Is Plantar Fasciitis (Heel Pain) common? Dr. Wellens has the answer.

Plantar fasciitis, or heel pain, is probably one of the most common conditions that I see in my office. In fact, approximately 40%-60% of all patients that I see are due to some sort of heel pain. In Florida, I also find it more seasonal as Floridians wear a lot of flip-flops in the summer that provide absolutely no arch support and therefore are more likely to develop heel pain.

In the United States, approximately 2 million Americans seek medical attention annually due to plantar fasciitis. It is one of the most common musculoskeletal problems in the human body. 10% of people in the world will suffer from plantar fasciitis in their lifetime. Statistics are on our side as only about 5% of patients who have this condition will end up having to have surgery. There are multiple studies that show that just a combination of foot orthotics and night splints reduces pain by 50%.

Depending on the level of pain in the heel, Cortisone injections sometimes are necessary to help with healing process. Many studies have shown that functional orthotics prevent plantar fasciitis from coming back. A lot of my patients start experiencing heel pain 3 to 4 years after they have seen me and have received a pair of orthotics because they are starting to wear out and they need a new pair. Even if nonsurgical treatments do not work, there is a light at the end of the tunnel. There is a new procedure called Tenex that has success rate of close to 95%.

Central Florida Foot and Ankle Center
101 6th St Nw Winter Haven, Fl 33881
Phone: (863) 299-4551
www.FLFootandAnkle.com

Insight on Insoles

Have you noticed that removable flap of material that lies inside those shoes you have just bought? Sometimes you may have noticed that this piece of material has come loose and has bunched itself deep into the shoe. Why is such a section of material necessary? Exactly what is it?

That shoe-bottom shaped material is called an insole.

Insoles or otherwise known as foot care orthoses are tools that podiatrists can use to help to cushion the foot and help to correct the biomechanics of your gait. They may also be used to alleviate pain, maintain and support the arch of your foot, accommodate foot deformity, and to relieve pressure.

The world of insoles is populated by devices in all different sizes, various shapes and a vast multitude of colors! They also have different classifications depending on their function. Foot care orthoses (especially custom made devices) work by slightly changing the angle that your foot strikes the ground. As a result, the biomechanics of your foot are slightly altered to better address the foot pathology that you may be experiencing.

In typical store bought shoes, the insoles you find really only have the purpose of cushioning your feet. However, specialized insoles can be made to deal with your problems and improve your ability to walk and maintain proper foot posture.

What goes into determining whether an insole is right for you?

Biomechanical evaluation
X-rays
Casting

A biomechanical evaluation consists of a series of objective measurements of the movement of the joints in your hips, knees, ankles and feet. Since your feet and their impact directly affects all the joints in your leg, it only makes sense to measure all of the body parts involved to accurately gauge what kind of insole will work best for you. This evaluation also involves a gait analysis so that your podiatrist can see how you walk without them and see if corrections need to be made. X-rays will give your doctor an internal look into the bone structure to verify some of the elements suggested by the biomechanical evaluation. Finally, a cast either in plaster or fiberglass is done to get an impression of your foot in its neutral position. Finally, all the measurements and casts are used to assemble your custom orthosis!

Insoles are a great non-invasive way to get you walking and functioning correctly! Talk to your podiatrist if this is a treatment right for you!

The majority of foot problems are associated with malalignments or imbalances in your feet. Problems that you may experience may include pain, fatigue, and/or deformity. Orthoses are a non-invasive way to correct those imbalances and help you stride in comfort.

Insoles are made of strong materials that can be subjected to the repetitive stresses of your body weight and the impact of the ground upon them without wearing down quickly. They are best used in close-toed shoes that will prevent them from sliding or slipping out! The beauty of these orthoses is that they can be transferred from one close-toed shoe to another. So for individuals that play a variety of sports, these devices can easily be placed into all your athletic foot gear!

Orthoses are durable and are not likely to be replaced if you are receiving them as an adult. As an adult, your bones and the resulting foot structure are probably at the point where significant change will not occur. Children who are prescribed orthoses for their foot pathologies will need new prescriptions due to their rapid foot growth. Orthoses may eventually see some wear and tear to them, and they can be refurbished if necessary.

If both you and your doctor feel that orthoses are the right therapy for your ailments, here are some factors that you might want to consider in order to get the most out of your treatment.

- Bring your shoes to your podiatrist’s office when you are called in to pick up your orthoses. This is a good way to make sure that the doctor sees these insoles properly fit in your shoes. If minor adjustments need to be made, your podiatrist will be qualified to make them.

- Whenever you go shoe shopping, make sure to bring your orthoses with you (along with the socks that you plan on wearing with the shoes).

- Make sure that you return for the follow-up appointment with your podiatrist for an evaluation of your orthoses. Your doctor will be able to ensure that that both your orthoses and your feet are in sync with each other.

As far as insoles go, there are so many options that podiatrists can choose from to suit your needs. nsoles are grouped into classifications depending on their material and subsequent function. The basics of orthoses and their categories are as follows:

Rigid Orthoses

These insoles are called rigid because they are made of a stiff material like carbon fiber or plastic. Such devices are primarily used in controlling foot function. Rigid orthoses can run from heel to the ball of the foot or from the heel to the toes. These insoles are supposed to be used in close-toed shoes which are mainly used in walking.
Rigid orthoses are durable devices are inflexible and resistant to deformity. They are hard to break and do not change their shape. Their major role is to control the motion in the two foot joints following the ankle. They are usually constructed for patients experiencing ailments in the legs, thighs or lower back. In addition, if a patient has a slight limb length discrepancy (one limb is longer than the other) these orthoses can be considered to help with gait and posture.

Semi-rigid Orthoses

This class of orthoses functions to maintain foot balance during sports activities. This type of insole helps muscles and tendons of the foot to perform efficiently and guides the foot through functions. The soft material layers are strengthened by the rigid materials giving the insole the nature of flexibility and stiffness.

Soft Orthoses

The materials that make up this type of insole are soft, moldable and compressible. As a result of these orthoses being easily deformed by pressures, they are not as durable as rigid orthoses and need to be replaced more often. Soft insoles have multiple purposes: ease pressure off of certain foot areas, enhance balance and absorb impact.
This class of orthoses are particularly suited for individuals with deformed feet where there is not protective tissue to help with shock absorption, arthritic patients, and people who have diabetes. Soft insoles are constructed with layers of soft materials making them substantially bulky. As a result, deep shoes or prescription footwear are necessary to accommodate these orthoses.

Central Florida Foot and Ankle Center
101 6th St Nw
Winter Haven, Fl 33881
Phone: (863) 299-4551
www.FLFootandAnkle.com

Foot Circulation

When you walk into an appointment with your podiatrist, you may have noticed that observation plays an important part in their evaluation of your foot health. Before the doctor even touches you, they are looking at the color of your skin, its hydration and the presence of hair. Why?

Biologically the skin is the largest organ on our bodies and many problems can be detected just by assessing it. For example, skin color is directly related to the amount of blood circulation in that area. If blood circulation to the foot is normal, the skin will appear a healthy pink. Another indicator of good circulation is the presence of hair on your toes and feet. The doctor takes all this into consideration when determining your foot health.

When the doctor starts to touch your feet it is to feel for skin suppleness, skin temperature, and pulses. Good circulation to your feet means that all the tissues of your feet such as the bones, muscles, ligaments and skin are able to get essential nutrients and oxygen to help them survive. Nutrients and oxygen are essential for cell repair and vitality. In addition, waste products made by these tissues will be carried away the blood to be expelled from the body. Blood flow to your feet also helps to keep skin supple and brings warmth to your feet.

Arteries are the blood vessels that take blood pumped by the heart to different areas of the body. They are direct extensions from the heart and just as the heart has a beat, so do the arteries. However, an artery beat is referred to as a pulse. With proper blood flow and unobstructed arteries your feet will get the nutrients it needs and the doctor can detect this by feeling your pulses.

What factors or ailments can lead to poor foot circulation?
Smoking
Obesity
Inactive/sedentary lifestyle
Diabetes
Increased age

If you feel that you may have poor circulation in your feet, it is important to see your podiatrist as soon as possible. Inadequate circulation to the feet may lead to very serious complications. Talk to your podiatrist on ways to manage and improve your foot health!

Central Florida Foot and Ankle Center
101 6th St Nw
Winter Haven, Fl 33881
Phone: (863) 299-4551
www.FLFootandAnkle.com

How to Cut Your Toenails

Clipping toenails – it seems like an everyday, mundane task, but the technique behind it is more important than you may think. Improper technique can lead to pain, ingrown toenails, and infection. What follows are tips on how to cut your toenails to avoid some of these problems.

§ If you have diabetes, or any other problems with circulation, it is important to have a trained professional do this work for you. A healthcare professional, like a podiatrist, will help you avoid injury and infection that is very common with diabetic patients.

§ Use the proper equipment. Toenail clippers are wider than fingernail clippers. They are made to handle the wider and thicker nails of the foot. You can keep your toenail clippers clean by disinfecting them with some rubbing alcohol before and after use.

§ Straight Cuts. You want to cut straight across the edge of the toenail, without curving the corners. This will help you to avoid ingrown toenails, which is when the corner of the nail grows into the skin. Also, keep your nails a little long. Cutting the nails too short is another way to get ingrown toenails, plus it can really hurt.

§ A Few Small Cuts. Don’t try to get the whole nail in one clip. Instead, make a few, smaller cuts across the whole nail. This will give you more control, and you’ll be able to shape the nail a whole lot easier, without getting into the corners.

§ Cut When Dry. Cutting your nails when they are wet, such as after bathing, is never a good idea. Wet nails are much easier to rip and tear, which can lead to cutting the nails to short, or tearing at the nail matrix, the living tissue underneath the nail. Instead, trim your nails when they are dry, perhaps before bathing.

§ One Way Filing. If you like to file your nails, file in one direction, straight across the free edge of the nail. Filing can be an easier way to trim the nails, and an easier way to shape them so they look nice.

§ Don’t Cut the Cuticles. This can lead to infection, irritation, and pain. If you want to do anything to them, use a cuticle stick to push them back a little bit, but be careful not to dig into the skin. You can buy a cuticle stick at most pharmacies.

§ Timing may vary. Different people’s toenails grow at different rates. One person may have to trim them once a week, while others can go several weeks between trims. When you think it’s time to trim them, go ahead. Just be careful not to trim them too short.

Follow, these steps, and you’ll be well on your way to a healthy nail regimen. If you have any additional questions or concerns, or if you notice any changes in the nail, contact a local podiatrist. Changes in the nail can often indicate disease, and should be dealt with promptly.

Central Florida Foot and Ankle Center
101 6th St Nw
Winter Haven, Fl 33881
Phone: (863) 299-4551
www.FLFootandAnkle.com

Athlete’s Foot

Athlete's foot, or tinea pedis, is a fairly common condition of the feet.  It is a fungal infection of the top layer of skin, most commonly caused by the fungus Trychophyton.  The condition is characterized by itching, flaking, and scaling of the affected area of skin.  Additionally, blistered or cracked skin may lead to raw, painful skin, or a secondary infection due to an opening in the skin.   

The feet are the most commonly affected area of the body, usually on the bottoms of the feet or in between the toes.  In particular, the area between the fourth and fifth toe is especially susceptible.  The condition can also be spread to other areas of the body, such as the groin.

            Diagnosis of athlete’s foot is generally done by a podiatrist or a general practitioner.  This involves ruling out other possible causes, such as bacterial infection or other conditions.  Fungal infections of the toenails are commonly associated with the condition as well.

            Athlete’s foot is transmitted from person to person in moist areas, such as public bathrooms and showers, pool decks, or locker rooms.  Prevention of tinea pedis is considered the best treatment.  Methods of prevention include wearing flip-flops or shower sandals in wet or moist areas where lots of people are walking.  This will prevent the fungus spores from getting on your skin.  Also, be sure to wash and dry your feet thoroughly.  Fungus thrives in moist, dark areas, like a pair of damp socks.  Pools and locker room staff will frequently disinfect the floors with an anti-fungal soap to prevent transmission. 

            Another good method of prevention is to change you socks frequently, especially after exercise.  Avoid sharing socks or shoes with people, as this can be a very easy way for the fungus to spread. 

            If you have athlete’s foot, there are some treatment options.  Topical treatments are common, such as sprays and creams.  These treatments will reduce the itch of athlete’s foot, but will generally not cure it on their own.  Oral anti-fungal medications have proven effective, but can often take six months to a year to show complete clear up. 

            There are some less conventional methods of treating athlete’s foot, some of which have shown to be effective, and some of which are simply myths.  The use of onion and garlic extracts has been shown to help fight a fungal infection, as well as vinegar or baking soda (But NOT together!).  Hairdryers have been used to dry the feet especially, the spaces in between the feet.  In theory, this would help against fungal growth, but watch out for burning your toes.  It has been rumored that urinating on your feet will clear up and prevent athletes foot.  There is no evidence for this method to be effective.

            The bottom line is that prevention is much more effective than treatment.  If you suspect you may have athlete’s foot, or are having problems with your feet, contact your podiatrist or general doctor.

Central Florida Foot and Ankle Center
101 6th St Nw
Winter Haven, Fl 33881
Phone: (863) 299-4551
www.FLFootandAnkle.com

Heely Craze

Heelys – they’re everywhere.  You can see them in shopping malls, schools, and playgrounds across the country.  They’re all the rage with kids, and over 4.5 million pairs have been sold globally since their introduction to the market in late 2000.  So what exactly are Heelys?

            Heelys, manufactured by Heeling Sports, Ltd in Carrolton, Texas, are a popular shoe with one or two wheels embedded in the sole.  The wheels are positioned in a way to allow the user to either walk normally, or to shift their weight to the back of the shoe and roll as if they were wearing a roller skate.  But how normal do they actually let you walk?

            A recent study conducted by researchers at the Center for Lower Extremity Ambulatory Research at the Scholl College of Podiatric Medicine investigated this very question.  The study looked at how a person wearing Heelys changes the way that they walk while wearing the shoes.  The research project was a case study, meaning that there was one subject that tested the Heelys. 

            The study found that the biomechanics of the individual wearing the Heelys was altered significantly.  The pressure that the individual was applying to the front of their foot was much greater than when wearing a normal athletic shoe.  This leads to a greater amount of stress put on the front of the foot, which may lead to biomechanical problems or injuries related to chronic-use of Heelys.  The shoes cause the wearer’s balance to change, which may explain the number of injuries reported by kids falling backwards while wearing the Heelys. 

            The research paper’s findings point out that the wheel in the shoe causes the individual wearing Heelys to shift their weight, causing the increased pressure on the front of the foot.  This has a great effect on the gait cycle, or normal walking pattern, of the individual, even with the wheel tucked inside the shoe.  This change in gait pattern may possibly lead to further gait abnormalities, as well as foot deformities associated with long-term use.  The study suggests that the shoes may be a fun and exciting recreational activity, but should not be used as an everyday athletic shoe.  This study was published in the Journal of the American Podiatric Medical Association (JAPMA), volume 99, number 3.

            With over 40 different pairs of Heelys to choose from, there are plenty of styles to choose from.  The website offers tips on how to wear them, how to ride on the wheels, and even how to do some tricks.  It’s easy to see why Heelys have become so popular, especially with young kids.  They may not be the best shoes for everyday use, but they sure are a fun way to get around.  For more information on Heelys, you can visit their website at www.heelys.com.

Central Florida Foot and Ankle Center
101 6th St Nw
Winter Haven, Fl 33881
Phone: (863) 299-4551
www.FLFootandAnkle.com

Picking the Right Shoes for You! (Part 2)

Shop Late in the Day.  As we walk around all day, our feet swell a bit.  The same things happens when we run or walk for a distance.  It is for this reason that you’ll want to shop later in the day, when your feet have increased a bit in size.

Allow For Wiggle Room.  A proper-fitting running or walking shoe has about 3/8-1/2 inch of space between your longest toe and the edge of the shoe.  This amount of space is about the width of a thumb, so you can use your thumb to measure this space very easily.  You should be able to freely wiggle your toes inside of the shoe, but the heel should be somewhat snug.  Avoid getting a shoe that slips on your heel – this will cause blisters and will make you less stable while walking or running. 

Wear Socks.  Wear the socks that you plan on running or walking in.  Different socks have different weights and thicknesses, and this should be taken into consideration when trying on shoes. 

The most expensive shoe on the wall is not necessarily the best.  Shoes come in so many varieties because there are so many varieties of feet.  Understand what makes a shoe expensive, and what makes a shoe cheap.  There are many materials that shoe companies put in their product, like high-end gel inserts in the heel, or seamless interiors.  The best shoe for you will be the one that fits you the best.  If the ultra-cheap, $15 shoes don’t feel right, don’t sacrifice your comfort for economics.  Those $15 shoes, if they don’t fit you properly, could cost you a lot more when you’re suffering from pain.  On the same note, don’t go for the super-expensive, $200 pair with lots of bells and whistles that you may not need.  If this shoe doesn’t fit as well, it’s not as good of a shoe for you. 

Breaking in is Bad News.  Both running shoes and walking shoes should be ready to go, without breaking them in.  Don’t get a shoe if it’s not comfortable out of the box, and don’t let anyone talk you into breaking them in. 

Replace As Necessary.  Running shoes and walking shoes typically last for around 350-400 miles.  This number may vary, depending on the terrain you run through, your body size, and the frequency that you run or walk.  If the soles are worn out, or they don’t feel as supportive as they used to, it’s probably time to replace them.  

Central Florida Foot and Ankle Center
101 6th St Nw
Winter Haven, Fl 33881
Phone: (863) 299-4551
www.FLFootandAnkle.com

Picking the Right Shoes for You! (Part 1)

Running and walking are some of the best and easiest forms of exercise around.  They let us walk out of our front doors and begin exercising immediately.  At their very core, they are simple activities – perhaps herein lies their appeal. 

            But with so many different types of walking and running shoes out there, how do we know which one is right?  Here are a few tips to picking out the right pair of athletic shoes for you.

Walking shoes are for walking; Running shoes are for running.  It’s as simple as that.  When you have a shoe that you use for both activities, you open yourself up to problems with biomechanics, which can lead to pain or injury.  A walking shoe typically has a wider base than a running shoe, and a running shoe will be angled up at the front to allow for a faster stride.

Know your foot type.  In other words, know the shape of your foot.  A really simple way to measure this is with something known as the wet test.  With a wet foot, step on a towel, piece of paper, or anything that will allow you to see your footprint.  What does your foot look like? 

·         If you have an outline of your entire foot with little or no curve on the inside edge, you have low arches.  You may also notice on an old pair of shoes that you have worn out the inside of the sole of the shoe much more than the outside.  You are probably over-pronating, which is the body’s natural way of distributing the forces of walking and running evenly.  Look for a shoe with lots of support and motion control.  This will give your feet the optimum position while walking or running. 

·         If you have an outline of your foot that shows a lot of the forefoot and the heel, with a little thin strip connecting the two, you have a high arch.  You may also notice on an older pair of shoes that you are wearing the outside of the sole of the sole much more than the inside.  In this case, you are under-pronating, or suppinating.  You’ll want a shoe with lots of cushioning, as you tend to put more weight on the outside of your foot.   

·         If you’ve done the wet test and you have a nice curve on the inside of your foot, you have a neutral arch.  Look for a shoe with the right mix of cushioning and support, sometimes referred to as a “stability” shoe.

Size Matters.  More specifically, a change in size matters most.  Our feet, even as an adult, change size.  Have your feet measured, at least once a year.  Also keep in mind that size may differ from one brand to the other.  A size 8 in one brand may not be a size 8 in another brand.  Go with what fits, not the number on the box.

Central Florida Foot and Ankle Center
101 6th St Nw
Winter Haven, Fl 33881
Phone: (863) 299-4551
www.FLFootandAnkle.com

Looking for a good collection of quotations about walking? Look no further! Here is a compilation of walking quotes:

"Me thinks that the moment my legs begin to move, my thoughts begin to flow.” ~Henry David Thoreau

“When you have worn out your shoes, the strength of the shoe leather has passed into the fiber of your body.  I measure your health by the number of shoes and hats and clothes you have worn out.”  ~Ralph Waldo Emerson

“Climb the mountains and get their good tidings.  Nature's peace will flow into you as sunshine flows into trees.  The winds will blow their own freshness into you, and the storms their energy, while cares will drop off like autumn leaves.”  ~John Muir

“Everywhere is walking distance if you have the time.”  ~Steven Wright

“Make your feet your friend.”  ~J.M. Barrie

“My grandmother started walking five miles a day when she was sixty.  She's ninety-three today and we don't know where the heck she is.”  ~Ellen DeGeneres

“The true charm of pedestrianism does not lie in the walking, or in the scenery, but in the talking.  The walking is good to time the movement of the tongue by, and to keep the blood and the brain stirred up and active; the scenery and the woodsy smells are good to bear in upon a man an unconscious and unobtrusive charm and solace to eye and soul and sense; but the supreme pleasure comes from the talk.”  ~Mark Twain

“All truly great thoughts are conceived by walking.”  ~Friedrich Nietzsche

“The sum of the whole is this: walk and be happy; walk and be healthy. The best way to lengthen out our days is to walk steadily and with a purpose.”  ~Charles Dickens

“The best, the most exquisite automobile is a walking stick; and one of the finest things in life is going on a journey with it.”  ~Robert Coates Holliday

“In walking, the will and the muscles are so accustomed to working together and performing their task with so little expenditure of force that the intellect is left comparatively free.”  ~Oliver Wendell Holmes

“Walking is man’s best exercise.” ~Hippocrates

"Many people nowadays live in a series of interiors...disconnected from each other. On foot everything stays connected, for while walking one occupies the spaces between those interiors in the same way one occupies those interiors. One lives in the whole world rather than in interiors built up against it."  ~Rebecca Solnit (Wanderlust: A History of Walking)

“If you are seeking creative ideas, go out walking. Angels whisper to a man when he goes for a walk.”  ~Raymond Inman

Central Florida Foot and Ankle Center
101 6th St Nw
Winter Haven, Fl 33881
Phone: (863) 299-4551
www.FLFootandAnkle.com

Not-So-Sunny Summer Shoes! Part 1

In order to accommodate all the diverse types of feet and personal preferences, footwear companies have developed an eclectic variation of shoes! It is probably safe to say there are more categories and styles of shoes available for women than there are for men! It probably comes as no surprise that a certain segment of the population (women, in particular are notorious for this) choose shoes based on their aesthetics first, comfort last. Personal taste should not be the only factor when it comes to purchasing footwear. Foot support, protection, and comfort should play the deciding roles! Certain styles of shoes should be avoided since they do not provide the above attributes and thus lead to foot pathologies! 

            The American Podiatric Medical Association conducted a survey and found that 82% of women are willing to sacrifice their foot health in the name of fashion! As much as shoes are considered art, shoes are also pieces of engineering. Each style of shoe has its own anatomy and is designed to accommodate your feet. However, not all shoes accommodate your foot properly or safely. 

Some of this summer’s top fashion trends are some of the worst styles for your feet. They cause problems ranging from minor irritation to bony changes that may require surgical intervention to correct! Despite the many ailments that certain varieties of shoes cause, health professionals have found it very difficult to sway women away from their beloved shoes.  Wearing shoes should not yield stress, pain and/or discomfort and place your foot in jeopardy. It is up to you to follow your healthcare provider’s advice on proper shoe gear and preservation of foot health! The best way to discourage the buying shoes that negatively impact foot health is to illustrate how a shoe can adversely affect your foot! Do not spend money on footwear that will destroy the integrity of your feet! Remember that feasible, fashion-forward shoes are the fad!

Take at the chart look below to see if your shoes match up with any of the styles listed! Check out the possible problems and some handy solutions that will help keep your feet in tip-top shape! 

Central Florida Foot and Ankle Center
101 6th St Nw
Winter Haven, Fl 33881
Phone: (863) 299-4551
www.FLFootandAnkle.com

Shin Splints! Are They Avoidable?

One of the most common injuries that runners suffer from is shin splints.  Shin splints can be a very painful experience, but it is fairly avoidable and very manageable.  What causes the pain is an overloading of the tibialis anterior muscle and the connective tissue that connects this muscle to the bone.  The tibialis anterior muscle connects to the outside of the shin bone, and plays a crucial role in keeping the foot stable while walking and running. 

            Because it is an overuse injury, shin splints are most often treated with “RICE” therapy – that is rest, ice, compression, and elevation.  Resting is most important, because further exercise will only further aggravate the condition.  Icing the area, as well as taking over-the-counter pain relievers such as ibuprofen will help to relieve some of the pain associated with shin splints.  Compression with a sock or specialized compression sleeve, as well as elevating the leg while resting will help as well. 

            In addition to RICE therapy, check the shoes you’re wearing when you get the shin splints.  If you’re running, look at your running shoes.  Do they fit properly?  Are they heavily worn on the bottoms?  Do they support your feet well?  If you’re walking when you get them, are you wearing proper walking shoes?  Sometimes wearing thin sandals while walking long distances can give you shin splints quickly. 

            Shin splints may be painful, but know that they are usually only temporary.  It is no reason to give up the morning walk or run.  One way to prevent getting shin splints to add strength training to your exercise routine.  Strengthening the muscles of the calves can help prevent ever getting shin splints, as these muscles help to balance the activity of the tibialis anterior during gait.  Also, wearing the proper shoes will help give your shins extra cushioning, preventing some of the impact that causes shin splints.  Adding low impact exercise will also help lessen the burden on your body in general.  Try mixing in swimming or biking to your exercise routine, or some low impact aerobics.

            As with any injury or pain that you’re suffering from, it’s important to tell a doctor about it if it doesn’t go away with rest, ice, compression, and elevation.  If the shin pain develops after a fall or other impact, a doctor will need to take x-rays to rule out a stress fracture or other type of injury.  

Central Florida Foot and Ankle Center
101 6th St Nw
Winter Haven, Fl 33881
Phone: (863) 299-4551
www.FLFootandAnkle.com

Are You Drinking Enough Water?

We all know we’re supposed to drink plenty of water, but how much is enough? Various studies have been conducted on the question, but the only consensus has been that water is vital to normal function. Our bodies, on average, are composed of around 60% water, making it the most abundant chemical of the human body.  Water is vital to virtually all of our bodily functions, making it critical to replace the water lost every day.  On average, we lose about 1.5 liters of water per day from urine output, as well as another liter from breathing, sweating, and other bodily functions. 

            One theory of how much water we should drink comes directly from this calculation.  The idea is to replace the water that we lose, approximately a liter and a half.  Another approach to this idea is the general rule of drinking eight 8-ounce glasses of water per day.  This is sometimes referred to as the 8x8 rule.  Still another idea is to follow daily recommended values for water.  These values are about 3 liters per day for men and about 2.2 liters per day for women.  This amounts to about 13 cups per day for men and about 9 cups per day for women.

            Of course, the amounts for all of these explanations are adjusted based on various factors, such as activity level, climate, health conditions or illness, and pregnancy.  For exercise lasting 20-30 minutes, an extra cup or two of water is necessary to replace fluid from sweating.  For longer exercise programs, especially those lasting over an hour, more fluid is needed.  Drinks with sodium and potassium are recommended, as these electrolytes are also lost in great numbers during extended periods of exercise.  Drinks such as Gatorade, Powerade, Vitamin Water, or any other drink containing electrolytes will do.

            In warmer climates or in altitudes of over 8,000 feet, additional fluids are necessary.  Pregnant women will also have an increased demand for fluids, as well as those with a cold or flu.  Symptoms such as diarrhea, vomiting, and fever will increase the body’s need for water as well. 

            Though water is usually the best choice for staying hydrated, other fluids will do as well.  Sports drinks and juice will count towards the daily water intake, as well as soda and coffee.  Even beer and wine will count, though these should not be used as replacements for water. 

            Waiting until you’re thirsty to drink water may not be the best way to keep hydrated.  In fact, your body’s signal that you are thirsty is already a sign that you are dehydrated.  The best way to stay hydrated is by drinking a cup of water with each meal, as well as a cup in between in each meal. 

            A good way to judge whether or not you are getting enough water is to pay attention to your urine.  A healthy person’s urine is clear or light yellow.  If you’d like more help on getting the proper amount of fluids in your diet, you can talk to your doctor or a certified dietician.  

Central Florida Foot and Ankle Center
101 6th St Nw
Winter Haven, Fl 33881
Phone: (863) 299-4551
www.FLFootandAnkle.com

The “Ow” in Ingrown Toenails!

What is an ingrown toenail?

An ingrown nail is defined as when the skin on one or both sides of a toenail develops over the nail edges or when the nail itself grows into the skin.

The medical term for the condition is onychocryptosis. Although it most commonly occurs on the big toe, the lesser toes may also be affected.

What are some reasons for ingrown toenail occurrence and the resulting pain?

Ingrown toenails may be caused by a variety of factors. They can have genetic origins; the nail is just too large for the toe or may be curved, leading to the predisposition of the condition. Or they may be due to trauma to the area such as stubbing your toe, dropping a heavy object or having it stepped on.

Improper clipping of toenails such as trimming too short leads to skin inflammation and shoe friction upon that skin further increases the pain. An impacted toenail can first be seen directly after improper grooming of toenails. The nail looks like it has been cut back too far and there is exposure of the pink tissue around the edge.

 Running often and hard leads to formation of ingrown toenails because the pressure on the toes from the shoes. Wearing tight shoes or shoes too small for the feet also lead to the condition because the toes have no room and the nails are becoming compressed.

How do you know that you have an ingrown toenail?

            Besides causing discomfort and pain, there are other indications that lead to the diagnosis of an ingrown toenail. The signs of a toe with an ingrown toenail are redness, swelling, tenderness and rigidity. In some cases, there may be pus drainage from the area of the impacted toenail. In addition, the condition will not fix itself and the nail will not correctly grow out. The nail keeps growing into the tissue surrounding it and increasing the severity of the pain. When you take a toenail clipper to the nail, it will become harder to trim the nail back. The skin around the ingrown toenail is very sensitive to touch and even contact with socks and shoes will inflict pain! In addition, an ingrown toenail may lead to infection causing further inflammation and pain!

            Read on further for more information on the prevention and treatment of ingrown toenails!  

The “Ow” in Ingrown Toenails! Part 2

Ingrown toenails are a common and uncomfortable foot condition that cause a lot of pain and discomfort. There are many reasons for ingrown toenail occurrence and some of those causes can be eliminated with education and hygiene.

What are ways to prevent an ingrown toenail?

            The most frequent causes of ingrown toenails are improper toenail clipping and tight shoe wear. Both of these reasons can be easily remedied.

Toenail clipping

            Many people are unaware that there is a certain technique involved when it comes to clipping toenails.  Toenails should never be longer than the tips of your toes, but do not cut them too short as to reveal the soft pink tissue underneath. This skin tissue is easily inflamed, causing pain.

When attempting to cut toenails, make sure to use proper toenail clippers. A normal nail cutter has slightly curved cutting edges while a toenail cutter has edges that are straight across in order to reduce the likelihood of ingrown toenails. Observe the natural line of your toenails and when grooming toenails make sure to trim them straight across. Do not round off or cut the corners of your nails or pry the corners when cutting.

Shoe wear

            Proper-fitting shoes are essential for good foot health. Small, tight shoes not only compress the toes and toenails, they do not allow your feet to breathe, lead to foot discomfort, and may even affect the biomechanics of your walking. When shoe shopping, do it in the late afternoon or evening because you feet are at their largest size. In addition, make sure your foot size is measured every time before purchasing shoes to ensure an appropriate fit.

What are treatments for an ingrown toenail?

            There are a variety of non-invasive and invasive (surgical) treatments for an ingrown toenail.

-          Soak your foot in warm water

-          Wear comfortable shoes with a sufficient room for your toes

-          Consider wearing open-toed shoes to prevent shoe material from touching the affected area

-          Take aspirin or ibuprofen for pain relief

As soon as you detect an ingrown toenail make an appointment with your podiatrist! An ingrown toenail may be complicated by an infection, so it is best to leave your problem in their hands. In the case of an infection, your doctor may prescribe oral antibiotics. Surgical intervention may be necessary to remove the offending part of the nail and prevent infection. A partial or complete nail avulsion is a procedure where the doctor injects anesthetic in your toe and then instruments are used to cut away the ingrown toenail portion without disturbing the nail bed. If you follow your podiatrist’s recommendations, you will minimize your discomfort and hopefully prevent the reoccurrence of the problem!       

Central Florida Foot and Ankle Center
101 6th St Nw
Winter Haven, Fl 33881
Phone: (863) 299-4551
www.FLFootandAnkle.com

Stinkin’ Feet!

Everyone has experienced the odor of shoe-confined, sweat-ridden feet! It is a phenomenon that either has occurred to you or to someone around you… and that unpleasant scent has traveled to your nose. Intense foot odor, also known as bromohidrosis, is a problem that millions of people experience every day!

Why does bromohidrosis happen?

            Bromohidrosis is primarily caused by wet, sweaty feet that find themselves confined in close-toed shoe wear. The feet have the most sweat glands than any other part of the body, almost 500,000 glands all together! Unfortunately, when feet are enclosed in shoes – the sweat has nowhere to evaporate and thus stays on your feet and in your shoes!

The warm temperatures and the moisture due to perspiration create an optimal environment for bacterial growth. Bromohidrosis is essentially the metabolic product isovaleric acid caused by the thriving bacteria in your shoes.

What causes sweaty feet?

            The condition of excessively sweaty feet is termed hyperhidrosis and is fundamental cause of foot odor. This disorder affects approximately 1% of the population. Other causes for more than normal perspiration leading to bromohidrosis are stress, hormonal changes and even some drugs. 

Is bromohidrosis dangerous?

Although bromohidrosis is uncomfortable and embarrassing, this foot condition is not a health hazard. However, bromohidrosis is a condition that should alert you that your feet and shoes are now home to plenty of bacteria. If not prevented or treated, toenail fungus may follow your sweaty predicament. Fungus also grows in the same type of environment as bacteria: dark, wet and warm. If you have a nail laceration or rupture, the organisms may find their way into your toe and spread in the area.

What are ways to prevent smelly feet?

-          Wear cotton or wool socks instead of those made of synthetic materials as these will help absorb moisture and allow your feet to breathe

-          Change your socks often, at least once a day to keep bacteria from taking hold

-          Wear open-toed shoes or minimize the wear of close-toed shoes

-          Practice good foot hygiene and shower regularly

-          Dry your feet thoroughly after washing them (especially between toes) and keep your feet dry

-          Dust your feet with foot powder to discourage sweating

-          Air out your shoes in natural sunlight

What treatment options are available for bromohidrosis?

            These options should be considered after you have tried preventing the condition. Consult your podiatrist about your problem and they may recommend stronger alternatives. Treatments may involve aluminum chloride hexahydrate 20% solution, electric current devices used to diminish sweating, or surgical intervention which involves cutting the nerve responsible for perspiration. Your medical professional will know the appropriate course of action for you and help you control this unpleasant problem!

Central Florida Foot and Ankle Center
101 6th St Nw
Winter Haven, Fl 33881
Phone: (863) 299-4551
www.FLFootandAnkle.com