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Swimming and Your Feet

If our feet could talk, they would complain about all the walking, running and long standing we put them through. Our feet deserve a break from the stress put on them, and swimming is a great way to do just that. This activity not only takes all the weight off of the feet, allowing them to relax—there are many other reasons why it is helps take care of feet as well.

Swimming is great for foot health because it improves blood circulation to all the lower extremities. This is especially true for older people or those with injuries, who often cannot exercise as much due to weakened muscles or joints. Water supports much of the weight of the swimmer, relieving aches and allowing him or her to move freely. This gets the blood flowing to the rest of the body, including the feet.

Improving blood flow is also paramount to those with diabetes, who usually have problems with circulation in their feet. Additionally, because of various foot complications, it is often difficult for these people to exercise. Swimming is a good, safe way to get in extra physical activity and improve circulation, without causing further trauma to the feet.

For those that have foot problems due to overuse, swimming can be very beneficial. Athletes and people who are constantly on their feet frequently suffer from injuries like foot tendinitis or ankle sprains. Swimming in cold water can reduce foot inflammation, while swimming in warm water can increase blood flow and make it easier to move and stretch the afflicted foot. Furthermore, because the feet are usually covered during high activity, they tend to sweat a lot. This can cause complications like athlete's foot. Swimming not only allows the feet to be open to the air, it gives them a chance to be cleaned as someone moves around in the water.

Pregnant women who suffer from edema can benefit from swimming, because it allows them to get off their feet for a while. Due to the buoyancy of the human body, they may comfortably float and move around without exerting uncomfortable and often painful pressure on swollen feet and legs. This also lets them to relax sore muscles and joints.

Swimming is, in general, one of the best ways to exercise while protecting and caring for your feet. It takes all the pressure off of them, allowing the feet to relax and recover, and improves blood flow to them. It also makes it easier for someone to stretch and ease an injured foot, which helps heal it and reduces recovery time. If someone has any foot issues at all, or if they simply want to let their feet relax for a while, they should just go swimming.

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Nerve Disorders of the Foot and Ankle

Similar to well-known nerve disorders in the hands, such as carpal tunnel syndrome, nerve disorders that affect the foot and ankle occur in patients for reasons ranging from stress to genetics. Nerve disorders of the foot should be addressed right away because they may be immobilizing in serious cases. Two of the most common nerve disorders of the foot and ankle are Interdigital Neuroma and Tarsal Tunnel Syndrome.

Interdigital Neuroma is caused by localized inflammation of one of the nerves that controls toe sensitivity in the frontal area of the foot. This inflammation is generally only found in the second or third interspace, and any other symptoms similar to Neuroma on other digits should be checked against other disorders. Symptoms include chronic burning or tingling sensations between the affected toes which can, at times, migrate to the toes themselves. This pain is often increased by walking, running, or by wearing shoes that compress the toes, such as high heels. A doctor should be consulted if this pain is chronic and if the symptoms get worse.

Typical examinations to determine the presence of Neuroma include radiographs, MRIs, and even bone scans of the affected area. Bone scans are only required if degeneration of bone is suspected, however. Surgery is often not required to alleviate the symptoms of Neuroma, and in many cases functional orthotics can be used to alleviate the stress of constant weight on the affected toes. Surgery is recommended for those patients that suffer from symptoms for 6 months or more, so reporting symptoms early can increase the rate of non-surgical recovery.

Tarsal Tunnel Syndrome, a condition that is less common than Interdigital Neuroma, is similar to Carpal Tunnel Syndrome in that it is caused by a compression of the nerve caused by any number of factors (mostly associated with excess pronation). Typically seen in those that have either flatfeet or valgus heel positions, Tarsal Tunnel Syndrome has patients complaining of moderate to severe ankle pain that starts along the bottom of the foot and often proceeds to the calf. Some more extreme cases occur with partial numbness and even atrophy of the foot and surrounding muscles.

If there is a good chance that someone has Tarsal Tunnel Syndrome, an EMG test is often used to diagnose the condition.  If the diagnosis is positive, an MRI can be used to identify the compression of the nerve. Treatment with NSAIDS, functional orthotics, and rest off of the feet is often prescribed, but again, long standing symptoms require surgery, as do exacerbated symptoms caused by lesions present between nerves.

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What To Know About Ankle Injuries

Ankle injuries are a very common injury to the foot. The ankle is the point of connection from the leg and the foot. The joint is the point where the tibia (big leg bone), fibula (small leg bone) and the talus (top of the foot) all meet. These bones are held together by tendons and ligaments. Tendons hold muscles to bone and ligaments hold bones together. An ankle sprain involves the ligaments of the foot.

Ankle sprains occur when the foot is twisted in an unnatural way. While sports injuries have many ankle sprains, other common experiences such as slipping on stairs or walking on uneven ground can result in an ankle sprain. When the foot twists in a way that is not natural, the ligaments will be stretched.

Immediately after an ankle sprain occurs, there will be fluid leakage into the tissues. This causes inflammation and swelling which results in pain. Nerves are sensitized and the increase in fluids puts additional pressure on the nerves which causes an increase in pain. When this occurs, heavy blood flow to the injured area will often result in heat, making swollen ankles warm to the touch.

Severe pain, deformity of the bone, loss of feeling, and inability to walk for even minimal amounts of time are indications that you need to seek immediate medical attention. The ligaments that hold the foot bones together might become too stretched which can cause the bone to feel out of place or dislocated. A podiatrist will provide an examination to make sure there is feeling present, adequate movement, and that the tendons have not been damaged. If symptoms warrant it, an x-ray will be ordered to determine possible fractures.

One of the first things to do after an ankle injury is to apply ice to the area of injury. The immediate use of ice helps to reduce inflammation, but should not be applied directly to the injured area. Reducing the pressure on the ankle is another key step when treating sprains. This involves elevating the ankle above the level of the heart to reduce the flow of fluids. An elastic bandage may be needed which provides support for the ankle and prevents inflammation through compression.

Limiting motion of the injured ankle will help speed up the recovery. Using a brace or crutch is an effective way to limit motion and promote a speedy recovery. If properly addressed, ankle sprains can heal in a minimal amount of time. There may be some limitation as to movement, however, stretching and rotation of the joint can get it back to prior injury status.

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Bunions

The term bunion refers to an enlargement of the base joint of the toe, the connection to the foot. This enlargement may be formed of swollen tissue or a bony growth, and is caused by the shifting of the bones in the big toe inward, toward the other toes of the foot. The area around the base of the big toe may become inflamed, red, and painful.

Genetic factors are important in the formation of bunions – people who get bunions are usually genetically predisposed to this bone displacement, and may cause its onset by wearing improperly fitting shoes, or by running or walking in a way that causes stress to the feet. Another common cause for bunions is wearing high heeled shoes. The weight of the body in these shoes pushes the toes into an unnatural position, possibly causing bone displacement.

A podiatrist who specializes in foot structure and bio-mechanics will be able to quickly diagnose bunions. Bunions must be distinguished from gout or arthritic conditions, so blood tests may be necessary. The podiatrist may order a radiological exam to provide an image of the bone structure. If the x-ray demonstrates an enlargement of the joint near the base of the toe and a shifting toward the smaller toes, this is indicative of a bunion.

Wearing wider shoes can remove the pressure on the bunion and reduce pain. High heeled shoes should be eliminated for a period of time as this type of shoe generally pushes the big toe outward toward the smaller toes. This may be enough to eliminate the pain associated with bunions; however, if pain persists, anti-inflammatory drugs may be prescribed. Severe pain may require an injection of steroids near the bunion. Orthotics for shoes may be prescribed which, by altering the pressure on the foot, can be helpful in reducing pain. These do not correct the problem, but by eliminating the pain, they can provide relief.

For cases that do not respond to these methods of treatment, surgery can be done to reposition the toe. A surgeon may do this by taking out a section of bone, or may rearrange the ligaments and tendons in the toe to help keep it properly aligned. It may be necessary even after surgery to wear more comfortable shoes that do not put undue pressure on the toe as the big toe can easily move back to its orientation toward the smaller toes.

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Foot Rehabilitation for Athletes

There is no sport that completely prevents the foot or ankle from becoming injured. In fact, even simple activities such as darts and pool might cause injuries to the foot. When an athlete does suffer from a foot injury, he needs to find a way to get back on his feet right away. Immediate results may be desired, but they are not always possible.

All foot and ankle injuries deserve immediate attention. When the foot or the ankle gets injured, muscles surrounding the bones can weaken or atrophy through disuse. While the bones heal on their own, it takes a more concentrated effort for an athlete to regain full use of his feet and ankles. A doctor may recommend that a person go through a course of physical therapy. The course of physical therapy treatment uses simple, repetitive isometric exercises. The use of the exercises will cause the body to rebuild the muscles and tendons in the area over time and restore the full range of movement.

When selecting ankle and foot rehabilitation services, an athlete needs to find a licensed sports therapist (other physical therapists work with more generalized conditions, and while these kinds of physical therapists are dedicated to their job, they do not necessarily understand the special demands of the athlete). A good sports therapist will take their time with a patient, and make sure that he or she understands the problem and the options available for treatment. As long as the doctor expects a person to return to the sport which he enjoys, the sports physical therapist will recommend the exact exercises a person needs to get back in the game.

Although the professional athlete needs a trained sports therapist, an amateur athlete or the weekend player can benefit from foot rehabilitation services for athletes as well. An ankle or foot injury does not have to cause a person go give up the game he loves entirely, so long as he or she seeks out a sports therapist.

Physical therapy may not always heal certain injuries perfectly, but it will more quickly and effectively help the afflicted person get better. Less severe injuries may only take a person out of his favorite sport just for a little while, if he or she sees a sports therapist. If a full recovery is possible, it is definitely worth it to check out ankle and foot rehabilitation services.

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Heel Pain

Heel pain is a stressful condition that effects day to day activities. Running and walking causes stress on the heel because the heel is the part of the foot that hits the ground first. This means that the heel is taking on your entire weight. Diagnosis and treatments for heel pain can be easily found through your podiatrist.

One of the main causes of heel pain is a condition known as plantar fasciitis. The plantar fascia is a band of tissue that extends along the bottom of the foot, from the toe to the bottom of the heel. A rip or tear in this ligament can cause inflammation of these tissues, resulting in heel pain. People who do not wear proper fitting shoes are often at risk of developing problems such as plantar fasciitis. Unnecessary stress from ill fitting shoes, weight change, excessive running, and wearing non-supportive shoes on hard surfaces are all causes of plantar fasciitis.

Achilles tendonitis is another cause of heel pain. Similar to plantar fasciitis, inflammation of the Achilles tendon will cause heel pain due to stress fractures and muscle tearing. A lack of flexibility of the ankle and heel is an indicator of Achilles tendonitis. If left untreated, this condition can lead to plantar fasciitis and cause even more pain on your heel.

A third cause of heel pain is a heel spur. A heel spur occurs when the tissues of the plantar fascia undergo a great deal of stress, leading to a separation of the ligament from the heel bone entirely. This results in a pointed fragment of bone on the ball of the foot, known as a heel spur.

Treatments for heel pain are easy and effective as long as problems are addressed quickly. The most common solution is simply taking stress off the feet, particularly off of the heel. This will ease the pain and allow the tendons and ligaments to relax. In the case of both plantar fasciitis and Achilles tendonitis, icing will reduce swelling of any part of the foot and anti-inflammatory medication is highly recommended. Properly fitting your shoes and wearing heel pads or comfort insoles will also reduce the risk of developing heel pain. Stretching before and after exercises such as running will help the foot muscles prepare for stress and lower the chances of inflammatory pain. In extreme cases, relieving heel   pain might require surgery. Always make sure to discuss these symptoms and treatment options with your podiatrist to keep yourself active and pain free.

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Effect of High-Heels on the Feet

Women have been wearing various kinds of high-heels for hundreds of years, mostly for aesthetic reasons. Shoes with heels make their wearer appear to be taller and to have longer and thinner legs, and change the wearer’s gait and posture. High-heels’ association with femininity have kept them popular over the years, but there are definite health problems caused by wearing high-heels too frequently.

High heels also limit the motion of the ankle joints as well when they are worn. The ankle is a very important joint in the body when it comes to walking. These joints have a great deal of weight put on them because of their location. This is why it is so important to keep them as healthy as possible. The main tendon in the ankle is the Achilles tendon. Studies have shown that wearing high heels often causes the calf muscle and Achilles tendon to shorten, and stiffens the Achilles tendon as well, which can cause problems when shoes without heels are worn.

By forcing the toes into a small toe box, and putting a great deal of pressure on the ball of the foot, high-heels can cause or worsen many foot problems, such as corns, hammertoe, bunions, Morton’s neuroma and plantar fasciitis.

Wearing high-heels regularly, especially very high ones, can have long term negative effects on many other parts of the body, as well as the feet. One of the most important joints in the entire body, the knees, can be affected by wearing high heels. Wearing high heels causes the knees to stay bent at all times. It also causes them to bend slightly inward as well. Many doctors believe that constantly walking like this is the reason that women are so much more likely to suffer from osteoarthritis later in life. High-heels also cause increased stress on the knees by limiting the natural motion of the foot during walking.

The back may also be negatively affected by high heels because this shoe style causes the back to go out of alignment. This affects the spine’s ability to absorb shock, and can cause continued pain in the back if high heels are worn constantly. High-heels also compress the vertebrae of the lower back, and can cause overuse of the muscles in the lower back.

This is not to say that high heels should never be worn. They will not cause serious problems if they are worn only occasionally. However, they should not be worn every day in order to avoid long term physical health problems to the feet, knees, ankles and back.

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What is Gout?

Gout is a form of arthritis that is unusually painful. A slight touch can send shooting pain. The most common area for gout to occur is in the metatarsal phalangeal joint of the big toe. Other areas of the body frequently affected by gout are the knees, elbows, fingers, ankles and wrists.

Gout occurs when there are elevated levels of uric acid in the blood. This condition is called hyperuricemia. Hyperuricemia is a genetically pre-disposed condition about 90% of the time and occurs because the kidneys do not produce the correct amount of uric acid. Children of parents who have had gout will have a 20% chance of developing it themselves. The excess uric acid in the blood forms crystals that deposit in between joints causing friction with movement.

Symptoms of gout caused by this friction include pain, redness, swelling, and inflammation. Fever and fatigue may occur as well, although these symptoms are rare. The pain can be worse during the night when the body’s temperature lowers.

Gout can be diagnosed clinically by a doctor’s observation of the redness, swelling, and pain. More definitive tests can be performed by the doctor as well. Blood tests check for elevated uric acid levels in the blood. The synovial fluid in the joint can also be withdrawn through a needle to be checked for uric acid crystals. Chronic gout can be diagnosed by X-ray.

Treatment given for acute gout diminishes the symptoms. Non-steroid anti-inflammatory drugs such as Colchicine and other corticosteroid drugs will stop the swelling, redness, and inflammation in cases of acute gout. If gout becomes chronic, there are multiple ways to combat it. Lifestyle changes and changes in diet may be necessary, as well as preventative drugs.

Gout can be aggravated by a sedentary lifestyle. Exercise will reduce probability of future cases of gout. Certain foods cause or increase the risk of gout and their consumption should be avoided or kept at a minimum. These foods include red meat, alcohol, sea foods, and drinks sweetened with fructose.

Lifestyle changes and diet that help prevent gout include exercise and certain foods that help decrease the chance of gout recurring. Gout preventative foods include Vitamin C, coffee and some dairy products. New drugs have been discovered that inhibit the body’s production of certain enzymes. These are the enzymes that produce uric acid. Lowering your levels of uric acid will greatly reduce the chances of developing further cases of gout.

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Barefoot Running

A new trend in running and jogging has popped up recently, called barefoot running. Barefoot running is a popular and growing trend that is just what it sounds – running without shoes. Before deciding to do any running without shoes, it's best to understand how this kind of running affects the feet.

Running without shoes changes the motion of running. Most running is done by landing on the heel of the feet. Running barefoot requires a different way of running; in a barefoot stride landing is done on the front part of the feet. Because of this, the impact shifts from the heels to the front feet. Runners also shorten their strides to create a softer landing.

Running barefoot does have its advantages. When running and landing on the front feet, the impact on the feet and ankle is reduced, which may reduce the incidence of stress injuries. It strengthens muscles in the feet, and also strengthens muscles in the ankles and lower legs that aren't usually worked. Overall balance of the body is improved and there is greater sensory input from the feet to the rest of the body, making overall position and motion less stressful on the body. It has been found that in countries in which some of the population regularly wear shoes and some do not, numbers of foot and ankle injuries are much higher in those who wear shoes.

People hearing about barefoot running for the first time are skeptical about it, and there are good reasons for skepticism. Running barefoot certainly has its drawbacks, the obvious being no protection of the feet when running. This makes it likely that when runners land on sharp or rough objects, scrapes, bruises, and cuts on feet will result. Blisters will form when beginning this kind of running especially, you may have plantar fascia problems. Landing on the front feet constantly also increases the risk of getting Achilles tendonitis.

So what can runners do to make barefoot running safe? It’s best to make a slow transition from running shoes to barefoot running. The body is used to wearing shoes so to slowly transition to bare feet, start by walking barefoot for a distance and then increase walking distance. Once the feet begin to adjust, try walking and then jogging and gradually increase the distance. If you have foot problems talk to the doctor first before attempting barefoot running. When starting out, it may also be helpful to begin by running on pavement or other consistent surfaces to avoid sharp or rough objects. Minimalist running shoes may also be an option, as they allow for many of the benefits of barefoot running while also protecting the feet from cuts and scrapes.

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Diabetic Foot Care

It is important when caring for the feet of diabetics to always wash and thoroughly dry the feet, especially between the toes. Next, examine your feet and toes for any redness or sores that may be there, even if you do not feel any pain. You may also use a mirror to examine your feet from the bottom side. Avoid wearing colored socks to prevent infections that may occur from the dye used in them. Well-fitting socks are also highly recommended.

Anyone with diabetes should have their physicians to monitor Hemoglobin A1C levels as this test lets the physician know how well the blood sugar levels have been controlled during the past 3 months. It is very important to keep the blood sugar levels in the normal range (70-110mg/dl). There are medications that a physician may prescribe to help with neuropathy of the diabetic patient. It is also advisable to visit a podiatrist if the diabetic patient is experiencing any conditions involving the feet. Toe nails may need to be taken care of by a podiatrist as some patients may cut to deep or not deep enough around the cuticles and risk having an infection that could occur.

While at home a person can take care of their feet if they follow instructions given by their physician or nurse. An effective treatment is using creams and applying them to the heels due to the possibility of extreme dryness. Be careful when using tools to remove the calluses as severe diabetics may not be able to feel pain, and this can cause a severe wound to develop.

Diabetic feet absolutely need to be inspected on a daily basis. Always notify your health care professional with any concerns that you may have about the care of your feet. Waiting to see if a wound will get better is not a good idea as it can turn into a life threatening condition. Gangrene is a serious problem for diabetics and can lead to sepsis and amputation. Early treatment and daily

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Tarsal Tunnel Syndrome

Tarsal tunnel syndrome, also called tibial nerve dysfunction, is an uncommon form of misfiring peripheral nerves in the foot. Peripheral nerves are the nerves that carry signals from the brain and spinal cord to the other parts of the body. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome, the tibial nerve is damaged, causing problems with movement and feeling in the foot of the affected leg.

Common causes of tarsal tunnel syndrome involve pressure or an injury. Direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or near the knee, or trauma to the tibial nerve can result in tarsal tunnel syndrome. Diseases that damage nerves, including diabetes, may cause tarsal tunnel syndrome. However, tarsal tunnel syndrome can appear without an obvious cause in some cases.

Feeling different sensations in the foot at different times is a common symptom of tarsal tunnel syndrome. An afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of affected leg, with primary problems occurring on the bottom of the foot. The foot muscles, toes and ankle become weaker, and curling toes or flexing the foot becomes difficult. If the condition worsens, the person may develop infections and ulcers on the affected foot because of the lack of sensation. The affected foot can become permanently deformed, and sensation loss, particularly in the toes, is sometimes permanent.

A physical exam of the leg can help identify the presence of tarsal tunnel syndrome. Medical tests, such as a nerve biopsy, are also used to diagnose the condition.

Occasionally, a person with tarsal tunnel syndrome can recover without specific treatment, but over the counter pain medication is still used to reduce the discomfort associated with the condition. Treatments for more severe tarsal tunnel syndrome focus on regaining sensation and strength in the affected toes and foot. Patients may receive physical therapy and prescription painkillers if the pain isn't managed by over the counter pain relievers. A surgery designed to lessen pressure on the tibial nerve can help in some cases. The surgeon enlarges the patient's tarsal tunnel, a ligament and bone structure in the foot that the tibial nerve passes through, relieving some of the pressure on the tibial nerve.

Poor blood circulation in the feet and legs is often caused by peripheral artery disease (PAD), which is usually the result of a build up of plaque in the arteries. Plaque build up, or atherosclerosis, can be the result of excess calcium and cholesterol in the bloodstream, which restricts how much blood can flow through arteries. Reduced blood flow to a certain area of the body severely limits the amount of oxygen and nutrients that part of the body receives, causing degeneration in the muscles and other tissues. Sometimes, poor blood circulation in the feet and legs can be caused by other conditions, such as damage to or inflammation of blood vessels, known as vasculitis.

The lack of oxygen and nutrients caused by poor blood circulation can restrict muscle growth and development, as well as cause muscle pain and cramps, weakness, and stiffness. Other common symptoms include numbness in the legs and feet, skin discoloration in the affected limbs, slower nail and hair growth, and erectile dysfunction in men. In more severe cases of PAD, pain can be present even when a person isn't exercising, and may range from mildly uncomfortable to completely debilitating.

Poor blood circulation in the feet and legs is more common in those who are overweight or obese, have diabetes, high blood pressure, high cholesterol, who smoke, or who have a family history of PAD or related conditions (heart attack, stroke, etc.). Diabetes and smoking place a person at greatest risk for developing poor blood circulation, although advanced age (over 50) can also increase risk.

If you are experiencing poor blood circulation in the feet and legs caused by PAD, it is important to make changes to your lifestyle in order to reduce your risk of experiencing a heart attack or stroke caused by this condition. If you smoke, quit completely -- this will increase the amount of oxygen in your bloodstream. Exercising and reducing the saturated fats in your diet (which come from fatty meats, fried foods, whole milk, etc.) can make a difference in improving blood circulation in feet. It is also important to avoid developing influenza and to carefully control your blood sugar if you have diabetes.

Your doctor may recommend combining lifestyle changes with a prescription medication regimen to improve blood circulation. The most commonly-used medications for PAD are called statins and work by blocking the amount of enzymes in your body that produce cholesterol. They are known by the brand names Zocor, Lipitor, Crestor, and others.

 

While running seems like a simple activity, it is actually a complicated movement that puts a lot of stress on the joints, bones and ligaments of the body. Consequently, choosing the right shoe is an important step in increasing performance and decreasing injury risk. You should select running shoes based on your foot type. While other considerations are important, such as trail versus road shoes, your foot type dictates the amount of cushioning, stability and motion control you need. The best way to determine your foot type is to visit a local specialty running shop. Professionals there can measure your arch type, stride and gait and summarize your shoe needs for future reference.

Running shoe design is based on the idea of pronation. Pronation is the natural rolling of your ankle from outside to inside during foot strike. In other words, proper running mechanics involve striking the ground on the outside of your heel and rolling toward your big toe before pushing off again. Pronation is a good thing: it helps your lower extremities absorb shock and store energy. Neutral runners who pronate correctly do not depend on their shoes to correct their form. Neutral runners can select from a large variety of shoes, even minimal or barefoot models. However, runners with problematic foot arches or incorrect form may pronate too much or too little and require specific qualities from their running shoes.

Overpronators run with excessive ankle rolling. Even when standing, severe overpronators exhibit ankles that angle inward. They also tend to have flat feet or bowed legs. Overpronation can cause a plethora of injuries, especially in the knees, ankles and Achilles tendons. If you overpronate, you should select a shoe with extra stability and motion-control. Motion-control shoes are firm and straight; they do not curve at the tip. The lack of flexibility along the midsole prevents the foot from rolling too far inward during your foot strike.

Underpronation, also called supination, is less common than overpronation. Unlike overpronators, underpronators have inflexible feet and high arches. When they land, their feet are unable to roll inward. While this places less rotational stress on the ankles and knees, it prevents any kind of shock absorptions. This additional force can result in fractures, ligament tears and muscle strains as the legs compensate for the impact. Underpronators require shoes with increased cushioning and flexibility. If you underpronate, stability or motion-control shoes may compound the problem by further preventing pronation.

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Nerve Disorders of the Foot and Ankle

Similar to well-known nerve disorders in the hands, such as carpal tunnel syndrome, nerve disorders that affect the foot and ankle occur in patients for reasons ranging from stress to genetics. Nerve disorders of the foot should be addressed right away because they may be immobilizing in serious cases. Two of the most common nerve disorders of the foot and ankle are Interdigital Neuroma and Tarsal Tunnel Syndrome.

Interdigital Neuroma is caused by localized inflammation of one of the nerves that controls toe sensitivity in the frontal area of the foot. This inflammation is generally only found in the second or third interspace, and any other symptoms similar to Neuroma on other digits should be checked against other disorders. Symptoms include chronic burning or tingling sensations between the affected toes which can, at times, migrate to the toes themselves. This pain is often increased by walking, running, or by wearing shoes that compress the toes, such as high heels. A doctor should be consulted if this pain is chronic and if the symptoms get worse.

Typical examinations to determine the presence of Neuroma include radiographs, MRIs, and even bone scans of the affected area. Bone scans are only required if degeneration of bone is suspected, however. Surgery is often not required to alleviate the symptoms of Neuroma, and in many cases functional orthotics can be used to alleviate the stress of constant weight on the affected toes. Surgery is recommended for those patients that suffer from symptoms for 6 months or more, so reporting symptoms early can increase the rate of non-surgical recovery.

Tarsal Tunnel Syndrome, a condition that is less common than Interdigital Neuroma, is similar to Carpal Tunnel Syndrome in that it is caused by a compression of the nerve caused by any number of factors (mostly associated with excess pronation). Typically seen in those that have either flatfeet or valgus heel positions, Tarsal Tunnel Syndrome has patients complaining of moderate to severe ankle pain that starts along the bottom of the foot and often proceeds to the calf. Some more extreme cases occur with partial numbness and even atrophy of the foot and surrounding muscles.

If there is a good chance that someone has Tarsal Tunnel Syndrome, an EMG test is often used to diagnose the condition.  If the diagnosis is positive, an MRI can be used to identify the compression of the nerve. Treatment with NSAIDS, functional orthotics, and rest off of the feet is often prescribed, but again, long standing symptoms require surgery, as do exacerbated symptoms caused by lesions present between nerves. 

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Elderly and their Feet

While proper foot care is important for everybody, senior citizens have the tendency to be more susceptible to certain conditions and should therefore be well informed about problems that may arise and what they can do to properly avoid or treat them.

Some of the most common problems are foot ulcers, ingrown toenails, fallen arches, and fungal infection. A foot ulcer is an open sore on the foot and can be a result of decreased sensation in the feet. An ingrown toenail is defined as when the nail grows into the side of the toe. Fallen arches are indicated by the instep of the foot collapsing. A fungal infection is a condition that results in deformed and discolored toenails.           

In order to avoid these conditions it is recommended that the feet be inspected by the patient on a regular basis. If these inspections are carried out routinely, there is a good likelihood that problems can be identified before they become severe, or can even be avoided altogether. If any abnormality is discovered, it is important that the individual consult a doctor for diagnosis and information on treatment options.

Proper foot hygiene is also important. Making sure that you always have clean, dry socks on can be a major deterrent to many different problems including bacterial infections, foot odor, and certain types of fungus. Wet feet are a major cause of many of these problems.  If your socks get wet, it is important to change them. Walking around in wet socks may not only lead to various infections, but can irritate the skin and result in a number of various complications. Clean, dry feet are less likely to be affected by fungal and other infections.

As people age, the fat present on your feet begins to deteriorate. The protective nature of this fat keeps the feet healthy by providing a barrier and between your bones and the ground as well as giving the skin on the foot a certain amount of elasticity. This is one factor that causes elderly people to develop some serious foot issues. Foot moisturizers can be helpful to avoid certain problems associated with this. However, water-based moisturizers do not work as well for elderly people as they do for the young. Instead, it is more effective to use an emollient instead. An emollient is effective because it binds the water in the foot, keeping it from becoming absorbed too readily which will result in dry skin. They also have a special property called occlusion, which provides a layer of oil on the skin. This layer prevents the foot from drying up and can be very effective in treating dry skin disorders.  If you can keep the skin on your feet healthy, this will substantially reduce the number of foot problems you will encounter in old age.

Proper footwear is another way to keep feet healthy. Shoes that fit well and provide proper support help prevent ingrown toenails and fallen arches.          

Certain medical conditions such as diabetes or poor blood circulation increase the risk for foot issues. For individuals with any of these conditions it is extremely important to conduct regular foot inspections to make sure that there are no sores or infections present.

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