Women's Foot Health by Dr. Marlene Reid

Fallen Arches

2011-08-24T19:11:00.000-07:00

I just answered a question on another blog about "fallen arches" are decided this was a topic that needs to be addressed - even if I have done that before!

Fallen arches are not normal. Usually it happens when the tendon that holds and supports the arch (the posterior tibial tendon) weakens or tears. This tendon can weaken with age, weight gain or flat feet. The problem is very subtle at first and may just present itself as subtle aching of the inside ankle and/or arch.

If diagnosed early on, simply supporting the tendon and the arch with custom orthotics is usually all that is needed; but if the tendon continues to be stressed without support it can tear or even rupture.

I currently have a patient who's tendon partially tore during her second pregnancy and she had been suffering for year until it finally ruptured.

Sometimes physical therapy is helpful, but if the tendon has tears and scar tissue, surgery is generally needed. The good news is that people do GREAT after repair of the tendon. Actually, that is the case with any tendon. If there is prolonged pain, there is always pathology. Once surgery addresses the pathology (tears or scar tissue) the person does great.

The only other consideration is what to do to stop the stress on the tendon after it is healed. Custom orthotics are used but it is also possible to have a stent inserted into the joint that supports the arch for a more permanent type of support. This surgery is a simple procedure that should be considered with this problem.

Why Some Shoes No Longer Fit

2011-07-22T08:29:00.000-07:00

I was getting ready for an upcoming trip and all set to pack my red/black/white floral skirt and my really cute red peep toe pumps that I haven't worn in awhile and slipped them on to make sure they still looked cute. But I got a surprise - they were no longer comfortable!

The fit of a shoe may change for a number of reasons. First of all, anyone with deformities such as bunions or hammertoes may find that shoes are suddenly causing more pressure and tightness around those deformities. This is usually a sign that those deformities are advancing, even if there is no pain associated with them. Custom orthotics made by a podiatrist can help reduce the progression of bunions and deformities.

Swelling of the feet often occurs in the summer months due to the heat. Swelling can tightness in shoes that were once comfortable. Swelling can also be due to a tendon problem or injury and should be evaluated by a podiatrist if persistent. Lower leg swelling that is continuous can be due to systemic problems, vein problems or even kidney or heart problems and should be evaluated by your primary care physician.

And finally, foot size can change as we get older. Pregnancy can cause the ligaments and tendons of the foot to stretch which may make the foot longer. The tendon that holds the arch commonly becomes stretched, torn or injured in people that have a flexible flat foot or are overweight. It is very important to see a podiatric physician if you develop pain in the arch with or without swelling!

So, I went shopping to set to find comfortable black sandals that I could wear with multiple outfits and I ended up finding really cute red sandals. Happy Day - red shoes make me happy!! It quickly became a really happy day when I saw the price of those red shoes!!

Try this link for the Video on Flip Flops

2011-06-30T22:12:00.000-07:00

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Click here

Summer Shoes - Flip Flops are NOT the Answer!!

2011-06-30T21:39:00.000-07:00

With the weather improving, more and more people are participating in their favorite outdoor activities and for many people, the flip flop is the first shoe they reach for. Easy to put on, airy and light weight– flip flops seem like the perfect summer shoe!

But, all flip flops are NOT always the best choice for your feet

Sometimes, it IS appropriate and safe to wear flip flops. For example – its fine to wear them to the beach and the pool, relaxing outside in your own back yard, or at a party where you won’t be walking too much.

But most flip flops are not appropriate for walking, biking, doing lawn work or for other athletic activities. Flip flops should not be your go to shoes in the summer!

For those who might over use these flimsy non-supportive shoes, you risk

• Tendonitis
• Heel pain
• Stubbing or jamming toe
• Ankle injuries
• Foot lacerations

Not all flip flops are bad, but most are.

Those that can easily be bended in half from toe to heel and twisted as well will not provide adequate support for normal daily activities.
If the “toe thong” is made inexpensively, either by design or material, you can also experience blistering in between the toe area because. This is a very common problem with flip flops. You want to make sure there are no seams that would cause irritation and its best when the material is soft. Blistering can also occur with constant slippage of an ill fitting flip flop.

Not all flip flops are bad however. Some flip flops have a more structured, solid arch support and make with a more sturdy material. Look for ones that bend at the ball of the foot and do not twist easily. Thicker soles and padding can be found in some flip flops. Look for those that have somewhat of an arch, a deeper heel cup and a soft and natural toe thong.

Go to http://abclocal.go.com/wls/story?section=resources/lifestyle_community&id=8173033 to see my discussion of better flip flops with Linda Yu and Sylvia Perez on a recent ABC Chicago News story.

Any sandal or flip flop that forces you to scrunch your toes or use your tendons abnormally is not a shoe you should be wearing.

Any shoe related problems should not be ignored. The bottom line is that no matter what shoe you wear, if you have foot pain, see a podiatric physician- foot pain is never normal!

Resolution#11: Don’t believe rumors and don’t be afraid of the unknown

2011-01-18T11:09:00.001-08:00

If foot surgery is recommended to you, there is no reason to panic. Foot surgery is designed to not only treat existing conditions, but to prevent further ones as well. Foot surgery rarely requires you to be off your feet for more than a few days, although some surgeries may require you to either have a cast or use crutches for up to several weeks. Our patients find that pain is usually mild after foot surgery, if at all. Our surgeons have the education, training and experience you want in a physician! When performed by either Dr. Marlene Reid or Dr. Lawrence Kosova, your feet and ankles will be in good hands!

Resolution #10: Don’t let flatfeet slow you down!

2011-01-16T12:35:00.001-08:00

When kids complain about their legs feeling tired, it’s often because of flat feet; flexible flat feet to be exact. While it may look like they have arches, flexible flat feet lose their arch when they bear weight during walking. The muscles have to work harder than normal and tired feet and legs are a common complaint. Adults suffer from problems from flat feet as well. Bunions, hammertoes, arthritis and heel pain develop over time due to the instability of flexible flat feet. Tendons in the arch are commonly affected in adults with flat feet. Many women over the age of forty have this problem but men can develop it as well. The tendons can become inflamed, tear, develop scar tissue and even rupture all because of the lack of support. There are so many ways to treat the symptoms of flat feet now – ways that do not involve the extensive reconstructive surgery that was once the norm. Dr. Reid and Dr. Kosova have had special training in a simple procedure that uses a stent to keep the arch from collapsing that many of our patients are benefiting from.

Resolution #9: Clear out that fungal infection once and for all!

2011-01-15T11:04:00.000-08:00

2011 brings much good news for fungal nails! New laser treatments are now being used to attack the fungus within and beneath the nails and are showing great success and Family Podiatry Center is the first (and one of the only) offices to offer it in the western suburbs! It’s no longer necessary to decide if the anti-fungal pills are worth the risk – laser treatments for fungal nails will change the way we look at our toe nails!

The laser we are using is a dual wave length laser that acts by destroying the fungal cells within the nail and the skin beneath the nail. The results we have been seeing are dramatic. The advantage for this laser is that you only have to treat the nails that have the fungus so it is more economical than outer options.

Resolution #8: Walk for fitness but make sure you have the right gear

2011-01-12T14:40:00.000-08:00

Walking is the easiest fitness program you can create but you need the right gear! A good pair of walking or running shoes that compliments your foot type is essential. Many people also benefit from custom orthotics that are like eye glasses for your feet. Custom Orthotics made by a podiatrist are prescribed based on your foot type, problems you are having and the amount of control you may require to keep your feet working their best. At Family Podiatry Center, orthotics are used to control progressive deformities such as bunions and hammertoes, relieve stressed tendons and to prevent additional injuries.

Orthotics can be made from a foam impression (the least accurate method), a plaster cast (the most traditional method) and the way that Family Podiatry Center makes them, from a computer analysis of the way you walk (the most advanced and accurate method). The computer analysis can be used for all types of orthotics - sport, dress or even sandal orthotics!

Patient satisfaction for both our dress and sport orthotics has never been higher! Typically, people relate that they can't believe the difference and can't imagine walking without their orthotics.

Resolution #7: Give your toes a break

2011-01-11T18:14:00.000-08:00

Hammertoes are deformities of the digits (toes) that cause them to bend or curve. They can be flexible or rigid and often cause pain, corns or bursitis on the tops of the toes. Severe hammertoes can even cause problems at the ball of the foot and make walking difficult with or without shoes. Changing your shoes can help give them more room to sit comfortably, but often surgery is necessary to “break” the toes to allow them to lie straight to avoid these problems.

When is it time to have your hammertoes corrected? Unlike bunions, hammertoes can be put off as the surgery usually involves destroying the joint sp it is not so necessary to try to preserve the joint. However, that being said; hammertoes are progressive and if treated early, it is possible to save the joint if treatment is during the flexible state.

Resolution #6: Take advantage of new technologies

2011-01-10T10:42:00.000-08:00

So many new technologies now exist for treating everything from chronic pain to heel pain to flat feet to lasers for fungal nails.

Stay tuned for more info on lasers for fungal nails in the upcoming weeks!!!!!

Resolution #5: Treat your injuries with the respect they deserve

2011-01-09T08:48:00.000-08:00

Each week, I see at least one or two paients telling me they has a previous injury and they are now having related problems! Sometimes it is the same injury or sometimes it is a problem that occured at the same time of an injury that was treated at an emergency room but was ignored by the emergency room staff!

Far too often we hear of people simply getting an ace wrap for an ankle injury! Injuries need to be addressed as soon as possible and need to be given proper attention. Injured soft tissues (ligaments and tendons) need as much support, if not more, than broken bones. If they are not treated properly, re-injury of the tissue is likely in the future and scar tissue and chronic problems can easily occur. If pain persists even after you have been told by an emergency room or other doctor that you didn’t suffer a fracture, please make an appointment at Family Podiatry Center to properly evaluate your soft tissues. Soft tissue injuries including sports injury are a specialty of our doctors.

Resolution #4: Don’t let bunions make you or break you!

2011-01-08T11:35:00.000-08:00

Bunions are more than that bump at the base of your big toe. Bunions are deformities of the joint due foot type and bone structure. Bunions are progressive deformities in both women and men. The longer they are left untreated, the more likely they are to develop debilitating arthritis and to interfere with your daily activities. Don’t wait until they are severe to have them corrected! It is best to treat them before they become arthritic. Our surgeons will use X-rays to determine what stage your bunion is in and how best to treat it. Most of our bunion patients are back on their feet within a few days of surgery.

A patient that had surgery right before the end of the year came in for her follow up visit last week and couldn't believe how easy the surgery was. She said she only took two pain pills. Don't be afraid of surgery if it is recommended - certainly feel free to get a second opinion, but be sure that the opinion discusses what procedure should be performed, not just if you are ready for surgery.

Resolution #3: Don’t put off to tomorrow, what you should do today

2011-01-05T12:40:00.001-08:00

Foot pain is not normal. Each foot is unique and we all have different foot structures that contribute to most painful problems. Ailments and disorders can occur with any of the 26 bones and 20 muscles in each foot. And don’t forget about the bones, tendons and ligaments of the ankles! Podiatrists are physicians trained specifically in the foot and ankle and have the experience, training and education to diagnose exactly what is causing your pain.

Resolution #2: Never be caught with your shoes off if you have heel pain.

2011-01-04T07:17:00.000-08:00

Heel pain is very common and makes up 35% of our practice. Wearing shoes with a firm heel counter is very important in controlling plantar fasciitis, the leading cause of heel pain. If left untreated, this inflammatory problem can progress to a much more severe problem of tearing and scar tissue. Having proper heel support is the first step in controlling the progression of heel pain. Heel pain lasting longer than two months should be evaluated by one of our podiatric physicians. We specialize in chronic heel pain and have been innovative in advanced and noninvasive treatments.

I have my patients start with the basics - no matter how long they have had the heel pain or even if they have been treated elsewhere because I believe in them so much! Proper heel support, stretching of the fascia and the Achilles and education on shoe wear is the basis for anyone with heel pain.

For those with chronic heel pain (more than a few months), there is great hope! I have been using radiofrequencywith great success.

Resolution #1: If the shoe doesn’t fit, don’t wear it!

2011-01-02T18:33:00.000-08:00

It’s so tempting for women to buy shoes that don’t necessarily fit - especially if they are on sale or perfectly match an outfit. Do your feet a favor and resolve to only buy shoes that do not pinch, squeeze or slip when you try them on. And don’t just try on a potential new pair of shoes; get off the carpeted area of the shoe store and really walk around in them to determine if they are a good fit.

Other shoe shopping tips to remember:

-shop for shoes at the end of the day so that any naturally occurring swelling has already occurred

-wear the appropriate hosiery for the shoes you are buying

-know your foot type before shopping for athletic shoes - a podiatrist can help you determine your foot type

-know your heel height limit, some women can wear 4" heels, but others may have to settle for 3"

2011 Resolutions to Walk With

2011-01-02T11:32:00.000-08:00

There are resolutions for everything from weight loss to self-betterment to political correctness - all intended to take you to a better place in 2011. Why not for your feet? You can’t go anywhere in 2011 without your feet taking you every step of the way!

For the next 11 days, I will post a resolution sure to keep you on track and walking in the right direction!!

Coming on Monday - Resolution #1: If the shoe doesn’t fit, don’t wear it!

Traveling in 2010

2010-12-07T22:18:00.000-08:00

A woman I met this week was telling me the worst thing about traveling for her is not the security, not the lack of snacks given on the plane, not the lack of a pillow on morning flights - but the problems with her feet when she travels!! I don't think she even knew I was a podiatric physician (podiatrist)!!

She was complaining that her feet sweat a lot and that she is very uncomfortable when flying. She is bothered when she has to take her shoes off and expose her feet and feels very constrained when in the air. This was the first time I have heard someone listing their feet as their main problem with flying!!

Here are some tips to keep your feet healthy and comfortable when flying.

1) ALWAYS WEAR SOCKS!! It is just too gross to think about all those people who take their shoes off to go through security. Even if you just wear socks until you get to the other side of security. I keep a pair of white cotton ankle socks in my purse to slip on as I slip off my shoes.

2) Don't wear nylons when you fly. Several reasons - first of all, nylon holds moisture so your feet will feel sweaty. Second, your feet will feel restricted in them, especially if your feet swell while you are on the plane which is very common. Finally, and I heard this on the Oprah show and it made an impression on me, if you are in a plane crash that involves fire, nylons will spread the flames!

3) Wear shoes that you can run in, walk in, and run in! You never know when you will be running to a gate! I like to wear shoes that are easy to get off and on to make security go smoothly. I also put my shoes down the conveyor belt first so that they are there ready for me to put back on while my other things are still going through the x-ray. Low heeled boots with a zipper are perfect for travel!

4) Put your feet through a range of motion while you are in your seat. Making circles or even spelling out letters with your feet will help keep swelling and stiffness down.

5) Enjoy your flight and hopefully the feet will be the last thing on your mind as you fly over the Grand Canyon!!

New Flip Flop Danger

2010-12-01T23:58:00.000-08:00

So I thought I have heard all the flip flop injury stories: getting one caught on an escalator, losing a flip flop when running, tripping over the end of the shoe, having the flip flop get stuck in bicycle spokes... and then until the other day I heard a new one!

A patient told me he tripped on the gas line while at a gas station! He fell, sprained his ankle AND broke a bone in his foot! He went to the ER for his ankle, but they totally ignored his foot pain.

Its not that uncommon to injure your foot when you sprain an ankle. The twisting can not only stretch the ligaments of the ankle, but can also cause a tendon to pull off one of the bones on the outside of the foot. Most emergency rooms will focus on the obvious - the ankle sprain and few ER doctors are even aware of the related injuries that can happen to the foot.

Whether its due to a flip flop injury, fall on the ice, or soccer injury, the BEST place to go after an ankle sprain is NOT the ER, but the office of a podiatric physician! Today's Podiatrists have the education, training and experience to properly evaluate ankle and foot injuries like no other physician. With almost all podiatrists having in office x-rays and many having diagnostic ultrasound, all your bone and soft tissue injuries can be identified properly the first time around! AND make sure you have the proper treatment - not just an ace wrap and crutches!

Heels and Uneven Floors do NOT Mix!

2009-12-17T19:32:00.000-08:00

I was in Las Vegas last weekend and had to walk from the hotel to the convention center. The path for the 20 minute walk was a floor that was uneven, shinny, super smooth and made to look like cobblestone. It was TORTURE! Certainly not designed by a woman or even with women in mind. I struggled with each step of my kitten heels (1 1/2 inch) and worried about all the women that tried to walk this walk in real heels!

It brought me back to my trip to Prague and the cobblestone streets which were even difficult to navigate in sneakers!

I think its time more women designed walk ways, shoes and maybe even cities!

Those Skinny Heels

2009-12-10T22:11:00.000-08:00

I have dreamed of skinny for years.

Skinny legs, skinny thighs - but never again of skinny heels! I recently slipped while wearing a pair of skinny heeled shoes (not too high, mind you) and sprained my knee. Okay, I'll admit it - I actually slipped TWICE before deciding not to wear them again!

The thinner the heel, the more unstable the shoe, regardless of the heel height. Slipping on smooth surfaces is an easy thing to do. Wider, chunkier heels can be just as appealing as the skinny heels and a lot safer to walk in.

If you must wear that favorite pair of shoes that happen to have a skinny heel, please make sure the very bottom of the heel is not worn out as this will really cause you to slip! Have your shoe maker replace the heel and ask them to use a slightly thicker material in the process. Your knees will thank you later!

Platforms - Are They Better Than Heels??

2009-11-16T12:22:00.000-08:00

I just answered a post on Zappos.com which asked this exact question. The answer is yes, and no.

Platform shoes do give you height without some of the problems of heels, but platform shoes have their own set of problems. The human foot is meant to go through a specific pattern of walking called the gait cycle. Shoes should allow normal gait unless there is a specific reason not to allow normal gait.

Normal gait includes the foot bending at the ball of the foot to allow propulsion of the body forward. The toes work in conjunction with the rest of the foot to stabilize while moving forward. Many people with arthritis find that normal propulsion is painful if their joints at the ball of the foot are arthritic. For these people, we recommend shoes that limit motion in that area.

Most of us do not have significant arthritis and have no reason to not allow that normal motion. Any shoe that does not bend at the ball of the foot does not allow normal motion. Most platform shoes fall into this category.

Platform shoes that are made of rigid materials stop the foot from its regular function and force the tendons and muscles to work abnormally. This can cause some muscles to be over used and others to be under used. Tendon pain, inflammation and irritation can occur if this is allowed for an extended length of time. If shoes worn on a regular basis cause the toes to grip the shoe excessively, hammertoes can even develop!

Listen to your feet. Foot pain is never normal and any shoes that cause pain or discomfort when wearing them or immediately afterwards should not be worn for any length of time.

SHOES!!!!

2009-11-13T19:57:00.001-08:00

I am always answering questions about shoes so I thought it was time that I began to write about shoes and how they can help or hurt your feet.

Lets start with everyone's favorite shoes - High Heels!!

High heels are simply not good for your feet! True, women with higher arches can wear them more comfortably and with more stability, but down the road they can cause problems at the ball of the feet. Torn ligaments, inflammation and stress fractures can occur from constant high heel use. Heels over three (3) inches put seven times the pressure on the ball of the foot and that pressure wears out the normal tissue. Many women as early as their late 20's start having problems at the ball of the feet.

I am realistic, however, and know women are going to continue wearing heels. So here is what you need to do:

1) Alternate your heel height daily, even if its from a 4" heel to a 3 1/2" heel. That will change the force on the bones daily.

2) When trying on shoes, get off the carpeted area. You want to see what type of padding the shoe itself gives - not the padding the carpet has!

3) Never wear a shoe that you feel unstable in. Many women sprain their ankles when they wear heels that are too high for them

4) Try to find a heel that is wide if you feel unstable.

5) Go for the kitten heels! Same look as heels but without the dangers

6) Height is an illusion! Stand tall, throw your shoulder back and go for the 1 1/2" heel instead of the 3" heel!

Next up - platform shoes!!

Subtle Injuries That Can Be Devastating

2009-11-06T06:49:00.000-08:00

I had a patient on Monday that had the most severe arthritis that I have seen in a very long time. She told me that 18 years ago, she injured her foot in a step class and that the doctor at the time suspected a stress fracture but never found it on x-ray.

This woman had an injury to the middle of her foot that is very often missed by general doctors, emergency room doctors and even radiologists. It is a disruption of what is called the Lisfranc's Joint. It involves many joints across the middle of the foot and if it goes untreated when it first occurs can cause severe arthritis years later.

It is VERY important to see a podiatric physician anytime you have a foot injury or foot pain. Looking at this woman's current x-rays not only showed the arthritis but clearly indicated that this subtle injury had occurred. A podiatric physician would have been able to detect the problem at the time of injury. This woman is now left with severe pain, limited activities and a total change in life style.

2009-09-09T16:36:00.000-07:00

I was just interviewed about neuromas and thought I would write about them.

Each toe has four nerves that supply sensation - two on top and two on the bottom. The bottom nerves of adjacent toes are actually formed by a larger nerve that splits into two at the ball of the foot. Sometimes, the point at which the split occurs gets irritated and inflamed. As a result, the nerve tissue enlargs becomes a nerve tumor. That is a neuroma.

Anything that irritates the nerve can cause a neuroma. Pressure at the ball of the foot from high heel shoes and having high arches are two of the most common causes. Arthritis and bone spurring around the joints that make up the ball of the foot can also cause irritation.

The symptoms of a neuroma can vary greatly depending on the stage of the neuroma development. Early symptoms may simply feel like you are walking on a stone or a lump in the area. More typical symptoms are numbness, tingling or even pain to the two adjoining toes. It is common to have these symptoms at rest or while in bed.

Anything that causes pressure to the area will worsen the symptoms. High heeled shoes put direct pressure on them and narrow shows pinch the neuroma also producing symptoms.

Foot pain is NEVER normal. All too often, people ignore their pain with the hopes of it going away. When pain increases in intensity or is present more frequently or changes in its nature - you are overdue to see your podiatrist! An examination is usually enough to test for a neuroma, but your podiatric physician may also recommend a diagnostic ultrasound or MRI to confirm the diagnosis.

Relieving the pressure on the nerve tumor is the key for conservative treatment. Changing shoes, wearing less narrow and lower heeled shoes can make a big difference. Often, a podiatric physician will use pads and more permanent custom shoe orthotics to control the pressure on the ball of the foot and control any abnormal motion of the foot.

Neuromas can certainly become a chronic problem. Like any inflammed tissue, if the nerve tissue continutes to be inflammed continue to enlarge and will change to include scar tissue and adhesions. Like most foot problems, it is very important to treat this early in its course. Often the nerve tumor can grow to the point that every step becomes painful.

Me: in focus for women in Chicago

2009-08-07T09:45:00.000-07:00

I just got my issue of

Me: in focus, the magazine for Chicago women and found myself on page 19! Check it out:

http://meinfocusmag.com/2009/07/body-in-focus-dr-marlene-reid-on-preventing-footankle-injuries/