Wednesday, September 15, 2010

Low Heels = High Style, Less Pain?



Kitten heels have appeared on the fashion scene, and fashionistas are rejoicing in the most comfortable footwear trend in quite a while! These shoes, a morph of stilettos and flats, offer the sophisticated look of high heels but with less discomfort. Kitten heels may have had their stuffy days, worn in bland styles in the workplace by 1980s working women, but the new styles are far from frumpy. In candy colors, pretty peep toes, or toughened up with hardware, these shoes are fun and, compared to last year's sky-high stilettos, comfy.

The New York Times is raving about this smart new style. “They give you the posture. They give you an elegant attitude right away,” says Giovanna Battaglia, fashion director of Italian Vogue accessories mags Vogue Gioiello and Vogue Pelle.

Low heels may be high on style, but how healthy are they for your feet? The real answer is all in how you wear them. While they give the wearer less immediate pain than high heels, there is still little support in most ladies’ dress shoes, even low-heeled or flat ones. Check that your dress shoes have sufficient arch support; if they don’t there are plenty of comfy (and stylish) orthotic options available in the foot care section of your local shoe store or drugstore. Some will fit invisibly into peep-toe or open-toe shoes; others are printed with fun patterns that you'll want to show off. Also, let your feet rest! Put your feet up or go barefoot when you get a chance, and wear more supportive footwear out in the yard, when running errands, etc.

In our offices we often see patients with foot pain due to wearing improper shoes constantly for long periods of time. You can prevent painful foot conditions if you make smart choices for your feet!

Friday, August 20, 2010

Cross Country Barefoot Encounter


Did you hear about the guy walking across the country barefoot?? Yes, you heard me correctly. Ron Zaleski is trudging across the US - BAREFOOT - to raise awareness about the need for mental counseling for all military personnel.

As a former military man himself, he is attempting to collect 1 million signatures for his petition along his back roads route to the west coast. The petition calls on Congress to mandate mental counseling for all military personnel.

Tuesday August 10 (just last week!) he passed through good ole' Buchanan, VA. Such a huge cause trampling right through our back yards. Our very own Roanoke Times had a chance to catch up with Mr. Zaleski and get an update on his journey.

Ron is giving everything he has to this cause including the health of his poor tootsies! Rex Bowman from the Roanoke Times reported that his feet were a "mess of broken skin and calluses." Not exactly the prettiest of mental pictures. He should definitely have stopped by to see us while he was in town. ;-)

Well, I just wanted to share with you a little about the barefoot walker's journey. If you'd like to follow him on his cross country trek, check out his website www.thelongwalkhome.org.



For more information visit our website http://www.shenandoahpodiatry.com/

VT Foot Fumble


It was grim news for VT Football fans when they heard Nick Becton, starting left tackle, sprained one of his right toes. He is going to be on the sidelines for an undetermined amount of time and there is no guarantee he will be able to be back on the field for Sept. 6th - the big season opener against Boise State.

For those of you thinking - "Toe sprain? He's seriously out for that? Walk it off man!" Here's the definition of a "sprained toe" according to Aurora Health Care. "A toe sprain is caused by a partial tear of the ligaments that support a toe. Ligaments are strong bands of tissue that connect bones to each other." Now it sounds a little more serious than you thought, huh?

Toe sprains can be caused by any number of things, from stubbing your toe to suddenly stopping a run and causing your toe to jam into the front of your shoe. And people MOST at risk for this type of injury are people playing sports, dancing, moving on rough ground, or people with poor coordination or the tendency to be clumsy.

If you think there is any possibility that you may have a sprain of any kind, you need to immediately see a doctor. They will need to run tests and determine a course of treatment which will definitely include rest from whatever activity lead to the injury.

Check out this site for more info on this particular injury. Toe Sprain

You can also check our our website if you are not sure what is causing your foot discomfort or pain. We have some great info on several different common ailments that may be the culprits. Shenandoah Podiatry


Wednesday, August 4, 2010

Unhappy Feet


No, this is not a parody of the popular cartoon children's movie with the tap dancing penguins. It actually has more to do with the fact that fall sports are kicking off - literally, and as a former soccer player myself, we don't always listen to what are feet are telling us.

“Athletes will play through a level of pain in their feet that, if they felt it in their knees or their shoulders, they’d be hammering at a surgeon’s door,” says Glenn Pfeffer, the director of the Foot and Ankle Center at Cedars-Sinai Medical Center in Los Angeles. Aching feet are the “forgotten stepchild” of sports injuries, he adds.

He's absolutely right! When I read that, it took me way back to high school. I remember first hand how much I paid for ignoring my own foot pain.

I played an entire game in high school with an aching pain in my right foot, but I didn't even let it phase me. I was completely focused on the win. This was one of the biggest games of our season against our rival team. All I could think about as we were getting ready to take the field was my dad's favorite "motivational" (I use that description loosely) saying. "Walk if off girl, walk it off. Be a champion." So that's just what I did. Only instead of walking, I was running, pivoting, kicking, and juggling all at full speed, for about 2 hours. Probably not the best choice I had ever made, then again I was a teenager.

By the end of the game, my adrenaline was through the roof because we had one by one goal when we were not the favored team. I couldn't even feel the pain anymore. It was the best feeling in the world...until I took off my cleats and socks. My foot was swollen to twice it's normal size and there was extensive noticeable bruising. Oops!

To make a long story short, I had just played that game with a navicular fracture. A bone in the middle of my foot was broken and I had no idea. Apparently, it was due to forcing too much stress on my foot without enough recovery time. I was also told that it appeared that the fracture was severely worsened by playing in that game. Had I been responsible and listened to what my body was trying to tell me and sat that game out, I may have gotten to finish out the season only missing a few games for recovery. Since I played, I was forced to sit on the bench the rest of the season and I missed indoor tryouts for the winter season.

We really don't think too much about what are bodies are trying to tell us. Especially our feet since most of the time we attribute our discomfort to walking too much, wearing the wrong shoes, or just being plain old tired. Of course, sometimes those things are true, but if you truly enjoy being active or playing sports, do you really want to be taking that risk?

I came across an article today from the NY Times that might be of some use. It explains just how serious this lack of "listening" to our feet really is. They use Kobe Bryant as a prime example. In 2004, he had a serious struggle with plantar fasciitis, which is an extremely painful heel condition. Can you imagine being a basketball player, worth millions, and having to play the game of your career with crippling pain in your feet? I sure can't (partly because I'm a terrible basketball player and no ever paid me to play soccer - but that's beside the point.)

If you're an athlete, a parent or friend of an athlete, or even a person that just likes to got out and start pick up games I strongly encourage you to check out this article from the NY Times. And next time your feet are trying to tell you something from way down there...LISTEN UP!

Tuesday, July 13, 2010

Freiberg's Infraction


Freiberg's
Infraction is a condition that affects the lesser metatarsal heads. The most common affected location is the second metatarsal followed by the 3rd 4th then 5th. This condition is also known as AVN (avascular necrosis). Freiberg's Infraction causes a loss of blood supply to the metatarsal head. The condition occurs at the metaphysis of the bone where the nutrient artery of the bone supplies the distal metatarsal. This results in a collapse of the metatarsal head. The condition is more common in females and usually occurs between ages 10-18 and can occur in adulthood.


Classification

Smillie’s classification (1967)


Stage 1: Subtle fracture line through the epiphysis.
Radiographic changes at this stage may be subtle.

Stage 2: Central depression of the articular surface.

Stage 3: Central depression leads to medial and lateral projections at the margins. Plantar hinge remains intact.

Stage 4: Central portion frees from the intact plantar hinge, forming a loose body. Fractures of the medial and lateral projections are present.

Stage 5: Flattening of the metatarsal head with secondary degenerative changes.


Contributing Factors:

Freiberg disease in adolescents is thought to be due to growth disturbances of the epiphysis or apophysis.
  • Vascular insult- an injury of the blood supply to the metatarsal head
  • Traumatic insult- a single acute injury or multiple repetitive injuries

Symptoms
  • Local pain and Tenderness that usually increases with activity
  • Stiffness
  • Limping
Differential Diagnoses
  • Metatarsalgia
  • Morton neuroma
  • Stress fracture
Treatment

Non Surgical:
  • Stiff Soled shoe or Post Op Shoe
  • Non weight-bearing cast
  • Short leg walking cast or CAM boot
  • Rest /Activity modification
  • Steroid injection
Shoe Modifications:
  • Metatarsal pads
  • Rigid shanks
  • Rocker bottom
Surgical Treatment:
  • Simple debridement
Osteotomies:
  • Dorsal closing wedge osteotomies- reorients the plantar intact cartilage to articulate with the proximal phalanx.
  • Shortening osteotomies- metatarsal overloading of the is reduced

Arthroplaty
  • Total joint arthroplasty- Utilizing an implant
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