How to Know When to Replace Your Running Shoes | Natalie McCoy, CPED

You often hear people say “you should listen to your body”. Your body will give subtle hints when you need new running shoes. Over time, your running shoes lose shock absorption, cushioning, and stability. If you run in worn-out shoes, it increases the stress and impact on your legs and joints. When this occurs, it causes overuse injuries such as: fatigue, shin splints, joint/heel pain, or even achy knees. All of these ailments are the result of an over worn shoe. The symptoms listed above are great indicators that you need new running shoes. If you are experiencing pain, even if your shoes are relatively new, you may want to consult with a professional, at a specialized shoe store. Speaking to a professional will help determine if you are wearing the correct shoe for your foot type or activity.

One of the biggest “RED FLAGS” that your running shoes need replacing is if the tread on the soles are worn-out. The rubber in the soles of your shoe will last longer than the shoe’s cushioning and shock absorbency. If you notice any uneven, wear pattern in the tread and it is favoring only one side, then this could be a possible gait issue. Making adjustments to your running form may help but it could ultimately be the shoe.

Talking to an expert at a local shoe store that offers gait evaluations is a way to help you find a correction, or help you understand your unique wear pattern. Alternatively, your shoes may require additional support, depending on your unique foot type. No two feet are the same. To test of the integrity of your shoes, follow these 3 easy steps listed below:

  1. If you hold your running shoe at both ends and twist the shoe, an old shoe or one that does not have proper support will twist easily, like twisting a wet rag.
  2. While holding the toe and heel of the shoe, bend the shoe upwards. If the shoe folds easily in the half, it needs to be replaced.
  3. Check the tread on the soles of your shoe. Flip the shoe over and view the bottom. If the tread is worn, consider getting a replacement.

Instead of wearing the same pair of shoes every day, consider buying at least two pairs of shoes. When you own multiple running shoes, it gives time for the damp/wet shoes to fully air-dry between runs. You can also separate the activities performed in your running shoes. For instance, if you wear a sneaker to work, your second pair of sneakers could be used for running. You should never run in shoes that have worn down soles.

Save the broken down shoes for working in the garden, or mowing the lawn. If you are currently wearing a pair of running shoes that you have any questions or concerns about, please feel free to bring the shoes with you to a local specialized shoe store. During your visit, a professional will help you decide if your running shoes are ready to be replaced, and if you need additional support in your shoes.

Listening to your body daily is one of the best ways to live a healthy active life.

How to Prevent and Battle Bunions | Sabina Abbasova, DPM

Patients often come into the office reporting that they have bunion growing like a “golf ball” by the great toe. While it is true that there is spurring that is happening around the joint at the later stages of bunion development the circular ball like bone, we are feeling through the skin did not grow out but moved out.

What are bunions and why do we get them? The diagnosis is called hallux abductovalgus deformity (HAV) which explains that the great toe moves away from the center of the body and the first metatarsal, the long bone behind the great toe rotates. This rotation causes the joint at the base of the great toe to dislocate moving the circular head of the metatarsal and creating an illusion of a “ball” that gets larger as the deformity becomes more severe and the joint continues to dislocate.

The type of dislocation and joint destruction will all depend on the biomechanics of the foot. Both nature and nurture contribute to development of bunion deformities. Looking at your grandparents and parents’ feet, you may recognize late stages of the deformities that you are beginning to face as alignment of the bones and flexibility of the joints that we are born with will largely determine the fate.

Does this mean that there is nothing we can do to stop the deformity and progression? We can slow the process and avoid much of the pain by wearing the proper shoes for the foot type and if necessary, getting custom foot orthotics. Consulting your local podiatrist and working with a pedorthist can educate you and provide you with the conservative treatment as well as medical devices to realign the biomechanics and slow the progression of the bunion deformity.

If the conservative treatment fails, the appropriate surgical procedure for the deformity can be discussed and considered. The extent of the deformity evaluated on x-rays as well as patient’s life style contributes to the decision-making process.

You don’t have to live with discomfort and pain and with conservative or surgical intervention there is a treatment option available to get you back to what you love to do.

Pedicure Do's and Dont's | Jamelah Lemon, DPM

Sunshine! Beaches! Swimming Pools! Vacation! These are the sights and sounds of summertime.

Now that the weather is getting hotter, we have our toes out and are getting them groomed at our favorite nail salons or spas. While pedicures are a fun way to unwind and relax you must be careful as some pedicures can cause harmful infections especially if you have diabetes.

Here are the Do’s and Don’ts for a safe & healthy pedicure.

DO schedule an early appointment. In the morning, the foot baths are usually cleaner and if you are the first customer of the day there is less chance that other customers have not contaminated the foot bath. If you can’t arrive early sure the technician cleans the tub and the filter before your service.

DO bring your own pedicure utensils. Bacteria and fungus can move easily from one person to the next if the salon is not sterilizing the instruments properly.

DO have your nails trimmed straight across. Make sure your technician trim them straight across and does not dig into the sides or try to trim out ingrown toenails; this can lead to infections and be very painful. If you have an ingrown nail schedule an appointment with one of our podiatrist at Physicians Footcare.

DO watch for signs of infection. If your skin bleeds or gets nicked at the salon, make sure to carefully clean the area. If you notice signs of infection such as redness, swelling, discoloration, drainage or warmth at the area please make an appointment with one of our podiatrist.

DON’T shave your legs before your pedicure. When your legs are newly shaven, you leave small cuts in your skin allowing an opening for bacteria to enter.

DON’T use blades. Never allow a technician to touch your feet with a blade, cheese grater instrument or razor to remove dead skin. The use of sharp instruments can result in permanent damage and easily cause infection.

DON’T apply nail polish to cover up discolored nails. Thick and discolored toenails could be a sign of a fungal infection. Nail polish locks in moisture and does not allow the nail bed to breathe. If you think you have a toenail infection, schedule an appointment with one of our podiatrists at Physicians Footcare.

Foot Odor Causes and Treatments | W. H. Singleton, DPM

A common problem that podiatrist are often consulted about is foot odor. Patients often say “I’m clean, I shower daily. So why do my feet stink?” There are many causes of this problem, and we hope to offer multiple treatments in our blog.  

First think of this: most of us wear shoes and some type of hosiery (socks or shear hose as nylons). With shoes the period of time that they are on our feet may range from 4 to 16 hours or more per day. Remember the normal body temperature is 98.6 degrees Fahrenheit. With shoes on we trap that heat and in-turn create “mini-ovens” on our feet. This produces sweat (prespiration) and the perfect environment for the growth of bacteria and fungus. Even with open shoes as sandals we still sweat. The most common cause of foot odor is bacteria and or fungal laiden sweat. Foot odor is medically termed bromhidrosis. While excessive sweating is hyperhidrosis.   

Ways to decrease foot odor: 1. Wash and dry feet thoroughly every day. This includes going between the toes. 2. If wearing shoes more than 8 hours a day, allow the feet time out of shoes may be during your lunch break. 3. Wear hose that use anti-bacteral materials and will wick, or pull sweat away from you. 4. Wear clean hose daily. 5. Rotate shoes, try not to wear the same shoes two days in a row. Allow them to dry out. Also, spray them with a disinfectant to kill bacteria and fungus.  If the shoes have liners repace them regularly, disinfect them after each use. Orthotics should also be cleaned on a regular basis. 6. For more intense cases of foot odor a topical antiperspirant may be prescribed. 

Additional treatments for foot odor are available. Please contact our office for information. 

Hot Take On “The Toe Bro” | Aaron Haire, DPM

As a person who does not spend much time out of my busy day watching network tv, I happened to find out about the A&E show through patients that would come in my office talking about A&E’s Toe Bro. After that I watched a few of the episode via Youtube. For those that don’t know “The Toe Bro” is a show which chronicles the daily care and interesting foot cases that come into the office of Chiropodist Johnathan Tomines.

Johnathan Tomines, a Chiropodist and podiatrist of today like myself differ and are the same in a few ways. Chiropodist mostly work from their office and handle pathology of nails, soft tissue and foot biomechanics (natural foot function). Podiatrist of “today” undergo a 4 year medical school training, train in a hospital setting for 3-4 years for surgical training/general medical care, some even get advanced skills training in a 1-2 year fellowship program. At the end of all that school and training todays podiatrist is able to treat conditions and injuries of all aspects of the foot and ankle in a hospital or office setting via general medical care or by surgical means.

After watching a few episodes of this show I am in total support of anything that will help get awareness out about foot problems and will help direct people in need to get care from a trained professional. Knowledge about foot issue and the importance of proper foot care is very important as the US population suffers from new cases of diabetes at an alarming rate. Diabetics are at the greatest risk of limb loss and death from preventable foot issues than any other demographic of people. Often times people neglect to get care they need until it’s too late.

Lumps and Bumps: What Do They Mean and How to Treat Them | Heather D. Driessen, DPM

Well it’s almost summer and it’s time for your feet to come out of hiding. I recall a popular movie in the 1990’s of a guy who was obsessed with the appearance of women’s feet. In fact, if there were any “lumps” or “bumps” either visible on her person or on her shoes, she would not get a second date. It may sound petty, but the above example may make some people (not just women) afraid to show their feet.

Discovering lumps or bumps on your feet can be a bit scary, even intimidating. Such questions may run though one’s mind: what is that? Is that normal?  Can I get rid of it? I will tell you the answer may vary depending on what the “lump” or “bump” is. So let’s go over some common abnormalities one may find:

Bunion: A mild to severe bony prominence on the outside of the big toe joint or small (baby) toe joint. They often have a hereditary link in which one develops the “foot type” from a parent. You may notice mom or dad or even a grandparent has a “bunion.” They are typically benign (non-cancerous) but may cause discomfort while wearing closed in shoes or while walking. Treatment usually involves wearing wider shoes, steroid injections, or in more severe and/or painful cases, surgical removal.

Hammertoes/Calluses: Contracted toes with or without callus (hard skin). They are caused by a tendon imbalance on top or bottom of the toes. The friction created from shoes and direct pressure (i.e. standing, walking, running) can cause painful calluses. They can involve a single toe or multiple toes. They can present in low- or high-arched feet. Often causes pain in certain closed fitting shoes. One can get pain relief with corn pads, toe separators, or surgical correction.

Plantar Fibroma(toses): Benign round soft tissue lesion(s) found on the bottom of feet within the arch. They grow relatively slowing but progressively. Plantar fibromatoses can be painful if located on the weightbearing surface of the foot arch. Treatment includes steroid injections, padding, medicated creams, or arch supports. Surgical correction may be necessary if painful or debilitating.

Exostosis (Extra Bone Formation): Exostoses are often described as a “knot” on top of the foot, usually overlying a joint. They are most commonly found overlying the midfoot joints but can theoretically be anywhere bone is. They are sometimes painful with shoe and/or direct pressure. Treatment includes extra-depth shoes, padding, or surgical removal.

The above examples are just a few “lumps” or “bumps” that can occur. So, no more hiding. If you suspect any abnormality with or without pain, consult your local podiatrist for further evaluation. Your feet will be glad you did.

How to Tell If You Have Flat Foot and What to Do About It | Robyn Adams, CPed

Flat feet, do you have them, or do you have feet that flatten?  There are a few ways to tell the difference.  I will discuss a couple of them.  When seated (non weight bearing), put one leg across the other with the outside of your ankle on top of your knee and keep the foot relaxed.  Can you see the curve of your arch on the foot that is crossed over the knee?  If so, then I say that foot is not flat because you can see the curve.  If you cannot not see the curve in your arch then your arch may be low or the foot may be flat. While standing (weight bearing), look at your wet footprint on the floor/pavement.

You should see your toes, the balls of your foot, the heel, and a line that is also wet that connects the heel to the balls of your foot.  If the connecting line between the heel and ball of the foot is as wide as the front of the foot then your foot either flattens or is flat. The lower the arch, the wider the line between the heel and ball of the foot.  The higher the arch, the thinner the line between the heel and ball of foot will be.  Flat or flatten, neither conditions have to be painful. None of these techniques are a definitive diagnostic tool for flat feet.
If you have foot pain and suspect that you may have flat feet or feet that flatten, you should visit a podiatrist or go to a shoe store that specializes in foot function and that performs gait analysis. Either way, flat or flattened feet don’t have to be painful but they can be. There are several things that can be done to care for flat feet or feet that flatten.  Through a store that specializes is proper foot function and gait analysis, getting a proper fitting shoe alone or one that is modified can help.  Over the counter inserts combined with the shoe may also help. Wearing custom arch supports inside the shoes will help to give you foot the support where you specifically need it.  Ask your doctor or podiatrist, pedorthist and or store staff about the benefits of using these devices for flat feet or feet that flatten.

How Does Advanced Imaging Help Diagnose and Treat Foot and Ankle Ailments | Kevin Ray, DPM

Sherlock Homes was one of the world’s most famous detectives.  He was known for his observational ability, logical reasoning, and extremely high index of suspicion.  In the 1800s, investigations required a nose for the unusual and a foothold in the case.  This made Holmes the most sought after investigators of his time.

Today, physicians are world renowned medical detectives.  We must attempt to capture some of Sherlock’s natural abilities in observation and reasoning.  Everyday a new case presents itself for investigation and some of these cases have lifelong or deadly consequences.  Fortunately, we are not limited by the natural abilities of physicians. We have advance technology that can assist us during our investigation.

Magnetic Resonance Imaging(MRI) and Computed Topography(CT) are two of those advance imaging devices that will assist the physician in diagnosing and treating many medical conditions including foot and ankle ailments.  These two devices are very unique in that MRI is best for soft tissue concerns and CT is best for bony concerns, simply.  Often times they can be used in combination, in order to facilitate a more specific or accurate treatment plan.

Picture this, Dr. Achilles is evaluating Mrs. Foot for pain and swelling in her ankle.  Pain and swelling has been present for several months.  Mrs. Foot reports that she fell off of her step some time ago but did not seek medical care.  She applied ice and wrapped it up; though pain and swell is better it’s still present.  Dr. Achilles suspects that Mrs. Foot has broken her ankle or has a tendon or ligament rupture.  He sends Mrs. Foot for a CT and MRI to evaluate her bones and soft tissues.  With the utilizations of these advance images, Dr. Achilles concludes that Mrs.  Foot has fractured her ankle, torn several ankle ligaments and has devised a treatment plan that will get Mrs. Foot back to activity quicker.

The use of advance imaging has several practical benefits to today’s foot and ankle patient.  These benefits include better diagnosis, safe and effective, and decreased healthcare cost.  The devices aid the physician in making better decisions and understanding the complexity of the human foot and ankle.   The National Institute of Health reports that radiation has great benefit to humanity and carries a lower risk than driving to work.  Advance imaging makes healthcare more affordable because it reduces the need for invasive or exploratory procedures allowing physicians to drastically reduce your treatment cost.

Physicians Footcare, South Carolina’s largest provider of foot and ankle care, employs each of these advance imaging devices in order to provide our patients with high level, affordable foot and ankle care.  We are extremely proud to be the first in the United States to offer mobile CT imaging allowing us to improve care in rural communities.  As your leading foot and ankle detective, Physicians Footcare believes in the importance of advance imaging aiding in the evaluation, management, and treatment of your medical concerns. “Elementary, my dear Watson.”

Debunking Myths: Podiatrists are Only for People With Foot Pain | Gregory Santamaria, DPM

A podiatrist is a doctor of podiatric medicine (DPM), a physician and surgeon who treats the foot, ankle, and related structures of the leg. All too commonly, there is a misconception that podiatrist only treat foot related pathology. However, foot pathology only makes up a portion of what podiatrists actually treat on a day-to-day basis.

Podiatrists also provide treatment for ankle and related soft tissue pathology of the lower leg. The ankle is made up of three bones—tibia, fibula, and talus. The talus sits above your heel bone and supports the tibia (your shin bone) and the fibula (thinner bone found next to the tibia). These three bones are held together by multiple ligaments that surround the ankle joint.

Some of the more commonly encountered ankle conditions podiatrists treat include: ankle sprains and strains, ankle instability (recurrent giving way of the outer (lateral) side of the ankle), ankle fractures, peroneal tendonitis, achilles tendonitis and achilles tendon ruptures. But that’s not all – podiatrists also treat soft tissue pathologies on the lower leg such as lipomas, ganglion cysts and wounds.

The most common causes of ankle pain are ankle sprains, both acute and chronic. An ankle sprain usually occurs because the foot twists beyond its intended range. This overstretches, or even tears, ligaments that hold the ankle together. Some people may think an ankle sprain is something that only happens to athletes, but anyone who walks could, and most likely will, suffer from this injury at some point in their lives. All it takes is misstep down a curb or stepping on uneven terrain.

Chronic ankle instability usually develops following an ankle sprain that has not adequately healed or was not rehabilitated completely. When you sprain your ankle, the connective tissues (ligaments) are stretched or torn. The ability to balance is often affected. Proper rehabilitation is needed to strengthen the muscles around the ankle and retrain the tissues within the ankle that affect balance. Failure to do so may result in repeated ankle sprains.

Repeated ankle sprains often cause—and perpetuate—chronic ankle instability. Each subsequent sprain leads to further weakening (or stretching) of the ligaments, resulting in greater instability and the likelihood of developing additional problems in the ankle. Without proper rest and rehab, an ankle sprain can lead to chronic ankle instability. People who suffer from ankle instability usually complain of persistent discomfort, pain and swelling, additionally described is an ankle feeling wobbly or unstable.

Therefore, it is important to rest, ice, compress and elevate the ankle following an injury. As the swelling and pain improve, proper rehab should take place. Failure to do so can lead to long-term issues. Likely on account of how common they are, most people think a sprained ankle isn’t really a big deal. With proper care and attention, they might be right. So next time you injure your ankle, don’t forget that the podiatrists at Physicians Footcare are here to help get you back on your feet.

The Do's and Don'ts of Open Toed Shoes and Sandals | Bridget Moore, DPM

As spring approaches, those of us living in warmer geographical regions are itching to pull out our open toed shoes and sandals. But before you slip on a pair of warm weather friendly shoes, make sure you are mindful of these criteria:

  1. Toebox: Only wear open toes shoes with a wide toebox that applies as little pressure on the toes as possible. Beware of peep toe shoes and sandals that are too narrow.
  2. Arch Support: Get sandals and open toed shoes that have an arch support already built in. There are several shoe companies that make orthotic based shoes, slides, thongs, and various strapped sandals.
  3. Non-flexible, thicker sole: Shoes that are too flexible create too much stress on your foot muscles, tendons, and joints making them more prone to injury. Thicker, more rigid soles create intrinsic stability and decreases motion, thus minimizing inflammation and pain.
  4. Motion/Rearfoot Control: The back of your foot needs control and this can be accomplished by wearing sling backs and sandals with a heel strap. Backless shoes force the front part of your foot to strain, making your toes work hard to grip the ground in order to stabilize you. This can promote the formation of bunions and hammertoes.

When in doubt, check with your podiatrist for the best shoe recommendations. While one shoe type may be recommended for those with a particular foot type, they may be dangerous or uncomfortable for you. Professional advice is always best.