Simard Foot Clinic Tips & Tricks

FINDING THE PERFECT FIT

jodi@simardfootclinic.com (Jodi Simard) — Fri, 13 Apr 2018 18:02:31 GMT

Shop for shoes at the end of the day when your feet are largest. The size of your feet change as you grow, so before buying shoes always have your feet measured while standing. Select shoes by how the shoe fits your foot and not by the marked size. Select a shoe that is shaped like your foot, and make sure there is a space of 3/8" to 1/2" for your longest toe at the end of the shoe when you are standing. Don't buy shoes that feel too tight and expect them to stretch to fit. Walk in the shoes to make sure they fit and feel right. Your heel should not ride up and down inside while you walk.

WHAT IS CHIROPODY

jodi@simardfootclinic.com (Jodi Simard) — Mon, 22 Jan 2018 02:20:37 GMT

The practice of Chiropody is the assessment, treatment and prevention of diseases or disorders of the foot. Chiropody is practiced by qualified, regulated practitioners who have undergone government established and recognized programs and examinations. Only those who are registered by the Ontario College Of Chiropodist are licensed to practice as Chiropodists in Ontario.

COMMON TOE DEFORMITIES

jodi@simardfootclinic.com (Jodi Simard) — Mon, 22 Jan 2018 02:06:26 GMT

The human foot is a marvel with its 26 bones in each foot. However, in some cases, the tiny bones in the toes can cause painful problems. Deformities of the toes can lead to painful conditions such as corns, calluses, ingrown toenails and infections.

Many disorders can affect the joints of the toes, causing pain and preventing the foot from functioning as it should. People of all ages can have toe problems, from infants born with deformities, to older adults with acquired deformities. The major culprit of toe deformities in adults is biomechanical imbalances. When the natural function of the foot is disrupted (through a variety of causes), the tendons may stretch or tighten to compensate. Thus, people with abnormally long toes, flat feet or high arches have a greater tendency to develop toe deformities.

Arthritis that slowly destroys the joint surface is another major cause of discomfort and deformity. Toe deformities also can be aggravated by restrictive or ill-fitting footwear worn for a prolonged amount of time. Or, problems with toe position may occur if a fractured toe heals in a poor position. All toe deformities and related conditions can be managed by a chiropodist. Only surgical procedures can permanently correct the problem.

1. BUNIONS Bunions are a condition which affects the joint at the base of the big toe. The bunion actually refers to the bump that grows on the side of the first metatarsophalangeal (MTP) joint. In reality, the condition is much more complex than a simple bump on the side of the toe.

Interestingly, this condition almost never occurs in cultures that do not wear shoes. Pointed shoes, such as high heels and cowboy boots, can contribute to the development of a bunion. Wide shoes, with plenty of room for the toes, lessen the chances of developing the deformity and help reduce the irritation on the bunion if you already have one. However, shoes alone are not "solely" to blame for the development of bunions. Abnormal foot function comes into play in the development of almost all bunions, and the most common abnormality is overpronation or excessive flattening of the foot. A foot orthotic can reduce the amount of overpronation and thus arrest or slow down the formation or a bunion. Only surgery can remove it.

2. HAMMERTOES A hammertoe is a fixed bend at the proximal toe joint. As the toe becomes deformed, it rubs against the shoe and the irritation can cause painful corns. Corns may also develop between toes. These are usually due to a rotation of the toe, rather than a contraction (buckling). This can cause the joints to rub together and may create small bone spurs that cause corns in a similar manner. In addition, the skin can break down and become infected. A severe hammertoe may create downward pressure on a metatarsal bone at the ball of the foot, and add to the cause of a callus.

A hammertoe may be present but not always painful unless irritated by shoes. One may have enlarged toe joints with some thickened skin and no redness or swelling. However, if shoes create pressure on the joint, the pain will usually range from pinching and squeezing to sharp and burning. Cramping in the toes, foot and leg may develop from the muscles and tendons functioning in abnormal positions because of the deformed joints. In long standing conditions, the dislocated joints can cause the pain of arthritis.

Although there is little doubt shoes are responsible for causing corns, the size, shape and other characteristics of our feet are hereditary. The contraction and/or rotation of toes can be the result of poor mechanics of the foot, resulting in over-pronation. This results in low or flat arches, which cause the muscles and tendons of the foot to twist the toes and joints away from their nonnal position. High arched feet ( over-supination) can also result in similar conditions. A severe bunion may also cause a hammertoe, as the great toe twists over or under the second toe, causing it to dislocate.

Shoes cause the com, as the bony top of the toe rubs on the toe box of the shoe, but the underlying problem is the abnormal position of the toe joints, which may be hereditary.

The most important thing is to purchase well fitted, comfortable, low heeled shoes that do not irritate the crooked toe. Also, make sure your stockings are not tight, causing the toes to contract. High heel shoes should be worn at a minimum, as they cause the tendons of the toes to pull them up into an contracted position. Tennis type and walking shoes have significantly decreased the complaint of many people with hammertoe deformities. Although the crooked toe is still present, it may not hurt if the shoebox is large enough.

Treatment may range from more appropriate footwear to periodic trimming and padding of the corn. Antibiotics may be utilized in the presence of infection. Removable accommodative pads may be made for you. If conservative treatment is unsuccessful, surgical intervention may be suggested. In the early stages, when the toe joints are flexible, this may involve a minor procedure, such as cutting or lengthening the tendons tostraighten the toe. If the toe is relatively straight and the corn is caused by pressure on a spur, the enlarged bone may be remodeled and the spur removed. In more advanced cases, when the joint is dislocated, part of the bone at the joint may be removed. Temporary pins may be used to keep the toe straight while it is healing. Sometimes, the removed bone is replaced with a synthetic joint implant, to straighten the toe and help it function properly.

3. MALLET TOE A mallet toe is bent at the distal joint area of the toe, most commonly of the second or third toes. It is not always painful but may be the cause of a persistent corns or painful nail. The treatment for mallet toes is similar to that of hammer toes.

4. CLAWTOES A claw toe is bent at both the proximal and distal joints of the toe. In some cases the deformity is merely the end result of persistent impaction and constriction from ill-fitting footwear. More commonly it is symptomatic of various alternative etiologies. There is increased pressure on the top and bottom of the joints which are common sites of painful corns or bursitis. The treatment is similar to that of a hammertoe.

5. OVERLAPPING AND UNDERLAPPING TOES Any one of the toes can overlap or underlap, pushing on adjacent toes and causing irritation.

Overlapping or underlapping of the fifth toe is a common congenital problem that is easily corrected in children. Bunions can cause the second toe to overlap in adults. The treatment of associated corns is also similar to that of a hammertoe.

CHILDREN'S FOOTCARE

jodi@simardfootclinic.com (Jodi Simard) — Mon, 22 Jan 2018 02:06:23 GMT

You worry about your children's teeth, eyes, and other parts of the body. You teach washing, brushing, and grooming. But what do you do about your child's developing feet which have to carry the entire weight of the body through a lifetime? Many adult foot ailments, like other bodily ills, have their origins in childhood and are present at birth. Periodic professional attention and regular foot care can minimize these problems in later life. Neglecting foot health invites problems in other parts of the body, such as the legs and back.

Your Baby's Feet

The human foot (one of the most complicated parts of the body) has 26 bones, and is laced with ligaments, muscles, blood vessels, and nerves. Because the feet of young children are soft and pliable, abnormal pressure can easily
cause deformities.

Foot care for Kids

A child's feet grow rapidly during the first year, reaching almost half their adult foot size. This is why foot specialists consider the first year to be the most important in the development of the feet.
Here are some suggestions to help you assure that this development proceeds normally:

- Look carefully at your baby's feet. If you notice something that does not look normal to you, seek professional care immediately. Deformities will not be outgrown by themselves.

-Cover baby's feet loosely. Tight covers restrict movement and can impede normal development.

-Provide an opportunity for exercising the feet. Lying uncovered enables the baby to kick and perform other related motions which prepare the feet for weight bearing.

-Change the baby's position several times a day. Lying too long in one spot, especially on the stomach, can put excessive strain on the feet and legs.

Starting to Walk

It is unwise to force a child to walk. When physically and emotionally ready, the child will walk. Comparisons with other children are misleading, since the age for independent walking ranges from 10 to 18 months.

When the child first begins to walk, shoes are not necessary indoors. Allowing the youngster to go barefoot or to wear just socks helps the foot to grow normally and to develop its musculature and strength. Of course, when walking outside or on rough surfaces, babies' feet should be protected in lightweight, flexible footwear made of natural materials.

Growing Up
As a child's feet continue to develop, it may be necessary to change shoe and sock size every few months to allow room for the feet to grow. Although foot problems result mainly from injury, deformity, illness, or hereditary factors, improper footwear can aggravate preexisting conditions. Shoes or other footwear should never be handed down.

The feet of young children are often unstable because of muscle problems which make walking difficult or uncomfortable. A thorough examination by a chiropodist may detect an underlying defect or condition which may require immediate treatment or consultation with another specialist.

Chiropodists have long known of the high incidence of foot defects among the young, and recommends foot health examinations for school children on a regular basis.

Sports Activities

Millions of children participate in team and individual sports, many of them outside the school system, where advice on conditioning and equipment is not always available. Parents should be concerned about children's involvement in sports that require a substantial amount of turning and turning, or involve contact.

Protective taping of the ankles is often necessary to prevent sprains or fractures. Parents should consider discussing these matters with a chiropodist if they have children participating in active sports. Sports-related foot and ankle injuries are on the rise as more children actively participate in sports.

Advice for Parents

Problems noticed at birth will not disappear by themselves. You should not wait until the child begins walking to take care of a problem you've noticed earlier.

Remember that lack of complaint by a youngster is not a reliable sign. The bones of growing feet are so flexible that they can be twisted and distorted without the child being aware of it.

Walking is the best of all foot exercises, according to chiropodists. They also recommend that walking patterns be carefully observed. Does the child toe in or out, have knock knees, or other gait abnormalities? These problems can be corrected if they are detected early.

Going barefoot is a healthy activity for children under the right conditions. However, walking barefoot on dirty pavements exposes children's feet to the dangers of infection through accidental cuts and to severe contusions, sprains or fractures.

Another potential problem is plantar warts, a condition caused by a virus which invades the sole of the foot through cuts and breaks in the skin. They require professional treatment and can keep children from school and other
activities.

Be careful about applying home remedies to children's feet. Preparations strong enough to kill certain types of fungus can harm the skin.

Whenever you have questions about your child's foot health, contact your chiropodist.

HOW PROPER FOOTWEAR CAN REDUCE FOOT PROBLEMS

jodi@simardfootclinic.com (Jodi Simard) — Mon, 22 Jan 2018 02:06:20 GMT

From ancient Egypt, medieval times and down through the centuries, footwear has been designed to meet mankind's real and perceived needs such as protection, support, comfort, sturdiness and style.

Today, there are almost as many different kinds of footwear as there are pieces in a jigsaw puzzle. An almost endless variety of shoe styles and materials make buying a pair of shoes a major dilemma. This dilemma can be minimized if you concentrate on the health of your feet. A well made, proper fitting shoe will help a great deal in the reduction of foot problems.

Our daily routine causes a great deal of pressure on our feet. An average day of walking brings a force equal to several hundred tons to bear on your feet. Your feet are more susceptible to more injury than any other part of your body. This is why we need to protect them with proper footwear.

Everyone including men, women, children, athletes, police officers, fire fighters, postal workers and construction workers have different shoe requirements, and such requirements will vary considerably across a wide range of activities.

WOMEN'S SHOES

Fashion footwear inflicts a great deal of punishment on women's feet. Chiropodists believe heels of more than two inches are orthopaedically unsound. Such footwear contributes to medical, postural and safety problems.

Women can lessen these negative effects by wearing good quality sneakers or flats for part or all of the day. They can also vary heel height. There are comfortable and attractive "walking" pumps (also called "comfort" or "performance" pumps) for work and social activities. These shoes blend fashion considerations and comfort with athletic shoe-derived construction, reinforced heels, and wider toe room.

Activity has a bearing on the considerations. Wearing the right shoe for a particular activity is very important.

Perhaps the best shoe for women, from an orthopaedic viewpoint, is a walking shoe with laces (not a slip-on) with Vibram-type composition sole. The shoe should have a wide heel with a rigid and padded heel counter. The heel should be no more than a half or three quarters of an inch in height.

MEN'S SHOES

The best shoes for men are good quality oxfords, loafers and low dress boots.

Men (and women), should buy shoes for work, leisure, and special activities -match the shoe to the activity, in other words.

Male (and female) office workers should have cushioned-sole shoes which give good support.

There is no question about the need for foot protection for those who work in heavy industry. Safety shoes and boots that are waterproof or water-resistant, with insulated steel toes and soles, help prevent and/or reduce the severity of foot injury.

CHILDREN'S SHOES

When a child begins to walk, shoes generally are not necessary. Allowing an infant to maneuver indoors without shoes helps the foot grow normally. It also develops muscle, and strength and dexterity in the toes.

As children grow more active, and their feet develop, the need for shoes becomes apparent. It becomes necessary to change shoe sizes at a pace which frequently surprises parents. Proper fitting shoes allow room for growth. Though fit is the most important consideration, function is also pertinent. For youngsters who have reached the stage of walking unassisted, footwear with crepe or rubber soles is best. Dressier thin soled shoes do little to cushion the impact of growing feet.

SHOES FOR ATHLETICS

Different sports activities call for specific footwear to protect feet and ankles. Sports-specific athletic shoes are a wise investment for serious athletes, though perhaps a less critical consideration for the weekend or occasional athlete. Nevertheless, it's a good idea to use the correct shoe for each sport.

Athletic footwear should be fitted to hold the foot in the position that's most natural to the movement involved.

For example, a running shoe is built to accommodate the impact on the forefoot, while a tennis shoe is made to give relatively more support to the ankles, and permit sudden stops and turns. Because of the many intricate maneuvers involved in such events and the added strain they put on the feet, athletic shoes ought to be fitted for comfort and support.

It is widely accepted that a regular regimen of walking is physically rewarding. Here again, footwear with proper support is most important. Choose a good quality, lightweight walking shoe with breathable upper materials, such as leather or nylon mesh. The heel counter should be firm and the heel positioned close to the ground for walking stability. The front or forefoot area should have flexibility, and plenty of room for the toes to move around.

Consideration should be given to cushioned soles for resilience on hard surfaces and tread for traction on slippery surfaces.

BUYING TIPS

Have your feet measured while you're standing. Always buy for the larger foot; feet are seldom precisely the same size.
Don't buy shoes that need a break-in period. Shoes should be comfortable immediately. Don't rely on the size of your last pair of shoes. Your feet do get larger, and lasts (shoemakers' sizing molds) also vary. Shop for shoes later in the day; feet tend to swell during the day, and it's best to be fitted when they are at their largest. Be sure that shoes fit well- front, back, and sides to distribute weight. Be sure the widest part of your foot corresponds to the widest part of the shoe. Select a shoe with a leather upper, stiff heel counter, appropriate cushioning, and flexibility at the ball of the foot. Buy shoes that don't pinch your toes, either at the tips, or across the toe box. Try on shoes while you're wearing the same type of socks or stocking.

Foot Ulcers : Causes, Symptoms and Treatment Options

jodi@simardfootclinic.com (Jodi Simard) — Mon, 22 Jan 2018 02:06:19 GMT

The term ulcer , is generally used to refer to breaks in the normal integrity of the skin. Ulcers are skin wounds that are slowto heal and are classified in four stages, according to which layers of skin are broken through.

Stage 1 Ulcers are characterized by a reddening over bony areas.The redness on the skin does not go away when pressureis relieved.

Stage 2 Ulcers are characterized by blisters, peeling or cracked skin. There is a partial thickness skin loss involving the top two layers of the skin.

Stage 3 Ulcers are characterized by broken skin and sometimes bloody drainage. There is a full thickness skin loss involving subcutaneous tissue (the tissue between the skin and the muscle).

Stage 4 Ulcers are characterized by breaks in the skin involving skin, muscle, tendon and bone and are often associated with a bone infection called osteomyelitis.

There are many different diagnostic tests that can be done in the course of treating an ulcer. If the ulcer appears to be infected (i.e., there is redness, and drainage) then a culture of the wound should be done. The reason for the culture is to identify the type of infection, so that you can be put on the appropriate antibiotic.

If there is suspicion of the bone being infected under the ulcer,x-rays and/or a bone scan can be done. If there is suspicion that the underlying reason for the ulceris poor circulation, then a non-invasive vascular study (doppler) can be done. This test is done to see if you have enough oxygen getting down to the area to heal the ulcer.

Ulcers occur due to different reasons, so it is very important to determine the underlying medical problem that caused the ulcer. There are essentially four main reasons people get ulcers on the foot.

Neuropathic: This type of ulcer occurs when a patient has loss of sensation in the feet. It is commonly seen in people with diabetes, but it can be caused by other reasons such as chronic alcohol abuse. These ulcers are generally seen under weight bearing areas and often will begin as a callus or a corn.

Arterial: This type of ulcer is due to poor blood flow to the lower extremities. This type of ulcer can be very painful and are usually found on the tips of toes, lower legs, ankle, heel and top of the foot. They can very easily become infected.

Venous: This type of ulcer is due to compromised veins. Veins are the vessels that take fluid out of the legs and back up to the heart. Veins have small valves that allow blood to flow only one way, back up to the heart. The valves normally block the tendency for gravity to pull the blood back down to the legs. Sometimes the valves leak or cease to work at all. If the valves do not work, then the fluid pools down in the legs, causing swelling. This swelling leads to increase pressure in the venous system,

producing discolouration of the leg and eventually this lead to ulceration. They are commonly seen around the inside of the ankle and are slow to heal.

Decubitus: This type of ulcer is caused by excessive prolonged pressure on one area of the foot. The most common place to see this type of ulcer is in a person confined to bed and they occur on the backs of the heels.

What the Chiropodist May Do

Treat the Infection

The chiropodist will thoroughly clean the wound to remove all infected tissue. Early, aggressive wound cleaning (called "debridement") has been shown to heal these wounds more rapidly. If there is an infection, antibiotics are prescribed . If the infection is serious, you may be hospitalized to receive intravenous antibiotics. Dressings are used to prevent further trauma, to minimize the risk of infection, to relieve local pain, and to optimize the environment for healing. A moist wound environment is important for wound healing to occur. You can help by keeping the area clean and moist at all times and using the

medications prescribed for you.

Reduce the Pressure

Depending on the location of your foot ulcer, you may need to keep pressure off the area. This is called "off-loading" and means avoiding all mechanical stress on the wound so that it can heal. If there is no infection, a total contact cast may be used to relieve pressure. Or your chiropodists may recommend using

"non-weight-bearing" devices such as orthopaedic shoes, a walker, crutches, or even a wheelchair or bed rest - these can help healing by relieving pressure on the injured part of your foot.

Simple daily foot care can prevent serious problems. According to the National Institute of Health, the following are simple, everyday steps that will help prevent serious complications:

1. Take Care of Your Diabetes

Make healthy life style choices to keep your blood sugar close to normal. Work with your health care team to create a diabetes plan that fits your life style characteristics.

2. Check Your Feet Every Day

You may have foot problems that you may not be aware of. Check your feet for cuts, sores, red spots, swelling, or infected toenails. Checking your feet should become part of your daily routine. If you have trouble bending over to see your feet, use a plastic mirror to help. You can also ask a family member to help you. Important Reminder - Be sure to call your doctor immediately if a cut, sore, blister, or bruise on your foot does not heal after one day.

3. Wash Your Feet Every Day

Wash your feet in warm, NOT HOT, water. Do not soak your feet because your skin will get dry. Dry your feet well. Be sure to dry between your toes. Use talcum powder to keep the skin dry between the toes and rub a thin coat of skin lotion or cream on the tops and bottoms of the feet.

4. Trim your Toenails Each Week or When Needed

Trim your toenails with clippers after you wash and dry your feet. Trim the toenails straight across and smooth them with an emery board or nail file. DO NOT cut into the comers of the nail or rip off hangnails. If you're nails are thick or yellowed, DO NOT cut your own nails, have a chiropodist trim them.

5. Wear Shoes and Socks At All Times

Wear shoes and socks at all times. Do not walk barefoot, not even indoors. It is extremely easy to step on something and hurt your feet. Always wear seamless socks, stockings, and nylons with your shoes to help avoid the possibility of blisters and sores developing. Wear shoes that fit well and protect your feet.

6. Be More Active

Walking, dancing, swimming, and bicycling are good forms of exercise that are easy on the feet. Avoid all

activities that are hard on the feet, such as running and jumping.

Created by S. & C. Hartman, Foot Works , Waterloo, Ont.

WORKPLACE ATHLETES

jodi@simardfootclinic.com (Jodi Simard) — Mon, 22 Jan 2018 02:06:17 GMT

Your ability to use your feet safely, with ease and comfort, is vital if you are to remain a valuable and productive worker. However, a large number of workers are exposed to injuries due to prolonged periods of standing and walking. For example, a person who picks orders in a warehouse may walk up to 13 miles in a 8 hour shift. Another worker in the same warehouse may be required to stand in one position for at least six hours during a shift. These individuals are often thought of as "workplace athletes", especially when considering that these workers perform the same tasks five to six days a week often working overtime.

There are many careers that may employ workplace athletes. Some of them include:
• Postal workers
• Bank tellers
• Parking meter attendants
• Teachers/lecturers
• Cashiers
• Factory workers
• Construction workers
• Nurses

Workplace athletes are susceptible to many of the same types of athletic injuries, caused by overuse. Lower back, hip, knee, and foot pain are frequent complaints, in addition to an increase in callous formations and ingrown toenails.

One treatment option for overuse in a factory environment is the anti-fatigue mat, which is designed to reduce the forces encountered by the lower extremity and spine. Although anti-fatigue mats do reduce the incidence of reported injuries, they are not successful for everyone.

Why should some individuals find relief and not others? The formula for success is unclear and while it is easy to see how forces might be reduced during walking, how such forces work in more static, standing jobs is less clear.

Risk Factors

What are the risks for non-traumatic lower extremity or back injury on the job?

1. Individuals who engage in long periods of standing and walking are at risk for injury. But this alone cannot explain why some individuals suffer injuries and others do not. The type of job and the flooring can re potential risk factors. For example, jobs that do not allow the individual to switch among several positions may have higher risks.

2. The type of shoes worn is also a consideration Poorly fitted shoes and work boots may aggravate callouses and ingrown toe nails. They may also accentuate a structural abnormality of the foot.

3. Obesity is another potential risk because it affects the forces exerted on the spine and lower extremity joints during both walking and standing.

4. Previous injury to a specific area that never really recovers may also be a risk for chronic workplace injury.

5. Perhaps the greatest risk is structural abnormality of the foot and lower extremity, such as a flat foot, excessive pronation or supination.

In considering risk factors, it is important to remember that a single risk factor usually does not lead to injury. A combination of risk factors is usually involved.

In the US there are about 120,000 job-related foot injuries. One third of them are toe injuries.

You can't take your feet for granted, and your concern for them cannot be divided. It should continue off the job, as well as at work.

Possible Treatment Plans

A Chiropodist is able to treat foot problems of the workplace athlete.

Ill fitting footwear, (such as work boots) and poor foot structure may be the cause of corns, callouses and ingrown toe nails. Regular, routine treatment by a Chiropodist can easily relieve the pain and discomfort caused be corns and callouses.

Ingrown toe nails can be also be managed with regular treatments.

Surgical removal of all or part of the toe nail may be an alternative.

More complicated problems such as heel knee or back pain require a thorough evaluation by the Chiropodist to determine the underlying factors causing the pain (see risk factors). These types of problems often require a combination of treatments which may include:

• Icing the affected area
• Strapping
• Laser therapy
• Orthotics
• Orthopaedic footwear
• Surgery

However, the best treatment plan for any foot problem is prevention.

Most foot problems can be avoided by following the these simple recommendations:
• Bathe your feet daily and dry them thoroughly.
• Check you feet frequently for corns, callouses and cracks.
• Keep your feet warm.
• Trim your toenails straight across, slightly longer than the end of the toe.
•At the first sign of a problem (pain or discomfort) see your Chiropodist. DO NOT wait until symptoms become severe.

Did You Know?

1. Seventy-five percent of the population will experience foot health problems during their life time.
2. The foot is an intricate structure containing 26 bones, 33 joints, 107 ligaments and 19 muscles.
3. The 52 bones in your feet make up about one quarter of all the bones in your body.
4. The average person takes 8,000 to 10,000 steps a day I which cover several miles. In a lifetime it amounts to about 115,000 miles. More than four times around the earth.
5. There are approximately 250,000 sweat glands in a pair of feet and they excrete as much as half a pint moisture a day.
6. Only a small percentage of the population is born with foot problems. It's neglect, lack of awareness and ill fitting shoes that create the problems.

SUMMER FOOTCARE

jodi@simardfootclinic.com (Jodi Simard) — Mon, 22 Jan 2018 02:05:54 GMT

The warm days of summer are almost upon us. As we break out the summer wardrobe and footwear here is some foot care advice for the summer months.

Watch out for flip-flops: While flip flops are popular and convenient to wear, they put people at risk of developing foot problems. Flips flops don’t have the necessary support. A flat piece of rubber or leather does not provide enough support in the arch area of the foot. If worn for a prolonged period of time, they can cause severe arch pain or pain on the ball of the foot. Also, flip flops offer no stability for the foot, causing the foot to move while walking. As a result, blisters, or pain on the ball of the foot can develop.

Flip flops do protect the foot from the hot sand at the beach, or prevent the spread of athlete’s foot or plant warts at the pool, but you’re more prone to injury because you’ve got your toes exposed.

Cute ballet flats are not much better. They provide very little support in the arch area and if worn for prolong periods of time, can cause arch pain. Also, ballet flats are difficult to keep on the foot potentially causing blisters and pain in the toes as they work extra hard to keep the shoe on.

Prevent Fungal Infections: If you have prone to sweaty feet, you are more prone to fungal infections. In the warm, summer months, take time to expose your feet, without socks, to the air more often, especially if you wear shoes and socks all day. Have 2 or 3 different pairs of shoes that you rotate through. Beware of communal showers at swimming pools as foot fungus and warts can be easily acquired in these areas.

Injuries: Going barefoot in the summer is only natural and has some benefits for short periods of time, but is not recommended for outside the home. Too often, injuries occur from punctures or cuts. Always wear footwear outside the home. If engaging in water activities, such as canoeing or kayaking, try to wear water shoes or sandals to protect your feet along rocky shorelines or river beds. If an injury as occurred, contact your chiropodist/podiatrist or doctor.

If you are a diabetic, shoes should be worn at ALL times to avoid injury. Even the slightest scrap can be cause for alarm among people with diabetes, where healing can be difficult and may lead to limb amputation.

Heel Care: During the summer, the skin on the bottom of your feet is prone to dryness and cracking due to excessive sweating. In extreme cases, your feet can bleed or become infected. Use a pumice stone on your heels everyday in the shower or bath. Apply softening footcare to the heels twice a day. If an over the counter cream doesn’t help, talk to your chiropodist or podiatrist about a prescription product.

Apply Sunscreen: Don’t forget to apply sunscreen to the tops of your feet and toes. If your feet are exposed, they will get burned.

Have a safe and enjoyable summer and above all, keep those feet happy and healthy.

DOES MY INGROWN TOENAIL NEED SURGERY?

jodi@simardfootclinic.com (Jodi Simard) — Mon, 22 Jan 2018 02:05:53 GMT

Ingrown toenails are one of the more common foot problems treated by chiropodists. They can be very painful, with people limiting their activity to keep off their sore feet.

Ingrown toenails are caused by impingement of the skin along the margins of the nail by the nail plate. Some ingrown toenails are chronic, with repeated episodes of pain and infection. Pain can be present without infection, and pain.

Complications of an Ingrown Toenail

• Infection, if present, may spread to the foot and leg, or into the blood stream.
• Loss of the nail plate from the infection or inflammation of the nail bed.
• Chronic ingrowing nails can cause deformity of the nail plate and/or surrounding soft tissues.
• A small benign tumor called a granuloma can form along the nail margins.

*** Diabetics and those with poor circulation to the feet must NEVER attempt to treat an ingrown toenail at home. Consult with a chiropodist or physician immediately.

What the Chiropodist May Do

Ingrown toenail treatment may need to done on a routine basis. Your chiropodist may perform any one or combination of the following procedures.
• Elevate the end of the nail plate to prevent impingement on the soft tissues.
• Prescribe antibictics or special foot soaks.
• Drain the infection.
• Surgically correct a chronic ingrown toenail.
• Surgically remove the toenail so it will not grown back.

KEEPING MIDDLE-AGED PATIENTS ACTIVE

jodi@simardfootclinic.com (Jodi Simard) — Mon, 22 Jan 2018 02:05:50 GMT

Most of the common foot problems that bother active middle-aged people are restricting and easily treated if detected early. In most cases, conservative treatment will enable patients to return to activity relatively quickly. Middl~aged men and women are participating in a variety of exercises and athletic activities more than ever before. As a result, they are more vulnerable to foot and foot-related injuries. Fortunately, most foot ailments are minor and can be treated conservatively. Early diagnosis and treatment are keys to returning these active people swiftly and safely to their sports.

Hallux Valgus

Pathologic changes can lead to an angulation of the great toe and enlargement of the medial portion of the first metatarsal and thickening over the medial bursa. The causes of hallux valgus include, but are not limited to, heredity, metatarsus primus varus, pes planus, rheumatoid arthritis and neurologic disorders. Most patients affected by the disorder are middle-aged women.

Patients usually have pain over the first metatarsophalangeal (MTP) joint and have difficulty wearing shoes because of the medial prominence and associated toe deformities. Occasionally, the degree of deformity is not always consistent with the severity of the symptom and this needs to be considered during treatment. Shoes with a wide toe box and sufficient insole padding are recommended to make the patient more comfortable. Orthotics that support the longitudinal arch and redistribute the pressure areas may give some relief of symptoms. This treatment plan is often successful. However, surgery is an option when conservative treatment has failed.

Hallux Rigidus

Hallux rigidus is a degenerative arthritis in the first MTP joint and may be accompanied by pain, diminished range of motion and difficulty wearing shoes. Participants in sports with running or jumping may be predisposed to this aliment.

Treatment of this condition includes wearing low-heeled shoes with adequate width and depth to accommodate the increased bulk of the joint. The use of an orthotic or rigid insole to reduce the stress across the MTP joint may also be beneficial. If conservative management is not successful, then surgery is another option.

SENIORS NEED REGULAR PODIATRIC CHECK-UPS

jodi@simardfootclinic.com (Jodi Simard) — Mon, 22 Jan 2018 02:05:48 GMT

Older people can develop systemic conditions like diabetes or vascular disease that cause problems in the extremities. Peripheral neuropathy, which can be a symptom of diabetes, causes loss of sensation in the feet and can affect walking and balance, making falls more likely, points out Dr. John Dailey, a podiatrist with The Missouri Foot & Ankle Institute in Washington, MO. Circulatory problems also can cause injuries to become ulcerated and painful because an inadequate blood supply slows healing.

“Usually, older patients see me when a problem has occurred, but preventive care would be better,” Dailey says. “Billions of dollars were spent last year on treating conditions of the lower extremities as a result of diabetes. Good preventive care could save money and help people avoid pain and suffering.”

Dailey’s preventive regimen includes regular podiatric check-ups. “I suggest everyone see a podiatrist for a preventive exam, just like you would see your primary-care physician on a regular basis,” he says. “Those who have health conditions should be checked twice a year. We may take x-rays, examine how you walk, and make sure you’re wearing appropriate shoes.”

Source: Connie Mitchell, Ladue News [10/15/09]
"Reprinted by permission from PM News. PM News is available free by writing to bblock@podiayrtm.com .";

FLIP FLOPS LACK NECESSARY SUPPORT FOR EVERYDAY USE

jodi@simardfootclinic.com (Jodi Simard) — Mon, 22 Jan 2018 02:05:47 GMT

One person’s comfort may be another person’s pain. Dr. Karen Rouw, a podiatrist at Central Minnesota Foot & Ankle Clinic in St. Cloud, has seen plenty of patients with foot problems. “In recent years, flip-flops have become the norm for so many people — not just teenagers,” Rouw said. “People will use them just as regular shoes, and yeah, they’re cheap and air out your toes, but you don’t have the support and are at more risk at developing foot problems.”

They may be supremely comfortable for some but — constructed of a flat piece of rubber or leather and held on the foot by a thin strip —flip-flops can be a headache. “There are people who need more support than their body is able to give naturally. If you have a flatter foot with very little arch, you’re more prone to having foot pain,” Rouw said.

Flip-flops do protect the foot from, say, the hot sand of a beach or the grit found poolside, and they can also help prevent the spread of athlete’s foot or plantar warts. Rouw said, “But you’re more prone to injury because you’ve got exposed toes.”

Source: Frank Lee, St. Cloud Times [5/19/09]

"Reprinted by permission from PM News. PM News is available free by writing to bblock@podiayrtm.com ."

SPORTS INJURY

jodi@simardfootclinic.com (Jodi Simard) — Thu, 18 Jan 2018 20:30:45 GMT

Most common of all athletic injuries.

Ankle sprains are the most common of all athletic injuries. Ankle sprains involving the lateral or outside part of the ankle are referred to as inversion sprains and are by far the most common type. Most inversion sprains occur during sports which involve jumping and side to side movement like basketball, volleyball and soccer. Ankle sprains involving the inside aspect of the ankle are called eversion sprains and are uncommon. Frequently, there exists some "extrinsic" factor such as contact with another athlete, incorrect shoes or a discrepancy in the playing surface. Several "intrinsic" factors may predispose one to suffer an ankle sprain such as ligamentous laxity, inflexibility of the achilles tendon and weakness of the peroneal muscles.

When an inversion ankle sprain occurs, the result is damage to the anterior talo-fibular and calcaneofibular ligaments ranging from a mild stretch or strain to complete disruption. Infrequently, a "high" ankle sprain occurs involving damage to the anterior tibio-fibular syndesmosis (ligament). The deltoid ligament, which is located on the inside of the ankle, is much stronger and is rarely significantly damaged.

When an inversion sprain occurs, the usual scenario involves the athlete "rolling" his or her ankle while landing from a jump and experiencing a sharp pain on the outside of the ankle. An audible "pop" or "snap" may accompany the injury and sometimes signals ligamentous rupture. If the athlete can walk on the injured ankle, the likelihood of a serious injury is less, but athletic participation should be Discontinued. Shoes should be kept on until examination and treatment. Careful examination is necessary to determine the severity or "grade" of the injury and x - rays should be taken to explore the possibility of a fracture or other associated injury.

Initially, rest, ice, elevation and compression (aka RICE) should be employed to reduce pain and swelling. This is most critical during the first 24 - 48 hours. If no allergies exist, oral antinflammatory drugs may aid in reducing swelling and relieve discomfort. Following this period, an attempt should be made to walk on the ankle and begin rehabilitation. If ligamentous disruption is suspected, a brace should be worn to provide stability during the recovery period. However, if the athlete can not bear weight due to pain or swelling, a soft, compressive cast should be applied for up to 10 days with no weight - bearing. If weight - bearing is still not possible, cast immobilization, surgery or further diagnostic testing is usually necessary.

Once an ankle sprain has occurred, the ligaments heal over time but never regain their original strength. For this reason, recurrent or "chronic" injury is very common. Rehabilitation and physical therapy are the key elements to a rapid recovery and avoiding recurrent injury. Strengthening of the peroneal muscles and proprioceptive exercise are the most important facets of rehabilitation. I recommend anywhere from 4 to 12 weeks (3 times / week) of rehabilitation, depending on the severity of the injury. Following this, an ankle brace, taping, high - top shoe or functional orthotic device may also be necessary. The athlete should be cleared by a Podiatrist or Athletic Trainer before resuming running or jumping Activities. If pain and or instability is still present following rehabilitation, the athlete is a candidate for surgery.

The ankle sprain, especially the inversion sprain, is a very common and often debilitating injury. Accurate physical examination followed by thorough rehabilitation are essential to allow for a full, rapid recovery and prevention of recurrent sprains.

Article provided by James M. Losito, DPM, Director, AAPSM 1999 - 2000

COMMON FOOT CONDITIONS

jodi@simardfootclinic.com (Jodi Simard) — Thu, 18 Jan 2018 20:29:48 GMT

Foot and ankle problems usually fall into the following categories: Acquired from improper footwear, physical stress, or small mechanical changes within the foot. Arthritic foot problems, which typically involve one or more joints. Congenital foot problems, which occur at birth and are generally inherited. Infectious foot problems, which are caused by bacterial, viral, or fungal problems. Neoplastic disorders, also known as tumors, which are the result of abnormal growth of tissue anywhere on the foot and may be benign or malignant. Traumatic foot problems, which are associated with foot and ankle injuries, such as fractures.

Leading foot problems are:

Bunions —misaligned big toe joints that swell and become tender, causing the first joint of the big toe to slant outward and the second joint to angle toward the other toes. Bunions tend to be hereditary, but can be aggravated by shoes that are too narrow in the forefoot and toe. Surgery is frequently performed to correct the problem.

Hammertoes —usually stemming from muscle imbalance, this condition occurs when the toe is bent into a claw-like position. Hammertoe can affect any toe, but most frequently occurs to the second toe, when a bunion slants the big toe toward and under it. Selecting shoes and socks that do not cramp the toes may help alleviate any aggravation of pain or discomfort.

Heel Spurs —growths of bone on the underside, forepart of the heel bone. Heel spurs occur when the plantar tendon pulls at its attachment to the heel bone. This area of the heel later calcifies to form a spur. Proper warm-up and the use of appropriate athletic shoes can reduce the strain to the ligament and prevent the formation of heel spurs.

Ingrown Toenails —toenails with corners or sides that dig painfully into the skin. Ingrown toenails are usually caused by improper nail trimming, but can also result from shoe pressure, injury, fungus infection, heredity, and poor foot structure. Women are more likely to have ingrown toenails than men. The problem can be prevented by trimming toenails straight across, selecting proper shoe styles and sizes, and responding to foot pain in a timely manner.

Neuromas —enlarged benign growths of nerves, most commonly between the third and fourth toes. Neuromas are caused by tissue rubbing against and irritating the nerves. Pressure from ill-fitting shoes or abnormal bone structure can also lead to this condition. Depending on the severity, treatments may include orthotics (shoe inserts), cortisone injections, and, in extreme cases, surgical removal of the growth.

Plantar fasciitis —an inflammation on the bottom of the foot that leads to heel and/or arch pain. A variety of foot injuries or improper foot mechanics can lead to plantar fasciitis. Treatments range from icing and foot exercises to the prescription of custom orthotics to correct the foot position and help alleviate pain.

Sesamoiditis —an inflammation or rupture of the two small bones (known as sesamoids) under the first metatarsal bone. Proper shoe selection and orthotics can help.

Shin splints —pain on either side of the leg bone caused by muscle or tendon inflammation. Shin splints are related to excessive foot pronation, but also may be related to a muscle imbalance between opposing muscle groups in the leg. Proper stretching before and after exercise and corrective orthotics for pronation can help prevent shin splints.

Stress fractures —incomplete cracks in bone caused by overuse. With complete rest, stress fractures in toes or any bones of the foot heal quickly. Extra padding in shoes can help prevent the condition. Left untreated, stress fractures may become complete bone fractures, which require casting and immobilization.

Article used with permission from http://www.podiatryinfocanada.ca

FOOT CARE FOR DIABETICS

jodi@simardfootclinic.com (Jodi Simard) — Thu, 18 Jan 2018 20:28:33 GMT

Most of us are aware that people with diabetes require special attention for their feet, but many do not know why. As foot specialists, Chiropodists deal with a wide range of issues related to diabetes on a daily basis. Much of our focus is on patient education, as we strive to prevent common complications, such as ulcers, infections and undetected trauma. Nerve damage, or neuropathy, is often described by patients as numbness, tingling, burning or dull pain. It becomes pronounced in the body’s feet, as they bear the body’s weight and are subject to external pressure by footwear. In addition to causing uncomfortable sensations, neuropathy can also affect motor nerves, causing muscle atrophy and ultimately structural / arthritic changes in the foot. The resulting changes caused by neuropathy make the diabetic patient vulnerable to injuries and ulceration as they bear weight abnormally, and have diminished sensation to detect such injuries.

Neuropathy is progressive and will become accelerated with poor blood sugar control.

Vascular disease (especially in the legs and feet) is also more prevalent in those with diabetes. Cramping in the calves, night pain, weak or absent pulses and skin changes are common symptoms. Marked thinning of the protective fatty tissue on the bottom of the feet causes increased mechanical pressure, and affected individuals frequently complain of weight bearing pain. Once again, ulceration becomes a concern as the vulnerable tissue readily breaks down. Because circulation to the tissues may be diminished, it becomes easier to develop infections, and increasingly difficult to heal them. Infections in the diabetic foot may occur at various levels and to varying degrees of severity. Simple skin infections such as fungus (Athlete’s Foot) or warts may take longer to heal due to a compromised immune response. Complicated infections develop easily in the presence of wounds/ulcers and could cause serious deep infection, osteomyelitis or gangrene if not treated by a professional.

It is advisable that every individual who has been diagnosed with diabetes (insulin dependent or non-insulin dependent) seeks the advice and care of a foot specialist. The first appointment will generally include a thorough neurological, circulatory, biomechanical and footwear assessment. Additionally the Chiropodist will provide crucial footcare education and information on the prevention of complications of the feet. Topics generally include basic foot hygiene, nail and skin care, footwear, daily routines and first aid. The assessment should be repeated once a year so that a baseline level of function and wellness may be established. Such a routine also serves to detect and document discrete changes in an effort to prevent or minimize complications.

Routine care that is provided by foot specialists include nail care, corns/callus, ingrown nails (must be treated by a professional) and infections. Chiropodists manage ulcers when they do occur, and employ various techniques to both facilitate healing and promote prevention. Custom orthotics may be prescribed for the management of painful neuropathy, arthritic changes or ulcers related to diabetes. Chiropodists are regulated primary foot health-care practitioners, who are trained exclusively to assess and treat foot problems. Chiropodists are often called upon by physicians and other health-care professionals for consultation and treatment of foot problems although a referral from a family doctor is not required.

Article by Danielle Willis used with permission from http://www.ontariochiropodist.com

FEET FACTS

jodi@simardfootclinic.com (Jodi Simard) — Thu, 18 Jan 2018 20:08:01 GMT

Feet get us around

Feet get us around – we use them for running, walking and jumping. And yet, most people know very little about what actually goes on inside the foot. Feet generally get taken for granted – that is, until something goes wrong with them. Nothing incapacitates you as much as a broken or badly infected foot.

Most people have 26 bones in each foot, but some people have 28. These extras, called supernumerary sesamoids, are found on the bottom of the foot just behind the big toe.
Fourteen of the 26 bones are found in the toes. Each toe has three bones, except the big toe, which has two.
The soles of your feet contain more sweat glands and sensitive nerve-endings per square centimetre than any other part of your body.
There are about 250 000 sweat glands in the feet. The average person will lose about a cup of moisture a day through the feet.
Flat feet are not always problematic – if flat feet are well-aligned, they enable a person to stand for longer periods of time, as the weight is distributed over a larger area.
Lower backache, headaches, indigestion and a misaligned spine can often be traced to problems with your feet.
The gait pattern of your right foot does not usually match that of your left.
When you are walking normally, the whole foot is never flat on the ground.
If your feet are well-aligned, your toes will point straight ahead when you are walking. The first point of contact is your heel, then the outside border of your foot, then the ball of your foot, and finally the big toe.
Standing in one spot is far more tiring than walking. The reason for this is that demands are being made on the same few muscles for a length of time.
Corns and calluses are never normal, but they are the most common foot problems. They indicate that you could benefit from foot alignment or from better choice of shoes. The next most common foot problems are warts, blisters, athlete's foot and fissures.
The skin on your feet is thicker than it is anywhere else on your body.
When you are stressed, you are more susceptible to the virus that causes warts on the foot.
When buying shoes, it is a good idea to buy them late in the day, when your feet are tired and may be slightly swollen. It's best to buy shoes that fit your feet under this condition as you are then unlikely to purchase shoes that are too small. Have your feet measured every time you purchase shoes, and do it while you're standing. When you try on shoes, try them on both feet; many people have one foot larger than the other, and it's best to fit the larger one.
The average person walks up to about 160 000 kilometres, or 115,000 miles, in their lifetime, enough to walk around the earth 4 times. That works out to around 6 and a half kilometres a day.
While walking, each step can exert a pressure on your feet that exceeds your body weight and when you're running, it can be three or four times your weight -- which adds up to a cumulative force of over 500 tons a day. With certain sporting activities this force can go up to 7 times bodyweight.
There are 26 bones in each foot, a total of 52 bones in the both the feet. There are 206 bones in the body which means more than a quarter of all our bones in our bodies are in our feet. Thirty-three joints, 107 ligaments, 19 muscles, and tendons hold the structure together and allow it to move in a variety of ways.
There are more nerve endings per square centimetre in the foot than any other part of the body. Our feet constantly supply us with information about the surface we walk on, without our being even being aware of it. They tell us whether the surface is hot or cold, rough or smooth, which side it slopes to, etc.
At birth the bones in the foot are mostly cartilage and slowly harden as the foot grows. The bones in the foot will only be completely ossified (hardened) at around 21 years of age.
During a typical day, the average person spends about four hours on their feet and takes between 8,000 and 10,000 steps.
Seventy-five percent of Canadians will experience foot health problems of varying degrees of severity at one time or another in their lives. About 19 percent of the Canadian population has an average of 1.4 foot problems each year. Women have about four times as many foot problems as men; lifelong patterns of wearing high heels often are the culprit.
Walking is the best exercise for your feet and is also good for your overall health. It also contributes to your general health by improving circulation, contributing to weight control and promoting all-around well being. Your feet mirror your general health. Such conditions as arthritis, diabetes, nerve and circulatory disorders can show their initial symptoms in the feet -- so foot ailments can be your first sign of more serious medical problems.
Heredity plays only a minor role in the early development of foot problems, as only a small percentage of the population is born with foot problems. It's neglect, and a lack of awareness of proper care -- including ill-fitting shoes -- that bring on the problems. A lifetime of wear and tear, plus neglect, accounts for the fact that most practitioners serve an older population.
Corns and calluses are caused by friction and pressure from skin rubbing against bony areas when wearing shoes. If the first signs of soreness are ignored, corns and calluses rise up as nature's way of protecting sensitive areas. Of the three major types of foot problems (infections, toenails, and corns and calluses), people are less likely to receive treatment for corns and calluses and more likely to continue to have corns and calluses as a problem without treatment.
Plantar warts are caused by a virus which may invade the sole of the foot through cuts and breaks in the skin. Walking barefoot on dirty pavements or littered ground can expose feet to this sometimes painful skin infection.

Sources: The People's Almanac. Editors David Wallechinsky and Irving Wallace. Dallas Fell, Cape Town chiropodist. Article used with permission from http://www.podiatryinfocanada.ca