Soles 4 Souls Helps You Help Japan

The earthquake and tsunami that devastated Japan last week have left many of us wondering how we can help. Soles 4 Souls is an organization put in place to do just that – give us a way to contribute to those less fortunate. It was formed in 2004 when its founder was inspired by footage of a single shoe floating ashore after the tsunami in the Indian Ocean. Soles 4 Souls has since donated gently used shoes to third world countries all around the world.


Their current focus is to provide those in Japan with shoes so that they may safely walk among the wreckage left behind by this brutal, natural disaster. For those who have lost everything, a simple pair of shoes can mean the world.


Please consider helping Soles 4 Soul’s effort in any way that you can. To find a participating location where you can drop off your new or gently used shoes, visit Soles 4 Souls Locations. Can’t find a location in your area? Helping is as simple as texting SHOES to 20222 to donate $5.00.

For more information about this effort and how you can get involved, please visit Soles 4 Souls Helps Earthquake Victims.

Don't be like Brady!

You don't have to be a football fan to know that the New England Patriots are no longer contenders for the Super Bowl this year. News of their seven point, playoff loss to the New York Jets spread like wildfire. Not as widely known, however, is that Patriots quarter back Tom Brady was battling a stress fracture in his right foot all season. He played through the pain all year and only went in for surgery to repair the injury when Super Bowl XLV was out of the picture. In this way, Brady is so much like the rest of us whether we want to admit it or not. Love him or hate him, you're just like him because you probably postpone visiting the doctor until absolutely necessary.
So many of us either try to work through pain or diagnose and treat ourselves. I can't tell you how many times I've found one reason or another to put off seeing my doctor about a health issue. All too often I hear "I don't have time to go to the doctor" or "I'd have to leave work early to get this looked at." It's scary how common this phenomenon is because our health isn't something that we should gamble with. Untreated injuries or illnesses can often develop into something much more serious than the original problem. That pesky ingrown can lead to a dangerous infection. That painful foot injury might need surgery but then again it might not. The point is that you won't know until you get it looked by a professional.

Make time. Leave work early. Schedule an appointment to see Dr. Feeny or Dr. Yeaman. Your feet will thank you for it and you'll save yourself a lot of grief in the long run.

Winter Tips for Cold Feet

Brrr! Winter is in full force here in the valley and that means it’s COLD. During this time of the year we often pile on layers to protect our core but tend to forget about our extremities. If you’re looking for tips on how to keep your feet warm this winter, Shenandoah Podiatry can help.
Socks made from natural fibers – like wool – should be worn because they have moisture-wicking properties. This helps to prevent fungus which grows best in warm, damp places. Leather shoes can also keep your feet warm because leather has natural insulating properties. If you choose to wear insulated boots, be sure that they aren’t too tight as this can cause ingrown toenails. Avoid electric socks and other heated inserts because they can be dangerous especially if there’s an underlying reason for your cold feet.

Aside from winter weather, cold feet can be caused by a number of serious ailments that should be addressed right away. If our feet are cold year-round, we might be especially quick to write it off as normal during the winter. Unfortunately, cold feet can be indicative of a more serious problem and should never be ignored.

Peripheral vascular disease (PVD) or poor circulation is a common culprit. Blood helps to keep us warm and without proper circulation our bodies direct heat to our core and away from out feet. If you smoke or have diabetes, you have an increased risk of developing PVD which can make it harder for small cuts and ulcers to heal properly. This is why it’s so important to see a podiatrist right away if one of these sores develops.
Diabetes can also put you at risk for chilbains or ulcers of the toes and feet after cold exposure. If you experience redness and swelling in your toes after being outside and it doesn’t go away once they’ve warmed, make an appointment to see us right away.
We hope that you’ll follow these tips and be on the lookout for these possible conditions. If you do, you’ll find it easier to keep your feet warm this winter which is important because warm, dry, pain free feet are healthy feet.

What is Athlete's Foot?

No, it's not just something athletes get. Athlete's foot is a skin disease caused by a fungus that can occur on the feet and between the toes. The term "athlete's foot" became popular because athletes who used these facilities would develop the fungal infection. Some symptoms of Athlete's foot are dry skin, itching, burning, scaling, inflammation, blisters, and pain.

Athlete's foot can happen to anyone, and the fungi grow abundantly in many common places. Shoes create a warm, dark, and humid environment, the ideal environment for the growth of a fungus, which is why a the feet are a common spot for a fungus to attack. Breeding grounds for fungi can also be found around swimming pools, showers, and locker rooms.

You can prevent Athlete's foot by practicing good foot hygiene and washing your feet daily with soap and water. Be sure to dry your feet well, especially between the toes, and try to change your shoes and socks often to decrease the moist environment. You can also decrease excess perspiration by using a talcum powder. If you are in an environment where a fungus can be found - such as a pool, locker room, public shower, or dressing room - avoid walking barefoot and wear shower shoes when rinsing off.

If treatment does not respond to good hygiene or self treatment, make an appointment with a podiatrist. The podiatrist will determine if the condition is a fungus or some other problem and determine a plan of treatment, which may involve topical and oral antifungals.

A Shoe For Every Sport

Shoes, shoes, and more shoes. There seems to be a shoe designed for every sport out there. But
there’s a method to the madness. Sport-specific shoes really can change your game. See the tips
from the APMA below to learn why the shoe you choose could make or break your day on the court or field.

Basketball

Whether you’re making the perfect pass or finishing off the high-flying dunk, basketball shoes have several features that will help you prevent injury.

• A thick, stiff sole gives support while running and landing from jumps.

• High ankle construction supports the ankle during quick changes in direction. A basketball shoe should have the strongest support on either side of the ankle.

Racquetball/Tennis

On the surface, court shoes for tennis and racquetball may look like any other athletic sneaker, but it’s what’s on the inside that makes the difference.

• A court shoe supports both sides of the foot because of all
the quick lateral movements and weight shifts in court sports.

• It provides a flexible sole for fast changes of direction.

• It has less shock absorption than a running or basketball shoe.

Running

The running shoe is perhaps the most personal and intricate
of all athletic shoes. Every runner has different needs and there
are a multitude of choices out there.

• A running shoe must provide maximum shock absorption to help
runners avoid ailments such as shin splints and knee pain.

• The shoe should control the way your heel strikes the ground, so
the rest of your foot can fall correctly.

• Know your foot type (high, medium, low arch) so you can get the
shoe with the right support for your foot.

“Generally, you want to go with the sport-specific shoe if you are participating
in a sport on a regular basis (2-3 times a week). Make sure the shoe fits correctly. Fit is just as important as the right type of shoe,” says APMA Director of Scientific Affairs Dr. Jim Christina.

To read more articles about shoes and your feet, check out the Footnotes link on our website at http://www.roanokefoot.com/.

Running for Women: An Uphill Trend

According to Running USA, over 10 million people finished a race last year. Running has taken on a huge growth in general over the past couple of years. Research shows that running as a form of exercise tends to increase in a bad economy, and with our economic situation running can be an appealing alternative to paying large sums of money for gym memberships.

However, money isn't the only reason for this increase. Many women run for the social aspect. "There's about 10 of us that will travel somewhere in the US. We'll say, 'This is where we're gonna go,' and we all pitch in and we get hotel rooms for all of us," says runner Hillary Mancuso.

Running is an excellent, inexpensive, effective form of exercise. So grab a pair of well-fitted and supportive running shoes, fill up a water bottle, stretch and warm up your muscles, and most of all have fun!

To read more, visit the article from WRCBtv Chattanooga News at http://www.wrcbtv.com/Global/story.asp?S=13628789.

Your Feet...Out on the Town

According to a survey in British newspaper The Telegraph, it only takes an average of 34 minutes for a woman wearing high heels to start feeling pain in their feet from high-heeled shoes. Four out of ten women surveyed stated that they carry a spare pair of pumps in case their first pair starts to rub throughout the night. More than fifty percent admitted to walking home barefoot after a night out on the town. The survey also showed that the average British woman owns 18 pairs of high heels.

The survey included 4,000 women between the ages of 18 and 65. Click here to read more.

Just remember that while your high heels may look fabulous, it's wise to listen to your feet when they hurt! Change into more comfortable shoes (not another pair of stilettos!) or take a seat and let your tootsies rest. And we don't recommend walking home barefoot - broken glass and rocks are just a few of the possible hazards you could stumble upon.

And if your feet keep hurting, please come see us - we can help! Visit our website or give us a call at (540) 904-1458 to have all your questions answered.

Diabetic Ulcers

Contributing Factors :

- Mechanical changes in conformation of the bony architecture of the foot

- Peripheral Neuropathy

- Peripheral Arterial Disease

- Glycosilation - Predisposes ligaments to stiffness

Diabetic Facts:

- 12-24% of individuals with ulceration require amputation

- Half of all non-traumatic amputations are the result of diabetic foot complications

- The 5-year risk of needing an amputation on the other extremity is 50%


Diabetic Peripheral Neuropathy results in:

- Loss of sensation in the foot

- Injuries and fractures

- Structural foot deformities

- Hammertoes

- Bunions

- Metatarsal Deformities

- Charcot Foot

- Tissue Breakdown


Peripheral Arterial Insufficiency Results In:

- Intermittent claudication

- Pain at rest

- Non-healing ulceration of the foot

- Ischemia of the foot - Inadequate blood supply

Examination:

Diabetic Ulcers tend to occur in the following areas:

- Heel

- Metatarsal Heads

- The tops and ends of hammertoes


Lab Studies:

- A complete blood count may signal an abscess or infection

- Non invasive vascular studies to assess circulation deficiencies

- Infection markers such as the sedimentation rate


Imaging (to evaluate the presence of osteomyelitis):

- Plain Radiographs

- CT

- MRI

- Bone Scans


Treatments:

- Treat infections with appropriate antibiotics

- Offloading the area of the ulcer

- Wound care

- Application of a Wound Vac - Negative pressure under an occlusive wound dressing for deep cavity wounds

- Surgical Debridement - Surgical management is indicated for debridement of non viable and infected tissue from the ulceration

- Debridement of infected bone

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic systemic inflammatory disease of unknown cause that primarily affects the peripheral joints in a symmetric pattern.

RA causes joint destruction and thus often leads to considerable morbidity and mortality.

Why do people Get RA ?

- An infectious etiology has been speculated
- Associated with a number of autoimmune responses
- Whether autoimmunity is a secondary or primary event is still unknown
- RA has a significant genetic component

Frequency :

The worldwide incidence of RA is approximately 3 cases per 10,000 population

Mortality/Morbidity:

- Daily living activities are impaired in most patients
- Life expectancy for patients with RA is shortened by 5-10 years

Signs and Symptoms:

- Morning stiffness
- Arthritis of 3 or more joint areas
- Arthritis of hand joints - At least one swollen area
- Symmetric arthritis with simultaneous involvement
- Rheumatoid nodules

Progression of RA :

Stage 1 (early RA)

- No destructive changes observed on x-ray
- Radiographic evidence of osteoporosis possible

Stage II (moderate progression)

- Radiographic evidence of periarticular osteoporosis with or without slight subchondral bone destruction
- Slight cartilage destruction possible
- Joint mobility possibly limited; no joint deformities observed
- Adjacent muscle atrophy
- Extra-articular soft tissue lesions (eg, nodules, tenosynovitis)

Stage III (severe progression)

- Radiographic evidence of cartilage and bone destruction in addition to periarticular osteoporosis
- Joint deformity
- Extensive muscle atrophy

Stage IV (terminal progression)

- Criteria of stage III
- Fibrous or bony ankylosis - stiffness of a joint due to abnormal adhesion and rigidity of the bones of the joint

Remission:

Remission of RA - Five or more of the following conditions present for at least 2 consecutive months:

- Duration of morning stiffness not exceeding 15 minutes
- No fatigue
- No joint pan
- No joint tenderness or pain with motion
- No soft tissue swelling in joints or tendon sheaths
- ESR of less than 30 mm/h for a female or less than 20 mm/h for a male

Lab Studies:

No pathognomonic test is available to help confirm the diagnosis of RA. The diagnosis is made using clinical, laboratory, and imaging features. Clinicians will analyze the following:

- Markers of inflammation, such as ESR and CRP
- Synovial fluid analysis
- Rheumatoid factor - Present in approximately 60-80% of patients with RA over the course
- Antinuclear antibodies - These are present in approximately 40% of patients with RA

Treatments:

Disease-modifying antirheumatic drugs:
- Leflunomide (Arava)
- Methotrexate
- Sulfasalazine
- Etanercept (Enbrel)
- Infliximab (Remicade)

Nonsteroidal anti-inflammatory drugs

Analgesics

Glucocorticoids

Immunomodulators:

- Anakinra (Kineret)
- Abatacept (Orencia)

Olympic Feet

With the winter Olympics going on right now, it makes me think of all the different sports we are able to participate in. Sports that ask us to run, jump, kick, twist, turn, and glide. Sports that ask for speed and agility that, without the versatility of our feet, would not be possible or at least would look quite a bit different!

The 26 bones and 33 joints in each foot allow us to effortlessly become mobile in many different ways. When I see someone skate their heart out down the length of the ice and stop on a dime, my breath is taken away. Though it may seem like the boot is doing the work, anyone who has ice skated before and had sore feet the next day will tell you otherwise. The complexity of the foot is amazing. And even more amazing than that are the mechanics that make a human foot work properly, the podiatrist.

Though feet are not visible during the winter Olympics, they are still a very important part of the games. A ski or a skate is merely an extension of the foot. Bobsledding wouldn’t be possible without the help of our feet mustering up enough momentum to make the sled go. Even changing the balance and placement of your feet in curling can change your game.

During the 2010 winter Olympics root for team feet! And keep in mind all the amazing things your feet do for you everyday.

Though we are all about feet, we want to recognize those who haven’t given up the games they love because their mode of movement is different than the movement of the original game. We want to recognize how these sports have been modified to work for all kinds of people. For more information about wheelchair and ambulatory sports check out http://www.wsusa.org/.

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.

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

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

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