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Monday, July 31, 2017

Podiatrist's Top 10 Recommendations to Alleviating Foot Pain!


Podiatrist Top 10 Recommendations 
to Alleviate Foot Pain

The Basics


1. Stop Walking Barefoot. This is absolutely crucial! We are living longer and we are living on concrete floors. It's your feet versus the concrete and the concrete is going to win. Walking barefoot leads to arthritic joint changes, degenerative joint disease, stress fractures, tendonitis, and promotes knee, hip and lower back pain (to name a few). If you do not stop walking barefoot, the foot pain will never resolve.

2. Stop walking around the house wearing only socks. Socks offer only minimal cushioning and they offer zero protection for your joints against the ravages of time and concrete floors. Socks are great for sleeping in or wearing with excellent shoes, but not walking in. The best socks to get are microfiber socks or any man-made fiber socks, which are far superior to cotton socks. 

3. Stop wearing flip-flops. Wearing flip-flops is better than walking barefoot, but not much. Even the 'best' flip-flops aren't good enough for your feet as they do not have the added protection of having rearfoot strapping, which I will discuss later in this article. 

4. Stop wearing flimsy bedroom slippers. Flimsy is bad. Ninety percent of slippers are flimsy and they offer only minimal protection for your foot joints. The world is full of flimsy shoes and bedroom slippers because that is what sells and that is what people think they need, but what actually feels much more comfortable and is better for your foot is to have a solid, supportive shoe with a thick, rigid and non-flexible sole. Like a firm mattress that has a cushioned top cover for more comfort, the same idea works with shoes. You need a firm, rigid sole (for more protection and support for your foot) and then it needs a cushioned top. 

5. As a bedroom slipper, I've listed your best options below. The only time that you should be barefoot and standing is when you are in the shower. I would recommend that you get a cushioned shower mat to stand while in the shower. As soon as you get out of the shower (or bath), step onto a thick, cushioned rug and, right after you dry yourself, immediately put on your bedroom slippers. If you get up to go to the bathroom in the middle of the night, step down directly into your slippers and then stand up and go to the bathroom. At our office, we treat a great deal of injuries that are caused by people walking barefoot between the bed and the bathroom in the middle of the night. Wearing a good slipper will prevent injuries as well as prevent falls for geriatric patients. 



Crocs Specialist (with no vents)
Don't purchase the Specialist Crocs that have the vents as they aren't as good. Crocs don't work as well for patients who have narrow feet because they tend to be wide. If you order these online, you need to order the next size up as they only come in full sizes. For instance, if you wear a size 7.5, then order an 8. If you wear a size 8, then order a 9. If your toes are touching the end of the Croc, then they are too small. If they feel too big, then that is the correct size. Remember, you have to be able to slip into them without fussing with the rear foot strap because you are using them as a bedroom slipper. They are only meant to be worn to get you from the bed to the bathroom and while you are puttering around in the morning. Once you are ready for your day, put on better shoes, such as the New Balance choices listed below.

***




Fleece Crocs
The fleece Crocs are a great choice if you live in a cold environment or if your feet tend to be cold. If you have severe athlete's foot or sweaty feet, this may not be your best choice. 

***



Orthofeet Diabetic Slippers 
This is my favorite choice for geriatric patients because they can slip into it easily and it offers great stability. It only has minimal rearfoot control, but the sole is extremely supportive. If Crocs don't work for you, this is an excellent choice.  

***



Orthoheel Vionix Relax Slippers
This is another great choice for geriatric patients. It is easy to slip into and the sole is supportive and it has excellent arch support. 

***



Birkenstock Sandals
For patients who don't like to wear enclosed shoes, the Birkenstock sandal is a good choice. Also, if you have sweaty feet, hot feet or chronic athlete's foot infections, the Birkenstock sandals is an excellent choice.


6. Wear only excellent shoes! This doesn't mean that you have to spend a fortune on shoes. This only means that you have to know what you are looking for when shopping for new shoes. For a shoe to be good enough for your feet, they must meet these three criteria, which are listed below:

7. Only wear shoes that have a thick, rigid and non-flexible sole. This concept is counterintuitive, but extremely important. If you are wearing a shoe that is flimsy and flexible, then you are allowing too much motion through your foot joints, which causes joint damage such as osteoarthritis and degenerative joint changes as well as stress fractures, tendinitis, and mechanical strain. For example, if you are recovering from a Lisfranc's Injury and you have just gotten out of a below-the-knee walking boot, then the last thing you want to do is wear a flexible shoe that re-aggravates the injury. You have to continue to protect your foot with a thick, rigid sole that never allows motion through the injured joint. And, yes, that is for the rest of your life. 

8. Only wear shoes with a wide toe-box. Pointy-toed shoes cause constant pressure and irritation to the toes, which causes bunions, hammertoes, ingrown toenails, corns, Morton's Neuroma's, and joint damage. It is important that you wear shoes with a wide and preferably soft toe box.   

9. Only wear shoes with rearfoot control. The reason why flip-flops don't work for anyone is that, without rearfoot strapping, then you are forced to scrunch down your toes to stay in the flip-flop, which causes more mechanical strain on your tendons, ligaments, and joints. It also increases your risk of injury as well as strain to your knees, hips and lower back. 

10. Wear arch support. Even if you think that you don't need arch support, the analogy I use is that bridges have arches and engineers put struts under bridges to help decrease stress and strain. Unless you are one of the ten percent of people who cannot tolerate arch support, then I would recommend trying either custom-molded orthotics or at least an excellent over-the-counter insert. Talk to your podiatrist about getting orthotics. Also, most podiatrist offices carry excellent over-the-counter inserts that are much less expensive and quite effective. The over-the-counter insert I recommend is Powersteps, which I've listed below. 


Powerstep Inserts



Best Shoe Choices:


Women's New Balance 928
The NB 928 is an excellent choice for anyone with foot pain. I always recommend that you go to the New Balance store to try them on and get properly measured. Try to go shopping after 2pm when your foot is a little more swollen and ask the store personel to measure your feet. If there is any pressure on your toes, go up a half size or width. Before you purchase the shoe, double check and make sure that the forefoot sole is not bending or flexing! Ten percent of shoes can be defective, poorly made or broken. Do not buy any shoes that have a sole that is bending or flexing. It's a waste of time, money and it defeats the purpose.



Women's New Balance 1540
If the NB 928 is not to your liking, the NB 1540 is a great second choice. It's not as good as the NB 928, but it is still better than anything else that I've found in the stores.




Women's Hoka One One Stinson ATR
This is a great choice for anyone with plantar fasciitis as it has amazing extra cushioning for the foot. Be aware that the toe box tends to run narrow. 



Remember, if your foot hurts then follow up with your local podiatrist for x-rays and a full evaluation. Avoid surgery and pursue conservative treatment first. 

Have a great day!

Dr. Cathleen A. McCarthy 

:)








15 comments:

jule said...
This comment has been removed by the author.
MarkT said...

Do you have any recommendations for Men's casual dress shoes?
thanks!

Herry Johnson said...

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Anonymous said...

Anonymous Anonymous said...
I almost want to move to Phoenix so you can be my podiatrist.

I've had aching feet (heel pain, plantar fasciitis) for so long, I almost gave up. But I found your blogger site, read everything, and bought myself a pair of ugly Crocs on 8/11/17.

I wore them everywhere because my feet hurt in all my shoes, except my Halflinger shoes, which have sturdy cork soles. I almost didn't try the Crocs because I have high arches and my feet are on the narrow side, but they were surprisingly comfortable to wear.

Now, my feet feel mostly normal again, but I never ever walk around barefoot anymore. I also bought some Danskos (Pammy clog) and am amazed at the difference they make on my feet. I didn't realize how important good shoes were until I found this site. The recommendations you made has changed the way I buy shoes.

I wanted to tell you that you are AWESOME!!! Thank you!!

Christine said...

Hello,

Thank you for your blog.

I'm a stay at home mom for the most parr and work twice a week in the er nights. I have developed fascitis, triwd the abeo clog, but doesnt seem to help.

My question is this:
Is the crocs specialist sufficient enough for when i stay home and do chores? (They are endless) i have 2 kids under the age of 3.

Thank you for your time.

Doctor of Podiatry Discusses and Recommends Shoes. said...

Hi Christine,
I recommend the New Balance 928 or 1540 as much as possible in the daytime and at work. You can also purchase either a full-length Powerstep insert OR Tully's heel cups to wear in the NB shoes. The Croc Specialist (with no vents) will work as a bedroom slipper only. Use the NB for chores and chasing after the kiddies!
Thanks for reading the blog and I wish you the best!
Cathy
:)

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Anonymous said...

Hi Dr. Christine:
I have learned so much and gotten lots of help from reading your blogs. Thanks for all the sound advice you provide and your shoe recommendations. I have a few issues: Achilles Tendonitis/Bursitis, Peroneal Tendonitis, and in the past, Plantar Fasciitis. Right now most of my pain is under the ankle and along the lateral part of my foot (outside and under the foot). About a week ago I started wearing the New Balance 928 and I think they are helping. But my dilemma is WHICH Powersteps insoles to wear for Peroneal Tendonitis? For this condition do you recommend the Powerstep Pinnacle Maxx? It has a medial heel post so I was not sure. Would the heel post tilt my foot outward and cause more pressure on the lateral part of my foot where the pain is? I would appreciate your advice and recommendation, as there are so many insoles to choose from. Thanks very much! Donna

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Anonymous said...

That’s interesting about going barefoot indoors causing foot problems. What are the statistics for how much worse foot problems are in Japan, where going barefoot indoors is standard, vs the US?

Anonymous said...

I don’t understand, how have we thrive as a species and spread across the globe if this kind of footwear is so crucial? Why would we have so many bones in our feet and joints if they aren’t meant to move?