Foot Problems

Achilles Tendonitis

img01The Achilles tendon runs down the back of the leg and connects the calf muscle to the back of the heel. In can become inflamed due to overuse or inflexibility. Younger people tend to strain the Achilles just above the heel, whereas when people age the strain is felt higher up, closer to where the tendon connects to the calf. An inflamed Achilles may feel tender and stiff.

Causes:

Running or over-exertion will tighten the calf muscle. When the muscle becomes too tight, it disrupts normal foot biomechanics and the Achilles becomes strained and inflamed. Increasing your level of activity or running hills too quickly can lead to inflammation of the tendon. If this level of activity is maintained despite the pain, the inflammation can result in a partial tear of the tendon. In time, a portion of the tendon will die and the remaining, now weakened tendon can easily rupture.

Treatment:

Reduce or stop any aggravating activities. Take an anti-inflammatory, such as ibuprofen, two or three times a day. Massage the Achilles with ice several times a day. In some cases a 1 – 2 cm heel lift will reduce the tension in the tendon. If the pain persists after 10 – 14 days you should see your doctor, a sports-oriented physical therapist or podiatrist. If your Achilles tendonitis continues to be chronic and unresponsive to other conservative measures, you may be a good candidate for Extracorporeal Shockwave Therapy.

Prevention:

Since tight calf muscles and tight tendons lead to Achilles tendonitis, stretching is essential. It is best to stretch your tendon after your activity (e.g. running). This way the tendon is warm and much more receptive to a slow and gradual stretch. Never stretch to the point of pain. Consider switching to a firm, motion-control shoe in order to limit rear foot motion and over-pronation, and make certain that there isn’t any pressure or rubbing from your shoes on the Achilles tendon.

Activity Restrictions:

You do not want to run through Achilles tendonitis. Even the mildest strains can turn into a partial or complete rupture, which could lead to permanent damage.

Fitting Kids Shoes

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Check Kid’s Feet Before School Starts

Simple At-home Checks Help Spot Foot Problems

While preparing for the new school year, it is recommended that parents take five minutes at home to check for signs of possible foot disorders that could prevent active children from participating in sports and other activities.

Add these additions to this year’s back-to-school checklist:

Do the bottom of the child’s shoes show uneven wear patterns?
Does the child walk irregularly? Is one leg longer than the other or do feet turn in or out excessively?
Do preschoolers walk on their toes?
Does the child often trip or stumble?
Does the child complain of tired legs, night pains and cramping?
If parents take time to perform these checks, they will identify symptoms of common foot ailments, such as ingrown nails, and more serious foot disorders like flat feet that can hamper a child’s performance in physical education classes and sports. If a child’s shoe is worn on the big toe side of the foot, it could be a sign of poor arch support or flat feet.

Tips for Kid’s Shoe Shopping

Checking Kids Feet in ShoesParents can spot several potential foot problems by observing kids’ walking patterns. For example, if a parent determines that one leg is longer than the other, heel lifts may be required to restore proper balance. Early intervention may prevent scoliosis (curvature of spine) later in life.
Toe-walking in younger children can result from too much time spent in walkers as toddlers. Parents are urged take action to correct tightness in the Achilles tendon area that occurs from excessive toe-walking. Recommended stretching exercises that can be fun for small children and will help prevent lower back pain as they get older.

For those beginning college, heel pain and shin splints can plague freshmen not acclimated to walking long distances across campus to attend classes. Often in the fall students complain about pain from walking so much everyday. Recommended daily stretching and proper walking shoes, and for those with deformities such as hammertoes, surgery is often advised to make walking more comfortable.

Parents also should heed complaints about tired legs, heel pain and leg or foot cramps at night. There’s no such thing as ‘growing pains,’ so when kids complain about leg and foot pain they might have flat feet or another disorder that should be evaluated immediately. She added that children with flat feet are at risk for arthritis later in life if the problem is left untreated.

Parents who think they notice a potential foot problem should have the child evaluated by a qualified podiatric foot and ankle surgeon.

Fitting Kids Shoes

Making sure that your child’s athletic shoes are comfortable and fit well is very important.

The bones in children’s feet are not fully developed until the age of 12 – 13 years old. The pressure from ill-fitting shoes – which increases during activity – can force bones to align incorrectly at the joints.

Various experts offer the following tips to help determine if your child’s shoes fit properly:

  • Measure both feet and fit the larger foot.
  • Check the fit when the child is standing and both shoes are completely laced-up.
  • Press toe area with your thumb. There should be about one-half inch (1.25 centimetres) between the end of the longest toe (not always the big toe) and the tip of the shoe.
  • Be certain that the ball of the foot is at the widest part of the shoe.
  • The heel should fit snugly, not tight, to prevent slippage
  • Check the top line of the shoe for rubbing against the ankle.
  • Use a ‘Double Fit Check Service’ whereby a second knowledgeable salesperson checks the fit of the shoe to ensure correct size and comfort.
  • Have your child jump, run and twist in place to make sure the shoes are comfortable.
  • You shouldn’t need to “break-in” athletic shoes. If they don’t feel good in the store, select a different style.

The following is a recommended guide for checking the fit of children’s shoes:

Age Check                                                  Fit Every
0 – 18 months                                           1 – 2 months
18 – 24 months                                         2 – 3 months
2 – 3 years                                                 3 – 4 months
3 years and up                                           4 – 6 months

Pregnancy, Edema & Over-Pronation

Pregnancy causes many different changes to a woman’s body, and most women will have various complaints throughout their pregnancy. One of the most overlooked complaints is that of foot pain. Due to natural weight gain during pregnancy, a woman’s centre of gravity is completely changed. This will lead to a new weight-bearing stance and added pressures to the low back, hips, knees and feet.

Two of the most common foot problems related by pregnant women are excessive rolling in of the feet (over-pronation) and excessive swelling (edema). These problems can lead to pain in the arches, heels or ball of the foot. Many women also can experience leg cramping and/or varicose veins due to their weight gain. Because of all of this, it is important that pregnant women learn more about foot health during pregnancy in order to try and make this 9-month period as comfortable as possible.

Causes:

Over-pronation and edema are very common foot problems experienced during pregnancy. Over-pronation, which is often referred to as flat feet, occurs when a person’s arch flattens out with weight bearing or walking. This can create excessive stress and inflammation in the arch area of the feet and in the heels. It can also make walking very uncomfortable or painful and can cause an increase strain in the calves or low back in addition to the feet. The reason that pregnant women suffer from over-pronation is simply due to the added pressures on the feet due to weight gain.

Edema, which is also referred to simply as swelling of the feet, is a normal part of the latter part of pregnancy. Edema occurs due to an extra amount of blood which accumulates during pregnancy. As the uterus enlarges, it applies pressures on the blood vessels in the pelvis, thus causing circulation to slow down and blood to pool in the lower extremities. Total water fluid content in the body remains more or less the same, it is simply temporarily displaced. Often some extra water can be retained during pregnancy, which can also contribute to swelling. If there is swelling in the face or hands, then the family doctor should be consulted promptly.

Treatment and Prevention:

Over-pronation can best be treated with proper comfortable fitting supportive walking shoes or sneakers. If symptoms persist then custom orthotics might be recommended. These custom orthotics will be made with appropriate arch support, as well as any additional required ‘posting’ to help correct the over-pronation and alleviate the aggravating symptoms. It is important to treat the over-pronation in order to alleviate the pain at hand and also to prevent other conditions, such as plantar fasciitis, metatarsalgia, or posterior tibial tendonitis from occurring.

Edema in the feet can best be minimized and controlled by doing the following:

  • Elevate the feet as much as possible. Whenever you are sitting use a stool to rest your feet on.
  • Wear shoe gear that is very comfortable.
  • If you are buying new shoes, have your feet measured each time. Your foot size will change throughout your pregnancy.
  • Wear socks that do not constrict circulation.
  • If you do a lot of driving, take several rest stops to walk around and stretch and exercise your legs and promote circulation.
  • Exercise regularly. Walking is usually one of the best.
  • Drink plenty of water. Keeping well hydrated will reduce the need for the body to retain any extra fluids.
  • Eat a well-balanced diet and avoid foods that are high in salt content. Salt will cause water retention.

Swelling is normally similar in both feet. If the swelling is not symmetrical then you should consult your family doctor promptly, as it may be a sign of a vascular problem.

General Guidelines for Diabetic Foot Care

Approximately 1.5 million Canadians suffer from diabetes. There are several well-known problems associated with diabetes, but foot ulcers are of very high concern. This is because nerve damage resulting from diabetes can lead to poor blood flow, a higher risk of skin infections and delayed wound healing. Minor scratches can sometimes be devastating for people with diabetes, leading to ulcers that could often necessitate amputation. The bad news is that statistics show that almost 6000 people with diabetes who develop foot ulcers will undergo amputation. The good news is that at least 85% of diabetes-related foot amputations can be prevented by prompt and proper foot care.

1. Check Your Feet Every Day

  • Look at the tops and bottoms. If you can’t see the bottom, use a mirror or ask a friend/parent to
    help you.
  • Look for scratches, cracks, cuts, blisters, etc., especially between the toes and around the heels.
  • Check for ingrown nails, corns, calluses and sores. Note any changes in colour, temperature or
    shape.

2. Wash Your Feet Every Day With Mild Soap & Lukewarm Water

  • Test the temperature of bath water first with your elbow to make sure it is not too hot.
  • Do not soak your feet. Soaking can cause your skin to become dry and crack.
  • Dry your feet gently, especially between the toes.
  • Keep your skin from cracking by using a moisturizing lotion daily.

3. Take Care Of Your Toenails

  • See a podiatrist regularly for necessary trimming and / or other appropriate care.

4. Protect Your Feet

  • Do not walk barefoot, even indoors.
  • Break in new shoes slowly. Wear new shoes for only 1 or 2 hours at a time.
  • Always wear clean socks with your shoes. They should not be too tight around the foot or ankle
    and should have smooth seams. Cotton or other natural materials are best.

5. Keep Your Blood Flowing Well

  • If you smoke, try to quit. Smoking decreases blood flow to the feet.
  • Keep your feet warm, but do not use heating pads or hot water bottles on them.
  • Avoid wearing tight garters or stockings.

Please be sure to follow these recommendations carefully, and please bring even minor unhealed foot irritations to the attention of your family physician or podiatrist without delay. The faster treatment is started, the better the chances are that your feet will last a lifetime!

Dr. Boroditsky – Fitting Shoes to High Risk Feet (Excerpt from Shaw TV Interview)

Ankle Sprains

Ankle SprainsAnkle sprains result in pain and swelling due to stretching or tearing of some of the ligaments surrounding the ankle. The outside of the ankle is the most common area of injury. As these tears heal, they form scar tissue, which sticks to normal tissue and causes inflammation and continued pain. Without appropriate treatment, ankle pain can persist for several months, or even years.

Causes:

Most commonly people sprain ankles by stepping in a hole or tripping over tree roots or rocks. Running on uneven ground can also be a contributing factor.

Treatment:

As soon as you sprain your ankle stop running or walking on it. Although you may not feel pain right away, continued weight-bearing can damage your ankle further. This next step is very critical; follow the R.I.C.E. protocol. This means rest, ice, compression and elevation. If pain and / or swelling persist, see your family doctor or podiatrist. A severely sprained ankle often needs to be treated by a physical therapist who will use ultrasound and massage to reduce scar tissue formation and help restore normal strength and range of motion.

Prevention:

If you are prone to ankle sprains, avoid rocky or uneven terrains. Wear a firmer or more supportive training shoe or sneaker for better stability, and do ankle-strengthening exercises often.

Activity Restrictions:

Do not run or participate in vigorous weight-bearing activities with a sprained ankle. This will only damage the ankle further.