Podiatry

Avoid the shoe blues this summer

When summer arrives, the whole pace of life changes — even what we wear. As sweaters and leggings give way to T-shirts and Capri’s, footwear also makes that welcome seasonal switch. No more Uggs: It’s sandal time.

But for some of us, that means a different kind of “ugh.”

Face it: Sandals bare everything from this squished little piggy to those dry heel pads crying for pumice stones. Even worse, there may be corns, calluses, hammertoes, bunions and unsightly sores brought on by two or three seasons hiding in ill-fitting, closed-toe shoes.

Yet Dr. Joseph Carbone, a podiatrist with Rochester Foot Care, says shoes alone aren’t to blame for the condition our feet are in.

“Most musculoskeletal problems of the foot are genetic or inherited and cause an imbalance in the foot,” he said. The wrong shoes just exacerbate the problem.

“You could say that a large percentage of people have a foot deformity, but not a lot are symptomatic,” he said. “A lot of men, for instance, have bunions but never seek treatment. They just wear wider shoes to accommodate the bunion.”

Not so for many women, since “fashionable footwear” for women rarely includes the word “wide.”

That’s what Brighton mom Jennifer Cintron discovered after living for nine years in Fort Lauderdale, Florida, where she wore flip-flops every day. When she left the Sunshine State in her mid-20s and donned fancy heels for jobs back up north, she discovered that her standard-width shoes no longer fit. Her feet had widened because of the lack of support from her flip-flops, she said. Now she’s stuck with D- and sometimes E-width shoes, which aren’t always available — or attractive.

Vexing as she finds that, Cintron is thankful to have avoided the foot pain that many women suffer. But some of those women willingly endure the pain — much to the chagrin of podiatrists.

That a 2014 survey of 1,000 women published in Today’s Podiatry showed that 49 percent of women wore high heels; of those, 71 percent had foot pain. With high heels, the higher the heel, the more pressure is placed on the ball of the foot.

“Many patients, even knowing that shoes will cause pain, will not change the shoes they buy,” he said. “So I try to minimize the damage. Regarding high heels, I encourage women to look for a lower heel (under two inches) and a wider toe box to lessen the pressure on the foot. Some women can tolerate buying a shoe a half-size larger, which gives them more room in the toe box.

“Sometimes having a metatarsal pad added to the shoe for cushioning helps. I also encourage women to limit the amount of time they spend in very high heels — if they are going out for an evening and want to wear a dressy shoe for a few hours, fine. But don’t try to make it all day in a very high-heeled shoe.”

Gruttadauria said women might develop pinched nerves in the ball of the foot because of the increased arch height, especially in a shoe with a narrow, pointy toe box.

“Using heels chronically can cause long-term problems, too, especially shortening of the Achilles tendon,” he said.

The other end of the spectrum, no heels, can cause problems, too (as Cintron learned). You should limit the time you wear flip-flops, Gruttadauria said. And he advises patients to look for ones with a molded foot pad, which offers a little more support.

“If you’re on vacation in the summer, don’t try to go on touring hikes or walk the boardwalk in them all day,” he said.

Besides high-heels and flip-flops, what shoe styles invite trouble?

  • Pointy-toe shoes that squeeze toes into too small a space, twisting, bending and curling them in ways nature never intended.
  • Platform shoes that have a rigid foot bed, preventing the foot from bending the way it needs to.
  • Plastic jelly shoes that don’t let the foot breathe, increasing the chance of fungal infections.
  • Any shoe that’s too tight.
  • Size matters

By some estimates, 90 percent of women wear shoes that are too small — some because they can’t stand the thought or look of wider, longer feet, and others because their shoes fit when they bought them, but suddenly don’t at another time. That problem, Carbone said, can be avoided by trying on shoes in the afternoon when feet are a bit swollen. Feet are at their smallest in the morning, which means shoes bought then will be tight by mid-afternoon.

Whether it’s vanity or an error, the impact of tight shoes can’t be overstated, given the painful bone and nerve damage they can cause.

Carbone’s go-to advice for foot pain is to wear shoes that fit right.

“If someone comes in with a terribly crooked second toe, corns, ulcerations, I’ll tell them to wear shoes with bigger toes boxes. Unfortunately, some patients won’t go for that,” he said.

“If someone won’t alter their physical activity or their shoes, their foot pain won’t get better.”

One of the more common painful foot maladies is plantar fasciitis, an inflammation of the thick band of connective tissue that stretches from the heel to the ball of the foot. Wearing shoes that support the arch area limits the pressure on the heel, preventing the painful inflammation.

Treatment ranges from icing, stretching and anti-inflammatory medication to surgery to lengthen the fascia, Carbone said.

No pain, no surgery

Unless you’ve done it yourself, you might be surprised to hear that podiatrists see numerous patients asking for foot surgery.

“We’ll have women who literally want to have surgery to fit into a certain shoe that’s how far some women will go to wear a shoe they love,” Gruttadauria said.

Carbone said surgery is an option if pain doesn’t respond to conservative treatment.

“But, if you’ve got a crooked toe, you shouldn’t have it broken to straighten it just to make it look better,” he said. “It might end up hurting after surgery if you do that.”

The good news …

Another summertime favorite is going barefoot, and Carbone said that, in moderation, walking in the sand without shoes has its benefits: It works the muscles and helps rub off the hard skin on the bottom of feet.

There is a “but,” however …

“The introduction of foreign objects is the biggest risk, especially for people with diabetes and peripheral neuropathy, because they can step on something without feeling it,” he said. “That’s how people end up with terrible conditions.”

Go-to shoe advice

Overall, there are things you can do to protect your feet from shoe-inflicted damage.

  • Make sure new shoes bend at the toe box but aren’t too flexible.
  • Don’t assume that an expensive shoe is the right shoe for you.
  • Consult a doctor about foot pain, “especially if it doesn’t resolve quickly with a change in shoe or a change in activity,” said Dr. Gruttadauria of UR Medicine.
  • Get your foot measured periodically to be sure you’re getting the right size shoe (shoe size can change over the years).
  • Don’t try removing thick calluses on your own. “One of the biggest things we see is people going to the store and buying callus or corn removers and inadvertently burning a wound on their foot,” Gruttadauria said.
  • Consult a podiatrist before buying an orthotic to be sure that you’re getting the right one for your specific condition.
  • Pedicure primer

Summer is pedicure season, too, so Dr. Michael Gruttadauria said there are a few things to keep in mind:

  • Nails can pick up the pigmentation of polish and any chemicals that are in the polish, which will make them more prone to flaking. So, let your nails remain unpolished for a while between pedicures to reduce the risk of fungus.

  • Don’t make a pedicure a one-stop foot-care visit. Letting a pedicurist remove corns and calluses and address ingrown toenails can cause bigger problems. “I worry about infections,” Gruttadauria said. He advises women to leave those treatments to a medical professional.

 

 

 

 

 

What Are the Qualifications of a Podiatrist?

Podiatrists are allied health professionals who specialise in conditions pertaining to the feet, ankle and lower legs. They also provide preventative care and advice on how to improve mobility, independence and the quality of life for their patients.

As a podiatrist you would treat a wide range of defects, injuries and infections of the lower leg and foot including ingrown toenails, bunions, corns and calluses. You would also treat foot and nail conditions associated with other major health disorders such as diabetes or oedema. Prescribing and making orthotic inserts for patients is also part of a podiatrist’s responsibility. Orthotic inserts provide patients with the additional support they need to help them walk without discomfort.

Having expert knowledge of the mechanics of the body is absolutely necessary in order to preserve and restore movement in patients.

Typical tasks would include:

Diagnoses, assessment and treatment of injuries, abnormalities and diseases related to the lower limb and foot in individuals across all age groups

Providing advice and treatment for high-risk patients such as the elderly and those with higher risk of amputation

Employing appropriate therapeutic or surgical techniques to treat foot and lower leg issues

Using different types of equipment from dressings and surgical instruments to X-Rays, lasers, grinders, treatment tables and shaping equipment

Prescribing, ordering and fitting orthotics and other mobility aids when necessary

Educating patients on matters concerning foot health

Podiatrists work closely with other medical practitioners including physicians, nurses, physiotherapists, occupational therapists and complementary practitioners in order to provide patients with the most comprehensive treatment.

Foot problems and the podiatrist

What does a podiatrist do?

Podiatrists are health care professionals who have been trained to prevent, diagnose, treat and rehabilitate abnormal conditions of the feet and lower limbs. They also prevent and correct deformity, keep people mobile and active, relieve pain and treat infections.

They can give you and your family advice on how to look after your feet and what type of shoes to wear. They can also treat and alleviate day-to-day foot problems, including:

toenail problems, such as thickened, fungal or ingrown toenails

corns and calluses

verrucas

athlete’s foot

smelly feet

dry and cracked heels

flat feet

bunions

heel pain

ageing feet

blisters

gout

sports injuries

How can a podiatrist help?

You may want to see a podiatrist for advice and treatment if you have painful feet, thickened or discoloured toenails, cracks or cuts in the skin, growths such as warts, scaling or peeling on the soles, or any other foot-related problem.

Podiatrists can also supply orthotics, which are tailor-made insoles, padding and arch supports to relieve arch or heel pain. You put the orthotic device into your shoe to re-align your foot, take pressure off vulnerable areas of your foot, or simply to make your shoes more comfortable.

Even if your feet are generally in good condition, you might consider having a single session of podiatry to have the hard skin on your feet removed, toenails clipped, to find out if you’re wearing the right shoes (take your shoes with you for specific advice on footwear) or just to check that you’re looking after your feet properly.

Podiatrists can also help with more complex foot problems including preventing, diagnosing and treating injuries related to sports and/or exercise.

What’s the difference between a podiatrist and a chiropodist?

There’s no difference between a podiatrist and chiropodist, but podiatrist is a more modern name.

 

Toenail Fungus: Is there a cure for it?

Nail fungus, also known as onychomycosis, is the nightmare for every big buck pedicure. It starts with an almost unnoticeable yellow or white spot on your toenail but as it spreads and goes deeper, it becomes more visible. The fungus will cause your toenails to become thicker, with the edges crumbling, and to discolor – a yellowish taint that looks as if the nail has rotten.

Fortunately, mild case of this common condition does not require treatment. However, if it has made the nail thicker and has grown painful, it has to be treated. You will have to stop it from spreading throughout your feet, and causing other conditions like athlete’s foot to develop. To help your toenail fungus, here are some of the most remedies.

Traditional Medication

The go-to for most fungal conditions are nonprescription products that you can research or ask your doctor about, but if those do not work, some of the other traditional drugs prescribed are listed below. You can try one or combine it with another product to increase the potency.

  • Oral antifungal medication

What this drug aims to do is grow a completely new and healthy nail to replace the one which was infected by the fungus. It takes 2 to 3 months for the product to work, and you won’t see how effective it is until the new nail grows fully.

Antifungal nail polish

This takes longer to take effect than oral medication because it takes at least year of use before you can see visible effects and to really kill the fungi. To use the product, you’ll have to paint your infected nails with the product daily, adding a new coat over the previous day after day. On the 7th day, you’ll wipe away all the layers with alcohol, and start a fresh batch of layers.

  • Antifungal nail cream

The thinner the nail upon application, the better the results, so it’s best soak your nails first in water, then apply the cream to the infected nails. This is often prescribed along with other topical creams to hasten the removal of the fungus.

Surgical Procedures

If the fungus proves to have spread and has now become severely painful and unresponsive to traditional medication, you can try nail removal surgery. This will facilitate the growth of a new nail, and will at least stop the pain and spread of the fungus. The new will take a while to grow though. In some cases, it takes over a year.

You can also try newer approaches like a laser or light therapy. These are not as common, but what the procedure does is kill the fungi, at the same time, enhance the growth of the new nail.

Apart from these, there are also home remedies you can try like soaking your feet in cornmeal paste or dabbing tea tree oil to the infected toenails. These are fairly cheap and accessible alternatives to the treatments mentioned above.

 

What is Raynaud’s Disease?

When the smaller arteries of your body which is responsible for supplying blood to your skin shrink, it limits blood circulation in those areas. That causes the affected areas of your body – like your fingers or toes – to feel cold and numb. This is often experienced when your body is subjected to extremely cold temperatures or to stress. That particular condition is called the Raynaud’s disease.

It’s more often observed in women than in men, and are far more common in areas where there are colder climates than in the tropics. For most, this disease is tolerable at best, but destructive to one’s quality of life at worst.

What are the symptoms of Raynaud’s disease?

How visible and constant the symptoms are depend the duration and frequency of exposure and the severity of the blood vessel spasms. Some of the symptoms are the following:

Cold fingers or toes
Stinging pain when you warm yourself, especially on your extremities
Numb and prickly feeling on your skin upon relieving stress, like getting a foot massage to relax.Changes in skin color when the it’s cold or you exert stress on it

There are also some changes that happen in stages, like before the finger or toes turn blue and numb, it turns white first. As you slowly infuse some warmth back to your body, you will notice the skin change to red. It will accompanied by this tingling or throbbing feeling and in some instances, your fingers and toes will swell. However, it is important to note that people do not go through the exact same changes. Others will go through all 3 colors, some just one.

Usually, Raynaud’s disease only affects your fingers and toes, but in some rare cases, it also affects ears, nose, nipples and lips. It should take at least 15 minutes of warming up to go back to normal. If you have a case of severe Raynaud’s disease, then see a physician right after a sore develops. That could quickly turn into an infection that spreads through your fingers and toes.

What are the causes of Raynaud’s disease?

There are a lot of speculations as to the different causes of Raynaud’s disease. The reason being is that doctors do not completely understand the nature of the condition yet. All they know is that the blood vessels in the hands and feet are overly sensitive to severely cold temperatures and stress.

What are the two kinds of Raynaud’s disease?

Raynaud’s disease has two variations: primary and secondary. The former is the disease’s most common form and is associated with the medical condition that incites vasospasm or the cutting off of blood circulation because the arteries shrunk.

The latter is caused by other underlying issues with arteries and is far less common than its counterpart. It also tends to be harder to treat and is a bit more a serious, especially in the manifestation of symptoms and how they affect the patient’s quality of life. This variation of the condition often appears later on in life, typically 40 and above.

Tips For Finding The Right Exercise Shoes

Getting into regular physical activity keeps us in good shape and reduces our chances from developing chronic diseases like diabetes, heart disease, and even cancer.

One of the most basic things needed when getting into any physical activity is a good pair of shoes. When it comes to exercise shoes, one should consider more than just the looks. After all, our choice can greatly affect the way we move and can determine whether or not we will end up with foot injury.

Here are some tips for finding the right pair of shoes for your feet:

Buy shoes designed for a specific sport

If the main purpose of buying shoes is for a specific activity (i.e. running, tennis, football, etc.), then you should buy shoes designed for that specific sport. Because these shoes are designed for that specific purpose, they will more likely provide your feet with better support.

Go shoe shopping towards the end of the day

The pressure on your feet will make them swell towards the end of the day. Hence, buying shoes in the morning is not a good idea as well-fitted shoes may end up to be too tight for you.

Look for shoes with sufficient support

This simply means that you should pick shoes with the insole that absorbs the pressure. If you cannot find shoes that provide enough support, then you may want to get orthotic inserts. These inserts are specially designed to keep you from experiencing foot pain. You can ask your physician for customized orthotic inserts.

Find shoes that suit the way you run

Running shoes are not created the same. This is because runners have different forms of feet and length of arches. Overpronators tend to roll their feet inwards when running while supinators tend to roll their feet outwards. You should consider then when buying running shoes.

Consider where you’ll be using your shoes

Shoes used in the woods are different from the shoes to be used in the tennis court. So you have to think where you’re more likely to be using your shoes. If you’re using it outdoors, then you’ll have to choose a pair with better grip.

Try the shoes on

A good way to test whether the shoes suit you well is to try them on and move around. Your feet should feel comfortable while wearing them.

Many people give up with their promise of doing more physical activities simply because the shoes that they have are either uncomfortable or are causing them pain. So don’t rush when buying shoes. Take time to examine them and trying them on to see if they’re the right pair for your feet.

Podiatry practice kicks in to help the homeless

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Country Foot Care is adding another name to the long list of charitable partners it’s garnered in 32 years.

The podiatry practice  with offices in Mineola, Williston Park and Patchogue announced Monday a partnership with California-based non-profit Shoes for the Homeless to help put shoes on the feet of homeless people on Long Island.

“The idea is to get the communities that we practice in involved so that rather than them tossing away their shoes that might not be stylish anymore, they could actually help somebody who really needs them,” said Dr. Steven Brook, Country Foot Care’s owner and founder.

The practice is donating $1,000 to Shoes for the Homeless and plans to start holding shoe drives early next year to help the organization establish a base in the New York metro area, County Foot Care’s Dr. Elizabeth Piselli said.

The group was founded by podiatrist Dr. Ira Diamond and is well known in the field, Piselli said. Its work is important, she said, because footwear can prevent many foot problems doctors see among homeless people.

“We just know that so many things can be avoided just by proper shoes that don’t have holes,” Piselli said.

The homeless populations are growing in Nassau County and Suffolk County, where Country Foot Care’s Patchogue office opened Dec. 4.

Long Island’s homeless population has increased from 3,123 people in January 2013 to 3,860 in January 2015, according to statistics from the Long Island Coalition for the Homeless.

“We just feel compelled to help,” Brook said.

Country Foot Care supports several other charities, including Habitat for Humanity, Disabled American Veterans and about a dozen animal welfare groups, Brook said.