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What Are High Heels Biomechanically Doing to My Body? | Heather Driessen, DPM

My face met the ground the first time I wore heels. Okay, maybe that was bit of an exaggeration. I didn’t exactly fall but I came pretty close. I wonder what went wrong. Could it possibly have been the height? No, they were only 3 inches. Despite how “low” I thought the heel was, research has shown, as the heel’s height increases, so does the increased amount of pressure on the forefoot (ball of foot). For example:

1-inch = 22%

2-inches = 57%

3-inches = 76%


Can you imagine if I wore 6 inch heels?

In a survey of 100 women, 26 said they never wore heels; 74 wore them at some point in their lives. Although it has been shown over a 30 year span, less women are wearing heels today (40%) than in the 1980’s (60%);

more younger women (ages 18-25) wear high heels (50%) compared to those in their 50’s and up (35%). I found this survey very interesting. The point is most women wear heels and this practice, although declining in comparison to earlier years, is still ever present.

Recall the old adage: “Form follows function”. This was a principle associated with architecture. It states that the shape of an object should be based on its intended function or purpose. Think of it this way, high heels cause muscles in the leg to become fatigued or function abnormally for long periods of time. One may develop “form” issues in the sense of poor posture, stress on the back of the knees, shortened calf muscles, or even spine problems over time.


Let’s Review Some Anatomy (And How High Heels Affect Them):

Feet: The feet can be considered the base or foundation of the body’s skeleton. For those home builders out there, you may know, if you don’t have a good foundation, that house is subject to unevenness and instability. In the foot, joints become unsteady, arthritic, and painful which can lead to bunions and hammer-toes.

Calf muscle: The calf muscle or Gastrocnemius-Achilles tendon unit is one of the strongest muscle-tendons in the body. It helps one during push off and the propulsive phase of gait (walking). It works best when it is elongated and freely glides. Wearing high heels can shorten this muscle-tendon unit over time, which can lead to problems when walking barefoot or in other shoes. You might be enjoying those compliments of how nice your legs look from behind, but they may be costly in the long run.

Knees: Wearing high heels shift the knees forward, thus straining the back of the knees and hamstrings. The knee joint itself may develop arthritis over time.

Hips: As the center of gravity continues to shift forward, the hips become affected and can throw off one’s posture. Many thigh muscles originate from the hips and control how one stands, walks, or runs.

Back: As the knees and hips move forward, the back compensates by hyperextending backwards. Sure this will back your derriere look nice (hence, the cat calls again); however, this may lead to back soreness, spasms, and eventually spinal issues.

Am I saying, “Don’t EVER wear heels”? No. But, I think the best patient is a well-informed patient. Would I wear them again? Sure. Knowing what I know now, I think I will stick with a lower heel.

Our expert team of Foot Doctors know feet. Contact Physicians Footcare and schedule your immediate appointment.



4 Typical Foot Injuries Found in Athletes | Harry Cotler, DPM

With constant running and jumping, an athlete’s body undergoes a lot of wear and tear. Although you need strong legs to participate in sports, your feet do much of the work. When athletes are suffering from ankle or foot pain, they visit Physicians Footcare

Here are 4 common foot injuries found in athletes 

  • Turf Toe: If you feel any pain or tenderness in your big toe joint, this could be due to turf toe. Repetitive hyperextension of the big toe, normally from performing box jumps, Olympic lifts, and triple extensions, causes this common foot pain. To make sure the toe isn’t fractured, get an X-ray from a foot doctor. Once fractures are ruled out, tape the toe to provide support and restrict movement. You can also wear stiff-soled shoes for added support.


  • Bunions: Using ligaments and bones to support the foot when you walk instead of the muscles that support the arch cause bones to shift and bunions to form. If you feel foot pain on the inside of your big toe, you may have a bunion.


  • Stress Fractures: If you feel tenderness in your long foot bone or the top of your foot is swollen, you might have a stress fracture. A stress fracture is an uneven balance between bone cells used for bone turnover. Over-training causes this common foot injury in athletes. To alleviate pain, apply ice to the area. A foot doctor can take repeated X-rays over a three to four-week period to see if calluses have started to form along the stress fracture. If calluses aren’t visible, the foot specialist can perform an MRI to find the damage.


  • Plantar Fasciitis: Wearing shoes that provide little support when running and jumping causes inflammation and tearing of the plantar fascia. Symptoms include foot pain when you get up in the morning as well heel pain and arch tenderness



Call Physicians Footcare and schedule your appointment with one of our expert podiatrist to discuss treatment



When to See a Podiatrist | Harry Cotler, DPM

Like issues with other parts of your body, not every foot problem requires a trip to the podiatrist. Some may resolve with a little rest, ice, and over-the-counter pain medicine. But, if you have a persistent problem that won’t go away, then a trip to Physicians Footcare is necessary.

Here’s a list of the type of foot problems that warrant a trip to a podiatrist:

• If you have one foot that has a flattened arch, it can be a sign of a tendon injury. Tendons that don’t function properly can lead to joint problems and misaligned bones. Prolonged tendon injuries can cause permanent damage to the foot, so the sooner you see your podiatrist the better.

• If you have a sore on your foot that won’t heal, you must see a podiatrist. Those with diabetes are especially at risk for foot sores. And if left untreated, sores may lead to amputations. The best advice is to go to your podiatrist as soon as possible. The longer you have an open sore, the more prone you are to infection which can eventually travel into your entire body, requiring hospitalization or surgery.

• If you’re experiencing foot or ankle pain that gets worse when you walk, you should see a podiatrist immediately. Many people try to live with the pain, which is not a good idea. Persistent pain may be a sign of a stress fracture. Your podiatrist can x-ray your foot to determine if a stress fracture exists.

• If you have severe pain in your foot or ankle that lasts more than 24 hours, then you need to see your podiatrist. There are a variety of conditions that could cause severe foot and ankle pain including compartment syndrome, deep vein thrombosis, or a broken bone.

• If you experience pain in your feet while they’re elevated, then you also need to see a podiatrist. For example: If you experience pain while resting your feet on an ottoman, and the pain goes away when you put your feet flat on the floor, then you may have peripheral artery disease or decreased blood flow. A Physicians Footcare podiatrist can quickly assess if you have these conditions and then refer you to the appropriate specialists for treatment.

• If you experience discoloration on areas of the foot or ankle, then you absolutely need to see a podiatrist. Your feet should look the same. Redness may be a sign of injury or infection. Blue and purple coloration could indicate vein problems. Your Physicians Footcare podiatrist is the authority on everything foot related and can quickly assess what the discoloration of your feet means and offer a treatment plan.

These are just some of the signs that you need to see a podiatrist. If you’re experiencing symptoms that persist for more than 24 hours, a visit to Physicians Footcare is warranted. As podiatrists, we’re the authority on feet and ankles. We can quickly assess your feet, treat your condition, and help get you back on your feet and back to what you love to do. 


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.

Physicians Footcare Welcomes Three New Podiatrists

Physicians Footcare is excited to announce the addition of three podiatrists to our team in August:

Dr. Jessica Fink will be seeing patients at our Florence and Hartsville locations.

Dr. Matthew Engelthaler will be seeing patients at our Aiken location.

Dr. Harold Cook will be seeing patients at our new location in Newberry.

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.