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