June Articles 2014

Barefoot Running

Barefoot running is becoming a popular running trend that has been permeating through the running and jogging communities. The act of running without shoes changes more about the motions of your stride than you may think, and choosing to run without shoes is not the only adjustment you will have to make.

Whenever you run normally, with shoes, your heel strikes the ground first as you land while you roll over the ball of your foot and push off with the front part and toes. Barefoot runners actually land on the front part of their feet and not their heels, shifting the impact from the back to the front of the foot. In order to do this safely and without much injury, runners need to reduce their stride to create softer landings.

One of barefoot running’s biggest advantages is the reduced risk of injury. Landing on the front of your foot with a reduced stride lessens the stress placed on the back of the foot, heels, and ankles. It also works out many muscles in the feet, ankles, and lower legs that you do not normally get to strengthen because of the different motion.  Your posture and balance are also improved with barefoot running, as is your sensory input from your feet to the rest of your body. Studies have shown that ironically, countries that have large populations of people who do not wear shoes every day are at lower risk for foot and ankle injuries and complications.

However, there is still some skepticism behind barefoot running because of some disadvantages it brings. One of these is the complete lack of protection for your feet while running. Bruises, scrapes, cuts, and even blisters can easily form when you have no protection from sharp or rough objects on the ground. Landing on the front of your feet can also cause Achilles tendonitis because of the overuse of the Achilles tendon.

Despite this, barefoot running can be made safe and enjoyable if you make a slow transition from your normal running routine into barefoot running. You cannot simply start the activity out of the blue one day, but instead gradually work your way from walking to jogging to running, increasing the distance each time. It is also recommended to start off on flat, even surfaces that do not contain sharp or dangerous objects because your feet are now unprotected. Minimalist running shoes are a great middle ground to start with because they combine the protection of shoes with the fit and feel of barefoot running.

 

Hammertoe: No Walk in the Park!

Hammertoe is a painful deformity of the second, third, or fourth toe, frequently caused by improper mechanics—the way a person walks or the shoes they wear that do not allow room for the deformity. Similar to mallet toe and claw toe, hammertoe involves different joints of the toe and foot. Shoes that are too narrow or short for the foot, or have excessively high heels, can cause of hammertoe. Improperly sized shoes force the toes into a bent position for long periods, causing the muscles to shorten and bend the toes into the hammertoe deformity.

Other causes of hammertoe may be complications from RA (rheumatoid arthritis), osteoarthritis, trauma to the foot, heredity, or CVA (cerebral vascular accident). Symptoms of hammertoe include, but may not be limited to, pain and difficult mobility of the toes, deformity, and calluses or corns from toes abrading one another.

A patient experiencing symptoms of hammertoe should seek examination by a physician, specifically a podiatrist. Podiatrists diagnose and treat disorders of the foot. If the doctor finds the involved toes have retained some flexibility, treatment may involve simple exercise, physical therapy, and a better fit to shoes worn by the patient. Treatment often targets controlling the mechanics, such as walking, that cause hammertoe by using custom orthotics.

In more advanced cases, where the toes have become rigid and inflexible, the doctor may suggest surgery. The operation would consist of incising the toe to relieve pressure on the tendons. The doctor may re-align tendons and remove small pieces of bone in order to straighten the toe. The insertion of pins may be necessary to fix bones in the proper position while the toe heals. Usually the patient is able to return home on the day of surgery.

If surgery is necessary, it is important to follow the postoperative directions of your physician. Theses may include various stretches, attempting to crumple a towel placed flat against your feet, or picking up marbles with your toes. Striving to wear shoes with low heels and ample toe space will ensure healthy feet and toes. Avoid closed shoes and high heels. Laced shoes tend to be roomier and more comfortable. Shoes with a minimum of one half inch space between the tip of your longest toe and the inside of the shoe will provide adequate space, relieve pressure on your toes, and prevent hammertoe from re-occurring.

Some tips on feet may include purchasing shoes at mid-day as your feet are smaller in the morning and swell as the day progresses. Ensure that she shoes you buy are both the same size and have the store stretch shoes at painful points to provide for optimum comfort.

 

Systemic Diseases of the Foot

There are several systemic diseases, or diseases that affect the whole body, that either display symptoms in the feet or affect the health of the feet. Common systemic diseases that affect the overall health of the feet, and the patient’s ability to walk comfortably, include gout, diabetes mellitus, neurological disorders, and arthritis.

In gout, which is caused by an excessive buildup of uric acid in the body, the most common symptoms of pain, inflammation, and redness occur at the metatarsal/phalangeal joint at the base of the big toe. Any excess levels of uric acid, crystallize and are deposited in tendons, joints, and surrounding bone and muscle tissue. Gout is commonly treated with NSAIDs to relieve pain and inflammation and other drugs to lower uric acid levels in the body. Gout most commonly affects those who are overweight, have low protein diets and lead a more sedentary lifestyle.

Diabetes mellitus is an increase in the level of blood sugar in which the body cannot counteract with naturally occurring insulin in the body. The three types of diabetes, Type I, Type II and Gestational Diabetes, are all signs the body is either not producing enough insulin or is not efficiently using the insulin that is produced. Gestational diabetes only affects women who are pregnant and have never, prior to pregnancy, exhibited symptoms of the disease.

There are two main issues that affect the feet that are commonly caused by diabetes. They include diabetic neuropathy and peripheral vascular disease. Diabetic neuropathy can lead to damaged nerves and affect the feet through numbness and loss of sensation. Peripheral vascular disease restricts the flow of blood to the foot and can, in extreme cases, lead to the necessity of amputating the foot. Peripheral issues that are caused by diabetes and can affect the foot include athlete’s foot, nail infections, corns, blisters, bunions, severe dry skin, plantar warts and ingrown toenails. These can all be attributed to the decrease of blood flow to the foot.

Neurological disorders and rheumatoid arthritis can also have severe impact on the health of the feet. Neurological disorders can affect the nerves in the main structure of the foot and cause loss of sensation and possible decreased muscle response. Rheumatoid arthritis can affect the bones and joint structures of the foot, making it impossible to walk normally without serious pain.

All systemic diseases that affect the foot can effectively be treated to minimize joint and muscle damage if they are diagnosed early and treated with medication and lifestyle therapy. Diabetes patients must monitor their blood sugar levels and work with their physician to keep their levels as close to normal as possible. Rheumatoid arthritis patients should work with their physician to ensure the proper medications are being taken to reduce the amount of damage to the joints of the body.


 

About Plantar Warts

The term plantar means relating to the foot, which is why plantar warts are only found on the feet. Plantar warts are caused by the human papillomavirus (HPV) getting into open wounds on the feet. These warts are recognizable by a hard bump on the foot. They are mostly found heels or on the balls of the feet. Plantar warts are basically harmless, and may be ignored unless they cause pain or embarrassment.

If you have a plantar wart you may notice some pain when standing, or just some tenderness on the sole of your foot. You will be able to see a fleshy wart, unless it has grown into the foot behind a callus. Since plantar warts are not cancerous and not dangerous, a podiatrist only needs to be seen if there is excess pain, the warts come back often or persist for some time, or if it affects walking. It is extremely important that people suffering from compromised immune systems or diabetes seek out a physician’s care immediately upon finding a plantar wart on their foot.

Doctors can usually easily diagnose plantar warts. The doctor will scrape off a tiny bit of the rough skin to make tiny blood clots visible that make up the inside of these warts. If the doctor is unsure of a diagnosis they may do a biopsy to be certain. Though plantar warts don't often call for treatment, there are many options for combating them if need be. They can be frozen using liquid nitrogen, removed using an electric tool or burned using laser treatment. For a less invasive treatment a topical cream can be used which is available only through a prescription. Over the counter wart medications may help, given enough time and patience.

If you prefer to use home remedies an apple cider vinegar soak is believed to help remove the wart. This treatment takes time. Soak your infected foot in the vinegar for 20 minutes before using a pumice stone to remove any loose skin from the wart. Keep the wart covered for protection in between daily treatments.

The best way to avoid contracting plantar warts is to avoid walking barefoot in public areas. This includes wearing shoes in public showers also. It is also important to avoid direct contact with warts, as they can be contagious. This means not touching your own warts, as well as those on others.

 

What is a Podiatrist

The branch of medicine that is focused on the treatment, diagnosis, and study of disorders of the lower leg, ankle and foot is referred to as podiatry. Because people often spend a great deal of their time on their feet, many problems in this area can occur. A person seeks help from the field of podiatry when they need treatment for heel spurs, bunions, arch problems, deformities, ingrown toenails, corns, foot and ankle problems, infections, and problems with the foot that are related to diabetes and additional diseases.

To treat problems of the foot, ankle or lower leg, a podiatrist may prescribe physical therapy, drugs, perform surgery on lower extremity fractures. Individuals may also be recommended to wear corrective shoe inserts, custom-made shoes, plaster casts and strappings in order to correct deformities.

When trying to gather information on a patient problem, a scanner or force plate may be used in order to design orthotics. During this procedure, patients are told to walk across a plate that is connected to a computer; the computer then takes a scan of the foot and indicates weight distribution and pressure points. The computer readouts will give the podiatrist information to help them determine the correct treatment plans.

Diagnosis is also provided through laboratory tests and x-rays. Through the foot, the first signs of serious problems such as heart disease, diabetes and arthritis can show up. For example, individuals that have diabetes may frequently have problems such as infections and foot ulcers because they experience poor circulation in the foot area. A podiatrist can then have consultations with patients when symptoms arise and referrals will be made to specialists that handle the greater health problems.

Some podiatrists have their own solo small private practices or clinics where they have a small staff and administrative personnel but many work within group practices. They usually spend time performing surgery in ambulatory surgical centers or hospitals or visiting patients in nursing homes. They typically spend between 30 to 60 hours of week working. Some podiatrists specialize in public health, orthopedics, surgery, or primary care. Some other fields include specialties in geriatrics, dermatology, pediatrics, diabetic foot care and sports medicine.

Some podiatrist specialists complete extra training in the area of foot and ankle reconstruction that result from the effects of physical trauma or diabetes. There are also surgeons that perform surgery of a cosmetic nature to correct bunions and hammertoes.

 

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