Fact or Fiction: There Is Nothing You Can Do For a Broken Toe?

Your alarm clock, conveniently located on the other side of your room, starts buzzing bright and early. No need to turn on the light…you know the way, BAM! You walk, barefoot, right into the dresser! Just like a cartoon character, you see stars. As your day continues, you can’t get past the throbbing pain. You know you have broken your toe.

Throughout the day your toe begins to bruise and swell. Wearing a shoe, or even walking, is excruciating, maybe even impossible. You know you need to call a doctor, but what did your mom always tell you? “There’s nothing you can do for a broken toe.” Will it be a waste of everyone’s time if you make an appointment with your podiatrist? Should you simply deal with the pain? But the pain is so bad…was your mom really right? Is the rumor true?

When people tell you nothing can be done for a broken toe they normally mean that a cast is not applied. A cast, made of plaster or fiberglass, is the most recognizable treatment for a broken bone. Does that mean if you don’t cast it, you’re not treating the broken bone? No!

The great toe has two bones in it, with all others having three. Although small, they are classified as long bones, just like an arm or leg. When any bone, especially a long bone, breaks, it is very important to make sure that it is not displaced; otherwise it will not heal properly.

During your appointment with us, we will take an X-ray and then be able to advise treatment. If the bone is not displaced, treatment can be as simple as applying a “buddy splint.” This is a splint that simply attaches the broken bone to an adjacent digit. This provides compression and stability.

If you have displaced the bone, most of the time we can realign the bone right here in the office. It involves numbing the toe and using traction to get the toe in a good position. In most severe cases, surgery may be necessary.

I know you may find it hard to believe but sometimes broken toes can become a medical emergency! Anyone who has poor circulation, such as a person with diabetes or peripheral artery disease, can end up with a spasm of the small arteries caused by the trauma, which can shut down the blood supply to the toes. If immediate care is sought, this can be reversed. If left untreated for even one day, however, amputation may be required.

So next time someone tries to argue that there is nothing you can do for a broken toe, let them know that the doctors at Shenandoah Podiatry informed you otherwise. The sooner you receive care, the quicker the pain and swelling will be reduced. Don’t be fooled by the popular rumor, call us right away!

Are your “ugly” toenails embarrassing you?

Do your thick, discolored, unsightly toenails cause you too much embarassment? Do you find yourself refusing to wear your sandals in the summer? Are you nervous that the infection will spread? Don’t worry, we are here to help!

Fungal toenails, or onychomycosis, are one of the most common conditions a podiatrist sees. Fungus is a naturally occurring component on the skin and nails, especially in the foot. If ignored, the fungus can cause an infection. Infection is especially prone when there has been a trauma to the toenail.

Are you unsure if your toenail is fungal? If your toenail appears thickened, yellowish, and crumble, chances are you have a fungal infection. People who have some immune compromise, such as diabetics, are more likely candidates for fungal infections. These people are also at risk for more severe infections if the fungal infection is ignored.

How do you treat fungal infections? There are many over-the-counter medications and preparations available, as well as many popular home remedies, which provide no cure. Fortunately, the podiatrists here at Shenandoah Valley Podiatry can evaluate and treat fungal infections with various medications that provide complete cures. No more “ugly” toenails for you!

Whether it be a prescription topical medication or an oral medication, a cure is possible. Remember, the nail is slow to clear so make your appointment today. We will cure you of your infection AND your embarrassment!

Corns

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


Corns are hyperkeratotic papules of the skin. They are also known as clavi. These lesions can be painful.

They develop due to excess pressure on the bony prominences of the feet and toes.


Factors that contribute to the formation of corns include:

Abnormal foot mechanics

Foot Deformities

High Activity Levels

Peripheral Neuropathy


Corns are often seen in:

Athletes

Elderly Patients

Diabetic Patients


Types of Corns:

Hard Corn (Helloma Durum)- Commonly found over the joints of toes.

Soft Corn (Helloma Molle)- Found in interdigital locations and has a macerated texture.

Periungual Corn- Found near the edge of a nail.


Presentation:

Corns present with a growth on the foot or toes. Pain is associated with walking or wearing shoes.

Direct pressure generally cause pain to the affected area.

After debridement a corn may have a central plug of skin.



Intrinsic causes:

Foot deformities such as a bunion or a hammertoe

Extrinsic causes:

Activity

Poor fitting shoe gear


Work Up:

X-rays of the feet while weight-bearing can help identifying bony prominences.

Pressure studies- Can help locate the exact location of pressure.

After trimming the lesion the examiner can attempt to determine if the lesion is a corn, callus, or wart.


Treatment:

Hard corns- Pare or debulk the lesion utilizing a small blade. Removal of the centralized plug.

This should be performed regularly in high risked patients such as diabetics.

Regular debridement might decrease the risk of ulceration.


Soft corns- Hygiene is important to decrease the chance of infection. The patient should wear a pair of properly fitting shoes.

The use of an antifungal or antibacterial powder may be helpful.

Toe spacers can also be beneficial.


Other treatment:

Keratolytics such as salicylic acid, urea cream, or lactic acid cream may be prescribed by your doctor.

Good fitting shoe that match the length and width of the patient's feet.

The use of a pumice stone for careful debridement.

The use of good foot hygiene.

The use of a silicone sleeve.

Orthotics


Surgical care:

If conservative treatment fails surgery may be indicated to remove bony prominences.

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)

Cross Country Barefoot Encounter

Did you hear about the guy walking across the country barefoot?? Yes, you heard me correctly. Ron Zaleski is trudging across the US - BAREFOOT - to raise awareness about the need for mental counseling for all military personnel.

As a former military man himself, he is attempting to collect 1 million signatures for his petition along his back roads route to the west coast. The petition calls on Congress to mandate mental counseling for all military personnel.

Tuesday August 10 (just last week!) he passed through good ole' Buchanan, VA. Such a huge cause trampling right through our back yards. Our very own Roanoke Times had a chance to catch up with Mr. Zaleski and get an update on his journey.

Ron is giving everything he has to this cause including the health of his poor tootsies! Rex Bowman from the Roanoke Times reported that his feet were a "mess of broken skin and calluses." Not exactly the prettiest of mental pictures. He should definitely have stopped by to see us while he was in town. ;-)

Well, I just wanted to share with you a little about the barefoot walker's journey. If you'd like to follow him on his cross country trek, check out his website www.thelongwalkhome.org.

For more information visit our website www.roanokefoot.com

Shoes that are creating their own path in our world Part 2

Simple Shoes

This shoe company has come along way since opening in 1991. The Simple shoes that we know and love today are not at all the same shoes from the 90’s. For about 13 years Simple was just like every other shoe company out there. But in 2004 Simple Shoes had an epiphany and decided to take on the challenge of providing eco friendly shoes to the public. They started small with 2 different styles in 2005 called their ‘Green Toe’ collection. These shoes where a hit and as soon as the ball was rolling for Simple there was no stopping it. Over the past few years Simple has produced with even more shoes that incorporate natural and sustainable materials into their products. In 2006, Simple set a new goal to become a 100% sustainable company. This was a huge step for any company, and a very exciting one at that. In 2007, they took it one step further (we didn’t think it was possible!). Simple shoes started to use recycled materials as well as products found naturally in our world. So now, old tires can gather dirt on people’s feet instead of in a dump. To learn more about Simple Shoes visit www.simpleshoes.com.

A Hiking We Will Go

I saw my first through hikers off the AT last weekend at Kroger-Daleville while doing my weekly grocery shopping. It got me thinking about all of the people that have limped into my office off the trail over the years.

Walking up and down steep hillsides and tramping through wet, slippery fields and wooded areas puts stress on the muscles and tendons in the feet and ankles, especially if you haven't conditioned properly before hitting the trail. Also, many don't realize that sneakers aren't the best choice for extended hiking and hunting. Had some of my patients worn sturdy, well-constructed hiking boots, they wouldn't have suffered sprained ankles or strained Achilles tendons.

Make the investment in top-quality hiking boots. Strong, well insulated and moisture-proof boots with steel or graphite shanks offer excellent ankle and foot support that helps lessen stress and muscle fatigue to reduce injury risk. The supportive shank decreases strain on the arch by allowing the boot to distribute impact as the foot moves forward. So if a boot bends in the middle, don't buy it.

In wet and cold weather, wearing the right socks can help prevent blisters, fungal infections. Synthetic socks should be the first layer to keep the feet dry and reduce blister-causing friction. For the second layer, wool socks add warmth, absorb moisture away from the skin, and help make the hiking boot more comfortable.

Don't ignore pain and hope that it will go away. If you are out on the trail, try and take a break to see if the pain subsides. As soon as you are able, make a visit to your podiatrist to determine the cause of your pain. Remember, pain is your body letting you know there is something wrong.

Dedicated To Your Health Feet,

Dr. Jennifer Feeny

For more information visit our website www.roanokefoot.com

Introducing Dr. Daniel Yeaman

I am pleased to announce that Daniel Yeaman, DPM has joined our team at Shenandoah Podiatry. A native Virginian, Dr. Yeaman recently completed an extensive fellowship in diabetic wounds and limb salvage following a three-year residency, specializing in reconstructive foot and ankle surgery.

His specialties are management and reconstruction of the diabetic foot and ankle. He also treats ingrown nails, skin conditions of the foot such as plantar warts, fungal nails and painful foot conditions such as heel spurs.

He has traveled to Honduras to assist in surgery for children born with foot deformities such as clubfeet and has volunteered locally throughout his education.

In his free time, Dr. Yeaman enjoys hunting, fishing and spending time with his family.

We strive to provide the best care possible for our patients and feel his addition will contribute greatly to our efforts. Please welcome Dr. Yeaman as we all work towards your good health.

Dedicated To Your Healthy Feet,

Dr. Jennifer Feeny

King Tut's Club Feet

When we think about world rulers, the ones who changed history, we usually concentrate on the changes they’ve done rather than think about the human aspects of their lives. Recent CT scans and DNA tests reveal a lot about the great Boy-King of Egypt’s very human life. They found out that he had club feet, Kohler’s disease, and a cleft lip just to name a few, yet he went on to rule the empire of Egypt for 10 years from 1333 B.C. until his death at the age of 19.

It is amazing to see that he was able to rule such a great empire with these ailments despite the physical pain that they cause and also though they caused visual changes in him as well. Club foot is a congenital deformity in which the foot turns inward and downward at birth causing that outer side of the foot to become the area that is walked on. Kohler's disease is a condition, where the navicular bone in the foot undergoes avascular necrosis. Avascular necrosis is a disease resulting from the temporary or permanent loss of the blood supply to the bones. Without blood, the bone tissue dies and causes the bone to collapse. Both of these ailments are very painful and make it extremely difficult to walk.

Often people have a hard time following leaders if they seem physically weak but King Tut was able to pull it off despite being in pain everyday and having to use a cane to walk. It is inspiring to know the lives that people have lead even with foot pain but makes me so thankful that we now have podiatrists and don’t have to live it foot pain!!

Fun fact: Over 130 walking sticks where found in King Tut’s tomb.

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/.

Helping Hatian Feet

It is about three weeks after the 7.0 earthquake hit Haiti. Sadly, the news of this devastating event is fading out of the spot light of our media and out of the minds of those in our country though the effects of this earthquake have hardly vanished from the eyes of the Haitians. Some of us have not forgotten, others of us just need a little reminder to bring us out of our own routine. Perhaps you have been keeping up with the news in your own way; checking blogs, talking to friends, watching videos, doing what you can to not let the Haitians vanish into the rubble that is now their country. Perhaps you have given your time, informed others, or given monetarily to show the Haitians your support. Every little bit helps and giving can be fun especially when you can find ways to give that resonate with things you are passionate about.

Since we are all about feet, we wanted to share some ways with you that will help the feet of the people in Haiti. Through these websites there are several ways that you can find to help protect the Haitians from the debris left by the earthquake.

http://www.soles4souls.org/

http://www.shoes2share.com/

Check them out today!

The Strength of Feet: A Remembrance of Martin Luther King Jr.

Today we remember a man who called on the feet of our country to bring about the changes that we needed. We remember those who marched for freedom and stood strong on their beliefs. We look back into history and take into account the miles traveled towards a more equal future for all Americans in our country.

From the beginning to the end of Martin Luther King Jr’s days as one of the most influential people in the civil rights movement, walking was an extremely important part of the campaign to bring about change. From the Montgomery Bus Boycott to the march supporting sanitary waste workers in Memphis, activists used there feet to get their voices heard and heard they were.

One momentous march, the ‘March on Washington for Jobs and Freedom’ has inspired people everywhere to get off the couch and get moving towards the things they believe in. It inspired local marches throughout cities all over the U.S. during the civil rights movements and beyond. Even today we see different groups of people taking to the streets to stand for what they are passionate about and to bring light to inequalities that unfortunately are still present in our world.

Today, take a few steps and remember those who rallied together and used their feet to peacefully make a difference in our world. Take a few steps for those in our history who have fallen fighting for the freedom we enjoy. Today, take a few steps for Martin Luther King Jr. and everything he stood for.

Common Symptoms for Foot Ailments Part 2

Do any of your toenails curl into the fleshy part of your toe causing pain?

You could have an ingrown toenail. This can occur from cutting your toenails rounded at the corners instead of straight across, tight shoes, injuries, toenail fungus, or infections. Do not attempt to cut the toenail out yourself. If you notice your toenail curling even before it is painful call a podiatrist to get this nail removed.

Do you have stinky feet? Do your feet sweat profusely?

You might have Hyperhidrosis or trench foot. This is caused by sweat glands on the bottom of your foot creating more sweat than necessary. What may start off as just an annoyance or unpleasant smell can cause skin to become thick, macerated or painful.

Do you experience a feeling of sharp pain, cramping, or burning in your feet?

You might have a neuroma. A neuroma is when the nerves are pinched by your toe bones. This pinching commonly occurs between the third and forth toes. Tight shoes irritate the symptoms.

Do you have wounds on your feet that do not seem to be healing in a normal amount of time?

You might have chronic wounds or ulcers due to poor circulation or increased pressure on the wound site. These can be very dangerous if they are continuously left untreated. They can become seriously infected or even gangrenous and in severe cases can lead to amputation. Treatment plans can be offered by podiatrists to help the healing process and in most cases can heal in a few months.

Do you have painful growths on the underside of your heel bone? Do the arches of your feet hurt when you get up in the morning?

You might have heel spurs also known as Plantar Fasciitis. This is caused by a strain on the ligaments and muscles attached to your heel bone that lead to the membrane covering the bone to tear. This leaves the ligaments becoming inflamed and the heel bone lacking its natural protective barrier.

If you are experiencing any of these symptoms please call our office and make an appointment today. Don’t live with foot pain any longer! The sooner you get into an office and get your foot pain diagnosed the sooner something can be done about it.

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.

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.