Published by Tampa Bay Times
Imagine walking around the earth — about 25,000 miles — four
times. That's how many miles the American Podiatric Medical Association
estimates the average person puts on his or her feet in a lifetime. But most of us don't pay much attention to
our feet until they hurt — and sometimes we wait until they really hurt.
That's too
bad. Because if you seek help early, "most people can be treated with
conservative measures," said Dr. Heidi Stephens, a foot and ankle surgeon
and associate professor of orthopaedic surgery at USF Health.
Address
your foot pain early, and you'll likely relieve it with simple measures such as
bracing, taping, padding, stretching, changing shoes, placing orthotic inserts
in shoes, taking anti-inflammatory medication or steroid injections. If all that fails, then "we talk about
surgical options," Stephens said.
Most foot
problems can be prevented, and the ones that can't — bunions, for example, may
be genetic — can at least be minimized with commonsense measures. And that doesn't mean being sentenced to life
in ugly shoes. "We know we're
fighting a losing battle on that one," said Dr. Timothy Runyon of St.
Anthony's Hospital and the Tampa Bay Sports Medicine Center in St. Petersburg.
"Women
love their high heels. Instead, I try to educate women and help them at least
find the appropriate high-heeled shoes and make sure they fit properly." More on that later. First, take a load off
your feet and read about the most common foot problems and how to deal with
them.
1.
Bunions
Bunions
are those bony bumps on the side of the foot at the base of the big toe. As
they grow, they cause the toe to turn in, toward the second toe.
Causes: Genetics, foot shape, flat feet and wearing tight shoes all
put too much pressure on the big toe joint.
Symptoms:
Pain, redness and swelling at the
base of the big toes; other toes may become painful as the big one crowds them.
What
to avoid: High heels, narrow shoes and shoes
with a pointed toe box.
What
to do: Anti-inflammatory medication,
orthotics in shoes to improve arch support and relieve pressure on toes,
wearing a foot splint at night.
Next
steps: When other toes become painful, you
can't find comfortable shoes or daily activities are disrupted, you might
consider surgery. Most procedures involve shaving down the bump and realigning
the bones of the big toe; usually outpatient. Recovery varies depending on
procedure chosen. "The one I like has you walking without crutches in two
or three days," said Stephens. "You can do low-impact exercise in two
months and high-impact in three months. No shoe shopping for six months."
2. Heel pain or plantar fasciitis
Plantar
fasciitis strikes along the bottom of the foot, the ligament that supports the
foot arch and connects the heel bone to the toes.
Causes:
A weak arch that allows the foot to
roll inward, or pronate; flat feet; tight calf muscles or Achilles tendons;
running, walking or standing for long periods especially on hard or irregular
surfaces; aging; being overweight; wearing shoes that don't fit well, are worn
out or are poorly cushioned.
Symptoms:
Pain while walking or standing,
especially with first steps of the day or after rest. You may find pain
improves with activity, then worsens as the day progresses. Foot pain, while climbing stairs or standing
on toes (to reach high, for example) also is a sign to watch for.
What
to avoid: Don't go barefoot; take a break from
pounding exercise like running and jumping rope.
What
to do: Stretch the foot and calf muscles
with simple exercises throughout the day. Wear shoes with good arch support and
well-cushioned soles. Try orthotics to improve arch support and cushion the
heel. Lose weight. Try anti-inflammatories. In severe cases, steroid
injections, physical therapy or wearing a walking cast to force the foot to
rest can be tried.
Next
steps: Only about 5 percent of people may
need surgery, which usually involves cutting the plantar fascia ligament to
release tension along the bottom of the foot. According to Stephens, patients
can be up and walking within a couple of days and must wear a protective boot
for two to three weeks.
3. Neuroma
Also known
as Morton's Neuroma, this is a swollen, thickened nerve in the ball of the foot
that can feel like your foot's on fire.
Causes:
Toes squeezed together because of
tight, narrow shoes, especially high heels.
Symptoms:
Sharp, shooting, burning pain in the
ball of the foot (usually between third and fourth toes) that worsens with
walking.
What
to avoid: Tight, high-heeled and/or pointed
shoes. Sports and activities that put pressure on the toes.
What
to do: Get shoes with lots of toe room; use
ice and anti-inflammatories. Get pads for the ball of the foot. Use a device
that spreads the toes so they don't squeeze the nerve. Try steroid injections.
Next
steps: "This is one you want to treat
early to prevent chronic inflammation and swelling, which can cause a wad of
scarring around the affected nerve," said Stephens. If it gets too severe,
surgery can be performed to remove the affected nerve through an incision on
the top of the foot.
4. Achilles tendon
problems
Also known
as tendonitis, this involves the tendon that connects the calf muscle to the
heel bone and allows you to stand up on your toes or push off from your toes
when you walk or run. Overuse and abuse, such as during sports, can cause tiny
tears in the tissue around the tendon. In severe cases, the tendon can tear or
rupture completely.
Causes:
This can happen to athletes who
engage in repeated pushing off or stop and go movement. But it also happens to
out-of-shape middle-aged people who suddenly put a lot of stress on the tendon,
or who fail to warm up before exercise. Shoes with poor arch support can be a
factor. But an actual rupture usually only happens during vigorous exercise or
sports.
Symptoms:
Swelling in the ankle area, mild to
severe pain that may come on gradually or occur only with walking and running.
Athletes notice weakness, less foot strength or less movement in the ankle. A
rupture of the tendon usually causes a sudden, sharp pain, a popping sound and
collapse.
What
to do: Rest — for weeks or even months.
Anti-inflammatories, stretching, well-cushioned shoes, shoe inserts such as a
wedge-shaped heel lift. Immobilizing the ankle with a walking boot or a lace-up
brace. "For many athletes, the ankle brace is all they need to continue
their sport," said Stephens. Physical therapy may be prescribed.
Next
steps: In severe cases, surgery can be
performed to repair the tears or reattach the ruptured ends of the tendon.
Wait!
There's more! More
reasons your feet hurt:
• Calluses,
corns, blisters: Generally develop from poorly fitting shoes or even socks.
• Warts:
Caused by a virus and can spread. May need
to be professionally removed!
• Ingrown
toenails: Avoid by keeping nails cut straight across.
• Toenail
fungus, athlete's foot: Can be addressed by keeping feet dry, changing
shoes and socks often, avoiding tight shoes. If you get pedicures, bring your
own instruments and sanitize them at home. Medication and laser therapy are
available for fungus if it's really bothersome.
• Swelling
of feet or ankles: Can be caused by poor blood flow, injury, medication
side effects, heart, liver, kidney disease. If one leg swells painfully, you
may have a blood clot. Seek medical help right away.
• Peripheral
neuropathy: Poor blood flow to the feet; bumps and sores become easily
infected. Caused by, diabetes and certain drugs, particularly those for cancer.
• Arthritis:
May cause painful deformity of the toes.
• Gout:
Causes pain, redness, swelling in big toe. See your doctor. Medication and diet
changes can help.
• Heel
spurs: A bony growth usually from ill-fitting shoes, standing for long
periods or being overweight.
TIPS
FOR SHOE SHOPPING
What woman
hasn't suffered through an event wearing a pair of killer shoes, complete with
pointy toes or staggeringly high heels — or both? An occasional evening won't do too much
damage, provided you don't topple off your sky-high heels and break an ankle.
But if you
love heels, consider a stylish pair of platforms rather than thin-soled shoes.
"They have more stability in the long run. The shoe should be inflexible
in the forefoot and the heel area firm," says Dr. Timothy Runyon of St.
Anthony's Hospital and the Tampa Bay Sports Medicine Center in St. Petersburg.
This
Rockport Women's Janae Platform Pump ($78 to $140 at amazon.com) fits the bill.
Alternate with lower heels to protect your Achilles tendon — try walking from
your car to the office in comfier shoes, then slip on the heels. But note:
Ballet flats aren't so great for your feet either. You're better off with a low
heel and good arch support.
You live
in Florida, you wear flip-flops. The cheap flimsy ones may seem fun, but your
feet won't think so, especially if you have plantar fasciitis. Invest in a pair
with some arch support like these from Spenco ($44 at Zappos). They're
particularly comfy if you have bunions. But remember, they're not for distance
walking — gripping them with your toes causes strain over the long haul.
Minimalist
running shoes — some of which, like this ZEMgear Men's Terra Barefoot Running
Shoe ($70 at runoutlet.com) even fit your toes like gloves — are all the rage. But not
among doctors.
"I'm
seeing lots more fractures in athletes who use them for long distances and
competitions. They're not designed for that," said Runyon, who is team
podiatrist for the Tampa Bay Rays and runs marathons in his spare time. Save these
trendy numbers for short,
15-minute runs on grass, he advises.
Most of us
could use more support, especially for sports. These Brooks Adrenaline GTS 12
shoes are lightweight but supportive enough to win praise from a man who's a
260-pound triathlete.(Similar models are available for women.) They're $110 at
Zappos. But unless you're familiar with running shoes, you'd do well to go to a
local vendor like Feet First to be fitted with shoes that meet your needs. As
Runyon noted, your dress shoe size may not be the same as your athletic shoe
size.
Also, when
was the last time you had your feet measured? If it's been a while, it's
probably time to have a proper measurement taken, especially if you've lost or
gained a significant amount of weight, or if you've had a baby. Over time, feet
can get both wider and longer, and denial will only lead you to the foot
doctor.
Please call Foot, Ankle & Lower Leg Center office located
in Las Vegas and the Henderson area, which we have 3 locations to serve
you. Call to schedule you appointment @702-878-2455 between 9am to 5pm, Monday thru Friday
and closed for lunch between 1pm to 2pm.
Please visit our website @ www.FallCenter.com where all of your questions may be answered and to also schedule
your appointment.
When pain or injury occurs, you deserve highly personalized
treatment using the most advanced techniques.
At the Foot, Ankle & Lower Leg Center (FallCenter), you’ll enjoy an unsurpassed level of quality
care. Dr. Ricciardi, Dr. Shalev and Dr. McLeod are proud to provide
comprehensive solutions for all types of foot and ankle problems.
Your quality care begins the minute you
arrive, as our staff greets you by name and answers your questions. Our team of foot and ankle specialists will
inspire your confidence and their genuine warmth and compassion will earn your
trust.
You’ll receive a prompt and thorough
assessment, including on-site diagnostic ultrasound and digital x-rays. Your treatment plan is designed to resolve
your condition without surgery whenever possible. When surgery is needed, your feet are in the
hands of leading physicians with expertise in the latest minimally invasive
techniques. As a result, you’ll be back
on your feet and back to your active life as quickly as possible.
Without proper treatment, an
injury or chronic condition can keep you from performing even the simplest
everyday tasks. To meet patients’ most
critical health needs, Dr.
Ricciardi, Dr. Shalev and Dr. McLeod have developed the
following “Center of Excellence” treatment programs: Bunion Solutions, Heel
Pain, Diabetic Foot Care and Sports Performance Center.
