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Sunday, October 19, 2014

Top Ten Reasons Why Your Feet Hurt - And How To Alleviate The Pain!

Ten Reasons Why Your Feet Hurt -
And How To Alleviate The Pain. 

1. You're walking barefoot. 
I don't care what any of the minimalist enthusiasts claim - if you are having foot pain then you need to eliminate barefoot walking from your life! Podiatrists make money by removing foriegn bodies such as glass or cactus spines from the bottom of people's feet. Not to mention warts, which are a virus and can live on floor surfaces for days - just waiting for you to walk barefoot so the virus can find a new home to thrive in - your feet! Warts can be painful, they are ugly and they can be expensive and time consuming for you to treat. Walking barefoot is the perfect way to get heel pain (plantar fasciitis), tendonitis, broken toes and encourage the development of bunions and hammertoes - just to name a few. 

The Fix: In the house, instead of barefoot, try wearing RX Crocs Ultimate Cloud or RX Crocs Relief. Other options are the Orthoheel Diabetic Slippers, which you can purchase online or Birkenstock sandals. You can use the 20% discount coupon in the upper right hand of this blog to order the Crocs. They only come in even sizes so order up a half or whole size. If your toes hit the front of the Crocs then they are too small. If they feel too big, that is okay. Wear the strap to the back so your feet stay in and remember that they are used as a bedroom slipper until you can put on your better shoes. You will not believe how much better your feet feel!

2. You're wearing flimsy flip-flops.
Flimsy flip flops offer no support or protection to your feet. They will help to prevent picking up warts and some foreign bodies, but they flimsy flip-flops can put you at risk of developing fractures, tendonitis, heel pain, bunions and hammertoes. 

The Fix: If you are a hardcore flip-flop fan - at the very least upgrade to the Fit-Flop flip-flop, which is one of the better ones. In my opinion, there are no good flip-flops and I do not recommend wearing flip-flops of any type, but consider the Fit-Flop flip-flop your 'gateway drug' to getting into better shoegear. 

3. You're wearing bedroom slippers that are too flexible. 
Flimsy bedroom slippers offer little to no biomechanical control for your feet and ankles. If you have any conditions such as osteoarthritis or rheumatoid arthritis or pain of any type in your feet - everytime your flexible bedroom slipper puts motion through that area of pain - you are aggravating the condition. 

The Fix: I recommend the RX Crocs Ultimate Cloud, the RX Crocs Relief, the Orthoheel Diabetic Slipper, or Birkenstock sandals to wear in the house as a bedroom slipper. 

4. You're walking around your house wearing only socks. 
Socks might protect you from warts, but that is about it. Once again, walking around in socks offers no support or biomechanical control to your feet, ankles, knees, hip or lower back and makes you prone to all sorts of injuries. I would estimate that twenty percent of my business comes from injuries sustained as the patient walks between the bed and bathroom at night when they are going to the bathroom. 

The Fix: I recommend the RX Crocs Ultimate Cloud, the RX Crocs Relief, the Orthoheel Diabetic Slipper or Birkenstock sandals. Even if you get up to go to the bathroom in the middle of the night - wear your RX Crocs. 

5. You have an underlying medical issue that is causing foot pain. 
There are many medical conditions that cause foot pain. Diabetes can cause nerve damage (neuropathy) pain in the feet that can feel like your feet are numb. The sensation of numbness can be excrutiating. Other sensations caused by neuropathy pain are if your feet feel like you have ace wraps wrapped tightly around your feet or if you feel like you are walking on sponges or if you feel like ants are biting your feet. There are many variations of neuropathy pain. Other diseases that can cause foot pain are fibromyalgia, chronic regional pain syndrome, gout, rheumatoid arthritis, varicose veins and peripheral arterial disease (poor circulation). 

The Fix: First, go to your primary care physician on a regular basis. If you have not been to a doctor in over a year, make an appointment with your primary care physician for a full physical. If you do have an underlying disease such as diabetes the most important thing is to get a proper diagnosis and proper treatment to get the disease under control. High blood sugars cause damage to the nerve, which results in nerve damage. Undiagnosed diabetes also takes a terrible toll on your eyes and can lead to blindness. The key to a healthy life is to get diagnosed with your disease early so you can spend the rest of your life medically managing the disease. I know that does not sound like fun, but it sure beats the alternative! Second, follow up with a podiatrist in your area. There are many things that podiatrists can do to help control the foot pain that is caused by various diseases.  

6. You're walking around with an undiagnosed fracture in your foot. 
If you are walking around with a dull, aching, constant pain (like a toothache) that rates at a four on a scale of zero (no pain) to ten (excrutiating pain), then there is a very good chance that you are walking around on an undiagnosed fracture. People assume that if you break a bone in your foot that you have horrible pain and you can't walk and although this can be true, it is more common to have a dull, low grade, constant ache in your foot that is often an untreated stress fracture. 

The Fix: Make an appointment with your local podaitrist who will do a full examination, take x-rays and properly treat the fracture. A  fracture usually takes six weeks to heal. Stop limping around and go get x-rays and get it properly treated so you can get back to having fun!

7. You work retail.
We are surrounded by concrete! Constant repetitive micro-trauma on a hard, unyeilding surface can be brutal on the feet. Even with the best shoes, careers in retail are tough on the feet, knees, hip and lower back. 

The Fix: If you can wear tennis shoes at work, get the New Balance 928 or 1540. If you have to wear black shoes, you can purchase the NB 928 in black leather. If you have to wear something a little dressier, try the Dansko Professional Clogs (wear the ones with rearfoot control). For more dress shoe options, please refer to my blog articles: Top 25 Comfortable dress shoes list' and 'Top 25 comfortable boot lists'. Scroll through my blog as I created it as a resource for my patients to find good looking shoes that are good for their feet and are pathology specific. Yes, there are some ugly shoes, but keep looking - there are tons of options and when you find something you like, google the shoe to see what stores carry it and go try it on. If it feels great, then get it. If it doesn't feel great, keep looking. If nothing feels good, then you need an appointment with your local podiatrist because there may be something else going on - like a stress fracture or an underlying systemic problem that can be treated. 

8. You have 'biomechanically challenged' feet. 
This is my own term and what it means is that you were born with a genetic biomechanical structure to your feet that, if you do not wear proper shoes and arch support throughout your life, then you are destined to at some point in your life hit a 'tipping point' where you start developing foot, knee, hip or lower back pain. Detroit car manufacturers have robots that slam the car door over and over again so that they can determine at what point the car door hinge breaks. Think of your forefoot joints as a 'hinge'. It is logical to realize that all hinges have a number where they start to wear out and break down. In medicine we call this 'osteoarthritis', which is a fancy way of saying that the joint and the joint cartilage is damaged. The good news is that if you do have an underlying foot structure such as flat feet or functional hallux limitus, then you can go to your local podiatrist and get the proper diagnosis and treatment. In my opinion, ninety-nine percent of biomechanically challenged feet can be controlled by proper shoes and inserts, which will help to stop or slow the progression of you developing foot problems and pain. 

The Fix: Make an appointment with your podaitrist to have a biomechanical evaluation with x-rays. I like it when my patients bring in one bag of shoes that they wear most often so I can evaluate if their shoegear is appropriate for their foot type. For more information, please refer to my article on this blog entitled 'My feet hurt: top ten things to do to alleviate foot pain' or 'Shoe recommendations for patients recovering from a Lisfranc's injury'. 
In a nutshell, wear RX Crocs Ultimate Cloud in the house as a bedroom slipper, purchase the New Balance 928 or 1540 and wear arch support such as a custom-molded insert or a good over-the-counter insert from your podiatrist. This will work quite well for eightly percent of people. If you do all this and are still having foot pain, make an appointment with your podiatrist. 

9. You are compensating when you walk because you are having knee, hip and lower back pain. 
If you are limping or compensating for any reason, then you are causing problems. It's a domino effect! No one has a perfect gait and to some degree we all compensate when we walk, but if you are limping because of knee, hip or lower back pain for more than three to seven days - all you are doing is learning how to limp. When you see geriatric patients walking with walkers and canes - that did not happen overnight. It can be a slow, insidious process that is years in the making. If you are limping around and telling yourself, "Oh, it'll get better", then you are probably fooling yourself. All you are doing is learning how to compensate, which leads to wear and tear of your joint and more limping. 

The Fix: If you are limping or in pain due to knee, hip or lower back pain for more than three to seven days, make an appointment with your primary care physician or an orthopedic specialist to get an evaluation, x-rays and proper treatment. Nip it in the bud! I had an eighty-two year old lady with chronic pain in both feet for twenty years before she made an appointment with a doctor. I was the first doctor she ever saw for her foot pain. We took x-rays and she had been walking around on a clearly seen stress fracture of the 2nd metatarsal for twenty years! With proper treatment, we had her back in proper shoes and inserts with minimal pain within eight weeks. After she was healed, I sent her to physical therapy for 'gait re-training' so she could learn how to walk more normally.

10. Genetics.
Foot problems are usually caused by what I call the big three: genetics, trauma and poor shoegear. Foot issues such as bunions, hallux limitus, hypermobility and flat feet (to name a few) can be genetic and run in families. Genetic foot problems can also skip a generation. So, just because your parents never had any foot problems, that doesn't mean that you didn't have a grandparent with the same foot type. 

The Fix: Ask your parents and grandparents if they ever had foot pain. If they did have foot pain, you probably already know all about it because they probably have been quite vocal about the pain at the end of the day! Check your children's feet. If you are having foot pain then there is a good chance that your children have the same foot type that can lead to the same foot problems that you have. The wonderful thing is that it is a golden opportunity for you to get your children into proper shoes and arch support early so that hopefully they don't develop problems as they get older. You could potentially save them knee, hip and lower back problems also! 

Also, Excessive Weight. 
I dislike talking about this one because it is so obvious and people already know if they need to lose weight. I would like to say that if your feet hurt then it becomes hard to exercise, which can cause you to gain weight. If you are gaining or have already gained weight because your feet hurt and you are unable to exercise, it is very important that you get treated for your foot pain so you can return to your exercise regime. It's a vicious cycle: foot pain leads to less exercise, which leads to more weight gain, which leads to more pressure on the feet and more foot pain, which leads to "I can't exercise because my feet hurt worse", which leads to depression and increased risk of diabetes, which leads to  more weight gain - and the vicious cycle continues. 

My Professional Mantra: My job as your podiatrist is to keep you as active as possible for as long as possible with less injuries so that you see less doctors, including me. This goal can be achieved by making sure that you are in proper shoegear and inserts and change some simple habits. I have based my private podiatry practice on these concepts and they work. I no longer have to perform surgery as I can treat the vast majority of foot pain with conservative, non-surgical treatment. Give it a try for four weeks and you judge for yourself. 

I hope that this was helpful! 

If you have any 'limpers' in your life, I would love it if you could share my blog with them through social media or just good old fashioned word of mouth. 

Also, if you are into detective stories, check out my latest novel 'Gunning For Angels', which is available on Amazon for Kindle or in paperback. 

Thank you for reading!

Dr. Cathleen A. McCarthy


Monday, October 13, 2014

Denzel Washington kicks butt in podiatry approved shoegear in his new movie 'The Equalizer'.

Denzel Washington kicks butt in his new movie 'The Equalizer'
while wearing New Balance 1540 - 
podiatrist approved shoe gear! 

Anyone who knows me knows that I am a huge movie fan! I've always been a Denzel Washington fan and I love a great revenge flick. When I saw that Denzel was wearing the excellent New Balance 1540's that I have been recommending to patients for years, I was thrilled. 

Sure, maybe it was product placement that got the New Balance 1540's into the movie, but I prefer to imagine that Denzel had it written into his contract that he needed to wear podiatry recommended shoegear as he wreaked blood-splattering havoc on the bad guys. Maybe he's been reading my blog? Hey, a podiatrist can dream, right?

By the end of the film, Denzel switched over to a more conservative orthopedic looking black oxford and I'm hoping that they were as comfortable as the NB 1540 shoes. 

The New Balance 1540's is a running shoe and has 'roll-bar technology', which creates a thick and rigid sole for more protection to the foot joints. The NB 1540 has good heel shock absorption, which helps with anyone suffering with heel pain as well as knee, hip and lower back pain. The extra-depth toebox is made of mesh and is great for anyone who has bunions, hammertoes or prominent bone spurs. To maximize comfort, wear a custom-molded functional orthotic, which you can from your Podiatrist, or wear a good over-the-counter insert like 'Footsteps' or 'Powerstep'. 

NB 1540 is recommended for patients with:
*Tailor's Bunions
*Plantar Fasciitis (heel pain)
*Rheumatoid Arthritis
*Hallux Limitus (limited range of motion of the 1st toe joint)
*Hallux Rigidus (no range of motion of the 1st toe joint)
*Morton's Neuroma
*Previous Lisfranc's Injury
*Ankle Instability
*Ligament Laxity
*Posterior Tibial Tendonitis
*Peroneal Tendonitis
*History of Ankle Sprains
*Achilles Tendonitis
*Some Diabetics
*Peripheral Arterial Disease (poor circulation)
*Peripheral neuropathy (nerve damage) 
*Drop Foot (you need to wear an AFO with this condition and the NB 1540 should accommodate the it)

NB 1540 is NOT recommended for patients with: 
*Charcot Foot
*History of ulcerations (Check with your podiatrist)

When I recommend to patients that they wear the New Balance 928 or 1540 - you should see the strange grimaces and facial contortions of horror and disgust that I get in response! New Balance doesn't have the best reputation for being a 'cool' shoe and I have to convince people that 'cool' is a mental attitude and it doesn't matter what you wear on your feet. I think that's why I was so thrilled to see the uber-cool Denzel Washington in the NB 1540's! 

Thank you Denzel for making the NB 1540's cool, which makes my job of getting patients into better shoegear easier! 

Dr. Cathy McCarthy trivia:
I had a screenplay entitled 'There Goes The Neighborhood' declined by Denzel's people (I was told by my manager). My screenplay entitled 'Oh Brother' was optioned by Gold Circle Film (the company that did 'My Big Fat Greek Wedding') in 2005, but the film never went into production. My novel 'Gunning For Angels' is my latest writing and can be purchased on Amazon in Kindle or book form. 

No hard feelings, Denzel! I still love you and can't wait to see your next movie.

I hope this review was helpful,

Dr. Cathleen A. McCarthy


Saturday, October 11, 2014

Podiatry Approved Excellent Men's Dress Shoe - Alden for J. Crew

Alden Men's Dress Shoes
For J. Crew

The Alden men's dress shoes for J. Crew are expensive, but they are worth every cent! Consider the money you spend on this shoe an investment in your feet. If you are experiencing foot pain or you have a history of foot issues, the money that you will save in medical bills far exceeds what you will spend on the shoe.  

What makes this shoe so exceptional is that it has a true full-length metal shank that allows absolutely no motion through the bottom of the foot, which achieves maximum protection for your foot. I am horrified by how many shoes falsely advertise that they have a full-length metal shank, but the sole is still soft and flexible. 

The full-length metal shank in the Alden men's shoe will prevent motion through any painful joints or foot structures, which allows less wear-and-tear on the joints and soft tissue structures. This translates into more comfort and decreased chance of injury. If you are recovering from a plantar plate injury, a Lisfranc's injury or have functional hallux limitus or rigidus (limited range of motion through the big toe joint), this is an excellent shoe choice for you.  

I do wish this shoe had an extra-depth toebox, which would be more accommodative for patients with severe bunions and hammertoes. This shoe has a slightly tapered toebox, which can cause pressure on any large bunions or painful 'bumps'. I would recommend that you try them on at one of your local J. Crew stores to get the proper fit. In Phoenix, three locations are Kierland, Biltmore and Fashion Square. 

For added comfort, add a custom-molded dress orthotic, which your podiatrist can have you casted and fitted for. It's a presription device that is custom-molded to your foot and goes inside your shoes to give you proper arch support, which helps decrease mechanical strain and help with foot, knee, hip and lower back pain. Your podiatrist's office staff can call your health insurance and check your benefits to see if the cost is covered under your insurance plan. 

This shoe is recommended for paients with:
*Hallux Limitus (limited range of motion through the 1st toe joint)
*Hallux Rigidus (no motion through the 1st toe joint)
*Plantar Plate Injuries
*Mild Morton's Neuroma
*Mild Hammertoes
*Mild Bunion
*Mild Tailor's Bunion
*Mild Rheumatoid Arthritis
*Plantar Fasciitis (Heel Pain)
*Mild Achilles Tendonitis
*Previous Lisfranc's Injury
*Posterior Tibial Tendonitis
*Peroneal Tendonitis
*Hypermobility and Ligment Laxity (wear a dress orthotic if possible)
*Ankle Instability
*History of 'rolling your ankle out' when walking
*Healing stress fractures of the Metatarsal bones
*Freiberg's Infarction

This shoe is NOT recommended for patients with:
*Peripheral Neuropathy
*Peripheral Arterial disease
*Excessive swelling
*Severe Achilles tendonitis
*Charcot Foot
*History of Ulceration or Open Sores
*Anyone with prominent 'bumps' on their feet 
*Severe Bunions or Tailor's Bunions 

For the Budget conscious:
You can purchase a similar men's dress shoe with a leather sole and take the shoe to a shoe repair or cobbler and ask them to put a full-length metal shank across the bottom of the sole to limit motion. 

Another idea is to simply purchase a New Balance 928 in black leather and wear that as your casual dress shoe. If your work restricts your shoe choices, I will be happy to write a prescription stating that it is medically necessary for you to wear them.

Thank you to my friend John Z. for introducing me to this amazing shoe!

I hope this was helpful,

Dr. Cathleen A. McCarthy