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Heel Pain Strikes Even the Best Athletes

Plantar Fasciitis Disables Carlos Quentin

KANSAS CITY, Mo. — Outfielder Carlos Quentin, who led the Chicago White Sox in home runs last season, went on the 15-day disabled list Friday with painful plantar fasciitis in his left heel.

The condition causes soreness in the bottom of the heel when you walk or stand. The move was retroactive to Tuesday.

“You have to learn how to play with soreness,” manager Ozzie Guillen said. “But it’s hard to play when you’re in pain. That’s two different things — play when you’re sore and play when you’re in pain. And I think he was in pain for all this month and that’s why I think it was hard for him to perform.”

Source: ESPN

 

Dr. Nirenberg’s Comments:

Plantar fasciitis is number one reason for heel pain.

Surprisingly, heel pain due to plantar fasciitis often occurs after the person has been resting and first starts walk. Patients often tell me they hate to get out of bed. This isn’t because they want more sleep, but due to excruciating pain in their heel the moment their foot touches the floor.

 The pain may ease up or even go away completely as the person continues to walk. However, as soon as they rest and resume walking, it often returns with a vengeance. Plantar fasciitis is due to an inflammation of the main ligament in our heel. There are many conservative treatments for this problem and surgery is usually not necessary.

 

Dr. Michael Lacey, my associate, writes:

Many of our elderly or overweight patients believe heel pain is due to their age or weight. When heel pain is due to plantar fasciitis, age or weight may be part of the problem, but the main issue is usually an abnormality with the structure of the person’s foot. Clearly, Carlos Quentin of the Chicago White Sox is a 26 year old professional athlete in great physical shape!

Nonetheless, he is now on the disabled list—for at least two weeks. He has tried to play through the pain but recently, but it became so severe he had to be carried off the field. 

In our practice, plantar fascitis is the most common cause of heel pain and one of the most common ailments that we treat. If you have plantar fasciitis, see a podiatrist – don’t let it put you on the disabled list.

Blisters May Be Soft, But They Are Painful

Blister on the bottom of the foot

Blisters are a common, annoying, and painful foot problem. At some point, nearly everyone gets at least one on their foot.

A blister is a pocket of fluid that forms between the outer and inner skin of our feet usually in response to friction. They can also form in response to heat, moisture, an allergic reaction, or an infection.

Sometimes blisters are due to a bony problem under the skin. Blisters are our body’s way of preventing the skin on our feet from breaking open.

Unfortunately, blisters can be very painful and they can lead to serious infections or even in some cases gangrene.

Preventing Blisters

The best way to prevent a blister is to remove the source of the friction. This may mean simply wearing a good pair of socks, padding your foot with moleskin, or perhaps, buying a new pair of shoes or wearing a different shoe brand or style.

I also recommend keeping your feet dry, wearing shoes that fit well and using a sprinkle of good foot powder.

The very interesting thing about blisters is that what works to prevent a blister today may not work tomorrow. Here is why: our feet change shape in response to temperature, humidity, the time of day, amount and type of activity, and other factors. An area of your foot that does not rub against your shoe today, may be a problem tomorrow.   

Treatment of Blisters

People in good health can treat small blisters by puncturing them with a sterile instrument and socking their foot in diluted betadine solution repeatedly. If blisters recur, they may be due to bone problem or spur in your foot, or in some cases may not be a blister. In any event, you should have the problem checked by a podiatrist.

Further, if larger blisters develop or if you have an underlying medical problem, such as diabetes, neuropathy, arthritis, or poor circulation, don’t treat the blister yourself; promptly see a podiatrist.

– Dr. Nirenberg

Are Your Running Shoes Dangerous?

Is it time to go bare?

Should You Toss Your Running Shoes and Just Go Barefoot? 

Remember when you were a kid? You raced around the playground or the yard for hours at a time, somehow managing not to hurt yourself despite your lack of $150 running shoes and custom-made $400 orthotic inserts. There’s a growing sense in many quarters that your childhood impulse may have been the correct one and that the very shoes we think are protecting us from harm may be causing it.

For decades, there’s been a grass-roots movement for extremely minimalist, i.e., barefoot, running. But only in the past few years have shoe companies begun to get in on the act, too. They now offer stripped-down models that don’t have the padding and structural elements that characterize conventional running shoes. There’s no little irony in Nike’s instructions to begin “barefoot-like” running with one $90-plus model of its Free lineup, then phase down through two more models before you’re running with a “nearly naked feeling.” (Presumably, they don’t want you to take the next step and swap Nikes for the actual naked feeling, though.) Other companies, including New Balance, Newton, Ecco, and Terra Plana, also have minimalist footwear for running and walking.

In his recent book, Born to Run, author Christopher McDougall explores the broader notion of what “natural” running would entail. Taking aim at shoe companies, he argues that modern running shoes promote a heel-first stride that makes us more vulnerable to injuries. (He’s a convert; since running in Vibram FiveFingers, a neoprene socklike foot covering, and changing his stride, he’s seen his problems disappear.) McDougall cites studies showing that more expensive running shoes don’t necessarily lead to fewer injuries. Other research suggests that heavily cushioned shoes actually prevent your foot from sensing the ground and can make you stomp down harder than if you didn’t have all that padding.

“They don’t let the foot, and ultimately the body, work like it’s supposed to,” says Galahad Clark, owner of Terra Plana, which produces a shoe technology—Vivo Barefoot—that puts just a 3-millimeter, flexible (but puncture-resistant) sole between your foot and the ground.

 

Vivo Barefoot Running Shoe

“Expensive running shoes let you run in a way and arguably for distances that you normally wouldn’t have been able to do,” he says. Walking and running barefoot, or close to it, allows what Clark calls your “amazing” foot to adjust to whatever surfaces—even modern, hard ones—and circumstances it experiences.

So what’s the evidence behind this notion? And should you try it? There isn’t strong evidence that barefoot running is any better or worse than running with more structured shoes, says Veni Kong, a kinesiologist at the University of Texas-El Paso, in part because there aren’t enough regular barefoot runners with whom to compare users of running shoes. But there’s a lack of a solid evidence base for running footwear in general, she notes. People are often prescribed shoes with elevated, padded heels that are designed to control pronation, but a March review in the British Journal of Sports Medicine found no evidence behind the idea that this will prevent injury or improve performance.

Keith Williams, an exercise biologist at the University of California-Davis, says humans are both incredibly varied and incredibly adaptable. The former means some of us pronate our feet as few as 2 degrees, and others as much as 25 degrees. Our bones articulate differently, our ligaments are structured differently. Some of us are heavy, some aren’t. And some people, he says, have truly been helped by modern shoes, inserts, and orthotics. Others probably don’t need the bells and whistles. So to prescribe one kind of shoe (or lack thereof) or running technique for everyone is not a good idea. “I’m against the one-size-fits-all approach for anything,” he says.

On the other hand, Williams says, our adaptability means that a lot of us could probably adjust over time to running with minimal or no cushioning, and for some, it might bring benefits. Just by wearing lighter footwear, you reduce the amount of energy involved in running. That kind of change, or varying the stresses on the lower legs, could theoretically reduce injury or improve performance for some people.

If you’d like to give it a whirl, don’t jump into it whole hog. Start off slowly, advises Kong, and stop if it doesn’t feel right, since you’re probably used to wearing regular shoes and need to adjust. “If we said to everyone in the world, just kick off your shoes and go running, a lot of people would hurt themselves,” says Clark. Obviously, be aware of the surface you’re running on; simply to protect against cuts and scrapes, going totally barefoot down the sidewalks of New York is probably not a great idea. If you’re using minimalist shoes, try to avoid landing on your heel, which you may be used to doing in padded shoes, and perhaps start out by running on grass, Clark says. In the end, he says, the ultimate experts on footwear are you and your body.

 

Source: U.S. News & World Report

 

Dr. Nirenberg’s Comments: 

Certainly, some running shoes can injure your feet, ankles or knees. But, that assumes you are wearing the right running shoes for your foot structure, biomechanics and deformities (if any).

Having to choose between a properly fitted, well-designed running shoe or going barefoot, is an easy decision. Wear the shoe.

Most people’s feet and ankles need good biomechanical control and support—especially runners.

However, there are exceptions. Some people do excel at barefoot running. I would suspect these athletes have a very good biomechanic structure to their feet and don’t need additional biomechanic control or support.

I would ponder to guess that the successful barefoot runners adapt to running barefoot and since they literally feel the ground and surface they consciously or eventually, unconsciously, place their foot on the ground in a way that protects them.

For those people who are considering barefoot running, I would only try it on a safe surface and if you have good health and great foot health—no biomechanical faults, foot weakness or other foot deformities.

Lastly, I will read McDougal’s book and give you an update on my thoughts. If anyone has read it or has experiences running barefoot, I would love to hear about them.

Catching Criminals “Red-Footed”

Footprint file catches criminals

CRIMINALS are more likely to find themselves caught “red-footed” after police introduced a new way of sharing their national database of shoeprints.

Whenever a footprint is found at a crime scene, forensic experts take casts and photographs of them and record them in a database.

These can later be compared to suspects’ shoes to see if they match.

Detectives have for many years used different methods of identifying footprints, but now forces across the country have signed up to a new computerised reference library, creating a more unified approach.

Staff from Lancashire Police, which covers the north of Bolton, have been involved in creating the new database, called the National Footwear Reference Collection.

Lancashire Police’s scientific support manager Dr Kath Mashiter said: “The launch of the NFRC represents a huge milestone in the footwear world, as for the first time, all police forces in England and Wales will be using a common reference collection.

“This will enable them to talk to each other in the same language – for example, a Nike 126 will mean the same in Kent as it does in Northumberland.”

Source: The Bolton News

Dr. Nirenberg’s Comments:

As a forensic podiatrist, I could not be happier to hear about this footprint file. Like fingerprints, no two footprints are alike, and many people have been convicted or cleared of wrong-doing based on their feet.

For more information about forensic podiatry watch the following Fox News clip:

What You Need to Know Before You Have a Pedicure

 

Nothing beats rewarding our tired, aching feet with a relaxing pedicure. It eases tension, and makes our feet feel and look better.

However, like so many other pleasures in life, pedicures can be dangerous. The main culprit is germs.

In one salon over 100 customers developed an infection from a dirty whirlpool.

Over the years I’ve treated several people who developed infections after pedicures and in one tragic case, the woman needed her big toe amputated.

The good news is that you can do a few simple things to minimize this danger.

1. Be Sure You’re Healthy Enough For a Pedicure

Consider your health first. Do you have diabetes, poor circulation, neuropathy (numbness or burning in the feet) or skin problems on your feet? These may increase your risk of infection, and you might not want to chance a pedicure.

If you are not sure if you’re healthy enough for a pedicure, have your feet checked by a podiatrist and get his or her opinion.   

2. Check Your Legs, Feet and Ankles Before the Pedicure

Any breaks in the skin, nicks, cuts or other sores on your legs, feet or ankles increase the risk of germs penetrating your skin, and until these problems heal you should avoid pedicures.

Along these lines, don’t shave your legs for at least one day prior to your pedicure as razors can leave tiny breaks in the skin too small for you to see, but large enough for nasty bacteria to enter.

3. Ask the Pedicurist Questions

There are a few simple questions you should ask the pedicurist or nail salon at your first visit or even over the phone before you go.

• Is the pedicurist licensed? They should be. And you should be able to see the license prominently displayed.
• Are the pedicurist’s instruments disposable? If not, ask how they clean the instruments. The best way to kill germs is by cleaning the instruments in a sterilization machine called an autoclave.   Soaking instruments in a disinfectant solution is not as good, but can be okay if a hospital grade disinfectant is used and the solution is changed regularly.
• How does the salon clean the footbath (and is it cleaned after every customer)?  Footbaths can breed germs. If the customer who last used it had an infected sore on their foot, you’ll want to be sure the salon disinfected it properly.  

4.  See How the Salon Looks

The salon should be clean with no dirt, debris, or hair or nail clippings on the floor or counters, and it should be organized, with bottles clearly labeled and instruments put away in drawers or containers.

If this is not the case, it is likely the salon isn’t taking the time to properly disinfect footbaths or instruments.

 5. Pay Attention to the Pedicurist

The pedicurist should be neat and presentable, with clean hands, or better yet, they should wear latex gloves.

And prior to the pedicure, he or she should examine your feet and ask about medical problems that may affect your feet.   

6. Be Wary of Pain

A pedicure should never hurt.

Pain during a pedicure may mean the pedicurist is doing something wrong or it could be signal your foot has problem that needs medical attention. Either way, it means its time to stop the pedicure.

Final Thoughts on Pedicures

When salons follow some relatively simple steps pedicures can be safe, soothing and a great reward for our battered feet.

If you have doubts about your salon or pedicurist, don’t risk your health, trust your instincts and go somewhere else.

Please feel free to share your experiences with pedicures.

– Dr. Nirenberg

Choosing Style Over Substance

  

When it comes to choosing shoes, many people opt for fashion over good foot health. Even Michelle Obama wore Jimmy Choo’s “Glacier” 3¼ Inch High Stiletto Pumps for the presidential inauguration.

Worn for short periods, high heels may not cause serious foot problems, but when worn at length they can cause corns, callouses, bent toes, pinched nerves and even a shortened or tight Achilles tendon.