Barefoot Running... The Official Stance

The official stance taken by the American Podiatric Medical Association on barefoot running is as follows:

Barefoot running has become an increasing trend, and a possible alternative or training adjunct to running with shoes. While anecdotal evidence and testimonials proliferate on the Internet and in the media about the possible health benefits of barefoot running, research has not yet adequately shed light on the immediate and long term effects of this practice.

Barefoot running has been touted as improving strength and balance, while promoting a more natural running style. However, risks of barefoot running include a lack of protection--which may lead to injuries such as puncture wounds--and increased stress on the lower extremities. Currently, inconclusive scientific research has been conducted regarding the benefits and/or risks of barefoot running.

The American Podiatric Medical Association, along with the American Academy of Podiatric Sports Medicine, encourages the public to consult a podiatrist with a strong background in sports medicine to make an informed decision on all aspects of their running and training programs.

Barefoot Running

A new trend in running has taken off in recent years though it is not a new concept. People have been kicking off their running shoes to go au nautrale and enjoy the intense connection with the earth that they feel when running this way. Though there has not been a lot of conclusive research done to prove whether or not running shoes are beneficial.

Even with out the concrete evidence showing that barefoot running is better for you, barefoot runners swear by this lifestyle. Barefoot runners believe that with out the obstruction of a running shoe, the brain knows where to place the body and foot in order to run in a way that is most efficient and beneficial to the particular runner. The world was wowed in 1960 when Ethiopian runner Abebe Bikila won his first of many gold medals running barefoot. Of course this was nothing new to him, but it caught everyone else off guard. Barefoot running was also brought to the world’s attention by European runner Bruce Tulloh and American runner’s Charlie Robbinson and Zola Budd.

Research done by Michael Warburton and published in Sportsscience journal entitled ‘Barefoot Running’ which can be found at www.sportsci.org/jour/0103/mw.htm has shown that running shoes increase ankle sprains, Plantar Fasciitis, and other shock related injuries. He also found that less expensive running shoes cause fewer injuries and fewer stressing points on your body than more expensive and advanced running shoes do. According to the article Amby Burfoot wrote in Runnersworld which you can read at http://www.runnersworld.com/article/0,7120,s6-240-319--6728-0,00.html, the brain is much more aware of your body and its surrounds when no shoes are worn.

Despite these findings, running shoes do have their advantages. Most importantly they provide protection. We live in a world filled with dirt, debris, and sharp objects no matter where you are running. Whether that is on a trial, a grassy field, on a side walk, or in a gym, puncture wounds are nothing to take lightly. These wounds can be very dangerous especially if they are not taken care of right away. Running shoes provide support for those with flat feet or high arches. Shoes also protect diabetics from foot injuries. Diabetics are strongly recommended not to try this style of running.

Barefoot running is a very controversial subject. Many people believe that humans should run exactly how they where made and not let anything get in the way of that. Others believe that shoe where invented for a purpose and are extremely important to wear. A third party believes that there is a happy medium between these views and has designed shoes that resemble barefoot running without the risk of puncture wounds. If you are going to start barefoot running make sure to take things very slow and consult your podiatrist before you start. If you don’t have a podiatrist, get one!! And make sure to go to regular check ups. If you are not sure if barefoot running is right for you, do a little research of your own and talk to your podiatrist to decide what is going to be the best running style for you.

How to keep your feet friendly during flights.

Sitting for hours in a cramped airplane chair is no ones favorite part of traveling. Not only are you much to close to the person besides you, your glutes and thighs get cramped and your feet get swollen and sore. There is no magical advice to keep the cramping away, although buns of steel exercised might help, but there are some simple ways to help keep the swelling and soreness away from your feet.

• Drink plenty of water. Keeping your whole body hydrated will decrease foot swelling. Try and stay away from salty foods and alcohol unless you are able to drink enough water to compensate.
• Walk around. You’ll need to use the bathroom after all that water and this is a good thing. Take this time to walk up and down the isles a bit to keep the blood in your body flowing. This will help prevent blood from building up in your feet.
• Wear big shoes. Wearing shoes that have enough room to let your feet to swell will help prevent them from becoming cramped and sore.
• Stay active. Do some seat stretches to keep your body active. Try wiggling your toes, rolling your ankles, and pointing/flexing your feet. This will help prevent tightness from building up in your lower body.

Keep these tips in mind the next time you’re in a plane to make for a more comfortable flight.

Safe Travels!!

The Origin of Shoes

Shoes have come along way since their invention. Some anthropologists believe that the invention of shoes happened as early as 40,000 B.C. These anthropologists noted substantially different toe bone sizes between different generations. The older generations had very big bones; the kind that are associated with a lot of hard work. Then fairly suddenly, the toe bone size got a lot smaller. A very possible explanation to this change is the invention of shoes.

Shoes had an open toed sandal design until about 1600-1200 B.C. when people in colder weather climates created ‘soft shoes’ made out of leather, similar to moccasins, covering the whole foot, and therefore inventing the first close toed shoe. The next major advancement in shoe technology was made by the Egyptians who where the first civilization to make shoes ornate. When the Pharaoh’s where dressed in all their glory, their outfits would be incomplete if they where wearing boring shoes. Shoemaking became a profession in the Egyptian society, making shoes more like jewelry than simply for necessity. Necessity for a hardier shoe brought about the invention of the boot during the ancient Greek era. They needed boots to keep their soldiers protected from different elements in nature and in war. Shoes where not particularly sturdy until about the Middle Ages, when due to the Crusades and the great deal of walking associated with those events, shoes needed to be more durable and more comfortable. Since then shoes have progressed into the styles we know and love today.


In 1850 the first shoe was designed to fit specifically the right or left foot. Soon after that, inventors created special sewing machines that made it able for someone to sew the soles of shoes to the uppers. This new machine expedited the time it took for shoes to be made, leading to the first mass manufacturing of shoes. In 1892 shoes started to look more like the shoes we wear today. Nine rubber companies used their resources and creativity to come up with a new kind of shoe, one that is very quiet and easy to bend. This new rubber sole shoe, a sneaker, was a huge success! Since then, shoes have progresses to fashion as well as necessity, being manufactured and computer engineered instead of handmade, and now mostly made from man made material instead of natural material. Though styles of shoes and techniques of how shoes are made have changed drastically over time, peoples love for shoes and desire to keep inventing haven’t.

Common Symptoms for Foot Ailments

Do you suffer from itching or scaling between your toes? Have you experienced this sensation in the past but now your feet are painful, inflamed, and possibly have blisters?

You might have Athlete’s Foot. Athlete’s foot is a fungus that enjoys the dark dampness between your toes. This is usually taken care of with an anti fungal cream or powder.

Does your big toe point towards the rest of your toes? Does your big toe look like its overlapping or invading the space of your second toe? Does the portion of bone that connects your big toe to your foot look like its protruding from your body?

You might have bunions. A bunion occurs when the bone starts pointing outward. This puts extra pressure on the toe joints which can cause inflammation and pain. Different splints and spacers can help slow this process or relieve pain but surgery is the only way to correct it.

Do you have sections on the skin of your foot that seem thicker than the rest of the skin?

You might have corns or calluses. These can be red flags for more serious foot ailments because they are caused by constant rubbing. These should only be removed by a professional.

Are your toe nails discolored, misshapen or smell? Is it painful to walk?

You might have toe nail fungus. The fungus can be gotten rid of by topical or oral medication. In extreme cases the toe nail will be completely removed so a healthy nail can have the freedom to grow.

Do you have severe and sudden attacks of pain, redness, or tenderness in your joints?

You might have gout, a form of arthritis that is caused by a build up of urate crystals in your body. These crystals are formed by uric acid, a by-product of breaking down of proteins. Different forms of therapy are now available to help cope with Gout.

Like any medical condition, the key to getting healthy faster is by listening the symptoms you have and treating the problem right away instead of just ignoring them and hoping they will go away. The sooner you see a podiatrist for your feet ailments the sooner your life doesn’t have to be run by them.

Pain!!! A cry for help.

If you called the fire department when your house was on fire and they didn’t come, that would be really bad. Since nothing was done to put out the fire, you’d end up losing everything. This is essentially what your body is doing when it creates pain and the results of ignoring pain can be just as bad. When something hurts, your body is saying “Help, something is not right! Something is malfunctioning!” Most people try to ignore the pain, take pain killers, or think that once the pain is gone the problem will be gone as well. Sometimes the pain does just go away. But this can be very deceptive. Just because your body has stopped sending calls for help doesn’t mean the problem is fixed. Often our bodies will try to correct the problem by compensating in another way, but this ends up putting unnatural pressures on another part of our body and can cause even more problems.

If you have an ingrown toenail, don’t think that just because it’s on a smaller part of your body you can be a surgeon for a day.

If you have pain in the arches of your foot in the morning and it goes away after you stretch a little bit, don’t think your body is just being cranky.

If your toes are starting to look bent and you get corns frequently, don’t think you are just looking in a fun house mirror.

These are all symptoms of foot problems and unlike wine they do not get better with time. Listen to your body. It knows what it needs. If you are experiencing foot pain in any way or a part of you foot is starting to look different than it has in the past, call a podiatrist before the problem gets out of hand. We want to help put out the fire.

For more information visit our website www.roanokefoot.com

Ankle Injuries: More than just an annoyance.

Though ankle injuries are painful when they first occur, the long term damage that is caused can be even more detrimental. Ankles that have suffered an injury are seven times more likely to become arthritic that ones that have seen no trauma. Injuries can very in severity and still have the same long term affects. From inconspicuous reoccurring ankle sprains to more seemingly detrimental ankle fractures or broken bones, the damage that is caused is irreversible. Ankle cartilage is quite strong and can usually withstand a life time of movement but when the cartilage gets damaged its cells are unable to be repaired. Cartilage is made to glide smoothly to create movement but when it becomes worn or frayed the movement is not fluid. This leads to swelling, inflammation, and pain in the ankle joints. If proper treatment is not attained after the injury, post-traumatic ankle arthritis could very well occur in the future.

A study taken from 1991-2004 at the University of Iowa, studying 639 patients with grade 3 or 4 arthritis concluded that ankle injury is the most common cause of ankle arthritis. Trauma was the primary cause of arthritis in 445 patients out of the 639 patients surveyed. That is about 70%. The other 30% was caused by rheumatoid disease and primary osteoarthritis.

Symptoms of ankle arthritis include: pain or tenderness, stiffness or reduced motion, swelling, difficulty walking, bone spurs, and instability. No matter what stage of arthritis is present, or if arthritis is just a possible threat in the future, professional care should be sought. Podiatrists everywhere have many surgical and non-surgical options to help cope with the pain, prevent arthritis from over running everyday life, and catch arthritis before it become a problem.

This little piggy...

This little piggy ran a mile. This little piggy swam three. This little piggy bench pressed. This little piggy danced free. And this little piggy showed up everyone else in the gym. But how did these piggys get so strong?? Because their owner never forgot to work them out before and after the physical actives the owner participated in.

When exercising, feet are usually forgotten to be warmed up and cooled down with the rest of the body. Rarely are they considered a body part that needs to be strengthened. They are smaller than other parts of the body, attract less attention, and are usually out of sight and out of mind. But these little guys under go a huge amount of impact during a work out or a physical activity.

Stretching and strengthening feet is a very important way to prevent foot injury from occurring during the everyday life not and in the future. This is also a very effective way to help relieve foot pain if an injury has already occurred. A little tender love and care is important to keep your feet healthy and pain free enough to get you the places you need to go.

Here are a few stretches, exercises, and massage techniques to keep your piggys marching on.


Stretches:
- Toe Raises: Hold onto a wall for support. From flat foot, rise up so you are standing on your toes only. Hold for 5 seconds. Repeat 10 times.
- Toe Points: Sitting down, flex the arch of the foot so the toes are pointed into a straight line and the heel is close to the back of the leg. Hold for 5 seconds. Repeat 10 times
- Toe Curls: Sitting down, scrunch all your toes together so they are pointing away from the top of your foot. Hold for 5 seconds. Repeat 10 times.

Exercises:
- Toe Squeezes: Hold a toe separator between your toes. Squeeze for 5 seconds. Repeat 10 times. This exercise is great for people with Hammer toes of suffer from toe cramps.
- Towel Scoop. While standing, place a towel on the floor, pick it up with only your toes. Repeat 5 times.

Massage techniques:
1. Apply an ample amount of lotion to feet.
2. Start by massaging the length of your feet up and down. Repeat 3-5 times.
3. Cup your heel and gently assist your foot in rotating the ankle. Repeat 5 times both directions.
4. Hold toes in one hand and heel in another. Gentle bring toes back towards your shins. This will stretch the calf. Hold for 3-5 seconds and repeat 5 times.
5. Gently grab each toe individually and pull directly away from foot to stretch and lengthen the toe. Hold for 3-5 seconds and repeat 5 times.
6. With your thumb, in circular motions, gently rub and apply pressure to the arch of your foot. Continue for 60 seconds.
7. To finish, once again massage the length of your foot 3-5 times.

Plantar Fasciitis causes problems for another NFL player

Defensive tackle Tank Johnson sat out for a second game last Sunday due to Plantar Fasciitis. The injury first flared up on Sunday, September 27th, 2009 and has kept Johnson out of the games and practices since then. The cause of the injury has not been disclosed, but the nature of Johnson’s job as an NFL player certainly contributes to his condition. The repetitious movements and weight shifts typical of an NFL lineman must be endured by the plantar fascia and can cause the tissue to become irritated and inflamed.
This is the second player to suffer from Plantar Fasciitis in the past two weeks. Is this an injury we will be seeing more frequently this season? Coaches, parents, and athletes should take the appropriate precautions to make sure a player’s feet are in top condition. Making sure shoes are appropriately supportive, protective, and correctly fitting is the first place to start. Extra arch support inserts might be a wise choice for the players with flat feet or weak ankles. Regular check ups ensure the feet are kept strong and healthy which will help keep the team running smoothly.
For more information visit our website http://www.roanokefoot.com/

Giant Hobbled by Plantar Fasciitis

Eli Manning, quarterback of the New York Giants, was recently diagnosed with plantar fasciitis. Plantar fasciitis is caused when the thick band of tissue running along the bottom of the foot, the plantar fascia, becomes inflamed. Symptoms include severe stabbing, burning, or aching sensations in the bottom of the foot and/or in the heel. These symptoms usually occur during weight bearing movements but may be present even when just standing. It’s obvious to see how this would cause difficulty for a quarterback to do his job. The QB sought council after he was diagnosed and immediately started treatment. He is hoping to practice with his team on Wednesday but for now his pain and ability to play is being judged day to day.

Being a quarterback for a professional football team is not the only profession where plantar fasciitis can cause problems. Almost any job or activity where frequent walking or standing on hard surfaces can cause this ailment. Pregnancy, obesity, and several other sports tend to make people prone to this injury as well.

Luckily for Eli and anyone who may suffer from plantar fasciitis, there is hope. There are several treatment options offered by podiatrists to correct this problem. Foot and heel pain does not have to be part of everyday life when correct council is available. Treatment can take anywhere from 6 to 18 months. When plantar fasciitis is caught in its early stages the recovery rate is dramatically reduced. Pain in the foot during the first few steps of the day (especially when just getting out of bed) is an early warning to call a podiatrist and get the feet checked out.

Take care of your feet today… so they can continue to take you the places you need to go tomorrow!

Hammertoes

A hammertoe is a bending of the toe at the first joint of the digit, called the proximal interphalangeal joint. Flexible hammertoes are still moveable at the joint and are less serious as they can be treated while still in the developmental stage. Splints such as Yoga Toes can help. Rigid hammertoes are more advanced than the flexible condition. The joint is misaligned and immobile, making surgery the usual course of treatment. Hammertoes are more common to females than males.

Hammertoes are formed due a muscle imbalance in the toes. This imbalance causes increased pressures on the tendons and joints of the toe, leading to its contracture. There is a strong hereditary predisposition to develop hammertoes, although shoes, trauma and arthritis can also contribute.

Your feet should not hurt. If you are suffering from hammertoes, call your local podiatrist to discuss the best option for you. If you live near Roanoke, VA, I'd love to help you at Shenandoah Podiatry.

Pregnancy And Your Feet

Being pregnant is usually a wonderful experience, but it can make life a little uncomfortable at times. Many women suffer from foot and leg problems during pregnancy but the good news is there are things you can do to prevent or relieve them. The two most common foot problems during pregnancy are over-pronation (flat feet) and edema (swelling). Leg cramps are also a common experience during the second trimester.

During pregnancy hormones can do some interesting things to prepare your body for birth. One of the things they do is relax ligaments to help the body during birth. Unfortunately it is not only pelvic structures that can become more relaxed, but also your feet. The other main reason that you may become prone to flat feet during pregnancy is due to the natural weight gain that occurs. Not only do you gain weight, but your body’s center of gravity changes quite dramatically forcing a change in gait.

While there is not a lot you can do to prevent this condition occurring, apart from keeping up gentle exercise and not over eating,there are things you can do to prevent any further pain or damage. Make sure your shoes are not too tight, you may even need to wear a half or even full size larger shoe than you normally would. Your feet will need extra support and shock absorption too. You can purchase specially designed orthotic insoles or shoes that will provide this extra support.

Edema, or swelling of the feet and ankles, is very common particularly towards the end of pregnancy. This is caused by increasing pressure from the growing uterus that can lead to fluid pooling in the lower extremities. Fortunately there are things you can do to help prevent edema and to relieve it.

Drink plenty of water as this actually helps the body to release the fluids and avoid retention. Cut down on salt in your diet,including soda drinks as salt encourages water retention. Wear comfortable shoes and avoid socks that have seams or tight bands. While it is important to exercise you also need to rest and elevate your feet frequently. If you do need to stand keep moving.

Swimming is great exercise during pregnancy and the support of the water will also help with swollen feet. Soak your feet in cool water too to ease pain and disperse fluid build up. Get in the habit of sleeping on your left side as this reduces pressure on your veins. Avoid crossing your legs or ankles when you are sitting. If you have to work at a desk remember to take plenty of breaks and walk around and if you can keep a footstool under your desk so you can raise your ankles.

Some women who suffer from severe edema also find that wearing compression stockings can also be helpful. Treat your self to a few reflexology treatments too. This can be great not only for foot problems but any other pregnancy issues as well.

If you develop swelling around your face see your doctor immediately as this can be a sign of something more serious. Feet can be a bit of a pain in pregnancy but it is usually controllable and any problems will dissipate after birth.

Welcome

I am pleased to announce that Dean Atway, DPM has joined our team. A native Floridian, Dr. Atway recently completed an extensive three-year residency, specializing in reconstructive foot and ankle surgery before joining us here at Shenandoah Podiatry. We strive to provide the best care possible for our patients and feel his addition will contribute greatly to our efforts. Please welcome Dr. Atway as we all work toward your good health.

Dedicated To Your Healthy Feet,

Dr. Jennifer Feeny

What Is A Podiatrist?

Simply put, podiatrists are medical experts that deal exclusively with problems associated with the foot and ankle. The DPM after a podiatrist's name stands for Doctor of Podiatric Medicine. Because our training is highly specialized, we are able to quickly and accurately diagnosis your condition while offering the most modern treatment plans available.
Many people know that podiatrists treat senior citizens and those with diabetic foot conditions but may not realize that we also treat patients of all ages for a wide variety of ailments. Podiatrists are well qualified to help children and young adults with any foot and ankle problems they may be experiencing . Sports injuries, heel pain, bunions and hammer toes are just a few problems we provide treatment for. If your discomfort involves any part of the foot or ankle, a podiatrist is the one to call.

For more information visit our website http://www.roanokefoot.com/

The Safest Golf Shoes

The sesamoid bones are located on the ball of the foot. Theses bones often become inflamed from high-impact sports like tennis and basketball, which involve athletes coming down hard on their feet throughout a game. Sesamoid bones may also suffer from the stress of spiked golf shoes. When a spike is positioned directly beneath the ball of the foot, the resulting pressure commonly causes pain and swelling around the sesamoid bones, a condition called sesamoiditis. Golfers who currently wear spiked shoes may modify the spike patterns to protect their feet without losing traction or hindering their game. Those shopping for new shoes should choose shoes with spike patterns that avoid the ball of the foot area.
When your sport has your feet hurting, get the advice and treatment from professional foot care specialists at SHENANDOAH PODIATRY. Whatever is causing pain in your step, we’re here to help, so call us for comprehensive foot care. If you are new to this area and don’t yet have a podiatrist, we’d like to take on the responsibility of your family’s foot care.

Dedicated to Your Healthy Feet,
Dr. Jennifer Feeny

P.S. An average round of golf involves taking 15,000 steps.

Golfing Feet

Golf legend Jack Nicklaus says the feet lead the way in golf, playing a critical role in timing, balance, distance, and direction. Lively feet, says Nicklaus, are the key to a great golf score. To improve your golf game and prevent injury, start by wearing proper golf shoes that will be comfortable over the four or five miles of a typical round. Stretch your feet and legs before golfing. For maximum results, maintain proper foot alignment during your swing. During the back swing, keep weight evenly distributed on the back foot while rolling the front foot in. A good downswing requires a quick weight shift from back to front, with the back foot rolling in and the front foot rolling out.
For those who participate in sports activities of all kinds, professional attention and guidance can help reduce the potential for discomfort and injury. Since all difficulties with your feet can adversely affect you comfort and lifestyle, SHENANDOAH PODIATRY invites your call for an appointment to maximize your health and well-being. We can’t promise you a better golf score but we can promise you comprehensive foot care geared to your personal needs. We can often accommodate same-day appointments.

Dedicated To Your Healthy Feet,
Dr. Jennifer Feeny

The Unique Nature Of The Skin On Your Feet

Your foot’s skin is unique— it contains some of the body’s most sensitive skin as well as the thickest skin— and require special care and attention. The skin on the bottom of the heel is the thickest of the body. Bearing incredible weight and pressure every day, this skin can become even thicker and suffer painful cracks if you don’t take care of it. On top of your feet is some of the body’s thinnest and most pliable skin. Skin problems that can affect the feet include blisters, corns, calluses, warts, and fungal or skin infections. These conditions can be painful and debilitating, so it pays to care for the skin on your feet.
You’re feet aren’t supposed to hurt, nor are they supposed to hurt you. Skin problems, bunions, fungal nails, heel pain, hammertoes— there’s no reason to suffer with them any longer. Visit your local podiatrist. SHENANDOAH PODIATRY treats patients of all ages for all kinds of podiatric problems, from minor to major to the prevention of both. Feet are our business, and our practice is designed with you, our patient, in mind.

Dedicated To Your Healthy Feet,
Dr. Jennifer Feeny

P.S. Excessive friction, pressure, and moisture are common triggers of skin problems on the feet.
For more information visit our website http://www.roanokefoot.com/

Summertime Injuries

With summer sporting events beginning, as podiatrists we begin to see increased foot and ankle injuries in athletes and runners. Some common injuries that will be seen are stress fractures. Stress fractures are caused by a bone not being able to withstand increased repetitive force, improper shoe gear (severe wear), and increasing activity too rapidly. Stress fractures can account for approximately 10% of running injuries and often occur in activities that involve muscle fatigue.

Signs and Symptoms of Stress Fractures

Female athletes are more prone to stress fractures than their male counterparts due to what is commonly called the “female athlete’s triad”. This triad involves eating disorders (anorexia nervosa or bulimia), amenorrhea, and osteoporosis. Each provides increased risk to developing stress fractures due to loss of bone density and mass. As bone density and mass are affected by hormones and nutrition.

If you suspect you have a stress fracture, you will possibly experience:

1. Tenderness over the area

2. Pain upon weight bearing

3. Slight swelling and reproducible pain with activity that is relieved with rest

Diagnosis

To definitively diagnose a stress fracture, an x-ray may be taken or other advanced imaging techniques (bone scan, CT, MRI, etc) may be necessary.

Treatment of Stress Fractures

It is advised to decrease your activity, change the intensity of your activity, change your footwear, and/or you may be prescribed orthoses. It is important to rest as the fracture will need 6-8 weeks to completely heal.

Prevention

To prevent your potential for stress fractures, inspect your shoes for creases and/or wear in the midsole, replace if worn or old, and be aware of changes in your running surfaces, as one the most common areas for stress fractures are the foot, tibia, and fibula. Try to add cross training to your exercise regimen, as alternating with different stretching; strengthening and flexibility exercises can decrease your chance for stress fractures. It is important to follow the medical advice during your recovery period, so that you can get “back on the road” in a shorter period of time. As returning to “normal” activity too quickly may cause a recurrence and possibly a larger, more difficult to heal stress fracture. Be an advocate for your foot health.

Pain In The Ball Of Your Foot

Metatarsalgia is a foot condition involving pain and inflammation in the ball of the foot just behind the toes. Pain may range between sharp, aching, or burning. Other symptoms may include pain that worsens with standing, walking, foot flexing, or running and improves with rest; sharp or shooting pain, numbness, or tingling in the toes; or increased pain when walking barefoot. Some patients describe a sensation similar to walking on pebbles. The primary cause of metatarsalgia is due to excessive pressure on the metatarsals, the bones that connect to the toes. Runners and others who participate in high-impact sports are most susceptible to metatarsalgia. Certain foot structures may also make a person more vulnerable to the condition.

Correcting foot problems has greatly improved over the past few years. Today’s newer treatments and techniques include special foot care products, custom orthotics, innovative, less invasive surgeries, even joint replacement. Your feet are not supposed to hurt. When they do, we are available at SHENANDOAH PODIATRY to ease your pain and get you walking in comfort.

For more information visit our website www.roanokefoot.com

8 Tips For Healthy Feet on the Trail

My office is located within one mile of the Appalachian Trail. Each summer, I observe the wave of through hikers making the 2,168 mile trek from Georgia to Maine and then later in the summer, those heading south from Maine to Georgia. Many end up with a visit to my office for ankle sprains, stress fractures, infected blisters and various other hiking related conditions. Recently, I received a call from a friend that is through hiking for her second time in the past 10 years. She was in North Carolina at the time and was experiencing unrelenting pain in her foot. Having a telephone consultation and attempting to determine her diagnosis without examination was interesting and challenging. It made me think about the new trend in Internet or telephone doctor "visits". But, that is a subject for another post on another day. I want to share with you these tips to keep your feet happy on the trail:

Train For The Hike:
If you are considering a long trip such as through hiking the Appalachian Trail, I strongly suggest that you start out training early with short day hikes. Marathon runners must train and condition for a marathon and hikers are no different. Those that are not adequately conditioned are more likely to develop overuse injuries.

Pack A Foot-Care Kit:
A small foot-care kit carried in a small Ziploc bag weighs only a few ounces. It should contain foot powder, alcohol wipes, a few tinctures of benzoin wipes to help the patch stick to your skin, several blister patches of your choice, a least a yard of duct tape wrapped around a small pencil, and a safety pin to drain blisters.

Invest In Good Footwear:
You should have a fingers width between the longest toe and the front of your boot. Be sure to also check the fit on an incline (both up and down). Any slippage of the boot will cause friction and blisters on a long hike. Try your boots on with the socks that you will be wearing while hiking.

Break In Those Boots:
Wear your boots around the house for a few days to be sure they feel OK. Then venture outside while shopping and on walks and short hikes so they mold to your feet. Leather boots are usually stiff until broken in. If a little snug, you can bring your boots to a shoe repair to have them stretched or purchase a leather expander and stretch the boots at home.

Wear Good Socks:
Wear moisture-wicking wool or synthetic socks rather than cotton socks. Consider wearing a sock liner but be sure that your boots will be big enough for two pair of socks.

Manage Your Toenails:
Toenails should be trimmed straight across the nail—never rounded at the corners. Leave an extra bit of nail on the outside corner of the big toe to avoid an ingrown toenail. Black toenails are a common hikers condition which is caused by blood being trapped under the nail.

Manage Your Skin:
Treat hot spots early! Use moleskin or duct tape to prevent blisters before they happen. Many hikers think tough callused skin helps prevent blisters but too much is never a good thing. Blisters deep under calluses are difficult to drain and treat. Use a pumice stone or callus file and apply Vaseline to manage callused areas. Blasters can be drained if painful but be sure to leave the roof intact to protect the sensitive skin underneath.

Rest Your Feet:
Take your boots and socks off when resting and eating lunch, elevating your feet to reduce swelling. In camp wear sandals or flip-flops. Your feet need the air and will appreciate the sunlight.

Long distance hiking is an incredibly rewarding experience. May these tips keep your feet healthy on the trail!

Happy Trails,
Dr. Jennifer Feeny

Why Is The Achilles So Sensitive?

While the Achilles is the body’s strongest tendon, it is also one of the most vulnerable. Spanning the calf and anchoring into the back of the heel, the Achilles is located on one of the most overused body parts. The foot handles extreme stress each day, sometimes accommodating the pressure of four times a person’s normal body weight during running activities. The Achilles also receives relatively poor blood supply, which leads to longer healing times when injured. The most common Achilles injury is tendonitis , an inflammation due to stress from excessive exercise, improper training, or high-heeled shoes. Tight calf muscles and biomechanical abnormalities can also strain the Achilles. Reducing activity levels when Achilles pain strikes may promote healing.

All the components of the leg and foot are designed to work together, sharing the tremendous pressures of day-to-day living. When they don’t work properly , or when one part like the Achilles tendon has to take on more than it’s fair share, it’s time to get help. The specialized care and treatment a podiatrist provides can make an important contribution to an individual’s total health. Call us at SHENANDOAH PODIATRY when pain plagues your every step.

Dedicated To Your Healthy Feet,

Dr. Jennifer Feeny

P.S. When Achilles pain persists for two weeks or more, seek podiatric care.

Heel Pain In Children

Sever’s disease is the most common cause of heel pain in the growing athlete. It is due to overuse and repetitive microtrauma of growth plates of the heel bone (called the calcaneus). Another name for Sever's disease is calcaneal apophysitis. Mostly seen in children ages 10-13, it is seen in children ranging in age from 7 through 15. During this time, the growth center of the heel bone is still open and children are often active in sports. Adults do not get Sever’s disease because their growth plates have closed. Unfortunately, adults still get heel pain but plantar fasciitis is usually the cause. Sever’s disease occurs more commonly in children who are tight in their Achilles tendon. You will see them walk on the balls of their feet and the heel hardly touches the floor when they walk.

Symptoms

• Pain and tenderness in the heel

• Difficulty participating in sports

• Limping

• Relief at rest

• Pain when running or jogging

Treatment

Elevating the heel may relieve some of the pain. Children who are active in sports and get heel pain should stretch their hamstrings and calf muscles 2-3 times daily. R.I.C.E may also help and no this is not the rice that we eat. R stands for rest, I is for ice, C is for compression and E is for elevation. Avoiding hard surfaces when running is highly recommended. If your child is having severe pain, an orthotic device may be needed. Surgery is generally not needed for Sever’s disease. Sever’s disease also may go away on its own once the bone is done healing. If your child constantly complains of heel pain after playing sports and you don’t know what to do see us today at SHENANDOAH PODIATRY.

Attention avid golfers

Are you ready for another season of birdies, pars and bogeys? If so, you should know about potentially serious foot problems that can result from years of playing the game.

Although golf is not considered a rigorous sport, the physical act of repeatedly swinging a golf club can lead to a condition known as hallux limitus, a jamming and deterioration of the big toe joint. The movement and weight transfer that occur during the swing's follow through can cause this problem and other chronic foot ailments.
When golfers follow through, they can overextend the big toe joint on their back foot. Those who have played the game for several years eventually can wear out the cartilage or jam the big toe joint. The likely outcome, if left untreated, is painful arthritis in the big toe, which would make it very difficult to continue playing.

If you have pain and swelling around the big toe joint or have less mobility in this area than other parts of the foot, schedule an appointment for an examination. A history of trauma to the big toe area and bone structure also can precipitate the condition. Individuals with a long first metatarsal bone (big toe), for example, are more susceptible to joint compression and hallux limitus. In most situations, orthotics can be prescribed to provide relief, but advanced cases may require surgery.

Check Those Golf Shoes!

Another foot problem that is common in golfers is a neuroma or pinched nerve at the bottom of the foot. The weight transfer to the front foot that occurs in the follow through applies pressure that, over time, can cause a pinched nerve. Wearing shoes that have a spike located directly beneath the ball of the foot can worsen the problem. Also, pressure from that single spike, magnified by the several thousand steps taken during an average round, can cause intense pain and swelling in the ball of the foot. Your golf shoes can be made more foot-friendly, without sacrificing traction, simply by removing poorly located spikes.

For more information visit our website www.roanokefoot.com

Tis the season for foot fungus

We are enjoying the warmer temperatures and water activities are soon to be in full swing. While the activities are relaxing and cooling there are some little friends that you may not want to take home with you. Public pools are a great resource for recreation in communities but with the public use there can be increased incidence of contracting fungal infections. The public showers available can be a source of contracting fungal infections, most commonly, tinea pedis, aka athlete’s foot. It is important to take precautions while using public facilities. If using the shower facilities wear flip flops or water shoes that will prevent your feet coming into contact with the floor, also protect your feet when lounging pool side as well. Bacteria can hide anywhere and any break in your skin is a potential avenue for entry. Bacteria love the damp, warm environment that showers and locker rooms provide.
Athlete’s foot can be spread by direct contact and is characterized by skin peeling and itching on the soles and sides of the feet. There may also be scaling and redness. Other skin conditions can have the same symptoms so it is important to get the correct diagnosis. Using an over the counter medication, that is not sufficient can make the condition worse or not provide any relief. Once treated and symptoms relieved, remember athlete’s foot can return. So it is important to keep your feet clean and dry, do not wear anyone else’s shoes, and wear cotton or synthetic socks to absorb perspiration. If participating in outdoor activities, long runs or hiking, be sure to change your socks frequently to prevent an environment that encourages bacterial growth.
If you are experiencing a troublesome foot condition, contact your podiatrist for expert medical treatment. Be an advocate for your foot health.

For more information visit our website http://www.roanokefoot.com/

Living With Gout

Gout is a form of arthritis that primarily attacks the big toe and causes redness, inflammation, and pain in the area. An initial attack of gout tends to last several days and may even disappear without treatment, but future attacks are typically more severe. To prevent repeated attacks of gout, several lifestyle choices should be made. Because gout is typically caused by an impaired ability to process uric acid, avoiding purine-rich foods like meat can help prevent episodes. Drinking enough decaffeinated, non-alcoholic beverages (water, juices) and losing weight, if necessary, can help patients manage gout. Reducing alcohol consumption and taking medications as prescribed are also recommended. Following your doctor’s recommendations and treatment plan for gout is important to reduce painful attacks.
While our specialty at SHENANDOAH PODIATRY is feet, our work in podiatry can affect all parts of the body. And as podiatrists, we have a unique opportunity to get an insight into how other systems of the body are working. With our knowledge and experience, your cooperation, teamwork with other medical caregivers, and the wonderful power of podiatry, we’ll have you once again walking with a smile. When gout or other foot aches and pains have you wincing with every step, it’s time to call our complete foot care facility, where same day appointments are often accommodated.

Dedicated To Your Healthy Feet,
Dr. Jennifer Feeny

P.S. Ninety-five percent of gout patients are men

Pregnancy And Your Feet

Two common foot ailments associated with pregnancy are arch pain and swelling.

The weight gain naturally occurs during pregnancy completely shifts a woman’s center of gravity and places extra stress on the knees and feet. The arch may flatten out, or overpronate, and feet may roll in when walking. The plantar fascia often becomes strained or inflamed as a result, leading to pain in the heel, arch, or ball of the foot. Edema, or swelling of the legs and feet, occurs when the growing uterus pressures surrounding blood vessels and slows circulation. Blood pools in the lower extremities and causes swelling and discoloration. Varicose veins and leg cramping are also common during pregnancy because of weight gain.

Just as you put prenatal care in the hands of a specialist, so should you entrust your hard-working feet to a specialist— a highly trained, specially skilled podiatrist. It’s time to pay attention to what your feet are trying to tell you when each step is more painful than the one before. Don’t ignore foot problems, whether caused by pregnancy, injuries, diseases, or inherited conditions. Call us instead at SHENANDOAH PODIATRY.

Dedicated To Your Healthy Feet,

Dr. Jennifer Feeny

P.S. Resting frequently with their feet up is good advice for pregnant women.

For more information visit our website www.roanokefoot.com

Healthy Nail Polish?

Are you ready to get your toes sandal ready? Do you worry about the chemicals in nail polish such as formaldehyde (a chemical which has been proven to cause cancer), toluene ( a chemical that the EPA restricts in our drinking water because it can cause nervous system disorders as well as damage to the liver and kidneys)and DBP (a potential developmental and reproductive toxin that may cause birth defects and is banned in Europe)? There is a healthier alternative for your nails.

Dr.'s Remedy Enriched Nail Polish is formulated without these harmful chemicals. Better yet, it is enriched with naturally occurring antifungal ingredients like tea tree oil, garlic bulb extract, as well as vitamins C & E and wheat protein. This enhanced nail polish promotes healthier, stronger, more beautiful nails. The chic yet affordable polish strips put harmful toxins without sacrificing effectiveness, quality or beauty!

Developed by podiatrists, Dr.'s Remedy Enriched Nail Polish is recommended by doctors nationwide. Isn't it nice to know that you no longer have to sacrifice fashion and beauty for health and well-being?

Nail Salons- Should I Be Worried About Infections?

Two weeks ago I published an article: Nails Salons-Should I Be Worried About Infections?

Yesterday, WDBJ7 aired a story about MRSA infection after a manicure. This again has stirred the debate...are nail salons safe?

I would suggest erring on the side of caution and paint your nails at home.

Dedicated To Your Healthy Feet,

Dr. Jennifer Feeny

For more information visit our website www.roanokefoot.com

What Is A Pedorthist?

You know that you make an appointment with a podiatrist for any foot ailments or injuries. But have you heard of a pedorthist? Many podiatric practices now engage the services of pedorthists to extend the value they provide patients. The field of pedorthics encompasses the design, manufacture, modification, and fit of footwear, orthotics, and devices to alleviate foot problems caused by disease, overuse, or injury. Pedorthists are certified by the Board for Certification in Pedorthics and must fulfill and maintain specific educational requirements to practice. Some of the more common disorders that pedorthists address with footwear treatment include heel pain, flat feet, high arches, hammer toes, pain or calluses in the balls of the feet, fallen arches, diabetes and arthritis.

At SHENANDOAH PODIATRY, we use today's high-tech diagnostic tools to fit orthotics and to detect foot imbalances, problems, and disorders, and to help determine the most appropriate treatment with more accuracy than ever possible before. We also use the most up-to-date materials for orthotics and other treatment modalities, always with the comfort of our patients in mind. Find out the many ways available today to keep your feet in the best of shape. Call us for comprehensive, family foot care.

Dedicated To Your Healthy Feet,

Dr. Jennifer Feeny

P.S. Improperly fitting footwear is one of the leading causes of foot pain.

The Foot's Complex Structure

The foot's intricate structure combined with the heavy demands we place on our feet make preventive foot care a necessity. The ankles, for example, serve as the foot's foundation. When they are swollen, strained, or sprained, proper treatment will get you back to your routine and pain-free more quickly. Heels are the first point of contact with the ground during walking and running and form the base of the arch, which supports your body during activity. Each foot includes 26 bones, 33 joints, and more than 100 ligaments that require care and attention when symptoms occur. Toenails— often a neglected foot part— can be a source of problems, and the foot's skin plays a key role in maintaining maximum mobility.

The components of the foot, ankle, and leg are designed to work together, sharing the tremendous pressures of day-to-day living. When they don't work properly, through, it can cause pain and other troubles for the rest of the body, and it's time to get help. The specialized care and treatment a podiatrist provides can make an important contribution to an individual's total health and well-being. SHENANDOAH PODIATRY offers comprehensive foot care by appointment .

Dedicated To Your Healthy Feet,

Dr. Jennifer Feeny

P.S. Corns, calluses, blisters, warts, and infections on the foot's skin can make daily activities uncomfortable.

Selecting the Correct Shoe Size

To help find the appropriate shoe fit, it is important to keep certain things in mind when shopping for shoes. So you like the color, style and price, what else is there to know, you ask? There are a few things that you may not know that can help you make smarter choices in your shoe selection. If the appropriate shoe size and/or shoe type are not correct for your foot type, it can cause hammertoes, bunions, corns, calluses, or heel pain. Many times the size that is on the box is not necessarily the correct size for your foot. So ladies, don't be in denial about your shoe size, get the correct size and prevent future foot problems. As we age, men and women, our waist size may increase a little, well so does our foot size. Here are a few points to remember:

• Heel to toe length: this is commonly used to determine your shoe size, but this is not the most accurate measurement. Reason is that the great toe joint may not always be at the ball of the shoe, so foot problems may occur.

• Heel to ball length: this is the most important factor in determining the size of the shoe. This measurement helps determine the correct position for the arch of the shoe and for the foot to bend in the proper position as well.

• Width: measure from the first metatarsal head to the fifth metatarsal head (widest part of the foot). Wearing a shoe that is too wide for a narrow foot type, allows the foot to move around in the shoe, which can cause injury due to increased mobility of your foot inside the shoe. Wearing a shoe that is too narrow for a wider foot type, can cause areas of pressure and not allow the toes to extend fully in the toe box. The excessive pressure can cause corns and calluses and the toes can develop into hammer, claw or mallet toes.

• Girth: thickness of the foot; measure from the top of the foot to the sole of the foot. A thicker foot will require an increased depth of shoe. A thinner foot may require extra padding to take up space in the shoe.

• Shape: take into account the shape of your foot, not just the shape of the shoe.

Many patients may have foot conditions that will not allow them to wear over the counter shoes without modifications. Their condition may require custom made shoes. If you have questions, regarding your shoe gear, schedule an appointment at Shenandoah Podiatry. I'd be glad to help you.

Dedicated To Your Healthy Feet,

Dr. Jennifer Feeny

Black Toenails

Do you have a long-distance runner in your circle of family and friends? If so, you may have seen an occasional black toenail. Common among marathoners and other athletes, black toenails occur when the top of the toenail continuously bangs against the running shoe and causes bruising under the nail. Black toenails rarely cause pain or discomfort, except for possibly preventing a person from wearing open-toed shoes. But the bruising does create a environment that encourages fungal infections under the toenail. Trimming the affected nail and applying an anti-fungal/antibacterial medication can prevent infection. Diabetics need too pay careful attention to toenails that darken suddenly as it could be a sign of a diabetic complication.

Feet seem especially susceptible to nail problems of all kinds, including black toenails and fungal infections. It might be because of the trauma they endure in shoes, or all the time they spend in dark,moist places, or perhaps just lack attention. Whatever the cause, your podiatrist is well-equipped to help provide the cure, from medication to surgery. When your feet hurt, don't take another step until you see SHENANDOAH PODIATRY for family foot care. Same day appointments are often accommodated.

Dedicated To Your Healthy Feet,

Dr. Jennifer Feeny

P.S. To prevent black toenails, choose properly fitting shoes and stretch calf muscles to decrease the impact of toes hitting the shoe when running.

Reflexology

Therapeutic reflexology, a popular therapy around the world, involves massaging the nerve endings of the feet to reduce stress and tension and promote healing in other areas of the body. The practice is based on the ideas that our body parts are reflected in the feet, with the front of the body on the sole of the feet and the back of the body on tops. For example, massaging the toes can help relieve headaches and other symptoms in the head. Massaging the anklebone can help with hip problems. The feet have always played an important role in healing, and reflexology dates back to 2500 BC. Some podiatric offices are now hiring therapeutic reflexologists as a complementary service.

It's always a good idea to listen to your feet, as they often have lots to tell you, including giving you clues about the rest of your body's well-being. When your feet tell you there's trouble somewhere, as your podiatrist, SHENANDOAH PODIATRY will work as a team with you, and other healthcare providers if appropriate, to keep you and your feet healthy and pain free. Feet that feel good make the rest of you feel good, too, so why not give us a call and start the process today.

Dedicated To Your Healthy Feet,

Dr. Jennifer Feeny

P.S. Eunice Ingham is widely recognized as the grandmother of modern reflexology for transforming its theory into a practical therapy.

COMMON FOOT INJURIES IN ATHLETIC KIDS

Millions of kids are involved in several sports, which is a good thing overall. But because many sports are hard on the feet--- and a child's bones, ligaments, and tendons aren't fully developed, stress-related foot injuries are common. Heel growth plate inflammation, a risk until age 13 to 16, can occur due to muscle strain and repetitive stress. Achilles tendonitis occurs most often after age 14 and results from stressful running and pounding. Tendo-Achilles bursitis is an inflammation of the fluid-filled sac between the Achilles tendon and heel bone. Plantar fasciitis is heel pain triggered by inflammation along the tissue spanning the sole of the foot. Stress fractures and hairline bone fractures caused by overuse.

Young or old, athletically inclined or not, no one can afford to play games with foot injuries, fractures, diseases, or disorders. Podiatric problems demand the attention of a professional. Don't let foot concerns keep you on the sidelines. Consult with us instead at SHENANDOAH PODIATRY . We offer treatment of specific problems as well as preventive care to keep you on your feet. Please call us for an appointment. Same day appointments are often accommodated.

Dedicated To Your Healthy Feet,

Dr. Jennifer Feeny

P.S. Do not allow your child to continue playing a sport if he or she is in pain. Find out the cause of it to prevent chronic problems.