Airline Travellers

If you are travelling for business or pleasure, chances are you’ll be doing a lot of walking, whether at airport terminals or sightseeing. Sore feet, which can act as more than a distraction can be avoided. Here are some tips to keep your feet comfortable and pain-free while travelling:

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1. Consider wearing soft-soled laced walking shoes for those long walks at airport terminals. This will reduce the jarring of the hard floors and not only make your feet more comfortable, but reduce the strain to your knees and back.

2. Women who prefer to wear dress shoes may want to consider flats or low pumps with cushioned soles. Feet and ankles tend to swell particularly with longer flights and so a tight fitting dress shoe will only feel worse by the end of the flight.Consider bringing an extra pair of thick socks to wear so that you can take off your shoes during the flight.

3. In your seat exercises:Try doing some range of motions exercises for your feet and ankles. Doing some circles with each foot as well as moving your feet up and down prevents stiffness. Also with your legs extended, pull your feet up at the ankles to stretch the calf muscles. On longer flights, going for a walk up and down the aisle may be helpful (as long as the serving carts aren’t in use at the time).

4. Consider taking some “moleskin” pads along with you. These little pads are available from a drugstore and can often reduce the irritation if there is a pressure point on a toe from a shoe. Better:   if you experience pressure points on your feet or toes, our 1/8" adhesive pads do an excellent job of alleviating pressure from shoes.  (Check out our store for those).

5. If you have corns or calluses, consider getting them treated by a podiatrist before your flight. These minor problems can be very painful particularly if extensive walking is involved. They can be painlessly treated before your trip to enhance your comfort.

6. If you frequently experience sore arches or heels, extensive travelling will only make it worse. If your feet are flat, this can cause stretching on the sole of your foot in which case orthotic devices would be helpful before your trip.

7. Orthotics advisory: If you do require orthotic devices, have them prescribed by a podiatrist. Many retail centers are playing the role of a foot specialist and will often dispense an off-the-shelf insert which may or may not be of temporary benefit but will not control the mechanics of the gait cycle to a precise degree.

8. Elevate your feet. When you get to your hotel room after a very long flight, your feet and ankles may be swollen and elevation would be helpful.

9. Ice for foot pain. If you are otherwise healthy with good circulation, but experience pain in your feet, an ice-pack applied for about five minutes to the sore area may reduce inflammation on a temporary basis.

Many people think foot pain is normal. It is not. A little care and attention can go a long way to enhance your foot comfort and allow for a more pleasurable business or pleasure trip.

Tips for Airline Employees

Many people that work for the airlines complain of painful feet. If your job involves long walks through terminals, or many hours on your feet, then aching or tired feet can ruin your day! It’s hard to offer service with a smile when your feet are making you miserable.

Here are some tips to keep your feet comfortable and pain-free while at work:

• When possible, consider wearing soft soled, laced walking shoes for added cushioning and support. This will reduce the jarring of the hard floor and also lessen the strain to your knees and back.

• Women who prefer or need to wear dress shoes may want to consider flats or low pumps that have cushioned soles. Flight attendants know that their feet can swell, particularly with longer flights. Avoiding a tight fitting dress shoe will prevent the shoe from feeling even worse by the end of the flight.

• Stretch when you can. Take a moment out to stretch your calf muscles or try some range of motion exercises with your feet, such as circles or moving them up and pointing them down. This will enhance flexibility, particularly if you’re doing a lot of standing.

• Flight attendants may want to consider having some “moleskin” pads available. These little pads are available at pharmacies and can reduce pressure or irritation on a toe where a blister or corn is developing, or where the shoe is just creating too much pressure.

• Corns and callouses are not normal. If you have these lesions on your feet, consider seeing a podiatrist so that they can be painlessly removed for immediate relief.

• Elevate your feet when you can. Flight attendants who frequently experience swelling of the ankles would do well to elevate their feet when the opportunity arises, or at the end of the day.

• Ice is good for foot pain. If you are otherwise healthy with good circulation but experience a painful problem in your feet, an ice pack applied for about 5 minutes to a sore area may reduce the inflammation on a temporary basis.

• Sore arches or heels can be very aggravating. You may have flat feet (pronation). This causes stretching along the bottom of your feet. Orthotic devices would correct this problem, but not all orthotics are the same. (See Orthotics Advisory)

How to Buy Athletic Shoes

The key to buying the best athletic footwear is to ignore all the advertising you see and the advice you hear, and buy according to your needs and wants. Before you go to the store: Take a look at one of your old athletic shoes, and see how it has worn.

Fit

This is the most important consideration when buying athletic shoes. No matter how good you hear a shoe is, if it doesn’t fit you, don’t buy it. Important: Have your feet sized every time you shop, since foot sizes often change over time.

Key Fitting Points:

• Length: Allow a thumbnail’s width between your longest toe (which may be your second toe) and the end of the toe box on you longer foot. Important: Have the sales person check the fit for you — if you bend over to check it you will change the fit of the shoe.

• Width: the widest part of your foot should be in the widest part of the shoe. Your foot should not hang over the platform of the shoe. Your foot should not move around from too much room inside.

• Heel: Your heel should not slip when you walk.

Support

• Put your old shoe on a table or other flat surface and study how it has worn.

• If you over-pronate (roll in excessively), you may see the shoe break to the inside. If you roll out excessively, you may see the upper part of the shoe pushed out over its platform.

• If you do have a special need, select a style of athletic shoe designed for your type of problem. For example, over-pronators should look for shoes with added medial (inside) support.

• People with rigid feet (Under-pronators) need shoes with more cushioning and lateral (outside) support.

Cushioning

Do you think your current shoes provide enough cushioning when you work out? If not, go to the store and talk to a salesperson you trust about a shoe that may meet these needs.

Wearability

Most people judge the feel of a shoe when they try it on in a store, so a softer shoe generally feels better. Problem: there is a lot of pressure exerted on shoes during exercise, so a softer shoe may not last as long as a firmer one, depending on the person.

Added problem: The insoles in most shoes are selected for first feel not for extended use, so they break down quickly. Recommended: when your original insole wears out, extend the shoe’s life by replacing it with over-the-counter Spenco® insoles.

After you buy new shoes, go back to the store to try on a new pair of that same model about every 3 or 4 months, depending on the extent of your activity. Reason: You may not realize the extent to which your shoes have worn until you compare them with a new pair.

Other Considerations

• Don’t buy from an inexperienced salesperson. Find a salesperson who understands footwear and who will take the time to help you find the right style. If you feel you’re being hustled, leave. You probably won’t get the right shoe if you buy based on what’s in stock instead of your needs.

• Bring your old shoes when you buy new ones. Manufacturers update models about every 19 months. This can be troublesome if it took you a long time to find a model you like, and you don’t like the new version. A knowledgeable salesperson should be able to find a style similar to your old one.

• Get the best value. Most people do not need top-of-the-line shoes that cost more than $150.00. The best values are usually in the middle to upper-middle ranges.

• Get off on the right foot. Beginning exercisers should buy good quality shoes because their bodies are less adapted to the stress of exercise.

• See a specialist for serious problems. Although the right athletic shoe will make your workout easier, it won’t fix a biomechanical problem. Consult a podiatrist who specializes in athletic injuries.

• Calf or Achilles problems. These problems can be worsened by a cushiony air soled walking shoe, if the heel compresses too easily. This stretches the calf further.

• Shoes are not always the cause of the problems. Often a foot imbalance may be at fault. This can be corrected with precision orthotic devices made by a podiatrist from plaster casts of the feet.

Self Help Tips for Ballet Dancers

1. Blisters: If you get a blister with water in it, you can puncture it with a clean needle to let the water out. (Try to puncture it parallel to the skin rather that at a right angle.) Leave the blistered skin on as it serves as better protection than a bandaid for the new skin developing below. Try applying some vaseline to the friction point before dance to avoid new blisters.

2. Pads: “Moleskin” or Kurotex” padding is often a dancer’s best friend. If you have a red spot or pressure point on a toe or anywhere on the foot, cut out a pad with a hole it. Place the hole over the sore spt. The pad will create pressure around the sore spot but not on it, to provide relief.

3. Pain at the ball of the foot can be due to many causes. If it is a callous, a podiatrist can easily scrape that way. (This is painless.) If it is sore or red, applying some ice will help. Sometimes padding placed on both sides of the sore spot will relieve pressure.

4. Ingrown Nails: These are common with ballet dancers and if sore should be treated early. If left untreated, they cause a foreign body reaction and puncture the skin to create an infection. A podiatrist can simply treat the nail which is painless and provides instant relief. More stubborn problems can be treated with a laser beam. The whole nail need not be removed — only the ingrown edge. You can resume dance within a few days following laser treatment.

5. Flat Feet (pronation) can cause arch pain, heel pain, ankle, shin or knee pain. Prescription orthotic devices made from a cast of the foot by a podiatrist will create dramatic relief and prevent future problems. While they cannot be worn in a ballet slipper, orthotics work well when worn in normal shoes during the rest of the day.

6. Hammer Toes: Ballet dancers often get curled toes with corns developing on them. Moleskin pads with a hole cut out will relieve pressure and provide immediate relief. A simple corn can be easily removed by a podiatrist and this, too, is painless.

7. Bunions: Enlarged toe joints often occur because of foot imbalances that are inherited. Dancers often experience increased pressure to the big toe joint. Ice is helpful after dance to calm down symptoms as well as comfortable walking shoes for normal walking. Treating the foot mechanics provides dramatic relief and prevents future problems. Surgery can be avoided if bunions are treated in their early stages.

8. Shoes: Often dancers wear flimsy slip-on shoes for normal walking. Your feet really should be in good quality running shoes or well cushioned walking shoes. Dress shoes are fine for short periods but added cushioning and support make a big difference.

9. Socks: It is better to wear shoes with socks than without socks. Socks will protect tender areas on the feet and absorb moisture as well as provide cushioning.

10. Spenco Insoles are specially designed sports insoles that provide lots of cushioning in walking shoes. Sometimes they will fit in dance shoes and reduce friction on the ball of the foot.

11. R.I.C.E.: This stands for Rest, Ice, Compression and Elevation. When you get an injury, rest and elevating the foot always helps. Applying ice for five to ten minutes usually is helpful and compression is usually done with something such as “coban” elastic wrap. Have a physiotherapist, family doctor or podiatrist take a look at your injury in order to treat it quickly and effectively.

12. Time Off: sports medicine practitioners know that athletes do not want time off from their sport, nor do dancers want to stop. Usually foot problems can be treated easily so that the dancer need not quit or take time off. Treatment is usually painless and the results are dramatic. Prevention is the key to avoid time off.

Ballet For Children

The severity of its physical requirements make ballet tougher than just about any other activity! Besides the need for flexibility and timing, great strength and endurance are required in order to succeed in ballet.

Ballet offers growing children and teens poise and grace along with good physical development, enhanced aerobic capacity, improved posture and even a more mature attitude to the student. When children are taught by competent instructors, usually any harm to the developing feet and legs are being avoided by proper instruction.

Nonetheless, the stresses and strains to the feet cannot be ignored and for this reason the following tips may be beneficial:

• Discomfort may be common, but acute longstanding pain should be investigated. “Dancing through” pain may lead to further disability later on.

• Ingrown nails are common in young ballet dancers. They should not be ignored, otherwise they can lead to severe infections. Often a simple painless treatment can provide instant comfort.

• Children should be honest with themselves, their instructors and their parents when it comes to pain. They often fear that if they admit to their foot pain that a long lay-off will result. However, by seeking prompt attention, usually time off dance can be avoided, and the pain can easily be relieved.

• Heredity can often play a role with foot problems. For example, bunions are caused by pronated (flat) feet and not necessarily by ballet. The inherited cause can be corrected to prevent future deformity.

• Warts can often show up on children’s feet. If left unattended, they can become painful, or they may enlarge or spread. Early recognition and treatment is the key.

• Street shoes of good quality are especially important for ballet dancers. Good quality running shoes or laced walking shoes with good support and cushioned soles are advisable for daily wear. (Not flimsy slip-ons.)

• Sore spots, red marks or points of irritation can be easily treated. Often a simple pad designed to relieve pressure can enhance comfort greatly.

• The outward foot and leg positions of ballet can often aggravate flat feet. Proper instruction minimizes this. However for day-to-day walking, a properly designed orthotic device can correct foot imbalances and strengthen and realign the feet.

• Prevention will avoid a number of future disabling foot problems.

Parents should feel free to discuss any concerns about their children’s foot health with our office.

Bunions – Treatment and Prevention

A bunion is a painful bump that occurs along the side of the big toe joint, at the ball of the foot. There is bursitis or swelling at the side of the big toe joint and very often there is a build-up or thickening of the bone as well. Often the big toe is deviated laterally or towards the lesser toes and the 1st metatarsal bone at the side of the foot is angulated as well.

Early Signs
Bunions can appear as early as teenage years, but more commonly they tend to slowly progress and show up in the 20 to 30 age group as an early bunion development. If left untreated over the years, the big toe tends to drift further towards the lesser toes and the build-up at the side of the big toe joint tends to worsen.

Shoes and Bunions
Many people are surprised to discover that they have bunions even though they have worn comfortable shoes all their lives. Obviously a woman’s dress shoe will aggravate a bunion problem if it is narrow or pointed and squeezes the toes. Bunions can and do occur in men as well. In fact, bunions occur in non-shoe wearing populations in Africa.

Cause of Bunions
Shoes tend to aggravate a pre-existing problem, but it is the foot mechanics that usually causes the bunion problem. The foot structure that one is born with can create bunions in later life. We find that teenagers and children who have flat feet, and whose parents or grandparents have bunions, may very well go on to develop a bunion problem unless treated preventively. Flat feet (pronation) causes bunions. The reason for this is that when someone with a flattened foot walks, instead of pushing off the bottom of the big toe, the foot rolls in towards the other foot and the pressure during the push-off phase of the gait cycle is at the side of the big toe rather than the bottom of the big toe. This pushes the big toe towards the lesser toes. At the big toe joint, continual pressure builds up more bone over the years, and this bone is actually the bunion problem. The overlying bursa, or protective fluid filled sac at the side of the big toe joint, becomes inflamed and this is the bursitis (swelling), redness and pain that goes along with the bunion problem.

Treatment
Obviously, avoiding shoes that press on the bunion is helpful, however if the bunion is in its fairly early stages, surgery can often be avoided and symptoms relieved. Correcting the foot mechanics if someone has a flat foot is the key in preventing the progression of the bunion problem. Note also that someone with a very high arch foot type can develop bunions because of the constant jarring on the big toe joint as well.

In order to relieve the symptoms of a bunion, besides comfortable footwear and the correction of one’s foot mechanics with orthotics, we often use accommodative padding or small 1/8th inch adhesive felt pads that can be placed behind the big toe joint or bump of the bunion in order to reduce shoe pressure.

(Check out our online store for these as they're not available in retail stores).

Sometimes toe spacers worn between the 1st and 2nd toes will help alignment of the big toe so that you propel off the bottom of the toe instead of the side of the toe. But toe spaces don't do much for bunions.  Nor do "bunion splints".  If the patient’s circulation is normal, then the application of ice or frozen peas for 3-5 minutes on the bunion will reduce inflammation.

Most of the time bunions can be prevented from progressing so that surgery can be avoided. For advanced cases that have been left untreated, surgery may be the only alternative.

Surgical Treatment For Bunions
There are many different surgical procedures that can be performed on bunions. The extent on the surgery is dependant on the extent of the problem. If the bones are badly deviated with such a bad angle to them that the foot is very misshaped, then the bone has to be cut and straightened to allow for proper alignment. In less advanced cases, it may simply be a matter of reducing the bump of the bunion which is a procedure that is less invasive.

Minimal Incision Surgery
Podiatrists for the past twenty years have been using a procedure called minimal incision surgery to correct bunion problems. Using a 1/4 inch incision, a micro instrument is used to reduce the bump of a bunion and as a result, there is far less trauma than with traditional orthopedic procedures involving large incisions. With a minimal incision procedure their is less tissue handling and therefore, less trauma and a lot less postoperative pain and swelling. Often the results are dramatic and patients can walk the following day after minimal incision surgery . It should be stressed, however, that minimal incision surgery is still a surgical procedure and the potential for postoperative pain can vary from patient to patient. While some patients walk right after bunion surgery and have minimal discomfort, others find that it can be sore for many months.

Lasers
Many people ask about lasers for bunions. Laser is a finely focused beam of light that vaporizes tissue and turns water in the cells to steam. Bone does not have the water content that soft tissue does and therefore lasers cannot be used to vaporize bone. Some podiatric surgeons may use a laser to make their incision, but it is misleading to think that the laser is going to vaporize a bunion away. At the present time, technology has not developed a procedure for lasers to correct the bone build-up of a bunion.

Recommended Approach

Try to avoid surgery, wear proper orthotics (that are prescribed for you), apply those 1/8" adhesive pads to avoid shoe pressure, and be careful about the shoes you wear.
If you are having mild discomfort from a bunion, the chances are you don’t need surgery. Your foot mechanics should be assessed to determine why you are developing the problem and whether or not changing the way you are walking with an orthotic device would alleviate the pressure on the bunion. This along with some padding and ice may circumvent surgery.

For children who have very pronated feet, as well a parents or grandparents with bunions, an assessment by a podiatrist would give some indication as to whether or not a bunion problem could develop. It should be noted that even if someone has a foot imbalance such as flat feet and winds up having bunion surgery, then the foot mechanics still have to be controlled postoperatively so that the bunion does not recur.

Buying Children’s Shoes – Ideas for Parents

Parents often complain about the high costs of children’s shoes – “$50.00 for these tiny shoes? They’re only going to be worn out in six months!” Almost every salesperson has heard this.

Think about it though: Your kids will walk and run several hundred miles in a few months. Their soft and developing foot structure needs protection and support against the hard surfaces they will pound on. The same workmanship that goes into adults’ shoes goes into children’s shoes. Quality, comfort and cushioning, stability and long lasting protection don’t come cheaply.

So, consider spending a bit more than you had planned. After all, most parents own at least several pairs of shoes, yet their children wind up with only one or two pairs at a time. Even though your children will outgrow their shoes relatively quickly, your buying the better quality shoes will be worth it in the long run.

Your children’s feet have to last them a lifetime --120,000 miles or more!

Here Are Some Things To Consider:

• An experienced salesperson will measure the widest part of the foot (at the ball) with the child standing.

• The longest toe shouldn’t touch the end of the shoe.

• The heel counter should be firm for support and not flimsy.

• The sole of the shoe should bend easily at the ball of the foot and not in the mid-arch area.

• If a dress shoe doesn’t bend easily at the ball of the foot, then a slight in-toe or out-toe gait can be markedly accentuated. (Many of the girls’ dress shoes exhibit this problem.)

• When buying dress shoes for boys or girls, consider that they may still do lots of running around in them. Therefore a dress shoe with a rubber sole may be better for their feet.

• Today’s good quality running shoes are excellent for children! They provide solid support and cushioning, stability and padding and are generally longer lasting. Avoid flimsy canvas sports shoes.

• If you buy shoes with velcro instead of laces, get the best quality available, otherwise stability will be compromised.

• Don’t “hand down” shoes from child to child. Biomechanical foot imbalances affect shoe wear patterns and then the next child’s feet will be adversely affected.

• Flat feet need the best quality shoes and an evaluation from your local podiatrist to determine the function of your child’s bone structure during walking.

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Foot Health Tips for Hotel Employees

There is an old saying, “when your feet hurt, you hurt all over!” Service with a smile is not always easy when your feet are aching, particularly for those in the hospitality industry who are on their feet all day long.

Many people think that having sore feet is normal and that there is nothing that can be done.

There is, in fact, a lot you can do to give yourself more comfort while on your feet so that you can focus your attention on customer service and not the pain of sore feet. Here are some tips that may help you:

1. Comfortable shoes will make a big difference for men and women. There are now both ladies and mens dress shoes that have cushioned soles that will reduce the jarring of the hard floors of the hotel.

2. If you spend a lot of time standing on your feet, doing some occasional stretching exercises for your calf muscles may provide you with some relief. Simply putting one foot ahead of the other and bending the forward knee will stretch the opposite calf. This can be done every so often for more flexibility and comfort.

3. Toes that are sore from corns, which are thickened areas of skin, can be easily and painlessly treated by a podiatrist. The acid preparations sold in drug stores often can do more harm than good and should not be used on corns or callouses.

4. If you have painful callouses on the soles of your feet, they are due to a foot imbalance. The bones under these callouses are experiencing too much pressure and this can be relieved by having your foot mechanics corrected by a podiatrist.

5. Sore arches or heel pain, are a common problem with hotel employees. Heel pads sold at drug stores and sporting shops may provide some cushioning, or applying adhesive tape under the arches may provide some temporary support. Usually heel and arch pain is due to a mechanical foot imbalance which can be corrected with orthotic devices prescribed by a podiatrist.

6. Ingrown nails occasionally occur with hotel employees. Many people fear lost time off work or severe pain in treating these, and so go on to suffer without having the problem looked at. These can be easily treated by a podiatrist with usually little or no pain.

7. Cushioned insoles sold at sporting goods stores often provide enhanced comfort for those who spend a lot of time on their feet.

8. Tendonitis or strained areas of the foot, can often be relieved by applying ice, or frozen peas, for example, for 5 or 10 minutes during your off time. Stretching exercises or range of motion exercises can help this problem as well.

Nowadays, foot pain should be a “thing of the past”. If sore feet are keeping you from working at 100% capacity, then it’s time to have your feet checked for good foot health.

By working in a hotel, you probably will wind up walking over 120,000 miles in your lifetime on one pair of feet that you can’t trade in. A little care and attention to your feet may go a long way in making you more comfortable and providing better service to your customers.

In-Line Skating

In-line skating is becoming more and more popular because it’s fun and great exercise.

If you can ice skate or ski, you’ll have no problem. If you don’t, it may just take a little more practice, then you’ll really enjoy it!

Here are some tips for improved Safety, Comfort, and Control:

• Protective gear is a must! Elbow and knee pads and wrist protectors will save those vulnerable parts from the pavement. Don’t forget to wear a helmet!

• The most efficient and comfortable boots are those with ski boot-like adjustable clasps. They’re lightweight, too.

• Always skate in control, and don’t go excessively fast unless you know you can stop or slow down quickly.

• Use your turns to slow down. “Set” your inside edges of the wheels by bending your knees and exerting pressure on the inside of the wheels. Practice doing this in both right and left directions. By doing this you will be able to skate with better control and slow down more readily.

• Don’t always count on the rubber bumper as a brake, especially if you are going fast downhill. It will slow you down, but perhaps not fast enough. Use a series of S-shaped turns with your knees well bent for control when going down hills. Just like a skier would do.

• Hills can be fun, but dangerous if you can’t turn in control. Once you’re experienced in turning to a stop (by aiming uphill), a downhill skate can almost be as much fun as skiing. Do repetitive “S” turns to keep your speed in check. If you’re going too fast, really bend those knees for greater turn control or head uphill from a turn to stop.

• Uphill skating is a great workout. For greater efficiency, try leaning forwards and fully extend the back leg and aim the foot out at 45 degrees for a better push off.

• If you wear orthotics for fallen arches (pronation), place then in your skates as well for better balance and control. (Just as with skiing or ice skating, if your feet flatten in the boot or skate, you need greater knee motion to turn, and so the orthotics will help.)

• Watch out for stones, twigs, or leaves which can result in slippage or injury.

• Avoid skating on wet roads since with turns, the wheels can slide sideways. If you’re caught in the rain, skate slowly exerting less pressure on the wheels through turns.

• Try some stretching exercises for your calf muscles before and after skating. Runners’ stretches work well.

How Painful Ingrown Nails Can Be Painlessly Treated

Many people with a painful ingrown nail will avoid going to the doctor for fear of painful treatment. Some fear having the whole nail removed or some equally drastic and horrible treatment. Usually, a podiatrist’s treatment is virtually painless!

With neglect, ingrown nail problems tend to worsen and an infection will often result. If left untreated, the infection can progress down to bone and become even worse. Here are some things to consider:

1. Some physicians may recommend antibiotics when there is an ingrown nail. The nail acts like a foreign body and penetrates into the skin. A podiatrist will simply clip away a segment of the nail that is digging into the skin and usually this is a painless procedure. The relief is dramatic and immediate. Often antibiotics aren’t needed.

2. A couple of soakings of the toe in lukewarm water and 3 or 4 tablespoons of Epsom salts often clears up any remaining infection once the offending nail border is clipped back.

3. At a later date, a corrective procedure with a laser can be performed by a podiatrist where a segment of the ingrown nail is removed. The growth cells are destroyed so the ingrown portion of the nail doesn’t come back. Therefore, the remaining portion of the nail is left to grow normally without the painful, ingrown side. You can walk right after the procedure.

Laser Surgery: A New Approach To Improving Foot Care

What is a laser?

A laser is a device which generates an intense, finely focused beam of light, known as the laser beam. This laser beam permits surgery to be performed more safely and conveniently for patients. This laser turns the water in the cells to steam, called vaporization. There is no burning.

Is laser surgery a new technique?
Lasers have been used in surgery for 20 years by eye surgeons and other specialists. Laser surgery to treat foot problems was introduced in Canada by our office in 1983.

What are the foot problems best treated by laser surgery?
The laser beam of light is used in place of the scalpel to remove warts, ingrown nails, fungus infected toenails, and some deep-rooted callouses, among other foot problems.

What are the benefits of laser surgery for foot problems?
Laser surgery takes advantage of the properties of lasers to remove tissue without many of the undesirable side effects that sometimes result from using a scalpel. The laser light vaporizes the affected tissues almost instantaneously and so precisely that normal surrounding tissues are not affected. The unique property of the laser is that as it vaporizes and destroy diseased tissue, it also sterilizes and stops bleeding in the surrounding areas.

Result: much less tissue injury and swelling after surgery, which in turn results in reduced pain and discomfort. There is faster recovery, with better healing for the patient and chances of infection are decreased. There is also a cosmetic advantage because there is usually no scar formation after laser surgery. With the laser, it is frequently possible to complete treatment in one visit, while with other techniques, many visits or even hospitalization may be required.

Where is laser surgery done?
Laser surgery is performed in our office. The patient is first given a local anesthetic and then the laser light is beamed on the affected area. The entire procedure is completed in a very short time and the patient is able to walk out of the office after the procedure. Post-operative discomfort is minimal.

Is the laser like an x-ray?
No! There is no ionizing radiation present in the laser beam, so there is no danger of radiation exposure. In fact, lasers are all around us today, not only in medicine. For example, supermarket checkout counters use lasers (of a different type) to read the universal product code on packages. Lasers are used for many things from more accurate surveying, to welding, to drilling holes in baby bottle nipples.

What is in the future for lasers?
Lasers have an important role to play in the future of medical treatment which is why we are so pleased about having today’s most advanced carbon dioxide laser, manufactured by Johnson & Johnson. Because of the many advantages to the patient, lasers are here to stay to assist us in the treatment of many medical disorders.

Pain-Free Feet – Helpful Hints for Marathoners

Fortunately, marathoners seem to have less foot problems than a lot of 10K runners. In fact, some marathoners could probably write the book on foot care.

Here are some tips that may be of use to even the most seasoned runner. After all, even a minor irritance on the foot can become a big pain when you’re half way into your run:

• If you notice points of friction or rubbing, this can be eliminated. For a toe, cut a small moleskin pad with a hole in it so the shoe pressure is around the sore spot, not on it. Same thing for a callous or small blister.

• Planning to run regardless of a sore toe, tendon, dull foot ache, etc? Add stability and comfort by wrapping a small compressive dressing around a toe or the foot. Try coban elastic wrap, a thin self adherent wrap available in medical supply stores and some pharmacies.

• If you’re prone to blisters, Spenco® insoles may reduce a lot of friction if used to replace your existing shoe insoles. They also provide a good deal more cushioning for runners with rigid high arches or shin splint problems. (They’re much lighter than sorbathane). Dabbing on some vaseline on friction points before the run can help.

• A word about new orthotics (less than a month old): Don’t run The Marathon with them, unless you have comfortably done a 10 – 15 mile run in them. Otherwise, they may be uncomfortable during a marathon. New biomechanical foot positions have to be adjusted gradually in long distance runners.

• You’ll feel better with stretching before your run, and after about 5 minutes into the run when you’re warmed up. Don’t forget to stretch after the run.

• First time marathoners should take note of how seasoned runners stretch, and stretch, in the infield immediately after the race. Do this! Ice and first aid will be in abundance for you at the finish line as well.

• Along the same lines, if you’re not wearing good quality running shoes you shouldn’t be running. It’s amazing how many people have run the Toronto marathon in past years in flimsy sneakers! That seems to be changing now.

• Need new shoes? Check for excessive shoe wear. The back of the heel counters should be vertical and not slanted.

• After 300 – 400 miles you’ve lost about half the cushioning of the shoes.

• If blisters develop later in the day of the race, use a sterile needle to puncture them to let out the water. (It doesn’t hurt). Leave the skin on as it is its own best protection. The underlying skin will heal and toughen up in a couple of days.

• For injuries or soreness remember “R.I.C.E.”, Rest, Ice, Compression and Elevation. Seek medical attention soon after an injury for quick healing and a speedy return to pain-free running.

Help for Military Personnel

You may be in great shape, but if your feet aren’t, they may be keeping you from optimum fitness. Here are some tips to treat minor problems and to prevent ongoing foot discomfort that will inhibit your active participation on your feet:

Sore Spots or Points of Pressure
Often the tops of the toes can rub in the shoes particularly if the toes are contracted or bent (hammer toes). Try using some moleskin pads available from the drugstore. A doughnut shaped pad will take the pressure off the sore spot and place pressure around it. Don’t use medicated pads because they tend to destroy the surrounding skin. Pressure points on the bottom of the feet or sides of the feet can be treated this way as well.

Callouses
This is a thickening of the skin usually on the balls of the feet. They are due to excessive pressure or friction which results from a foot imbalance. It’s best not to use a razor blade to treat these. Pads going around the callouses will relieve pressure. Better yet, have a podiatrist scrape them away for you which is painless. Correcting the foot mechanics helps callouses clear up.

Ingrown Nails
If your nails are ingrown and sore (usually the big toes are involved) they can be easily treated. Leaving them untreated can cause infection. Treatment is painless and lasers can even be used to cure them. You can walk right after these procedures.

Warts
Warts are a common nuisance and spread easily and rapidly. Have them attended to by your base physician. Wear sandals in common showers and locker rooms since that is where warts are often transmitted. Lasers can be used to vaporize resistant warts.

Sore Arches and Heels
Sore arches and heels are often related to the feet flattening or rolling in (pronation). Ice packs or frozen peas provide temporary relief and using adhesive tape helps as well. Apply successive strips of tape along the arch of the foot by starting on one side of the foot, going under the arch and up the other side a couple of inches.

A properly made prescription orthotic device may be required. This is something that can be made for you by a podiatrist after casts and biomechanical measurements are taken of your feet.

“RICE” for Injuries
It’s best to get the problem diagnosed immediately, but if you do sustain an injury, applying the principles of “RICE” will help.

This stands for Rest, Ice, Compression and Elevation. Rest always helps. Ice or Frozen peas reduce pain, inflammation and promotes faster healing. Compression wrap such as a tensor bandage or “coban” (by 3M) helps a lot. Elevate your feet when possible to reduce swelling.

Athlete’s Foot Fungus
This is frequently transmitted in showers and locker rooms and sandals are helpful to prevent getting this problem. Anti-fungal foot sprays or powders such as Tinactin and Desinex are helpful. Your base doctor may need to prescribe a stronger anti-fungal agent. Change your socks once or twice during the day if possible.

Are You Sure You Need Orthotics?

Orthotics are not just arch supports!

It seems that lately many people are getting into the foot care business and want to sell you orthotics. They offer you comfort and relief of your symptoms. Sounds promising but…

Ask: Just what are the qualifications of the person wanting to treat your feet?

If they are a foot specialist, then they are trained to recognize and treat foot disorders and you are in good hands. If, however, this person has training in another area and is doing foot care “on the side”, then you may want to consider getting a second opinion.

Consider: You may not even need orthotics in the first place!

Podiatrists will frequently use different treatments to make your feet more comfortable without orthotics. For example, a podiatrist can show you how the application of padding, taping or other materials can bring you instant relief. Sometimes a simple treatment in a podiatrist’s office will bring dramatic and long lasting comfort without the need for orthotics.

Pronation / Flat Feet

If your arches flatten out when you stand up, and your ankles appear to roll in towards each other this is called “Pronation“.

Basically this is due to a structural imbalance of the bones of the feet making them unstable so that they collapse rather than perform as a rigid lever to propel you from one step to the next.

This problem is easy to recognize. In fact, many people who recognize this want to sell you orthotics. If you’re having foot pain, then their offer to sell you orthotics may sound appealing.

Caution: Not all orthotics are the same. The results vary as some work well and others don’t.

Reason: The knowledge and training of the individual treating you usually is directly related to the success of your treatment. Also, there are a number of methods used in making orthotics. Some methods work well while other methods are less than desirable.

How You Can Recognize Which Methods Will Work For You

Before you get orthotics, inquire as to how they will be made.

Preferred:  A plaster cast taken of the corrected foot position assures the greatest accuracy in the fabrication of orthotics. When you are sitting with your feet non weight bearing, the ideal positioning of the foot can be achieved. This allows for maximum effectiveness when walking.  We have used this methodology in our practice for 30 years and up until now has been the “gold standard” for capturing a corrected foot position.

**NEW** — and even better….is a 3D Laser Scanner

We are now using a  non weight bearing 3D laser scanner which is  replacing the previously preferred plaster casting technique.  The foot is still positioned in its corrected non weight bearing “neutral subtalar joint” position and then the laser scanner captures that desirable foot shape and creates a virtual cast.  The lab then gets a 3D image of the foot as though they had a plaster cast. 

How To Avoid Surgery

When it comes to foot surgery, most procedures are elective. That means you may not have to do it at all.

1. Consider getting a second opinion if somebody suggests surgery to you.

2. Podiatric surgery in the 90′s often means no scalpels or no incisions. For example, crooked toes (hammertoes) can often be straightened with a tiny puncture and a tendon release in an office setting. This surpasses general anesthetic, large incisions, fusion of bone with pins and cast, etc.

3. Bone spurs can often be removed with minimal incision surgery. A tiny puncture is used and a small rotating burr files down the bone spur. This is another alternative currently being performed in podiatric offices.

4. Removal of warts doesn’t have to be a painful ordeal, especially at the bottom of the foot. New laser techniques allow for vaporization of warts with far less post-operative discomfort and without residual painful scars resulting. You can walk right after the procedure. Avoid having warts excised.

5. Ask your podiatrist if there are other ways to avoid surgery with the use of accommodative padding or various modalities in order to reduce pressure from a painful spot on the foot.

6. Office foot surgery can be postponed until it is convenient for you, rather than convenient for the doctor performing the procedure.

7. If someone calls your surgery “minor”, it may be minor to them but not to you.

How To Extend the Life of Your Shoes

1. Both sports shoes and dress shoes will last longer if you undo the laces each time you take them off. This saves the heel counter and maintains the stability of the shoe.

2. Runners: If the foot beds inside your shoes are removable, consider replacing them after about 200 miles. This gives more cushioning to the foot and the shoe lasts longer.

3. Try rotating your shoes and not wearing the same pair from one day to the next. In fact, even switching shoes in the middle of the day gives your feet a break and the shoes get a chance to air out. If your shoes are wearing out excessively, then you may have a foot imbalance and orthotic devices, if made properly, would prevent the excessive shoe wear.

4. Buy good quality running shoes rather than flimsy shoes and the better quality will last longer, and feel more comfortable.

5. For runners, consider using two pairs of running shoes, one pair for rainy or muddy conditions where you would perhaps wear them one third of the time, and a new pair for drier conditions, where they can be worn the rest of the time.

How To Stay Active When Your Feet Say “Stop!”

If you and your body want to run or play sports, but your feet hurt too much:

1. Try to pinpoint the sore area, determine if shoes aggravate the problem or if simply standing aggravates the problem.

2. Then try to determine if pads will relieve pressure. Pharmacies sell moleskin and other pads that can be used if there is pressure on a toe from a shoe. Placing pads around the sore spot on a toe or the ball of the foot ca relieve pressure. (Don’t use medicated pads, as they damage surrounding skin.)

3. If you’re an active, healthy person with good circulation and a spot on your foot is sore, try applying some ice or frozen peas for about 5 minutes at a time. Don’t rush to buy orthotics just because someone in a store tells you that you need them! They are not a cure-all, and the diagnosis and cause of your problem should be determined by a podiatrist first.

4. See a podiatrist to determine the cause of your problem. In most cases the doctor can apply pads or use other treatment to relieve pressure and enhance comfort right on the spot.

5. Consider changing sports temporarily to maintain your level of fitness. For example, if running hurts, consider swimming or cycling until you recover.

6. Don’t let nagging problems persist hoping they will go away. There’s no need to fear a visit to a foot doctor’s office when it comes to foot problems. Treatment is usually painless and often relief is immediate.

How Painful Ingrown Nails Can Be Painlessly Treated

Many people with a painful ingrown nail will avoid going to the doctor for fear of painful treatment. Some fear having the whole nail removed or some equally drastic and horrible treatment. Usually, a podiatrist’s treatment is virtually painless!

With neglect, ingrown nail problems tend to worsen and an infection will often result. If left untreated, the infection can progress down to bone and become even worse. Here are some things to consider:

1. Some physicians may recommend antibiotics when there is an ingrown nail. The nail acts like a foreign body and penetrates into the skin. A podiatrist will simply clip away a segment of the nail that is digging into the skin and usually this is a painless procedure. The relief is dramatic and immediate. Often antibiotics aren’t needed.

2. A couple of soakings of the toe in lukewarm water and 3 or 4 tablespoons of Epsom salts often clears up any remaining infection once the offending nail border is clipped back.

3. At a later date, a corrective procedure with a laser can be performed by a podiatrist where a segment of the ingrown nail is removed. The growth cells are destroyed so the ingrown portion of the nail doesn’t come back. Therefore, the remaining portion of the nail is left to grow normally without the painful, ingrown side. You can walk right after the procedure.

Pronation/Flat Feet

Feet that flatten out upon standing are referred to as pronated. Pronation means that the ankles roll in towards each other and the arches flatten.

Some people have a fairly high arch when they are sitting, but as soon as they stand up, their feet collapse.

Is Pronation a Bad Thing?

No and Yes. Pronation is required when we walk so that when the heel strikes the ground, the foot rolls in to absorb shock and to adapt to the supporting surface, particularly on uneven surfaces. Therefore, pronation is a normal, necessary component of walking.

It becomes a bad thing when the foot remains pronated throughout the walking cycle. Therefore, the heel strikes the ground and pronates to absorb shock, but then at the midstance phase of the walking cycle, the foot has to reposition to become a rigid lever for pushing off effectively with every step. If the foot remains collapsed or pronated, then muscles and tendons will strain and the foot shows excessive signs of wear and tear.

What Are The Problems Associated With Pronation?

Commonly, people experience generalized pain or fatigue in their feet, or sometimes arch pain or even heel pain. When you stand up first thing in the morning and your heels are sore, this is because the foot is bearing weight, pronating and the band that extends from the heel to the ball of the foot stretches and pulls excessively as the foot collapses. Pronation can cause enlarged toe joints (bunions), pinched nerves (neuroma), callous formation at the ball of the foot, heel pain, arch pain, ankle soreness or even lower leg or knee pain.

How Do The Feet Affect The Rest Of The Body?

If your feet collapse or pronate, then the lower legs rotate inwards and the knees are affected. The knee cap can move side-to-side which creates a problem called “runner’s knee” or “patellofemoral syndrome”. Furthermore, if the feet collapse, then the muscles and tendons extending from the lower leg down to the foot stretch or strain excessively (often referred to as “shin splints”).

How Is Pronation Caused?

Pronation becomes evident around the age of 3 or 4. When children first start to walk, their feet are quite flat and there is a fat pad under the arch, and this is normal. By the age of 3 or 4, children’s feet should be stable.

However, because of tilting of the bones of the foot, this problem may remain as children grow and as a result, the bones of the feet strike the ground on an angle and so the feet compensate and roll in. This is the pronation that we commonly see in childhood. If left untreated, then children go on to develop with pronated feet which can result in problems in adulthood.

If adults that have bunions for example, had been treated as a child, then the bunions could have been prevented from progressing. Often the foot structure is inherited, but by correcting the foot mechanics, the problems that result from the inherited foot structure can be prevented.

What Can Be Done About Pronation?

Many years ago doctors used to recommend wedges, arch pads or other types of “cookies” or modifications to the shoe. Research in podiatric biomechanics for the past 25 years has demonstrated that shoe modifications are not enough. Orthotic devices are used to correct biomechanical abnormalities of the foot. Orthotics are prescription inserts that are worn comfortably in the shoes and they are made following a plaster cast of the foot.

What Types Of Orthotics Are Best?

Many stores and clinics are now treating feet with shoe inserts, even though they are not foot specialists. Orthotics have been so successful in the podiatry profession that many with little training on the foot have decided to treat foot pain as a side line. One should be careful where they get orthotics. Retail stores or booths at trade shows or malls make what they call orthotics on the spot. Basically all they are doing is taking a tracing of your foot, or getting an imprint and you wind up with an off-the-shelf device which is no more than an arch support that you would buy in a drugstore. These may provide a bit of support or temporary comfort, but they do not control the mechanics of the gait cycle. They are not true “orthotics”.

Arch Supports from drug stores may provide some temporary relief or insoles from sporting shops may control pronation to a degree. However, they are not specific enough to precisely control the foot motions during the walking cycle.

Plaster Casts

Podiatrists use plaster casts of the feet in their corrected position in order to exactly control the mechanics of the walking cycle. A plaster cast enables a laboratory to fabricate an orthotic device that is made exactly to your foot and in this way it will be comfortable. The best available orthotics were always made by prescription with a plaster cast of your feet. Now replacing plaster casts is a 3D laser scanner which captures your feet in a non weight bearing "neutral" position and thereby creates a virtual cast of your feet in their ideal corrected position.

Avoid Foam Impressions For Orthotics

Many allied health workers make what they call an orthotic and have you step in a foam box. This is quick and easy for them and not messy. However, by stepping in a foam impression, a deviated position of the foot is captured and hence adequate control of the foot mechanics cannot be achieved. There is quite a bit of guesswork involved since these orthotics are usually made from a standard stock size item. It’s best to avoid orthotics made from a foam impression.

What About Computerized Orthotics?

Many places are now using a computerized gait analysis. They have you step on a pressure pad and a digitalized read-out of your footprint is seen on a screen. This is very impressive and will show where there are pressure points on the foot. This computerized gait analysis helps to make the person that is using it look like they really know what they are talking about when it comes to the feet, even if they know very little about podiatric medicine!

Caution however: The orthotics that are made after this computerized gait analysis are in fact basically an off-the-shelf device of a standard stock size to match your shoe size and to approximate the height of the arch. The devices are not made by a computer, and it is only the gait analysis that is computerized. This gait analysis basically confuses the issue and it makes it appear as though you are getting computerized orthotics. You are not, and as a result the correction or control of the foot mechanics may be limited or ineffective.

Bottom Line

If you are having problems with your feet and your feet are pronated, you are best off having your feet looked at by a podiatrist in order that proper correction can be achieved for the many years of walking that you have ahead of you.

Seniors’ Tips for Foot Health

If you are over 65, then you have over 100,000 miles on your feet! Nonetheless, that doesn’t mean it’s too late for foot comfort. While you can’t trade in your feet like a new set of tires, there are lots of things you can do for your feet in order to walk in comfort:

1. Wear good quality running shoes or the shoes designed especially for walking. Many seniors love to wear their running shoes all day long.

2. Corns and callouses can be painlessly treated by a podiatrist. Don’t use over-the-counter remedies as they can damage surrounding skin. Relief of pain is often instantaneous with a visit to a podiatrist..

3. Corrective procedures are being performed by podiatrists in their offices to permanently remove such problems as corns, ingrown nails, etc. The treatment is virtually painless and you can walk right away.

4. Gentle exercises such as moving your feet in circles or up and down help to improve mobility and flexibility.

5. Calf stretching exercises reduce tightness in the back of lower leg muscles particularly with women who are used to wearing higher heels and change to lower heeled shoes. By leaning against the wall and placing one foot forward and one foot back, bend the forward knee and you will feel the calf muscle of the opposite leg stretch. Hold for ten seconds.

6. Add cushioning to your feet. Soft soled shoes help, but consider an insole such as “Spenco” which is a thin flat foam insole that will add lots of cushioning to your feet. As you get older, the fat pad under the bones at the ball of the foot tends to get displaced forward and therefore reduces the cushioning at the ball of the foot.

7. Consider having your foot mechanics evaluated by a podiatrist. Structural imbalances that lead to bunions and callouses can be corrected at your age. A podiatrist can take casts of your feet and have an orthotic device fabricated to be worn comfortably in your shoes to reduce pressure to those areas that are experiencing excessive strain. A store bought “orthotic” is not prescribed to your foot but sometimes can lend a bit of help.

8. Ingrown nails can be sore. The nail can penetrate the skin and act as a foreign body. Avoid chemical “cures”. Again a foot specialist can painlessly clip away a segment of the nail for immediate relief and then a procedure can be performed by laser to permanently remove the offending nail border while leaving the rest of the nail intact.

9. Varicose veins are common in your age group. The best thing you can do for them is to elevate your feet when you can. The next best thing is walking. The worst thing is dangling your feet, at the side of the bed, for example.

10. Circulatory problems are common particularly in diabetics. Your family physician, podiatrist or vascular specialist can evaluate your circulation. Smoking is the worse thing for your circulation since it takes only one cigarette to reduce blood flow through your arteries.

11. Walking programs are an excellent idea for exercise and fitness. Get clearance from your family doctor first and then once you have comfortable walking shoes or running shoes, start your program gradually and build up your distances slowly. Avoid hills at first or uneven terrain that can create an ankle sprain.

Keep walking, and by offering your feet a little extra care and attention, they should keep you going for many more miles to come!

Help For Teachers

Ask any teacher about to retire, and they’ll likely tell you that their feet will be pleased by their forthcoming retirement.

Most teachers are aware that long hours each day on their feet can often result in foot or lower leg fatigue. Certainly this can take away from the teaching experience. Here are some tips to keep you going on those hard, terazzo floors of your school:

1. When possible, soft soled, laced walking shoes are ideal for support and comfort. Women who are interested in wearing more of a dress shoe may want to consider the soft soled flats or low pumps that provide added cushioning on the hard, unyielding floors of a school.

2. Standing for prolonged periods can result in contraction of the calf muscles. Try doing stretching exercises throughout the day where you simply lean against the wall with one foot forward and one foot back, keeping your back knee straight. Hold for 10 seconds. You can then bend the back knee and continue to stretch.

3. Many people think foot pain is normal. It is not. If you have painful corns or calluses, a podiatrist can easily and painlessly clear these up for you.

4. Sore spots on your toes or feet can often be accommodated with “moleskin” pads commercially available at drugstores. Be careful not to use any medicated pads on your skin because they can often damage the normal tissue.

5. Sore arches or heels may mean that you have a foot imbalance. Flat feet often cause strain to the arches and can be easily corrected with orthotic devices prescribed by a podiatrist.

6. Ingrown nails are not common among teachers but they do occur. Many teachers have told me over the years that they have feared having this attended to because of pain. The fact is that they can be painlessly treated and ongoing discomfort can be easily alleviated.

Exercises

Sitting Exercises: When at your desk, if you get a chance, consider doing some range of motion exercises with your feet and ankles. Simply rotating your feet in circles and moving them up and down enhances their flexibility and avoids stiffness in muscles and tendons. Also, try extending your legs and bend your feet up at the ankle to stretch the calves.

Walking as an exercise is excellent. If you feel too tired to exercise it may be that taking up a walking program may give you even more energy. Start off with short, easy distances and increase your mileage gradually.

Orthotics Advisory

Avoid getting orthotics from commercial centers. These are no more than expensive arch supports that don’t correct the mechanics of the gait cycle. Sophisticated computer graphics look impressive, but the end result is basically a stock item arch support that is being dispensed by a retailer. You’re better off seeing a foot specialist who can prescribe an orthotic that works precisely according to your foot mechanics. Follow up visits are important.

It’s hard to be an enthusiastic teacher if your feet are sore. A little care and attention to your feet can enhance your level of comfort so that when your retirement comes, your feet will be ready to do what you want them to.

Helpful Hints in Tennis

1. Work on flexibility, strengthening exercises and building up your level of conditioning.

2. Prevent injury – warming up before starting play, without fail. Consult a qualified instructor and develop your own warmup routine, centering on specific muscles which come into play during a tennis match.

3. Get expert instruction. The pros will help you as well as provide you with various fitness programs to suit your particular physical condition and level of play.

4. Consider a running program. Daily running will help you sustain a top level of play through long matches.

5. Socks have improved! Try those for tennis to wick perspiration away and to reduce friction.

6. Wear tennis shoes for stability and cushioning. (Not running shoes which are designed for forward motions and could easily lead to an ankle sprain in tennis.)

7. If you are prone to ankle sprains, tape up with the proper athletic product, or consult a sport shop for an ankle brace designed for tennis.

8. Keep a couple of bandaids in your bag in case they’re needed.

9. If you have callouses, place 1/8″ or 1/4″ moleskin or felt on each side of the callous to reduce pressure until proper care can be provided by a podiatrist.

10. Calf muscles can get tight in tennis. Do lots of runners’ stretches before, between, and after matches. This is especially good for women who spend time in dress shoes since when you go into lower heeled tennis shoes, calves shorten.

11. Sore feet or legs in tennis may be a result of a mechanical foot imbalance. This can often be easily corrected by a sports podiatrist with proper orthotics.

Common Problems in Tennis

Corns and Callouses
Corns and callouses indicate pressure, friction and imbalance of the foot. Do not use commercial acid corn “cures”, since irritation to the skin or infection can result. Because most corns and callouses are signs of some underlying disorder, they cannot be eliminated permanently until the disorder itself is corrected. Professional attention from a podiatrist should be sought as simple corrective procedures can be performed to relieve disabling problems.

“Tennis Leg”
Sudden movements of the foot and leg may result in a “tennis leg”, or a tear in the interior of the calf muscles. Never play with calf muscle pain. If this arises, seek medical help.

Tennis Toe
Tennis toe is characterized by severe, throbbing pain beneath the toenail with symptoms including a vague swelling of the toe and a purple discolouration under the nail. The condition usually affects the first and second toes and the discolouration is the result of hemorrhaging which may appear as vertical streaks beneath the nail palate. The problem is caused by modern tennis shoes which give such good traction that the foot is forced to the front of the shoe in sudden stops, thus traumatizing the nail. Initially, cold compresses and analgesics such as aspirin can help if pain is severe. Professional care by a podiatrist can help.

Shoes
Wear proper shoes which give good support to your feet. Shoes should be designed specifically for racquet sports, should support the arch firmly, and allow sufficient room to move the toes. Replace worn-out shoes. Patches or other repairing techniques are temporary at best, and excessively worn shoes can affect both your feet and playing style. NEVER play in improperly fitted or borrowed shoes. Running shoes will not give the support needed for the side-to-side motions of racquet sports. As a rule, the more expensive shoes designed for racquet sports are of better quality.

Look for:

• Reinforcement at toe for foot drag.

• Sole at ball of foot should be well padded since this is where most pressure is exerted.

• Sides of shoe should be sturdy for stability during continual side-to-side motions.

• Heel should be well cushioned for absorption of jarring forces.

• Toe box of shoes should allow for ample room in order to prevent blisters.

• Back and sides of heel (heel counter) should be firm for support and well padded.

Returning To Play After a Day Off
Do not attempt to return to full activity after an injury or other forced layoff. Return gradually, or get professional advice if unsure on how to resume your playing program. Many foot problems can be aggravated by racquet sports. Inflammation, stress, and strain won’t necessarily mean one has to stop playing altogether. A proper assessment and appropriate treatment by a podiatrist may pave the way to pain-free playing.

Nagging Pain
Acute injuries are not always the cause of problems, nor are shoes. Often “overuse syndromes” cause subtle, continual stress over many years. A foot imbalance may be the cause of your pain. If so, a prescription orthotic would help.

Other Interesting Tips

1. Drink lots of water before, during and after your match. Avoid caffeine, alcohol and drinks that are high in sugar.

2. Warm-up means to get warm.

3. Don’t forget to do calf stretching exercises. Also, building your quads and stomach muscles will help to support the back

4. Hold the tennis racquet as you would a small bird. This seems to reduce the tendency towards overuse syndromes of the arm.

Foot Health Tips for Veterans

If you are reading this, you likely have over 125,000 miles on your feet. Some days they may feel like it, but here are some ideas to make your feet feel younger.

• You should be wearing well cushioned, soft soled shoes all the time. Even dress shoes now have these soft soles. Laced shoes are better than slip-ons.

• Elevating your feet at the end of the day or after a long walk is helpful. For added cushioning in your shoes, try SpencoR insoles. They should be the thin flat insoles that sell at sports stores or some drugstores.

• Over-the-counter arch supports won’t do much for you. If you have sore feet, a prescription orthotic device designed from casts of your feet and precise measurements will give you the support and correction of your foot structure that you may need. Podiatrists do biomechanical foot examinations and can prescribe these for you.

• Corns and callouses can be painful. Don’t use razor blades or other tools to get rid of them. A podiatrist can easily and painlessly treat these for you to give you immediate relief.

• If you do use corn pads, make sure they are not medicated so that you do not damage the surrounding skin and cause infections, making the problem worse.

• Consider using moisturizing cream if your feet are dry or if you are getting scaling or cracking of your feet or heels.

• Try changing your socks a couple of times during the day and even changing your shoes.

• Try some gentle stretching exercises for your feet by pointing your toes up and down, doing circles with your feet and this keeps the motion going.

Many veterans think they’re “over the hill” and it is too late to do anything about foot pain. But in fact, it is never too late to get relief from pain in your feet an this can be accomplished without surgery.

Walking is great exercise, and comfortable feet can made a big difference!

Children’s Foot Care

• Don’t pass down snow boots from one child to the next. The insulated inner lining of the boots become compressed and the next child won’t have the warmth and comfort that the boot originally offered.

• For skaters: Be sure to check that the skates fit properly at the beginning of the season. Visit your local skating shop to have an expert evaluate the fit of the skates. (Be sure that your beginner skaters wear a hockey helmet and not a bicycle helmet while on the ice.)

• For skiers: Even if you’re confident that the ski boots fit perfectly on your child, be sure to have a local ski shop adjust and check the bindings so that the ski boots will release from the skis in order to prevent injury. (The same hold true for anyone in the family that is skiing.)

• Often children want to run out in the snow in running shoes. Obviously this is something to watch out for since the feet can become cold and wet. Frostbite of the toes is something that kids don’t think about until it is too late.

• Two pairs of socks in a slip-on winter boot can provide added insulation and help to keep the feet drier.

Help For Ladies

• Consider wearing boots with low and wide heels rather than high heeled dress boots for walking on ice and snow, particularly if you are doing a lot of walking during the day.

• Bringing along a comfortable pair of walking shoes to the shopping mall and switching from your dress boots may give you much more comfort during the time you spend shopping.

• Well cushioned insole material such as SpencoR provides added cushioning and insulation to your feet, particularly when warmth is needed. They can be used in skates or ski boots as well.

• Bunions (enlarged big toe joints ) can be prevented from progressing without surgery. Correcting abnormal foot mechanics can relieve pressure and enhance comfort. Try to wear boots that don’t squeeze the forefoot which can cause bursitis of the big toe joint.

Help For Men

• Winter boots often reveal pain in the feet that would not otherwise be present. Arch pain and heel pain may occur from the lack of support in a slip-on boot as compared with a supportive shoe.

• Prescription orthotic devices often can correct these mechanical imbalances of the feet that lead to pain with walking. They add a great deal of support to slip-on boots.

• Consider wearing laced dress shoes with soft soles for business. They provide added cushioning and support (versus a flimsier type of slip-on shoe). However, they can be troublesome as they don’t slide easily into overshoes (galoshes). Therefore, changing out of those shoes into a warm, slip-on boot may be preferred.

• If you’re a skier, be sure to have your bindings checked and adjusted if necessary.

• If the ski boot shop tells you that you need to buy orthotics from them for skiing, consider having your foot mechanics checked out by a podiatrist to evaluate any true medical problems or significant bone imbalances of your feet.

Running In Winter

• If anyone in the family is outside during winter, consider wearing running shoes with good traction soles. Watch for icy patches and go slowly or carefully over any suspicious surface.

• Try 2 pairs of socks for added insulation.

• Running on a smooth, flat, compact snow surface is preferable to a field with unknown ruts or uneven spots where one can easily twist an ankle.

• Shortening your stride may help to avoid muscle pulls in the leg, particularly if you hit a slippery spot.

• Winter sports such as skating, hockey, cross country skiing or downhill (alpine) skiing are a great way to enjoy our winters. Using the proper equipment and doing warm-up exercises such as stretching, and by utilizing proper technique or getting instructions when necessary, should enable you to enjoy the winter months.

Contrary to popular belief, foot pain is not normal and if your feet hurt, something can be done to correct this. A Doctor of Podiatric Medicine can detect any foot faults and correct problems before they worsen.

Foot Care for The Working Woman

A Baker’s Dozen Self Help Tips

It goes without saying that women’s dress shoes are not designed with comfort in mind. Nonetheless, there are things that women can do to keep their feet more comfortable both during work and after hours. Here are some ideas that may help you:

1. If you’re required to wear dress shoes at work, consider shoes with cushioned soles if possible. Certainly, lowering your heel height by even an inch will make a big difference.

2. If you’re active in sports, do lots of stretching for your calf muscles. Leaning against a wall with one foot forward and one back is useful. This is especially important if you wear high heels at work since your calf muscle undergoes shortening and will be over-stressed once in a lower sports shoe.

3. If you must wear a dress shoe, take a look at the shape of your foot and the shape of the front of the shoe. If the shoe is much narrower that your foot, then surely your toes will be pinched.

4. If your toes do get pinched, particularly your little toes, consider wearing a little pad on the toe to relieve pressure. As long as they are not medicated, this should be helpful.

5. Sports insoles such as “Spenco insoles” add lots of cushioning to your shoes. They’re usually available in sports shops and can be trimmed to fit a dress shoe. They also can be shortened to just reach the ball of the foot so they don’t make the toe box area of the shoe too tight.

6. Wear good quality running shoes or walking shoes as much of the time as possible. For example, prolonged walks, shopping, or even going to and from work can be made a lot more comfortable by wearing this type of footwear rather that dress shoes.

7. If you’re working behind a desk and get a chance to slip your shoes off, try doing some circles with your foot and up-and-down motions with your toes. This will let the muscles relax and stretch a bit before they get back into the confining dress shoe.

8. Shoes are not always the cause of women’s foot problems. Often mechanical imbalances can create such problems as bunions, heel pain, arch pain and even hammertoes. The causes of your foot problems should be evaluated and corrected.

9. Prescription orthotic devices are now available that can be worn in women’s dress shoes. They often enhance comfort and prevent additional deforming forces from taking place, such as bunions, heel spurs, etc.

10. Feet that ache at the end of the day can often be helped with proper podiatric care. In the meantime, consider using an ice pack (frozen peas works well) applied to sore areas for five minutes at a time; elevating your feet for ten or fifteen minutes at the end of the day (when possible) is helpful.

11. Callouses are a frequent complaint. They are caused by faulty foot mechanics, excessive pressure under a bone, or too much friction. They can be easily treated and prevented from recurring. In the meantime, “moleskin” padding helps.

12. Corns, which are concentrated areas of thick skin, usually over a bony prominence on toes, can really hurt. Protective pads help but the cause of the corn can be corrected with new techniques such as “minimal incision procedures”. If standing in the kitchen at home for long periods, try using your running shoes for that added support and cushioning.

13. Many working women feel that painful feet are a fact of life. In the 1990′s this need no longer be the case. With a little care and attention to your feet, you should be able to walk over 100,000 miles in your lifetime with minimal problems

Foot Health Tips for Young Campers

The last thing kids are concerned about when they’re having fun at camp is their feet. However, every year during the summer we see children in our office who have developed all sorts of foot problems that could have been avoided with a little advanced care and attention on the part of the parents.

Here is a list of tips that may be helpful for your child or children if they are going to camp:

1. Make sure they have good quality running shoes. Children put a lot of mileage on their feet every day and a supportive, well cushioned running shoe will give them better comfort and protection. Avoid flimsy and inexpensive sneakers.

2. Check your children’s feet for any sign of warts. They can usually multiply or spread and they are best treated early to avoid a bigger problem later on and to avoid transmission to other campers.

3. Older children frequently develop athlete’s foot fungus and a camping environment doesn’t help. Redness, scaling or cracking at the base of the toes is a sign of this and it’s best treated early.

4. Ingrown nails are a common problem with children and yet they often will suffer with them for fear that they will be forced to avoid camping activities. However, they can often become infected and an even bigger problem. A podiatrist can easily and painlessly treat even the sorest of ingrown nails.

5. If your child complains of pain in the arches, heels, ankles or lower legs, try applying some ice or frozen peas. This may be a tip-off to a mechanical foot imbalance which can be corrected easily. Poor quality shoes can be an aggravating factor.

6. Children should be encouraged to wear their socks with running shoes. This avoids blisters and helps to prevent athlete’s foot infection since socks will absorb perspiration. Some parents like to put an additional pair of socks in a backpack on rainy days. While this may not be of great help when the inside of a boot or shoe is wet as well, it’s nice to have dry socks if needed. Then again, some children come home on rainy days with a ½ cup of water in their boots and it doesn’t seem to bothered them!

7. On sunny days be sure that sunscreen is applied to the top of the feet, front of the ankles and front of the lower legs. This region is particularly susceptible to sunburn.

Here are some tips from a camp director who’s had 20 years experience and knows what he’s talking about:

1. Kids, tie up your laces! It may sound like a big job and is maybe a real pain, but you’ll be more comfortable and you won’t trip and hurt yourself.

2. Open toe sandals are a no-no. They may look cool, but in a camp setting where there are all sorts of rocks and stones, injuries to the toes are quite common and you’re asking for trouble. A little cut or scrape on a toe can ruin your day.

3. Avoid rubber boots on hot days. While this may seem like common sense, when your feet really sweat, then that’s a good time to develop fungus infection.

4. Don’t lend out your shoes. Besides spreading possible athlete’s foot fungus or warts, having someone else wear your shoes can result in your shoes being pushed out or deviated because of someone else’s foot structure.

5. Don’t use your running shoes like they’re thongs. Many kids walk around camp by slipping their foot into the front of the shoe and crushing the back heel counter of the shoe. This of course ruins the shoe for support and comfort and at the same time, makes your ankles unstable and can result in you winding up with an injury, especially on uneven trails.

6. A little extra care and attention to your children’s feet may prevent a minor problem from becoming a major distraction from a pleasant camping experience. Children don’t usually complain of aches and pains in their feet, so if they do, it’s worth having it looked into.