Women's Foot Health by Dr. Marlene Reid

Making Sure Your Shoes Stay Put!

2021-07-29T13:53:00.004-07:00

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.

Wishing Tiger Woods a Recovery With the Very Best Biomechanical Function to Return to Golf

2021-03-04T11:33:00.001-08:00

Both as a golfer, and a podiatric physician, immediately, I have had Tiger Woods on my mind these past several days. I started to think specifically as a podiatric physician who has been exploring the role of lower extremity biomechanics. Tiger’s injuries will, of course, impact his ability to play; but a golfer of his level may certainly return to his beloved sport with accommodations to his eventual residual injuries.

Foot deformities, arthritis and muscle or tendon conditions all play a role in one’s ability to maximize your golf game. However, the lower extremity biomechanics of both bone and soft tissue pathologies as well as foot type has lagged in research in the golf arena when compared to conditions of the upper extremities. Despite the recognition that the swing “starts from the foot” and continues upward, very few have studied the limitations and conditions of the feet on the swing.

As a fairly new golfer and podiatric physician, I have been lecturing across the county on considerations for both podiatrists and golf instructors. Foot deformities, tendon problems, previous surgery and joint limitations all have influence on the golf swing. I have been working with golf professionals to consider what types of accommodations may be helpful for golfers. A recent lecture.

Along with the rest of the world, I wish Tiger a speedy recovery and a return to the best possible outcome for his foot function in both walking and in golf. To quote Tiger himself, I hope he is able to “stay patient, stay in the moment, and keep grinding”. If anyone can overcome the severity of this injury, it is Tiger Woods.

Wishes for a Foot Healthy New Year! New Concerns That Have Made the News....

2021-01-03T11:15:00.004-08:00

It may now be 2021 but the lingering affects of 2020 are still upon us. Covid 19 has made its mark in so many ways that continue to effect foot health for the start of 2021. While Covid Toes is the most obvious way that the pandemic effects the feet, there are many other considerations for maintaining healthy feet and ankles as we begin the new year. Recent articles in the Chicago Tribune have addressed some of these concerns.

Covid Determines Who is Willing to Provide Treatment

Many pediatricians, including those in suburban Chicago, are avoiding seeing their pediatric patients in person and sending them to urgent care centers if a virtual visit is not enough. While this may be adequate for some minor illnesses, this is not acceptable for injuries of the foot. Unless an obvious broken bone is present, the emergency room is the wrong place to go even in non-Covid times. Foot and ankle injuries are often mismanaged by urgent care centers or undermanaged by emergency rooms. While these facilities may be able to rule out fractures, the immediate treatment of foot injuries may not be adequate based on the limited knowledge and resources of these emergency room or internal medicine physicians. In either case, your child will likely be referred to a podiatric physician for follow-up.

Covid Footwear: The Return of Crocs and Resurgence of Slippers

Many retailers, both online and brick and mortar, will tell you that the sale of dress shoes has been way down since the beginning of the pandemic. With people working from home, casual slip-on shoes, slippers and even Crocs Crocs have made a comeback. The problem with all of these shoes is that the lack of heel and arch support lead to heel pain for many people. Commonly known as plantar fasciitis heel pain begins when band like structure on the bottom of the foot (the plantar fascia) is unsupported and becomes strained at its attachment at the bottom of the heel. This condition is both easily controlled if treated early on and extremely debilitating if it is not.

Croc’s were all the rage not too long ago. In fact, at Family Podiatry Center, we used to sell the medical version of these slip-on shoes which had a deeper heel cup for some heel stability. The rubber absorbs shock and the wide toe box makes them perfect for accommodating bunions.

Have a Foot Healthy New Year! Make one of your foot care resolutions to have your heel pain or other foot and ankle problems evaluated and treated by a podiatric physician!

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

2020-12-01T13:28:00.002-08:00

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!

Regenerative Medicine for Heel Pain has Become the Standard of Care!

2020-08-10T09:10:00.005-07:00

Regenerative medicine involves techniques to replace, engineer or regenerate cells and tissue to restore or establish normal function. Techniques include injections of stem cells, bone marrow aspirate and amniotic tissue which all supply needed hormones and substances that enable non-healing tissue to heal. Heel pain due to plantar fasciitis or plantar fasciosis is the perfect indication for regenerative medicine.

Many practices, including my own, now use some type of placental tissue as an in-office injection.

Placental tissues may include the placental disc, umbilical cord and the amniotic membrane. These tissues do contain stem cells but in smaller concentrations; however they have the same advantages of controlling inflammation and preventing scar formation which is common in chronic heel pain. These "amnio injections" contain all the good stuff such as extracellular matrix, growth factors, cytokines and collagen. They function as a foundation for the regenerative process and support restoration of tissue.

So next time your podiatrist recommends an injection for your heel pain, don't be surprised if it's not a cortisone injection!

Do Your Feet Look Like This??

2020-05-04T08:45:00.000-07:00

So many problems while we are staying at home can arise from not wearing shoes! Even dry skin and calluses. Friction and instability of the foot can lead to dryness and calluses of the heels.

There are a MILLION different creams and lotions out there to combat dry skin. There is even a new foam that will be coming on the market soon that is helpful in repairing the skin layers! But until then, heavy creams and even some with urea can be helpful in getting rid of dry skin.

If severely dry, or cracked heels occur, you may need to see a podiatrist. These cracks can be very painful and can become infected.

Do not let your heel calluses go unattended!

Stay at Home Causing an Increase in Heel Pain

2020-04-28T10:49:00.001-07:00

Do you suffer from heel pain and it has it worsened since you have been stuck at home? We have some tips for you! Most often, heel pain on the bottom of the heel is due to plantar fasciitis or plantar fasciosis. Either condition causes pain where the large ligament, the plantar fascia, attaches to the bottom of the heel bone. So many people have had an increase in pain recently, especially those that are at home not wearing shoes. Shoes with an enclosed heel provide much needed support so its best to wear your sneakers or other shoes with a stiff heel counter as much as possible, even while you are indoors. Doing runners stretches that stretch the Achilles tendon along with physically (using your hands) bending the toes toward the knee helps stretch the plantar fascia. Please do not go too long with heel pain without getting medical help. While it may start out as inflammatory (plantar fasciitis), the problem can develop into a more chronic one (plantar fasciosis) which is much more difficult to resolve. Many podiatrists are considered essential and are open for injuries and other painful conditions.

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

2020-04-24T10:38:00.001-07:00

"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!

Women's Feet After Menopause

2020-04-22T17:56:00.000-07:00

Does the ball of your feet cause you pain when you walk or wear certain shoes? Do you feel that your arch is falling as you get older? Do you feel that your bunions and hammertoes are becoming more painful? Is your skin more dry and calloused? Menopause may be the culprit! Hormones have major effects on our bodies, including our feet. Both in pregnancy and after menopause, foot problems develop in many women.

See the article that I was interviewed for here.

COVID 19 Signs in the TOES of People Without Symptoms

2020-04-12T13:45:00.002-07:00

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).

Dancing in the New Year! Resolutions Your Feet Will LOVE

2019-01-02T14:41:00.000-08:00

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!

Why are “Heel Spurs” Important When it Comes to Military Service?

2018-12-26T12:19:00.000-08:00

The New York Times released an article today that claims President Trump was given the diagnosis of “heel spurs” so he would be exempt from military service. Putting aside the ethical, moral and political components of this story; one might wonder why heel spurs would disqualify someone from service.

A heel spur is actually an abnormal outgrowth of bone of the calcaneus (heel bone). They may occur on just one foot or both. The tissue on the bottom of the foot called the plantar fascia attaches to the bottom of the heel bone and when stressed, can produce a spur of the bone due to the traction that is occurred with the stress of the fascia attachment. It is the plantar fascia that actually causes the pain.

Heel pain is VERY common. One estimate is that there are 5 million Americans that have heel pain at a given time. Approximately 35-40% of patients at Family Podiatry Center present with the complaint of heel pain.

Plantar fasciitis developed as a diagnosis to more accurately define the source of the pain over time and it takes on definite course with consistent symptoms of pain in the morning and after periods of rest. More recently, some podiatric physicians that specialize in heel pain recognize that there are two forms of plantar fasciitis including a chronic version called plantar fasciosis. The plantar fascia is much easier to treat before it becomes chronic and it’s important to seek treatment from a qualified podiatrist once the pain cycle changes. Chronic plantar fascial damage will not respond to the traditional treatments and may require regenerative medical treatments.

So why did “heel spurs” exempt people from military service? Aside from being very painful, heel pain was often associated with “flat feet” which tire easily. Nowadays, both flat feet and heel pain are easily maintained using custom orthotic devices and no long pose a threat to our soldiers.

Heel Pain - Why Some Shoes Help and Others Don't!

2018-08-04T11:35:00.000-07:00

Millions of people suffer from heel pain - most of which (although not all) is due to plantar fasciitis/heel spurs/plantar fasciosis. Some people swear by their Vionics/Birkenstocks/Oofos/Chaos sandals and most podiatrists will tell you to wear a closed heel shoe such as a running shoe for stability. So which shoe is right for you and why??

First of all, let me tell you that not only am I a podiatric physician, but I also suffer from plantar fasciitis (PF) on and off. I have personal experience as well as professional experience and knowledge of the anatomy and biomechanics of the lower extremities. The simple answer is: What works for you may NOT work for someone else!

The more complicated answer comes down to foot type, foot structure and the reason for your plantar fasciitis and how long you have had it. These individual factors become especially important in controlling re-occurrence which is common with PF.

First of all, it is so important to get rid of PF before it becomes chronic. Acute PF is thought to be inflammatory but chronic is not. Chronic PF is a topic in of itself; but for now, know that steroid injections often fail because chronic PF progresses beyond inflammation producing scar tissue or tears within the fascia itself.

There are two important parts to controlling most acute PF - control of your rearfoot (heel and subtalar joint) and allowing the tight tissues to stretch. Heel control is an integral part of treating acute PF because it helps control the motion of the heel causing inflammation. Shoes with a stiff heel counter (the back of the heel) such as running shoes are a very important part of resolving heel pain. I tell all my patients to wear them 24/7 "for now" to control the heel. It's not necessary once the pain subsides, but until then it is a must!

Rearfoot control is also achieved with most types of custom orthotics. (This is how they differ from over the counter arch supports sold as "orthotics"). There are many factors if prescribing custom orthotics based on your shoe wear, foot type and associated anatomy. Even if the orthotics prescribed by your podiatrist don't help the acute pain, they are important in controlling the heel to prevent re-occurrence! Hopefully your podiatrist explained this to you, but if not, don't be upset if they don't help get rid of the acute pain because they are still very important!

Both flat feet and high arch feet can develop PF due to tightness of the fascia, but also can develop from tightness of the Achilles tendon and even the hamstrings. Vionics and Birkenstocks help people because they have a negative heel (where the heel sits lower than the toe box) which helps to stretch the Achilles tendon. While those sandals may help with the pain while wearing them, they often don't improve the condition overall because they don't provide heel control. I think they are great once the pain has subsided and for those times that you absolutely can't wear sneakers, but sneakers with heel control are much better at getting the problem under control quicker. Running shoes that have a negative heel are a great tool in allowing stretching of the Achilles as well as providing heel control.

Finally, a few words about those sandals that I mentioned and others that are heavily marketed to the public for heel pain. Whenever anyone talks about heel pain, recommendations for these sandals are given quickly but the success of specific sandals is based on individual foot type! Oofos, for example, provide extra shock absorption so they may be great for a high arch foot type but not for those that need a negative heel. Vionics (based on personal experience) seem to provide rearfoot control further back in the arch as opposed to the high mid-arch support found with Chaos which is a different type of control. I know for myself and my foot type, this makes a huge difference. It is important to make sure you have a discussion with your podiatrist on which sandal might be best for YOU once you get the PF under control.

Controlling PF goes beyond the control of shoes and sandals; but with so many people making recommendations to their friends on which of these costly shoes to buy I felt compelled to write about the differences between them and why YOUR foot may need something different than your friends. Please see a podiatrist well versed in PF if your heel pain persists for longer than 4-6 weeks to be properly evaluated for YOUR individual treatment and shoe recommendations!

IMPORTANT PEDICURE TIPS!!

2018-07-25T07:51:00.001-07:00

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???

2018-07-11T16:26:00.002-07:00

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!

It’s July 4th so we should all be thinking Red, White and Blue!! Even when we are thinking of our toes??

2018-07-04T13:05:00.000-07:00

The color of each and every toe can indicate the health condition of that toe!

With the summer months of having exposed toes, it’s important to understand what each color might mean.

Red Toes. Assuming we are not talking about active bleeding, having redness appear suddenly or even gradually may indicate inflammation. Inflammation is your body’s reaction to something that is injuring or irritating your body. Stubbing your toe, a cut in the skin or even an ingrown nail can all cause inflammation. As inflammation increases, the area that appears red, or pink, may spread. Infection is always a worry with redness as well. It is often difficult to know if your redness is infection or inflammation so if it worsens, its important to see a podiatric physician as soon as possible. At Family Podiatry Center we always make room for same day appointments for injuries, ingrown nails or suspected infections.

White Toes. If a toe turns white, it is likely related to your arterial (blood) supply to that toe. People with heart disease or peripheral arterial disease may experience white toes, but even otherwise health people may have this problem. Raynaud’s is a condition that causes spasm of the small arteries that give blood and oxygen to the toes. Some people develop Raynaud’s by itself or it may be present with certain inflammatory or arthritic conditions. It’s important to take protective measures of proper socks and shoe wear and not to smoke cigarettes which can increase the spasms of the arteries. These spasms can occur in the cold of winter but also in damp climates regardless of temperature. Speaking of cold weather…white toes in the winter may also be the result of frostbite!

Blue Toes. Blue toes usually indicate that the veins leading the blood away from the toes are not working and the blood is pooling in the toes. Veins function to bring blood from all areas of our body back to the heart. With the toes having the smallest veins and being subject the most to gravity, venous congestion of the feet (and toes) can be a sign of vein disease. It’s not uncommon for women and men n their 30’s and 40’s to begin having symptoms of vein issues. A podiatric physician can identify if your veins are causing your swelling, pain or discoloration.

Resolutions for the New Year: Resolve to Walk!

2018-01-06T09:31:00.000-08:00

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!

2016-02-04T10:41:00.000-08:00

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

2015-09-03T12:57:00.000-07:00

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!

When Your Feet Still Hurt AFTER You Take Your Heels Off!

2015-08-28T12:59:00.000-07:00

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.

Great - Now I Have Blisters BETWEEN My Toes!!

2015-04-29T08:17:00.000-07:00

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!

BEST Treatments for Toenail Fungus would NOT Include Cornmeal Mush!!

2015-02-24T10:44:00.000-08:00

I was shocked recently to read in the Chicago Tribune that "Cornmeal Mush" may help "cure" toenail fungus! This article suggests soaking your cornmeal for an hour then soaking your feet for an hour. While I have heard MANY home remedies, this is the first I have heard that cornmeal has antifungal properties!
Fungus residing in the toenails is very difficult to "cure" because there are so many factors that contribute to its existence and infection - its not so easy to just say the infection developed because of a pedicure. While pedicures can, and often do, directly cause fungus to be seated within a toenail, there are many other factors that make treating fungus challenging.

It is important to treat toenail fungus, known as onychomycosis, because it can spread to other nails, worsen in an isolated nail, cause deformity of the affected nails and cause a fungal infection in the skin. Once you have decided to treat the nail, you need to be committed as persistence is very important. Despite what the pharmaceuticals would have you believe, there is no "magic pill" that rids you of fungus permanently. The best defense we have now is a combination of treatments which includes laser treatments, topical treatments, treatments and possibly including short term oral antifungal treatments.

Not everyone is ready to treat their fungal nails and while I am a podiatric physician I am also a woman who understands that decision! There are certain times when a pedicure is a must! Many podiatrists now offer a cosmetic temporary solution that will allow you to show off your pedicure without worry that your toes will be a source of embarrassment. I have recently began using KeryFlex which will transform your ugly nails (whether there is fungus in them or not) to a normal looking nail that will last for weeks. KeryFlex will also help stop the spread of the disease as it creates a seal over the fungal nail.

Deciding when and how to treat your onychomycosis is a decision you should make with your podiatrist. While home remedies may show improvement in some individuals, the most effective and direct treatments should have research behind them and clinical results. I think most podiatrists would agree - leave the cornmeal at the breakfast table and bring your feet to us!

I LOVE Kitten Heels

2014-07-14T06:19:00.001-07:00

As a woman, a female podiatrist and the American Podiatric Medical Association's expert on shoes, especially women's shoes - I must say that I do NOT agree with the statements made here in Yahoo this morning about Kitten Heels! I think they are the perfect alternative to heels for women who want or need to feel dressed up. The height is perfect and the usually skinny heel is not an issue with sidewalk cracks! All women know what to avoid walking over when wearing skinny heals - especially in the city where there are all kinds of grate coverings. I also do not agree that shoes cause bunions, even shoes that pitch the foot forward as stated in this article. They can aggravate bunions, but its foot type that generally causes bunions. I encourage patients to wear Kitten Heels every day in my practice due to their modest heel height!

Emergency Padding!!

2014-02-27T12:54:00.002-08:00

So...........

A few months ago I was interviewed for an article on emergency padding for blisters. At the time, I spoke of coban which is a self adhesive bandage that works great on toes and controls friction to stops irritation. Of course, it was pointed out that most people don't carry around a small section of coban (I do) and I spoke of how you can modify a Band-Aid to protect a blister without adding too much bulk to the blister itself.

Well............

I was in a similar situation this past weekend
when the boots that were so comfortable on my last trip ended up being NOT so comfortable on this past trip! I felt as if I was developing blisters at both my heels and the balls of my feet. Cobain would not work in this situation!

So I tried to figure out what to do for the following day and then I remembered that I had panty shields with me!
It was perfect.

They provided the perfect amount of friction control and didn't add too much bulk in my shoes. The adhesive was strong enough that they stayed in place and it was quite a successful! I was totally comfortable all day long.

SNOW!! More Dangerous than Ice!

2014-02-04T10:26:00.000-08:00

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!!