8 Tips For Healthy Feet on the Trail

My office is located within one mile of the Appalachian Trail. Each summer, I observe the wave of through hikers making the 2,168 mile trek from Georgia to Maine and then later in the summer, those heading south from Maine to Georgia. Many end up with a visit to my office for ankle sprains, stress fractures, infected blisters and various other hiking related conditions.

Recently, I received a call from a friend that is through hiking for her second time in the past 10 years. She was in North Carolina at the time and was experiencing unrelenting pain in her foot. Having a telephone consultation and attempting to determine her diagnosis without examination was interesting and challenging. It made me think about the new trend in Internet or telephone doctor “visits”. But, that is a subject for another post on another day. I want to share with you these tips to keep your feet happy on the trail:

Train For The Hike:
If you are considering a long trip such as through hiking the Appalachian Trail, I strongly suggest that you start out training early with short day hikes. Marathon runners must train and condition for a marathon and hikers are no different. Those that are not adequately conditioned are more likely to develop overuse injuries.

Pack A Foot-Care Kit:
A small foot-care kit carried in a small Ziploc bag weighs only a few ounces. It should contain foot powder, alcohol wipes, a few tinctures of benzoin wipes to help the patch stick to your skin, several blister patches of your choice, a least a yard of duct tape wrapped around a small pencil, and a safety pin to drain blisters.

Invest In Good Footwear:
You should have a fingers width between the longest toe and the front of your boot. Be sure to also check the fit on an incline (both up and down). Any slippage of the boot will cause friction and blisters on a long hike. Try your boots on with the socks that you will be wearing while hiking.

Break In Those Boots:
Wear your boots around the house for a few days to be sure they feel OK. Then venture outside while shopping and on walks and short hikes so they mold to your feet. Leather boots are usually stiff until broken in. If a little snug, you can bring your boots to a shoe repair to have them stretched or purchase a leather expander and stretch the boots at home.

Wear Good Socks:
Wear moisture-wicking wool or synthetic socks rather than cotton socks. Consider wearing a sock liner but be sure that your boots will be big enough for two pair of socks.

Manage Your Toenails:
Toenails should be trimmed straight across the nail—never rounded at the corners. Leave an extra bit of nail on the outside corner of the big toe to avoid an ingrown toenail. Black toenails are a common hikers condition which is caused by blood being trapped under the nail.

Manage Your Skin:
Treat hot spots early! Use moleskin or duct tape to prevent blisters before they happen. Many hikers think tough callused skin helps prevent blisters but too much is never a good thing. Blisters deep under calluses are difficult to drain and treat. Use a pumice stone or callus file and apply Vaseline to manage callused areas. Blasters can be drained if painful but be sure to leave the roof intact to protect the sensitive skin underneath.

Rest Your Feet:
Take your boots and socks off when resting and eating lunch, elevating your feet to reduce swelling. In camp wear sandals or flip-flops. Your feet need the air and will appreciate the sunlight.

Long distance hiking is an incredibly rewarding experience. May these tips keep your feet healthy on the trail!

Dr. Jennifer Feeny
Happy Trails,

Dancers Starting Pointe Earlier and Earlier

Yesterday I went to Dance-Tech in Blacksburg, VA to talk to the owner about Shenandoah Podiatry, she was so relieved to find out we are located just around the corner! She started talking to me about how so many of the young girls want to start Pointe classes earlier and earlier in age. The owner herself started at the young age of 8 and now shows the girls just what starting so young can do to your feet.

I think this is definitely a positive preventative measure to try to hold the girls off a couple more years, however, more than likely it goes in one ear and out the other!

After talking with the owner yesterday, I did a little research on common foot and ankle injuries dancers’ experience.

•  Dancer’s Fracture (5^th metatarsal fracture)- results in landing awkwardly on the outside  portion of the foot or twisting the ankle
• Ankle Sprain- occurs by stretching or tearing one or more ligaments on either or both sides of the ankle.
• Bunions- are caused by your big toe joints becoming incorrectly aligned. This causes the one bone on your big toe to slant outward and the second bone then angles towards your other toes.
• Stress Fractures- results from too much repetitive activity of the foot which causes the bones to weaken
• Ankle Impingement Syndrome- results on the front or back of the ankle and is related to bone structures that pinch the soft tissue when the ankle is pointed in one direction or the other
• Turf Toe- a sprain caused by overuse or hyperextension
• Heel Pain, Achilles Tendonitis, Sesamoiditis and Hallux Rigidus are all related to overuse and repetitive trauma

As much as we don’t mean to scare you with all of these common injuries, any daily activity can result in an injury so this is no announcement to stop your daily activities.

Shenandoah Podiatry is here to aid in foot and ankle health; if you hear any scary noises after a fall don’t do the “I’ll wait a couple days to see if the pain is still there.” The sooner you make an appointment the sooner you’ll be back on your feet!

Foot Problems? Get them in shape for summer!

Come learn ways to get your feet in tip top sandal shape for summer! Dr. Kate will give suggestions on ways to treat bunions, hammertoes and heel pain as well as running tips (are you a heel striker?) to reach your PR!!

Bring your questions and get answers!
No pre-registration required, this is a FREE event!

Got Feet? Your Guide to Sports & Running Injuries

Shenandoah Podiatry offers two free books, "Got Feet? Your Guide to Sports and Running Injuries" and "Got Feet? A User's Guide to Foot and Ankle Health." Today I'd like to take an excerpt out of our running book, as more and more people are slipping on their running shoes to hit the Huckleberry trail in this beautiful Blacksburg weather!

"Chapter 10: How Do I know if I Need Orthotics? Foot pain is not normal and should not be ignored. It can lead to complex problems that can affect the functioning of other parts of the body, including the hips, knees and back. Foot-related problems are often treated very successfully with functional orthotic shoe inserts.

Orthotics are prescribed to:

• Reduce pain
• Provide support
• Prevent or slow down the development of a foot deformity
• Provide better positioning of the foot, knee and hips
• Improve the overall biomechanical function of the body"

As you can see, Shenandoah Podiatry is here to help. We want you to be an informed patient, knowing what we can do to help and how. To receive your free book, head to our website and request either one or both!

Remember your feet when sledding!

Are you tired of the cold and snow yet? If so, then that makes at least two of us. I can't wait to drive my car without having to clear the windshield and to be able to comfortably walk around without being bundled up. Unfortunately, springtime is still a couple months away and there's more snow in the forecast.
There is, however, one thing I enjoy about snow season. Whether it's the first snow of the year or the 20th, a fresh snow always seems to awaken us from our indoor hibernation. I always see the young and the young at heart out enjoying snow right after it's fallen. In my neighborhood, that usually means that most of us are sledding. I've often seen sledders and thought to myself how unsafe they're being. I must admit that I too have done some risky sledding. The problem with this is that we see far too many preventable, snow-related injuries. If you plan on sledding in the predicted snow, please follow these tips:

1. Choose proper equipment. I've seen people use anything from laundry baskets to pizza boxes. These devices can send you down the hill going backwards which can be dangerous for everyone. Instead of using whatever you have laying around, always use a store-bought sled designed for the snow because these are less likely to spin around. Also, be sure to read and adhere to the capacity guidelines of the sled. Putting more people on it than it can hold is unsafe.
2. Dress for success. When bundling up, be sure to protect your feet. Wear moisture-wicking, wool socks and insulated, weather-proof shoes to shield your feet from the elements.
3. Use hills! We're in the mountains which means mother nature has provided us with tons of natural sledding ground - take advantage of it. The use of ATVs or even golf carts when sledding is dangerous because it makes you more likely to be thrown off of the sled. Chances are that you'll land wrong and injury your ankle.
4. Clear the area. Find a place that is both free of dangers such as trees, fences, and roads and that gives you plenty of space to stop. It is a natural instinct to stop ourselves with our feet if we're about to sled into something. Clearing the area prevents this and any foot injuries that it may cause.

I know that fresh snow is exciting and that even those who know the precautions just get caught up in the fun of it all. With that being said, I can't stress to you enough how important it is to sled carefully or not at all. Please enjoy the snow but do so safely.

Inspired by http://www.womansday.com/Articles/Lifestyle/Family-Fun/Winter-Sledding-Safety-Tips.html

Obese children are more prone to leg, ankle, and foot injury.

A new pediatric study reveals that obese children are more prone to leg, ankle, and foot injury than other children their age. Dr. Wendy J. Pomerantz of Cincinnati Children’s Hospital in Ohio and several of her colleagues studied the patient records from the emergency room in their hospital from January 2005 to March 2008. They noticed some very interesting trends. About 30% of obese children in their study had suffered from lower extremity injuries verses the 18% of normal weight children. On the other side of the spectrum the study showed that 15% of the normal weight children suffered from head injuries compared to 10% of the obese children. The study showed that over weight children often had a longer recovery time than other children. They also found that ankle sprains where twice as common among obese children as other children their age. Although the researchers didn’t have the information explaining how these children became injured the group hypothesized that obese children are more vulnerable during walking or running while normal weight children have an easier time playing sports that carry the risk of head injury.

Of course parents want to protect their children so these numbers might scare some parents into not letting their children be active. But this is not what the study was meant to do. We want children to be active but we want them to be safe about it. Obese children (just like adults) should ease into exercise and sports instead of jumping right in.

Pomerantz’s steps following this study are to figure out why these numbers are slated this way and try to find some protective measures to help keep children safe.

Weekend Warriors….Take It Easy!

Spring is here and so you want to relive those glory days of playing football or basketball. But hold on weekend warrior, you might want to think about a few things before you do. Many times injuries are caused from the lack of preparation before engaging in strenuous activities that involve a lot of running and sprinting. Many patients have complaints of ankle pain, ankle sprains, jammed toes, and/or black toenails from injuries. If you haven’t been active or exercising during the winter months, the sudden increase in activity and demand on the joints and muscles can cause pain, soreness, and inflammation

An ankle sprain is the stretching and/or tearing of ligaments that can occur from twisting motions, sports, or walking and/or running on uneven surfaces. Individuals that have had previous ankle injuries it is important to have some additional support to prevent re-injury, by using ankle bracing or other athletic support, as those previously injured areas may be weak. It is also wise to get a thorough exam before participating in strenuous activities. Also, make sure you “warm up” before you begin your activity by stretching your muscles to prevent strains and sprains. Make sure you that you wear the proper shoes for your activity because wearing improper shoes can mean the difference between you scoring a goal or a sprained or broken ankle.

A black toenail is caused by repeated injury to the nail bed. This is usually caused by the toe being jammed against the sides, front or top of shoes when running or walking. The toenail may or may not be painful, but it is not a pretty sight. The black color is due to blood accumulating underneath the toenail. If the toenail becomes too painful, it will be necessary to seek professional treatment. The toenail may take 4-5 months to fully grow out and be replaced by a normal toenail. Make sure that your shoes fit properly to prevent this type of injury during rigorous activities. So throw out those old athletic shoes that have been sitting in your garage all winter. One point to remember, don’t “break in” a new pair of shoes during a strenuous activity. This can cause some areas of blisters or calluses from friction and additional pain from the “break in” period.

If you do have an ankle or foot injury or just need advice before engaging in an activity, get some guidance from your podiatrist. Remember, be an advocate for your foot health.