Ice Your Way to Flexibility

From the sidelines of your favorite sport to backyard games of touch football, applying ice to an injury is one of the key components of relieving inflammation.  We don’t often recommend the old “RICE”, rest, ice, compression, and elevation, method any longer, but ice remains a mainstay of treatment.

In this article you will learn more about how ice works to relieve inflammation.

http://breakingmuscle.com/mobility-recovery/icing-isnt-just-for-injuries-cryotherapy-improves-flexibility

Happy New Year! Resolutions Can Lead to Sore Feet.

Excitement is at its peak!  Time to get those new running shoes out from beneath the tree and begin your New Year’s Resolution.  That first run of the new year feel soooo good!  So much so that the following day you might run longer or faster.  Then it begins.  You wake up to sore muscles.  There might be a stiffness or sharp pain in your heels lasting just long enough to get your attention, but then it goes away.  Because it is your new year’s resolution you continue to work through it only to get increasingly sore and stiff.

By February your heels are so sore, toes and ankles are stiff, muscles ache so much that you don’t want to run or work out today.  The next day you might return, but then the soreness is back.  People at work are noticing a slight limp.  You are thinking about skipping more and more days of exercise.  So much for that resolution.  I have been there and know how to get through it.

As I always say, “Normal feet don’t hurt!  If you have pain, get them checked out.” Let me help you get back to exercising at the level you desire.  Desert Foot Surgeons works with high level athletes and the casual weekend warrior.  We differ from other offices in our team approach.  Your needs and goals are a key component of treatment.  This is personalized foot care and Desert Foot Surgeons is the only place you will find it.

Happy New Year!  Don’t become another statistic.  Let us get you exercising at the level you desire.

Changing the Way Shoes are Made

Under Armour has made an analogy that I have never heard before:  A shoe that acts as a bra for your feet.  The senior creative director of footwear says that the company is “changing the way footwear is made”.  The Speedform is not made in a footwear factory.  These seamless shoes that are said to be made to the anatomy of the foot are manufactured in a bra factory in China.

 

This is possibly the start of a new feel and fit for running shoes.  The current models are for racing, but more cushioned versions and planned for the future.

I have no opinion on these shoe at this time and as always I advise caution.  The current model is akin to a minimalist shoe so if you have an unstable foot these are not for you.

If you are interested to read more on these shoes, here is an article:

http://gizmodo.com/speedform-under-armour-has-built-a-bra-for-your-feet-510120541

How to Choose The Best Running Shoe for You

 

Choosing the best running shoe is a common issue addressed at Desert Foot Surgeons.  Dr. Geller spends a great deal of time discussing pronation and shoes designed around this normal foot motion that when excessive leads to many common foot problems.  The link below is a nice video that demonstrates pronation and discusses the design of running shoes.  Enjoy!

http://www.runnersworld.com/running-shoes/inside-the-doctors-office-stay-injury-free-with-the-right-shoe?cm_mmc=Twitter-_-RunnersWorld-_-Content-ShoesandGear-_-PickRightShoe

Treat Shin Splints with Foot Orthoses

http://lowerextremityreview.com/cover_story/medial-shin-pain-in-runners-evidence-for-orthosis-use

This article has a nice little review of shin splints, otherwise known as medial tibial stress syndrome.  The most likely cause of medial tibial stress syndrome is rotational problem of the leg anywhere from the hip down.  For some reason this was excluded from the article.  That is why custom foot orthoses work in treating shin splints, because of the ability to prevent excessive rotation.  Enjoy the article.

Do Your Feet Get “Tired” While Running?

I spend the majority of my day finding the flaw in people’s feet that explains why they are suffering from pain and deformity.  Usually it is this flaw that I can attribute to causing a problem with muscles, making them fatigue early.  The question always arises in the back of my mind, do people without the flaw in their foot also get muscle fatigue.  A recent study in the Journal of Podiatric Medicine answered this question.

 

The Effect of Moderate Running on Foot Posture Index and Plantar Pressure Distribution in Male Recreational Runners, took  30 men who run for exercise on a regular basis.  They examined the foot for flaws and excluded anyone who had a problem.  These men ran at 3.3 m/sec (7.3 mph) for 60 minutes.  The measurements reveal that all subjects suffered muscle fatigue leading to pronation while running.  This evil word “pronation” is the root of many problems in the foot.  The interesting part of this study is that even people who began the study with “very supinated” foot posture (that is the complete opposite of pronation) ended the run in a pronated foot posture.  This change altered the pressure on the ball of the foot and inside of the heel most.  This could explain pain in many people who run.

But what about runners who don’t have pain?  In a study of ultramarathon runners, Karagounis found the same changes in foot posture and pressure, but these changes resolved within 24 hours.  The take home message is that if your feet hurt when you run and the pain doesn’t go away in the first day after the run, you need help.  This could be as simple as adding support by orthoses or arch supports.  The risk of not getting help…stress fracture, plantar fasciitis, tendonitis.

 

References:

Escamilla-Martinez E, Martinez-Nova A, Gomez-Martin B, et al: The Effect of Moderate Running on Foot Posture Index and Plantar Pressure Distribution in Male Recreational Runners, JAPMA 103(2): 121-125, March/April 2013

Karagounis P, Prionas G, et al:  The Impact of the Spartathlon ultramarathon race on athlete’s plantar pressure patterns. Foot Ankle Spec 2: 173, 2009.

When to Retire Running Shoes

I often get asked when to change shoes especially running shoes.  There are few standards established by the manufacturers.  This article has the most scientifically based answer I have seen.

Please read.

http://well.blogs.nytimes.com/2013/02/18/when-to-retire-a-running-shoe/?smid=tw-nytimeswell&seid=auto

Peripheral Neuropathy: Treatment is Like Finding a Needle in a Haystack

Do you know that feeling when your leg falls asleep?  Some people refer to this as pins and needles or burning.  If you suffer from peripheral neuropathy then you know this feeling all too well.  Imagine the end of the day thinking you finally get to relax and forget all about the stresses of work, kids, the economy, but when you begin to relax your feet or even your legs begin to burn or having that feeling like they are asleep.  Some people describe the feeling of bugs crawling on their legs.  Either way it is hard to relax with this going on.

“Neuropathy” means nerve damage.  My initial impression of how to treat peripheral neuropathy was rather simple.  Something injured the nerve, find it, fix it, and the nerve gets better, right?  Wrong!  Nerves are tricky, very complex, yet very sensitive to injury.  Some of the more common nerve injuries that are linked to peripheral neuropathy include compression such as a bulging disc in your low back or carpal tunnel syndrome in your wrist, infections such as HIV or hepatitis, organ failure such as kidney or liver disease, poor blood flow, diseases such as Diabetes or autoimmune conditions, many medicines and drugs especially alcohol, and even poor nutrition causing vitamin deficiencies.  Put it this way:  there are about 150 known causes of neuropathy, which means there are at least another 150 causes we have yet to discover.

Finding the cause is like looking for a needle in a haystack.  There are so many potential causes and they can overlap.  A patient can have Diabetes, low thyroid, and degenerative disc disease in their low back, all of which can cause nerve damage.  Which one are you going to blame for that burning, tingling, and numbness in your feet?  Well, we try to blame it on the cause that is treatable.  This patient in my example can control their Diabetes, take thyroid hormone supplement, and their back can be fixed.  What if the burning and tingling in their feet remains?  In that case we now call the nerve damage, “idiopathic neuropathy”.  Basically a big word that means we really have no idea what is causing this nerve damage.

The next option is to treat the symptoms of neuropathy and I’m sorry to say that pain medications (narcotics) do not work for neuropathy pain!  There are older treatments such as anti-depressants and newer derivatives such as Cymbalta.  We can use medications aimed at preventing seizures in low dose like Gabapentin or Pregabalin.  There are the often overlooked physical therapy treatments such as electrical stimulation, counter-irritants such as Capsaicin or Biofreeze.  The treatment grows like a pyramid with more specific and more complex treatments at the top.  Anything above what I have already mentioned would best be prescribed by a Neurologist.  That’s the nerve specialist.

So what’s the take home message about neuropathy?  See your doctor, don’t wait!  Since I am a podiatrist at Desert Foot Surgeons, I am often the first to see a patient about these nerve complaints.  The longer you wait, the more difficult it will be to fix.