and clinical settings that provide them with the ability to evaluate and treat conditions of the lower extremities. After attending four years of specialized medical school, which shares a similar curriculum as traditional medical school, podiatrists complete additional training in a clinical setting for up to three years. When a patient has foot and ankle problems, they may not know where to seek treatment. One way to find a good pediatric clinician is through the primary care physician’s office. In addition, a local search might guide one to the nearest podiatrist’s office.

A timely visit is frequently necessary to avoid future issues. People who ignore foot problems, whether a painful ingrown nail, fungal infection, or pain in the ball of the foot, are more likely to suffer significant repercussions. Consider the case of a diabetic patient with poor circulation and loss of feeling in his/her feet. If he/she fails to see a podiatrist when an ulcer or infection develops, the digit or leg may need to be amputated.

1. You’re a Runner

Runners are prone to aches, pains, and injuries, including tendonitis (inflammation of the tendons) and other soft tissue inflammation. When that happens, it’s important to see a podiatrist, who can guide the runner is able to get back to what he/she loves the most: running. 

2. You Feel Joint Pain in Your Feet or Ankles

Arthritis is one of the most frequent conditions affecting the joints in the foot. Consult a podiatrist if the joints in your feet are usually swollen, red, stiff, or sensitive. Arthritis can impair the function of the foot, resulting in pain, instability, and often day-to-day function. A podiatrist can recommend therapies that will help you maintain joint health and simplify your day.

3. You’re a Diabetic

Diabetes makes you more susceptible to foot problems. People with diabetes have altered skin conditions that cause the skin to become dry, cracked, and prone to ulceration. Often, such skin conditions may become a secondary infection due to the presence of fungus in the nail and bacteria in the skin, which may enter the bloodstream and cause systemic infection. There are things a patient could do to avoid this scenario. If you have diabetes, you should see a doctor or podiatrist at least once a year for a foot exam. Studies suggest that having a podiatrist on your healthcare team more than halves the risk of amputation due to diabetes.

4. You Experience Frequent Heel Pain 

Heel discomfort can be caused by a variety of factors. A heel spur is a bony protrusion on the back of the heel. Another possibility is that one of the tendons connected to the heel is irritated. Consult a podiatrist if you’re experiencing persistent heel pain. He/she will examine your feet and maybe take X-rays. The first step in designing a treatment plan is to receive a proper diagnosis.

5. You Have an Ingrown Toenail

Ingrown toenails can lead to infection if they spread into the skin. The big toe is the most commonly affected by ingrown toenails. Consult a podiatrist if a toenail is really red or has a lot of discharge. In rare circumstances, a portion of the nail may be removed by the doctor. If the region is infected, your doctor will prescribe medication.

6. You Have a Sprain, Strain, or Broken Bone

Sprains, strains, and broken bones in the foot and ankle are also treated by podiatrists, who will be able to diagnose your injury and make treatment recommendations. A podiatrist can also make a flexible cast to aid in the healing process. Following an injury, swelling, difficulty walking, redness, and increased discomfort are all reasons to contact a podiatrist.

7. You Need Foot Surgery

For many foot issues, surgery is the final option recommended by a podiatrist. Podiatrists will perform foot and ankle surgery if necessary. Bunions, repeated ingrown toenails, and shattered bones are all conditions that may necessitate surgery.

8. You Have a Bothersome Corn or Callus

People consult a podiatrist for a variety of problems, including corns and calluses. If the build-up of skin becomes too thick, it can become painful. In such cases, a podiatrist may recommend a keratolytic agent to reverse the thickening of the skin. This is important because, when the thickness increases, the foot becomes prone to ulceration. Therefore, managing to reduce the size of corns and calluses will prevent further foot problems. Your podiatrist may also use a surgical blade to trim the thickened lesion. This treatment is pain free.

9. You Have a Painful Bunion

A bunion is a lump that forms at the base of the big toe when the bone or joint is misaligned. Bunions tend to worsen if left untreated. Treatments like cushioning, taping, or medication are often suggested by podiatrists. In severe circumstances, surgery is also an option.

10. You Think You Have Athlete’s Foot—And It Isn’t Going Away

Athlete’s foot is a fungal infection that causes the flesh between your toes to become scaly and uncomfortable. Over-the-counter antifungal creams may be beneficial; however, your podiatrist may recommend other treatment options that are more effective. Prescription medicines that are taken orally or applied topically are often more effective. Your doctor will also look for symptoms of a bacterial infection that would necessitate antibiotic treatment.

If you’re one of the five million Americans suffering from painful bunions each year, you already know the correct answer to the question of whether or not treatment is necessary. Heck yes! Bunions can cause so much foot pain that you won’t even want to walk to the refrigerator for a snack, much less take part in your daily activities.

However, pain is subjective. On a scale of one to ten, a bunion could be at either end of the spectrum. It all depends on how long the bunion has been forming and what you intend to do about it.

At the Ankle & Foot Care Center, our doctors are aware that bunion deformities (also called hallux valgus) are the most common foot problems in the nation (second only to ankle sprains). Only about one-third of those with bunions seek help from a podiatrist or foot and ankle specialist. Bunions only worsen over time and the gnarly big toe joint can lead to other conditions, such as a hammertoe and formation of callus on the toe, which would also require treatment. In general, women experience most bunions, mainly as a result of wearing ill-fitting shoes and high heels. Often, genetics play a role. If parents have bad bunions, their children may develop them when they get older.

From the outside, bunions appear as an inflamed bony bump at the base of the big toe. At the beginning of their formation, this bump may be quite small and may not cause a significant amount of pain when walking. There may be some signs of inflammation of the joint, such as redness. Over time, the condition may cause the patient to compensate and develop other foot conditions, such as plantar fasciitis, heel pain, or a stiff big toe, which may lead to trouble fitting into a normal pair of shoes.

Though simply annoying during the initial formation period, bunions are often not very painful at that point. However, as bunions progress, the area becomes increasingly swollen, red, shiny, and tender to the touch. Often, bunions become unsightly and cause patients to feel embarrassed about showing their feet.

Soon, you may develop a callus where the first and second toes rub together from being pushed by the bunion. This may lead to constant burning pain or discomfort that comes and goes. The reason is that we have sensory nerves around the joint and swelling often places pressure on those nerves, causing them to send abnormal signals. 

It’s bad enough that bunions can be extremely uncomfortable when walking or wearing tight shoes. In addition, nerves being compressed by the bony growth often wait until the nighttime to fire off, which causes soreness and throbbing.

However, there are several methods of non-surgical treatment you can try. These foot care options include:

• Start using contrast bath therapy to improve pain and swelling
• Apply bunion pads to limit your foot from rubbing on your shoe
• Wearing wider shoes with custom orthotics
• Stretch your foot
• Get cortisone injections
• Practice physical therapy

Often, conservative treatment will allow the patient to resume their normal activities and lead to pain free mobility; however, there are cases in which the patient’s big joint has severe arthritis, loss of cartilage, and displays signs of “bone on bone” on x-ray scans. In such cases, conservative treatment may or may not work, as the joint has been destroyed and the patient would be better off opting for surgery. 

What are the different types of bunion surgeries available?

There are several procedures that can be used to treat bunions, ranging from minimally invasive techniques to traditional osteotomies, in which a healthcare professional removes part of the bone and surgically realigns the remaining bones. The physician will also use pins or screws to maintain the bones in the corrected position to allow the bone to heal properly.

Meanwhile, an exostectomy is a different type of surgery for bunions wherein the physician eliminates the bony growth overlying the joint of the big toe that causes pain and jams the joint when walking. In such cases, the patient is not able to fully extend the toe, partly due to the presence of the bony growth, and exostectomies are used, along with other methods like osteotomies, to accurately align the toe.

Minimally invasive bunion surgery or “MIS Bunion Surgery” is another type of surgery for bunions that was first appeared in the mid-19th century. However, motivation for such surgeries quickly diminished because the first procedures of this type yielded poor results due to the surgeons’ lack of experience. Surgeons used 5-6 cm incisions for bunion surgeries. These procedures often led to cosmesis issues, swelling, and lengthy post-operative recovery times.

Minimally invasive bunion surgery involves making small incisions to realign the bone. Due to improvements in technology, minimally invasive surgery has become a modern mainstay of surgical treatment for painful bunions. The surgery is performed on the same day at a surgical center. It usually takes a few hours from the time a patient comes into the surgery center to the time he/she is released. Patients will have to walk using a walking boot for the first few weeks and then return to the office for a follow-up after two weeks. There are many advantages to performing a minimally invasive surgery, such as:

1. Small incisions
2. Less discomfort
3. Minimal scarring
4. Less blood loss during surgery
5. Lower complication rate
6. Aesthetically pleasing
7. Faster recovery
8. Patient can return home the same day
9. Most insurance plans cover the cost of surgery
10. High success rate

Although minimally invasive surgery is a wonderful tool for correcting painful bunions, not all patients are candidates. Being a candidate for this procedure depends on the level of deformity caused by the bunion. For example, some patients may have a deformity that is so severe that it would require a traditional surgical approach with a larger incision to achieve a proper correction. In addition, the patient’s overall history, physicals, x-rays, and activity level play a role in determining whether the patient is a candidate for minimally invasive surgery. Patient expectations would also be taken into account. If the patient is young, athletic, and concerned about having a thick scar, he/she may benefit from the less invasive procedure. On the other hand, if the patient is in their mid-sixties and has late-stage arthritis of the joint, a traditional approach with a longer incision would serve the function better as the surgeon would be able to expose the joint, examine it, and decide what type of implant would be best to provide optimal stability.

Ingrown toenails are common conditions that affect people of all ages, young and old. Not only do ingrown nails look unsightly, but they can be painful! The pain may keep the person from wearing close-toed shoes, walking or taking part in normal activities.Some patients make the ingrowing nail worse by self treating it by “digging the corner” in the hope that the pain would improve. Often it does not. In fact the toe becomes more inflamed and starts to have throbbing pain. This is the point when people begin to wonder: “Should I visit a nail salon or a podiatrist for treatment?” If you have any issues related to ingrown toenail causing pain, discoloration, or formation of pus, it’s important to visit a podiatrist. First, It’s a good idea to try some home remedies before the visit.

Here are some home remedy ideas:

• Regularly clean and trim toenails to a moderate length.
• Avoid wearing tightly fitted shoes.
• Soak the affected nail in Epsom salt for 15 to 20 minutes daily and apply over-the-counter antibiotic ointments.
• Trim the affected toenail with clean tools.
• Do not use cotton under the toe to lift the corner in the hope that it would improve the pain.It does quite the opposite: introduce bacteria and microorganisms into the nail fold.
• Do not dig the nail corners to alleviate the symptoms; often this makes the toe more swollen and worsening pain.

Top 5 reasons to visit a podiatrist for an ingrown nail are:

1. Podiatrists understand the anatomy and pathology of the nail and are better able to diagnose.
2. Podiatrists use sterile tools during the procedure so that the chance of infection is less.
3. Podiatrists will be able to prescribe antibiotics for the ingrowing nail if needed.
4. Podiatrists are licensed professionals and are able to treat complications after an ingrown nail procedure.
5. Podiatrists could advise if an ingrown nail procedure is ok to perform after assessing for adequate healing potential in a patient. Often patients with long standing diabetes and poor circulation are not ideal candidates for the ingrown nail removal procedure due to the wound not being able to heal. In such cases there are alternative approaches available, which the provider will mention during the visit.

Ingrowing nail procedure at a podiatrist’s office

The procedure begins with the use of lidocaine injection to the toe, which is what dentists use to anesthetize the gums before dental work. Then the toe needs to be prepped with an antiseptic solution to make sure there are no bacteria on the skin. Sterile tools are then used for the procedure to remove the offending part of the nail. The physician would then thoroughly cleanse the nail fold to remove any remaining nail specks once that is performed, a sterile dressing and antibiotic ointment is used to dress the toe. Often the doctor would also prescribe the oral antibiotic for 7-10 days depending on the extent of infection. Post-procedural steps and how to care for the toe are outlined to the patient. Normally the patient would return in two weeks for a follow-up to ensure that the recovery is going well. As you can imagine, a lot of careful handling and steps involve safely treating ingrown nails at the podiatrist’s office. Now let’s see what we could encounter at a nail shop.

How do a pedicurist remove the ingrowing nail at a nail salon?

Many patients have told me that they use simple tools to remove the cuticles, most are not surgical grade tools. Often what they deem an ingrown nail is completely different from what we learned during podiatric medical school. I also am not sure if the average salon uses any aseptic techniques, or can prescribe an antibiotic ointment or medicines. Receiving treatment for the so-called “ingrowing nail procedure” at a nail salon seems to be very risky because they are not licensed to deal with the patients’ acutely inflammable soft tissue problems. Often not knowing how to treat an ingrown nail and delay could lead to a worse outcome.

Does the ingrown nail procedure hurt?

Generally no. When the toe is anesthetized properly. The patient should feel no pain during the procedure. There are also painless ways to inject the anesthetics to cause less pain during the injection.

Is there a way to permanently remove the ingrown nail?

Yes, Phenol is used for treating and inactivating the nail matrix. This is the part that lies deep and gives rise to the nail. When phenol inactivates the matrix, the chance of ingrown toenails becoming a recurrent issue is reduced since it prevents the nail from developing. Your podiatrist will be able to perform the procedure and apply phenol to the area of the nail. The phenol is applied using a cotton tip applicator and left for a couple of minutes.

This process, and all treatments for ingrown toenails, should be performed by a licensed podiatrist. Although the use of phenol phenol to permanently address the ingrown toenail isn’t a 100% guarantee; there is always a chance the nail will grow again. However, when performed by an experienced podiatrist, the outcome is much better.

Are there any adverse effects to using the phenol (chemical) for the permanent procedure?

Not to my knowledge. Although overzealous use and not using enough chemicals could lead to the nail matrix not becoming fully inactive, which may cause the nail to grow back. There is no risk of skin discoloration, skin being “burned” or other adverse effects.

What should the patient do after the procedure?

Soak the foot in epsom salt and lukewarm water for 15 min daily for 7 days and apply triple antibiotic ointment and band-aid to cover the toe.

Can the patient wear closed toed shoes after the procedure?

Yes, however it is advisable to use open toe shoes during the next two weeks so that the toe does not rub against the shoe and cause pain.

Should the patient take pain medicine after the procedure?

Generally it is not necessary, however tylenol or Advil is advisable if there is pain.

What are some signs to look out for?

Increased redness, pus, throbbing pain, toe becoming dark or dusky. In those cases, immediately reach the doctor at the office for advice.

Does having an ingoing mail have anything to do with fungal nails infection?

Having a fungal infection of the nail normally causes the nail to become thick, and show a lack of having a normal shape which could cause the surrounding soft tissue to become inflamed as the thick nail starts to grow. So it is also important to treat the nail to remove the fungal infection. Your podiatrist will inform you if such a condition is noted.

What should I do if I have diabetes and currently have an ingrown nail that is painful?

If you have diabetes, good care for ingrown nails is essential for your health. This is because some of the side effects of diabetes on your feet include numbness/loss of ability and reduced blood flow, and the ability to heal wounds effectively. These effects put you at risk for a toenail to become ingrown, as well as being ineffective in eliminating infections or wound healing. This means that delayed treatment could lead to ulceration and develop secondary infections that are very dangerous to your overall health. Diabetic ulcers are currently the main cause of lower body amputation – with the exception of traumatic injuries and accidents. If you have diabetes, we will examine your feet in your overall diagnosis and discuss the best options for you now and in the years to come.

So How Do I Treat My Ingrown Toenail – And The Infection If I Already Have One?

We do not recommend trying to cut the nail at home, as the nail often goes deeper than you can see, so most people will not be able to completely remove the edge penetrating the surrounding skin leading to increased pain. You also won’t have the right tool for the job – while we have everything you need to do it quickly and easily – even anesthesia if you need it or want it!

After removing the offending piece of nail, the body is able to effectively heal the wound and fight infection – and of course, we help it by applying betadine (antiseptic) or triple antibiotic. You are encouraged to soak the foot in Epsom salts at home for 7 days – but once the nail is removed, it should be relatively simple and straightforward to cure it and the infection will disappear.

The best way to take good care of your ingrown toenail is to visit your podiatrist. Here at the Ankle & Foot Care Center, Inc., our trained podiatrists could perform the ingrown nail procedure that is safe, pain-free, and will allow quick recovery.

Running is a fantastic exercise for getting in shape and staying in shape. Many of us have had the experience of seeing somebody who used to be overweight but now looks fantastic thanks to becoming an avid runner. And, for those looking to keep cardiovascularly fit, all it takes is a quick morning jog to get the blood flowing.

For some people, running is a way of life. After all, a healthy body is a happy body, and running is an ideal approach to keeping the body both happy and healthy.

Now, let’s talk about the downside of running. It’s not a mystery why avid runners sometimes have to deal with leg, knee, foot, or ankle pain. But we’ll take a look at the factors to keep in mind:

Over-running

If you run every day, the ligaments in your feet and ankles don’t have much time to recover. As you add frequency and distance to your running routine, this becomes even more of a factor.

The many ligaments and tendons in and around the ankle may become sore and painful when exposed to increased use and pressure.

Poor running footwear

Some people seem to think that running in anything resembling a sneaker is fine. But running in old, ill-fitting, or cheaply designed footwear can also lead to ankle pain.

Even though many of us may have similar “shoe sizes,” we still have completely different feet. Wearing shoes that don’t fit correctly, especially for a long period of time, can cause problems.

Poor running technique

Bad technique can also be a problem. According to Runners World, using and maintaining the following form can help you avoid pain while running:

• Maintain a short, quick stride.
• Keep your knee in line.
• Focus on pushing up and off the ground behind you.
• Watch your elbows, keeping them bent at an angle of 90 degrees or less.
• Relax your hands, keeping them loose and below your chest.
• Work your core. A strong core makes it easier to stay upright – even when you’re tired. Avoid leaning too far forward from your hip, which can lead to injury.

What to do if you have foot and ankle pain?

If you’re dealing with any of the above issues and the resulting increase in foot and ankle pain, try the following.

Ice when needed

Icing your sore foot and ankles after a run will ease the swelling and keep the pain down. It’s a quick fix, but there’s a reason that professional athletes use ice to ease their aching joints after the big game – it works.

So, keep an ice pack in your freezer, and, when your feet and ankles get sore after a run, hit ‘em with the cold.

Rest your feet

Sometimes, the best way to deal with any kind of pain is to give the body part in question a rest. How much of a rest? Depends on what you are dealing with. If you are a runner experiencing chronic pain, it may be as simple as adjusting your technique, finding footwear that is more supportive, or just dialing it back a little.

If you make adjustments and the pain persists, it’s time to get off your feet and let them heal a little bit. Taking a few days off should have no impact on your overall fitness if you lead a healthy lifestyle.

Taking a break from running doesn’t mean that you have to give up exercise completely. Tweak your workout a little and incorporate some swimming or stationary biking into the program.

Then, when your feet have had enough of a break, re-introduce running into your regimen. If the pain comes back, consider consulting an orthopedic foot and ankle specialist; we’ll be able to give you specific answers to help you get back onto the track.

So, you think you have plantar fasciitis (inflammation of the thick ligament under your arch that runs from your heel to your toes).

It is typically attached at the heel where it is sore on examination. If the soreness is somewhere else than its attachment, then it is probably not plantar fasciitis. Generally plantar fasciitis is self resolving, meaning it should get better with treatment within two to three weeks. Plantar fasciitis will cause pain in the morning when you get out of bed.

If the condition progressively gets sore over weeks and months, pain is sudden, and is under the heel bone, it is not plantar fasciitis. My next “How I Approach Problems” will be on sudden onset heel pain which is definitely not plantar fasciitis.

Plantar fasciitis should have little to no soft tissue swelling. The patient typically can not feel heel swelling, but a doctor or therapist should. If there is significant swelling between the two sides of the body, it is probably not plantar fasciitis. Again, one of my next posts on “How I Approach Problems” will be on heel pain with swelling.

Plantar fasciitis should respond to ice massage, plantar fascial stretching, and taping. It can take a few months. The goal should be to attain a pain level between 0-2.

Treatment #1: Freeze a sports water bottle after filling 1/2 full of water. Roll over the painful area for 5 minutes 2-3 times a day with a towel on the floor as you sit and roll.

Treatment #2: Stretch the plantar fascia by grabbing hold of the foot using a towel with both hands. Stretch and hold for 1 minute. Do another two sets. These are typically done 3 times a day, especially before and after exercise like running.

Treatment #3: Tape the arch to immobilize the pull of the plantar fascia. This could be done with Quick Tape from Amazon. This is typically left on 5-7 days at a time.

Plantar fasciitis always gets a lot better with this regimen. If there is little to no improvement, I doubt the patient (you) have plantar fasciitis at all. If the patient gets 50% or so improvement but plateaus, an increase in the treatment is recommended.

Plantar fascial treatment should allow full, but modified, activities. A non-response to treatment for plantar fasciitis, typically means that there is no plantar fasciitis but it can take a month of treatment to know that. A partial response to plantar fascial treatment typically means more specialized treatment is needed with custom orthotic devices and physical therapy.

Does having a heel spur cause me to have plantar fasciitis?

Having a heel spur by itself does not cause one to have plantar fasciitis. Many asymptomatic patients do not have heel pain but they have a bony spur that is evident on the X-Ray. They do not need surgery to remove the bony prominence if it is not painful.

If the patient is an athlete, when can he or she return to sports?

Weight-Bearing vs. Non-Weight-Bearing Sports. Plantar fasciitis can be aggravated by all weight-bearing sports. Any sport where the foot lands and strikes the ground repeatedly, such as running and jogging, can aggravate the problem. Non-weight-bearing sports, such as swimming and cycling, are adequate temporary replacements and can help the athlete maintain cardiovascular fitness without irritating the plantar fasciitis.

Warming Up. The athlete should move all major joints through their complete range of motion several times before starting play. Stretching and strengthening exercises help prevent injury.

Playing the Game. When resuming the sport of choice, play at a lower intensity. In running, run for shorter periods of time, at a slower speed, and less frequently. The athlete should choose flat, even surfaces on which to run. If the athlete experiences pain either during the run or the following morning, then he is doing too much. Resume competitive running or play once the foot has healed.

Is the surgery necessary for plantar fasciitis?

Sometimes the pain is recalcitrant and the patient does not respond to conservative treatments. This usually consists of surgical release of the plantar fascia at the point of greatest tension and removal of heel spurs if necessary.

Pain in the back of the heel?

Pain in the back of heel may be caused by a bone projection or spur, or by inflammation of the Achilles tendon when it inserts into the back of the heel bone. X-rays or an imaging ultrasound examination are necessary to diagnose these conditions.

Walking is a part of everyone’s daily routine. Even babies try hard to stand and walk on their own two feet. As we grow older, we walk and stand for hours, without knowing how this might affect our feet in the future. Venous and pressure ulcers are two frequently seen pathologies in a podiatrist’s office. They may not be common in young patients and can drastically change the quality of life in the patient. We will first discuss pressure ulcers, their treatments followed by an understanding of venous ulcers, and their treatment.

What causes this condition?

People who are at risk of developing heel pressure ulcers are typically obese, diabetic, malnourished, dehydrated, immobile, have undergone major surgeries, deformed, have a hip fracture or other comorbidities. These risk factors are common, so we should all pay more attention to the health of our feet. Long hours of walking and standing put a lot of pressure on our heels, so it’s wise to take the pressure off your heels occasionally. Managing minor foot injuries properly is another way to prevent foot ulcers from developing. If heel ulcers develop, treat them immediately.

How to treat heel pressure ulcers

Treating heel ulcers involves early intervention, infection control, promotion of healing, and preventing recurrence. To prevent the condition from worsening, it’s important to manage the ulcer properly. Do this by offloading pressure from the heel. Some medical devices can do this for you. You can also use pillows. Position them underneath the calves to keep the heel raised above any surfaces. This can be done when the person with foot ulcers is sleeping or resting. As much as possible, avoid using the infected foot. Remember that if ulcers worsen, the limb will probably require surgical intervention to remove the infection. In the most severe cases, amputation may be necessary.

When walking, ensure that your weight is equally distributed to your legs and feet. Walk properly. Practice good posture. Maintain a healthy diet. Stay fit. Do regular exercises and most importantly, maintain healthy foot hygiene. This way, you won’t have to worry about developing heel ulcers.

Proper foot management is crucial to the health of our feet. It is best to check them daily, and if you notice a wound in your foot, call today us. Dr. Hassan will provide you with the care you need.

Frequently Asked Questions

What are venous ulcers?

An ulcer is a skin condition that causes a loss of skin. In the case of venous ulcers, the veins in the legs become unable to return blood back to the heart. This is due to the valves in those veins losing their capacity. As a result, fluid pools around the legs causing pressure and the breakdown of the skin.

What are some of the risk factors for developing venous ulcers?

Some of the risk factors include being 50 years of age or older, obesity, smoking, having varicose veins, a family history of the condition, or standing for long periods of time.

What are some symptoms of venous ulcerations?

Some of the symptoms include leathery skin consistency, swelling in the lower legs and ankles (especially after extended periods of standing), tiredness in the legs, varicose veins, flaky and itchy skin, as well as discoloration of the skin.

What could happen if venous ulcers are not treated in a timely manner?

When an ulcer is present, the chances of infection in the soft tissue is high as there is an opportunity for microbes to enter the bloodstream. This can cause fever, chills, nausea, and malaise. Infection of the subcutaneous tissue can also occur, which is known as cellulitis.

What are some treatments that can be used to heal a venous ulcer?

Ulcer debridement and compression therapy are the mainstays of the treatment. The wound takes up to 12 weeks to heal and requires weekly visits to a specialist’s office for the debridement, which is a process of removing the unhealthy tissue, inducing bleeding, and applying a compression bandage.

What are some long-term treatments once the ulcer is healed?

Once the venous ulcer is healed, the patient should aim to monitor and prevent future breakdown of the skin. Regular wearing of compression stockings, elevating the feet to reduce swelling, and/or taking diuretics or “water pills” will prevent swelling in the legs and changes to the skin that could lead to breakdown. Performing calf exercises and adopting an appropriate diet are also useful.

Ankle sprains are the most common type of soft tissue injury seen in the clinic. Most patients with this issue have minor bruising without any rupture of the ligaments (ligaments hold bones together) or the tendons (tendons attach muscle to bone). Not all ankle sprains result from diseased bone or require surgery. Often conservative treatment — rest, ice, elevation, and physical therapy — are enough to allow you to resume normal activities after healing takes place. Some patients may still feel unstable and prone to repeat ankle sprains despite physical therapy and rehab. In those cases, wearing an ankle gauntlet brace usually helps them to maintain proper alignment, improve function, and reduce sprains. We often recommend contrast bath therapy as a helpful kind of therapy for patients to perform at home.

What Is a Contrast Bath?

Contrast bath therapy is a special way to soak body parts in alternating warm and cool baths. The procedure has been in practice for over 2,000 years to help reduce fatigue, soreness, and swelling.

How Contrast Bath Therapy Works

Because you start in a sitting position, you’re already preparing to feel comfortably relaxed. Soaking for a few minutes in warm water opens the blood vessels and allows the blood to bring more oxygen and nutrients to your foot as it carries away waste products from the cells. Switching then to cold water causes the blood vessels to constrict. After one minute you switch back to warm water. The alternating temperatures cause the blood vessels to repeatedly widen and narrow, making them work similarly to an old-fashioned water pump! In addition to boosting your circulation, the shock of temperature change is thought to trigger the inflammation cycle and speed healing.

Benefits of Contrast Bath Therapy

This form of therapy can help reduce the symptoms of a sprained ankle such as swelling, inflammation, and pain. If additional treatment is needed, imaging tests such as an MRI are available. Patients with other conditions including anxiety, asthma, fibromyalgia, hemorrhoids, plantar fasciitis, rheumatoid arthritis, and labor pain have benefitted from this form of hydrotherapy.

Home Instructions for Contrast Bath Therapy

• You’ll need two basins or buckets, two clean towels, a timer, a thermometer, and an ACE wrap or similar elastic bandage (available at groceries, pharmacies, and superstores).
• Use the bathroom before beginning the therapy!
• Partially fill one basin with warm water 95-113°F.
• Partially fill the second basin with cool water from the tap 50-59°F.
• Place the affected foot in the warm water for four minutes.
• Switch to the cold water bath for one minute.
• Repeat this cycle four additional times for a total of 20 minutes.
• While your foot is in the water, do range of motion activities with your big toe. You can pretend your toe is a paintbrush and write imaginary letters of the alphabet or Chinese characters.
• When finished, dry your foot.
• Elevate the foot for 20 minutes.
• Gently apply the ACE bandage snugly at the base of the toes, gradually circling upward and overlapping at each wrap. The bandage should be smooth without tightness, binding, or wrinkles. You should feel more pressure in the foot that’s graded around the ankle and up the calf to provide support and compression.

You should start to feel less swollen afterward.
Perform Contrast Bath Therapy once daily. Twice daily baths are recommended on busier days.
Continue for at least four weeks.

Frequently Asked Questions

What if I don’t have a thermometer at home?

You can estimate the warmth of the water by dipping your wrist in it: it should be warm without being hot enough to cause steam or burning. Cold water from the tap is acceptable.

What if I can’t continue for 20 minutes?

Continue for as many cycles as you can comfortably do.

What if I have trouble wrapping the ACE bandage?

Practice beforehand if you can. Packaging on new bandaging sometimes contains directions. If you can’t find directions online, you can phone a home care nurse if you have one or Dr. Hassan’s office.

Does it matter what time of the day I Contrast Bath Therapy?

Unless Dr. Hassan’s office suggests a specific time, do it when you’re awake and alert so you can keep track of the time and apply the ACE wrap.

What if putting my foot in the water makes me have to go to the bathroom?

Visiting the bathroom first is advisable!

What if I skip a day?

You can resume the following day.

What if my foot is bleeding?

Postpone the therapy and phone the office for further directions.

Does Contrast Bath Therapy work for everybody?

People’s conditions are different and may not all respond to the same kinds of treatment. Dr. Hassan tailors each Plan of Care to the individual patient for the best results.

If you have any questions or concerns, don’t hesitate to call the office! Dr. Hassan’s goal is to resolve your pain and improve function so your recovery will be as easy and stress-free as possible. As a caring supporter of Integrative Medicine techniques, he uses a wide variety of conventional as well as holistic healing methods to give you the best outcome.