March Articles 2015

Choosing the Right Running Shoe for Your Foot Type

Running may seem like a simple thing to do, but in reality it is a complex movement that puts stress on the ligaments, bones, and joints of the body.  Because of this, selecting the correct running shoe is important for increasing performance and avoiding risk of injury.  Running shoes should be selected based on your foot type.  Considerations such as trail versus road shoes are important, but your foot type dictates the degree of cushioning, stability and motion control you require.  The most accurate way to learn your foot type is to visit a local shop that specializes in running shoes.  Professionals there can measure your arch type, stride and gait and let you know your shoe needs for future reference.

The design of running shoes is created around the idea of pronation.  Pronation is the rolling of your ankle from outside to inside when your foot strikes the ground, which is natural.  If you run properly you strike the ground on the outside of your heel and roll in the direction of your big toe before pushing off once more.  Pronation is beneficial because it assists the lower half of your body in absorbing shock and storing energy.  Those considered neutral runners pronate correctly and do not need running shoes that help correct their form.  Neutral runners can choose from a wide variety of shoes, including barefoot or minimal types.  However, those who have arch problems or who adopt an incorrect form while running may experience too much or too little pronation and require running shoes that offer additional support.

Those who overpronate experience an over-abundance of ankle rolling.  Even while standing, those who severely overpronate display ankles that are angled inward.  It is not uncommon for them to have flat feet or bowed legs as well.  The tendency to overpronate may cause many injuries.  Areas that tend to become injured are the knees, ankles, and Achilles tendon.  If you find that you have a tendency to overpronate, you should look at shoes that provide extra stability and motion-control.  Motion-control shoes are straight and firm; shoes of this type do not curve at the tip.  The restricted flexibility along the middle of the shoe prohibits the foot from rolling too far inward as your foot strikes.

A less common problem is underpronation.  Underpronation, also called supination, is when the feet are unable to roll inward during landing.  Those who underpronate have feet that lack flexibility and high arches.  This prevents any kind of shock absorption, even though it does place less rotational stress on ankles and knees.  This added force can cause fractures, ligament tears, and muscle strains because the legs are trying to compensate for the impact.  Those who underpronate need shoes with more cushioning and flexibility.  If you have a tendency to underpronate, selecting stability or motion-control shoes may cause you more problems by continuing to prevent pronation.

Bunions

The term bunion refers to an enlargement of the base joint of the toe, the connection to the foot. This enlargement may be formed of swollen tissue or a bony growth, and is caused by the shifting of the bones in the big toe inward, toward the other toes of the foot. The area around the base of the big toe may become inflamed, red, and painful.

Genetic factors are important in the formation of bunions – people who get bunions are usually genetically predisposed to this bone displacement, and may cause its onset by wearing improperly fitting shoes, or by running or walking in a way that causes stress to the feet. Another common cause for bunions is wearing high heeled shoes. The weight of the body in these shoes pushes the toes into an unnatural position, possibly causing bone displacement.

A podiatrist who specializes in foot structure and bio-mechanics will be able to quickly diagnose bunions. Bunions must be distinguished from gout or arthritic conditions, so blood tests may be necessary. The podiatrist may order a radiological exam to provide an image of the bone structure. If the x-ray demonstrates an enlargement of the joint near the base of the toe and a shifting toward the smaller toes, this is indicative of a bunion.

Wearing wider shoes can remove the pressure on the bunion and reduce pain. High heeled shoes should be eliminated for a period of time as this type of shoe generally pushes the big toe outward toward the smaller toes. This may be enough to eliminate the pain associated with bunions; however, if pain persists, anti-inflammatory drugs may be prescribed. Severe pain may require an injection of steroids near the bunion. Orthotics for shoes may be prescribed which, by altering the pressure on the foot, can be helpful in reducing pain. These do not correct the problem, but by eliminating the pain, they can provide relief.

For cases that do not respond to these methods of treatment, surgery can be done to reposition the toe. A surgeon may do this by taking out a section of bone, or may rearrange the ligaments and tendons in the toe to help keep it properly aligned. It may be necessary even after surgery to wear more comfortable shoes that do not put undue pressure on the toe as the big toe can easily move back to its orientation toward the smaller toes.

What Are Ankle/Foot Orthotics?

Ankle/foot orthotics are devices that are inserted into the shoes to protect the foot from a wide range of foot problems. Orthotics are available as prefabricated over-the-counter and through a prescription for custom-made orthotics tailored to the individual. Although custom-made orthotics are generally more expensive, they may be more efficient in correcting certain foot and ankle ailments. Typically inserts can be made out of pieces of rubber, leather, plastic, or any other type of synthetic material.

Orthotic devices may be used to:

  • Support the foot or ankle
  • Align the foot or ankle
  • Correct/prevent foot deformities
  • Improve function of the lower extremity

Types of Ankle/Foot Orthotics:

  • Full contact orthotic
  • Heel insert

Orthotics have been known to reduce or even remove pain in conditions such as flat feet, Achilles tendonitis, rheumatoid arthritis, plantar fasciitis, bunions and heel pain. If you are experiencing foot pain, your doctor will decide if you are in need of foot orthotics as well as the type of orthotic will be right for your foot type.

Corns: What Are They, and How Do You Get Rid of Them

Corns are areas of the skin where it has thickened to the point of being irritating and sometimes painful. Corns are circular or cone-shaped and are commonly found on the feet where there are areas of pressure or friction, such as on the little toe where it may rub against shoes or on the ball of the foot. The medical term for corns is helomas.

Corns can easily be confused with a callus, but there is a difference between the two. Corns can be a raised bump that feels hard to the touch and painful. They consist of a thick, rough area of skin that may be dry and waxy. Corns tend to be surrounded by inflamed skin and are usually smaller than calluses.

The key to treating a corn is to remove the dead skin that has built up. Salicylic acid is the most common medication used to accomplish this. Salicylic acid works by dissolving keratin, the protein that makes up the majority of corns. You can purchase salicylic acid over-the-counter in the form of wart removers. It comes in medicated pads, drops or creams. People with diabetes should not use salicylic acid, but should immediately consult their doctor.

To treat corns, apply the medication directly onto the corns according to the product directions. The top layer of the corn will turn a white color. When that happens, the layers of skin can then be peeled away, making the corn smaller. It is never a good idea to try and shave off corns with razors or other pedicure equipment. This can lead to infection. If your corns get infected or do not respond to over the counter treatment, a visit to the doctor is necessary.

Orthotic inserts fitted by a podiatrist also help to treat corns and help prevent their return. Inserts fit into shoes and help to adjust the way your foot fits in your shoe, thus fixing the way you walk. This will reduce friction, lowering your chances of getting a corn and eliminating the pain for current corns.

Surgery is seldom an option for corns, but does occur on rare occasions. Surgery for corns actually deals with the underlying issue causing the corns. During surgery, the bone is shaved and any abnormalities are corrected to reduce the amount of friction that occurs during walking.

The first step to preventing corns is to reduce any possible friction. Wear well fitting shoes that don’t rub on your feet. If you notice rubbing developing, pads can be purchased to help reduce the friction. These can be purchased over the counter and are simply placed on the area that is being irritated. Friction can also be reduced by using cushioned insoles in your shoes, and making sure to wear well-fitting shoes. This will make sure your foot is not being squeezed awkwardly, and stop corns from forming in the first place.

Causes, Symptoms, and Treatment of Poor Blood Circulation in the Feet

Poor blood circulation in the feet and legs is often caused by peripheral artery disease (PAD), which is usually the result of a build up of plaque in the arteries. Plaque build up, or atherosclerosis, can be the result of excess calcium and cholesterol in the bloodstream, which restricts how much blood can flow through arteries. Reduced blood flow to a certain area of the body severely limits the amount of oxygen and nutrients that part of the body receives, causing degeneration in the muscles and other tissues. Sometimes, poor blood circulation in the feet and legs can be caused by other conditions, such as damage to or inflammation of blood vessels, known as vasculitis.

The lack of oxygen and nutrients caused by poor blood circulation can restrict muscle growth and development, as well as cause muscle pain and cramps, weakness, and stiffness. Other common symptoms include numbness in the legs and feet, skin discoloration in the affected limbs, slower nail and hair growth, and erectile dysfunction in men. In more severe cases of PAD, pain can be present even when a person isn't exercising, and may range from mildly uncomfortable to completely debilitating.

Poor blood circulation in the feet and legs is more common in those who are overweight or obese, have diabetes, high blood pressure, high cholesterol, who smoke, or who have a family history of PAD or related conditions (heart attack, stroke, etc.). Diabetes and smoking place a person at greatest risk for developing poor blood circulation, although advanced age (over 50) can also increase risk.

If you are experiencing poor blood circulation in the feet and legs caused by PAD, it is important to make changes to your lifestyle in order to reduce your risk of experiencing a heart attack or stroke caused by this condition. If you smoke, quit completely -- this will increase the amount of oxygen in your bloodstream. Exercising and reducing the saturated fats in your diet (which come from fatty meats, fried foods, whole milk, etc.) can make a difference in improving blood circulation in feet. It is also important to avoid developing influenza and to carefully control your blood sugar if you have diabetes.

Your doctor may recommend combining lifestyle changes with a prescription medication regimen to improve blood circulation. The most commonly-used medications for PAD are called statins and work by blocking the amount of enzymes in your body that produce cholesterol. They are known by the brand names Zocor, Lipitor, Crestor, and others.