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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:

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.

Are Big Feet Related to Breast Cancer?

Women with bigger feet (the average UK shoe size is a five), trunk and shoulder breadth in childhood had a greater risk of breast cancer, according to a study at Bristol University.

An increased foot size might be linked to greater calorie intake during childhood, which has been linked to an increased risk of breast cancer.

Source: Mail Online

Dr. Nirenberg’s Comments:

This is one of those interesting, but probably useless facts. At best, it may mean that women with large feet should have more mamograms.

Should Flip-Flops Be Banned?

 

Are Flip-Flops to Feet What Cigarettes Are to Our Heart?

Manasquan shore bar The Osprey bans flip-flops for patrons

MANASQUAN — The Osprey nightclub in Manasquan has banned flip-flops from customers’ feet starting today after a patron suffered an injury at the often crowded bar during Memorial Day weekend.

The bar posted hand-written signs about the dress-code change. Osprey owner Diane Bisogni said she’s aware the ban may be unpopular with some of her patrons, but it was a matter of safety after a flip-flop-wearing customer fell down three steps when someone behind her stepped on the back of her sandal.

“It was a decision we had to make for everyone’s safety and everyone’s well-being,” Bisogni said.

Bisogni said that doesn’t mean all sandals are banned. Open-toed shoes are acceptable as long as they have a strap around the ankle or the instep, she said.

“I know we’re at the shore, but I’m not the only club that has a dress code,” Bisogni said, adding that the idea was suggested by her insurance company last year, but she resisted the change until last weekend’s incident.

The move, however, has sparked an angry response from some of the Osprey faithful, who have created a Facebook group to protest the new rule with a boycott. The group had 369 members by this afternoon.

“That’s interesting,” said John Coluni, 29, of Point Pleasant Beach, who was wearing jeans and flip-flops when he learned of the ban today. “I guess it’s a pretty common trend among the bigger clubs. I think they’ll be in the minority by doing that, but I don’t think it’ll affect attendance.”

“That’s a dumb rule,” said Lindsay Sittinger, 21, of West Milford as she walked off the Manasquan beach with her friend Jason Cagney. “I never tripped over my flip-flops or had them come off.”

Source: New Jersey Real Time News

 

Dr. Nirenberg’s Comments:

The typical flip-flop is cute, cheap and comfortable, but it probably is not good for your foot, ankle, knees, or back, and in fact, may be hazardous.

Every year we see ankle sprains and fractures as a result of flip-flops, but does that mean we should ban them?

To learn more about flip-flops and tips for wearing them safely see my post “Doctors Advise: skip the flip-flops this summer.“