Tag Archives: Feet

Dr. C’s Journal: Flat Feet And Overpronation

Flat feet will exempt you from the draft, but that is where are their benefit stops. This condition can be inherited, but the arch can also fail to develop during puberty.

The entire bottom of the foot will contact the ground when walking if you have flat feet.

Overpronation happens when the way you walk causes the arches of the feet to flatten even more, putting a strain on the muscles, tendons, and ligaments that support your arches. Overweight and running a lot on hard surfaces accentuates this problem, and pain in the ligaments in the arch of the foot is the result.

Overpronation may be indicated by excessive wear on the inside of the heels and soles of your shoes, and can cause all kinds of problems such as Achilles tendinitis, iliotibial band syndrome, plantar fasciitis, shin splints, and even knee, hip, or back pain. these things may  develop in compensation to overpronation while walking.

As an older person, I have pretty much given up tennis and running, and walk rapidly for long (for me) distances in order to get sufficient exercise. Without noticeably increasing my walking, I have recently developed tenderness in the arch of my left foot that made walking painful. Curling my toes, and walking on the outside of my feet seemed to alleviate the pain. This is an exercise that I remember from my childhood, and may have been shown me because of my moderately flat feet.

Swimming for Exercise, and decreasing the amount of walking seems to have corrected the condition at least temporarily, but I have also ordered some orthotic inserts for my shoes as an arch support, in case I need them going forward. I have been told that if this is insufficient I can go to a specialty store and order some special shoes that might help. I have not mentioned painkillers such as NSAIDs, because I try to avoid them

Please check with the accompanying references for more information about flat feet and over pronation.

—Dr. C.

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Dr. C’s Journal: Plantar Fasciitis And Foot Pain

Our feet are subjected to such abuse that it is amazing we don’t have more problems with them. But problems there are, and I have been having some. I will be exploring the different types and causes of foot pain  beginning with this article on plantar fasciitis.

The plantar fascia is a triangular web of connective tissue on the bottom of the foot that begins at the heel and fans out to attach to the toes. With repeated stress, it can become torn or inflamed and caused pain.

The pain of plantar fasciitis is usually centered around the heel, on the bottom of the foot. It is often absent first thing in the morning, produces a stabbing pain on first walking, and goes away with activity; you can “walk it off”. Plantar fasciitis is usually slow to heal and may take several months

The doctor will usually make the diagnosis by your story(history), and the localization of the pain. X-rays, CT scans, and MRIs or necessary only if there’s a suspicion of a stress fracture.

Conservative treatment focuses upon stretching exercises and orthotics, but there are various types of injections, shockwave therapies, ultrasonic tissue repairs, and surgeries that some people need.

A particularly interesting treatment cited was the injection of platelet rich plasma from your own blood to promote healing. I recently read that this technique, in addition to a collagen scaffold  is currently used to treat rupture of the anterior cruciate ligament of the knee.

Of course, prevention is the ideal. Maintaining a healthy weight is important. Supportive shoes, with thick soles and good arch support will help. stretching exercises are also helpful as a preventative.

Please check with the Mayo Clinic article for more information.

—Dr. C.

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DR. C’S JOURNAL: SOME TIPS FOR CARE OF THE FEET

When not walking barefoot at night or on the beach, my toes have been squeezed together most of my life. Closed-toe compression stockings for my varicose veins plus inadequate space at the front of my shoes have encouraged my big toe to “scissor” and to cross over the second toe. At that point I started wearing open-toe stockings, and tried to give my toes more room in larger shoes. I also used a spacer to push the big toe out.

Walking on the beach is a wonderful place to free up your toes. For a while, I walked in the deep sand at the top of the beach, trying to get more exercise. Periodically I would get some thorns in my feet, and go to podiatrist to get them out.

During one visit, the podiatrist told me that I was getting a hammer toe in the toe right next to my big toe, and I now use a little ring shaped cushion for that second toe, incorporated with a spacer.

It is amazing how little we use the musculature of our feet, and how surprisingly well they hold up. People that are really in good athletic shape stress flexibility as being very important, and athletes often do stretching exercises before they do their workout. Practically anything that will stretch a joint is helpful, such as flexing, extending, and spreading the toes, plus flexing and extending the foot.

You can overdo it, however, as I have learned to my discomfort. You must do any exercise within the limitations of your body, beginning slowly, and working up to your desired level.

My big toe has almost no flexibility, and the joint that attaches it to the foot is enlarged and pretty fixed. I am very careful how much range and pressure I use .Even something as simple as stretching the Achilles tendon can be a problem if you do too much of it all at once. Always work slowly into your exercises to make sure that you do no harm.

Ingrown toenails have also bothered me from time to time. I very carefully try to trim them back and avoid breaking the skin; the foot is easily infected, particularly among diabetics and older people. A podiatrist is very helpful if you let things go too far.

My toenails, particularly on my big toe, are getting white and thick with a nail fungus. This can be treated with an oral medication, dispensed by a doctor or a podiatrist. I have chosen to keep it in check with clotrimazole cream, and that seems to be working. I worry from time to time about creating a resistance factor in the fungus, but they are very slow growing, and not likely to develop a mutation.

If you would like further discussion on foot exercises, please check the following reference, one of many on the Internet.

—Dr. C.

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