Why A Medical Pedicure Is The Key To Healthy, Happy Feet This Sandal Season
Why A Medical Pedicure Is The Key To Healthy, Happy Feet This Sandal Season
Source: Vogue
A few weeks ago, I arrived at a close friend’s apartment with the unthinkable: freshly tended-to feet. “How?” she asked—or, really, begged—as she curled up her own toes, which still bore the traces of the polish from her last pre-quarantine pedicure. Much to her surprise, I hadn’t snuck into my neighborhood salon prematurely but rather paid a visit to Medi Pedi, the midtown Manhattan destination for medical-grade pedicures.
“We do not pamper the feet—we just treat them,” owner Marcela Correa warned me as I leaned back in a raised chair in her ground-floor clinic, which evoked a sterile doctor’s office more than a plush spa. Of course, any sandal season calls for some TLC, but after months of leaving our feet to their own devices, who couldn’t benefit from a deep clean? Performed by technicians trained to spot the difference between a callus and psoriasis, say, every session begins with a once-over of the feet to assess their condition.
In my case, that translated to a custom treatment, executed with laser-sharp focus, that included a hand-held drill to smooth my nails’ surface, a hydrating oil to return the beds to a healthy hue, and a file to gently mend my cracked heels. Thirty (painless!) minutes and a dollop of moisturizer later, my feet looked like those of a newborn—especially because they were completely naked. (Appointments are polish free—lacquer can dry out the nail beds and lead to discoloration and brittleness, Correa noted.) But as I walked down Park Avenue with my bare toes—now so shiny that they almost sparkled—staring up at me, I can’t say I missed the color. In fact, with phalanges this naturally glowing, there was no longer a need for even a barely-there coat of nude, let alone my go-to deep crimson. “I want people to feel proud of their feet,” Correa said, plain and simple, just before I left. I never thought I’d say it, but: Mission accomplished.
Keys To Achieving Better Outcomes With Shin Splints
Keys To Achieving Better Outcomes With Shin Splints
Source: PodiatryToday
“I love the academic challenge that shin splints pose to figure out what is wrong and what muscle or tendon is contributing to the issue at hand. I break down shin splints into medial, lateral, anterior and posterior shin splints.” – Richard Blake DPM
Medial shin splints involve the posterior tibial tendon, flexor hallucis longus tendon or the flexor digitorum longus tendon.
Lateral shin splints involve the peroneus longus tendon or the peroneus brevis tendon.
Anterior shin splints involve the anterior tibial muscle, extensor hallucis longus tendon, extensor digitorum longus tendon or the peroneus tertius tendon.
Posterior shin splints involve the gastrocnemius muscle or the soleus muscle.
The actual definition of shin splints is pain between the ankle and the knee. There are a lot of structures with potential involvement that are important to consider when treating these symptoms.
When we treat shin splints, we can simply emphasize activity modification, some ice, general leg strengthening, and cross training, and most patients will do fine. However, if we treat shin splints with a little more zest, we can prevent reoccurrence. This may mean a longer running career for an athlete. For the patient who does not respond to simple measures, he or she could have compartment syndrome or tibial/fibular stress fractures. Muscle testing sometimes helps but most cases of shin splints are associated with muscle fatiguing when athletes get tired. This is hard to test in the office when the patient is rested although I normally have patients intensely work out or work out to the threshold of pain before their appointment late in the day. One muscle testing principle is to test the muscle in two basic positions: one where the patient has the advantage and one where the examiner has the advantage. When you test a muscle with the tendon shortened, you give the patient the advantage. When you test a muscle with the tendon stretched out, you (the examiner) have the advantage. At times, it is testing with the tendon stretched out that you find the weakness. You can pick up subtle weaknesses this way.
A thorough understanding of shin splints starts with classification as one of these four types and then delving into the function of the muscles. It is important to identify how the patient may have overused that muscle or muscle group. For the purposes of this blog, I will focus on medial shin splints.
If the patient presents with medial shin splints, we need to look for overuse with the posterior tibial, flexor digitorum longus and flexor hallucis longus muscles. These muscles have many functions but let us look at what they do at the ankle.
Since they all arise from the deep compartment, these muscles are ankle plantarflexors and ankle invertors. What is the primary ankle plantarflexor? That is the Achilles tendon but anything that makes the Achilles tendon weak can cause a patient to overuse one of the three muscles causing medial shin splints as they try to help the Achilles tendon perform its job. Typical weakness in the Achilles may stem from simple fatigue in doing a new sport or from adding hills to a running program. However, force-length physics considers an over-stretched Achilles or excessively tight Achilles weak. With the recent craze of zero-drop shoes, I now see more Achilles strain problems, the resultant weakness and then development of anterior or medial shin splints.
The ankle inverter function is probably the more common cause of medial shin splints. What taxes the inversion strength of these muscles? Excessive pronation can cause these three muscles to fatigue and strain as they attempt to decelerate the pronation. As the arch collapses in pronation, all three of these tendons can strain, but this is especially the case with posterior tibial tendon as the primary decelerator of rearfoot pronation at heel contact.
What are some of the causes of excessive pronation? Running itself with landing on the lateral side of the heel will cause two to four times more pronation than walking in many runners.1 Another one of the common causes of severe foot pronation is equinus. This tightness can be the cause of posterior shin splints but also anterior and medial shin splints. This is why a complete understanding of Achilles strength and flexibility is crucial. If the Achilles is tight, it is harder for the anterior extensors to dorsiflex the foot (thus causing anterior shin splints). If the Achilles is tight, the foot can pronate and the arch collapses (medial shin splints), both putting strain on the functions of the deep posterior compartment. If the Achilles is tight, the forefoot is forcibly loaded by ground reactive force, making it difficult to bend the toes in propulsion. Stress influences the long flexors (medial shin splints) and long extensors (anterior shin splints).
In Conclusion
So when a patient comes into my office with shin splints, I need to see what type he or she has (medial, lateral, anterior, or posterior) and determine what the patient did wrong other than add a new sport. I need to check for excessive pronation. I watch him or her run since running and walking for a patient can be totally the same or different. I need to measure for Achilles tightness or over-flexibility. I need the patient to wear his or her normal running shoes. If the patient is a pronator, I also want to categorize this as mild, moderate or severe so I can determine what level of support to offer in my treatment to lower the tissue stress threshold and allow healing.
This is where podiatry usually excels since proper shoes, custom or over-the-counter insoles, appropriate strengthening exercises and taping can speed up rehabilitation and prevent recurrence. In a future blog, I will discuss stress fractures, anterior and lateral shin splints, and other general rules.
Dr. Blake is in practice at the Center for Sports Medicine, which is affiliated with St. Francis Memorial Hospital in San Francisco. He is a past president of the American Academy of Podiatric Sports Medicine. Dr. Blake is the author of the recently published book, “The Inverted Orthotic Technique: A Process Of Foot Stabilization For Pronated Feet,” which is available at www.bookbaby.com.
Editor’s note: This blog originally appeared at www.drblakeshealingsole.com. It is adapted on PodiatryToday.com with permission from the author.
Reference
- Williams 3rd DS, McClay Davis I, Baitch SP. Effect of inverted orthoses on lower extremity mechanics for runners. Med Sci Sports Exerc. 2003;35(12):260-268.
What Is A Podiatrist And When Should You Visit One?
What Is A Podiatrist And When Should You Visit One?
Your feet are complex anatomical structures that are critical to your overall health and well-being. They stabilize you as you walk and stand, absorb shock when you jump and land, and propel you into motion when you push off for a jog. As such, if an injury occurs or treatment is needed, your feet require and deserve expert care from a DPM (doctor of podiatric medicine).
What is a podiatrist?
Podiatrists (DPMs) are medical specialists focused on treating problems that affect the foot, ankle and related structures of the leg. They can also treat foot-related injuries and complications that result from ongoing health issues, like diabetes.
Before practicing, podiatrists must complete four years of training in a podiatric medical school followed by three years of hospital residency training. In some cases, additional fellowship training is obtained for further advancements in specialty training. Additionally, to further advance their expertise, some podiatrists may also earn board certification from the American Board of Foot and Ankle Surgery and the American Board of Podiatric Medicine.
When should you visit a podiatrist?
Your feet keep your life’s journey in motion. In fact, according to the American Podiatric Medical Association (APMA), by the time you’re 50, you’ll have walked 75,000 miles on your feet. Don’t let foot or ankle pain slow you down on your journey. Instead, visit a podiatrist to treat pains affecting your feet, like:
- Fractures and sprains
- Arthritis
- Skin and nail disorders
- Diabetes
- Heel pain
- Bunions and hammertoes
Experience a Balanced Approach to Total Wellbeing
From medical and surgical appointments to aesthetics and wellness, Balance Foot & Ankle’s well-rounded and comprehensive approach to foot and ankle treatment fosters an environment of excellence, hospitality and compassion within a contemporary yet warm setting.
Take a virtual tour of our Lakewood clinic here.
Ensuring superior standards, products and care at Balance’s clinic, the staff of experienced specialists and highly trained surgeons prioritize building relationships with patients, clients and community. In this way, the Balance staff is able to design personalized treatment plans that address each individual’s unique set of needs whilst emphasizing a holistic approach rooted in education, health and wellness.
Experience a balanced approach to total wellbeing. Schedule your appointment today!
5 Moves to Prevent Plantar Fasciitis
5 Moves to Prevent Plantar Fasciitis
Source: Active
Plantar fasciitis is a runner’s recurring nightmare. It’s a notoriously stubborn injury that strikes when the thick band of fibers that runs along the bottom of the foot becomes inflamed. It often starts as a minor irritation but can advance and develop into a sidelining injury, especially if it’s not treated promptly or properly.
While ice, rest, orthotics and pain relievers may ease the discomfort, the injury can come back again (and again) unless you address the underlying cause— weak and tight muscles and tendons that make up and support the foot, says Irene Davis, Ph.D., P.T., director of the Spaulding National Running Center, Harvard Medical School in Cambridge, Massachusetts.
If arch pain is your nemesis, Davis recommends doing the following exercises, barefoot, daily. Learn to do the moves with correct form: watch the video how-to of the five exercises and follow along.
Video: Tour Our Office in Lakewood
Video: Tour Our Office in Lakewood
Locally & Family Owned and Operated
- Nestled in the heart of Lakewood, Ohio just west of Cleveland.
- State of the art and modern facility within a warm and intimate environment creating a pleasurable patient experience.
- Nationally and internationally recognized leaders in the field of foot and ankle medicine and surgery with years of experience in the nation’s top-rated hospitals.
- Our neighborhood office allows for more individualized time with your provider, continuity of care, and better relationships with patients and the community.
State-of-the-Art Equipment
- On-site digital X-Ray unit uses cloud based software while using a fraction of the radiation put out by traditional equipment
- Our AAMI certified Autoclave sterilizes all instruments used in the clinic and spa with hospital grade steam sterilization while avoiding harmful chemicals
- Zero gravity chairs in patient treatment rooms and spa. The zero gravity position cradles your body to remove pressure from your spine and disperse stress evenly throughout your entire body. This is the most ideal position for your circulation, back muscles, spine, heart, lungs and blood oxygen levels
Specialty Products & Services
- Holistic medical spa managed by our surgeons
- Non-toxic products with certified organic options highlighting local brands chosen by our surgeons and licensed master esthetician
Accommodations
- Easy access to Interstate 90
- Ample off-street parking
- Telemedicine visits through Chiron Health
Local Partnerships
- The talented team at AoDK Architecture has transformed our building into the modern yet warm environment it is today
- Guests in our waiting room and spa are able to enjoy plants from Lakewood Plant Company that are proven air purifiers assisting in a variety of physical and mental health benefits
- Cleveland Coffee Company, a local small batch roaster, supplies us with fresh roasted coffee for our guests to enjoy before their appointments
- Our custom orthotics are made by the craftsmen at Earthwalk Orthotics combining high-tech digital software, high-quality materials, and decades of experience to create a premium medical device for our patients
Are Your Feet Beach Ready?
Are Your Feet Beach Ready?
Source: The Conversation
The summer sun sees us strip off. And from a podiatrist’s perspective, that’s means the arrival of new footwear, as people ditch boots and trainers for sandals and flip flops. For the past several months, our feet have been hidden away, and in some cases, neglected, but now, most of us want our feet looking and feeling good for summer.
So as an expert in feet, here are my top tips for things you can do to get your feet ready for the summer.
General foot care
When it comes to toe nails, cut straight across – avoid cutting down the sides of the nails as you run the risk of an ingrowing toe nail.
During the winter months our feet can become dry, cracked and form hard skin called callus. A useful approach to combat this is to soak your feet in warm water for about ten minutes and then use a pumice stone or foot file to lightly take the dry skin off. This should be followed by a moisturizer cream applied daily. For those who have particularly dry and callus feet, a cream with the ingredient urea (which can hydrate and regenerate the skin, soothe irritations and soften the top layer of the skin) can be very useful.
If your feet are very dry, you may wish to put on a pair of socks after the application of the cream to increase absorbency. And if you do suffer with callus that is not responding to self-care, or you have corns – concentrated hard areas of skin that occur on the joints of the toes or on the bottom of your forefoot – then you will need to see a registered podiatrist.
If your feet are dry, with a scaly-type of rash or the skin is itchy you may have Athlete’s foot which is a fungal infection. Likewise, if you have thickened and discolored nails that crumble on cutting, it may also be due to a fungal infection known as onychomycosis. While it is tempting to cover them up with nail varnish don’t – this will only make the problem worse. Again a registered podiatrist can help and there are a number of over-the-counter fungal topical products that a pharmacist can advise you about.
Summer footwear
The less-is-more approach to footwear in the summer has many of us donning sandals and flip flops, the latter of which in particular offers minimal protection and support to the foot and lower limb. Changes to footwear styles and an increase in activity – summer walks in parks and along the beach, for example – can increase the chance of injury to the foot. In the case of flip flops, the separator between the first and second toes can cause all of the toes to claw (curl) during “toe-off” as we walk to keep the flip flop on, since there is little support across the top of the foot. This can increase the stress and forces within the forefoot area and for some individuals, the separator between the first and second toes can cause irritation of the skin resulting in blistering during the early stages of wear.
We advise that individuals stage the use of less supportive footwear such as flip flops and sandals with more supportive footwear – trainers, lace ups.
In addition, where possible, for those who wear sandals, it is advised that a style which incorporates a strap mechanism across the top of the foot be worn. By adopting a staged approach to summer footwear, it can allow the feet to adapt and minimize the risk of problems that could occur within your foot, ankle and lower limb – this can include forefoot pain, heel pain (tendinitis), fractures, strains and sprains.
It is important to note that if you have poor circulation, diabetes and/or a loss of sensation of your feet (neuropathy) you will need to be extra cautious. Remember, everyone needs to protect and care for their feet – looks are important, but pain-free walking in the summer sun is even more essential.
Should I Worry If My Child Is Pigeon-Toed Or Duck-Footed?
Should I Worry If My Child Is Pigeon-Toed Or Duck-Footed?
Source: The Conversation
Babies regularly have their feet, legs and hips checked by their doctor in hospital, or at maternal and child-health nurse visits.
As children grow, parents are often concerned about their feet pointing inwards when they walk (also called in-toe or pigeon-toed walking) or outwards (also called out-toe walking or duck-footed).
These walking positions, commonly called “rotational deformities”, often cause parents to seek the opinion of an orthopaedic surgeon, physiotherapist or podiatrist for more specialized assessment.
Rotational deformities
When the leg or foot faces inwards or outwards during walking, it may be from a number of typical changes in the leg or foot.
When a baby is born they often have bowed or curved legs. This is thought to be because of the position of the baby in the womb.
This position can remain and seem more obvious when the child begins to walk. It may appear as if the feet face inwards. Sometimes children may appear to trip or fall over their own feet.
In-toe walking may come from a curved foot (metatarsus adductus) or an inwards twist in the leg bones (tibial or femoral torsion).
Similarly, out-toe walking may appear from the foot or leg. A foot that is very rolled in or “pronated” may appear as if it is pointing outwards. A leg may also turn outwards from the leg bones or the hip.
The flexibility of a child’s joints or the way they use their muscles could also cause in-toeing or out-toeing. A twist in their bones is one possible contributing factor to in-toe or out-toe walking.
Curved feet
Metatarsus adductus is the most common foot deformity in infants. In metatarsus adductus, the foot has a curved or banana-shaped appearance. In 95% of cases, the foot corrects itself with no treatment.
In the past, it was recommended to put shoes on the wrong feet. This is no longer recommended as it may cause further foot deformity.
Sometimes treatment is needed. Plaster casting or splinting may be required to help the foot straighten if it doesn’t on its own.
Parents should see a health professional if their child’s foot is curved, stiff and unable to be straightened, or isn’t straightening as their child gets older.
Twisted shin bones
Tibial torsion is where the lower leg or tibia turns in or outwards. An inward-turned tibia is common in children under the age of three. It usually straightens after this age and sometimes even slightly turns outward with no treatment. These changes occur in children up to the age of eight.
Health professionals will sometimes recommend children with in-toe walking wear a type of orthotic called gait plates. While gait plates may provide some cosmetic effect when worn, there is no evidence they will result in long-term change.
Parents should be cautious about claims these devices will fix in-toe walking. They need to consider if the expense is worth it for something that will naturally get better on its own. There is no good evidence stretches or footwear will change this type of walking.
Turning inwards or outwards at the hip
Femoral torsion is where the upper leg bone (femur) or hip is turned in or outwards. Children may appear to walk with their feet inwards or outward. It also looks like their knees point inwards or outwards.
The femur goes through many changes up to the age of 12 and an inward turn at the hip is more commonly seen in girls. Rotational changes at the top of the leg are also a very normal part of growth.
Walking changes from the top of the leg and hip sometimes appear more common in children who frequently W-sit. This sitting position is with their bottom on the ground and legs folded outwards.
There is no research proving sitting like this is harmful, but therapists often observe hip muscle tightness in children who sit this way and it may affect the child’s walking. As harm is unknown, it might be best to get children to sit or play in other positions.
There are no shoes, orthotics, garments, taping or stretches that have evidence supporting them being used to change walking associated with these rotational changes. Parents should seek medical attention quickly if there is pain at the hip or pain extends into the groin while walking at any age.
Children walk in-toe and out-toe for many reasons. Parents should see a health professional if their child is tripping from their leg position when their child is school-aged, if one leg turns substantially more inwards or outwards than the other, seems longer or looks very different compared to the other.
For the majority of children, in-toe or out-toe walking is just part of growth.
Balance Foot & Ankle Expands Footprint, Adding Medina Location
Balance Foot & Ankle Expands Footprint, Adding Medina Location
Lakewood, OH (September 29, 2020) — Balance Foot & Ankle, a restorative foot and ankle practice, today announced the opening of its second location at 4071 North Jefferson Street in Medina, Ohio.
“We’re excited to extend our unique patient services and approach to foot wellness to even more communities in Northeast Ohio,” said Dr. Jennifer L. Prezioso, Founder & CEO, Balance Foot & Ankle. “Our new facility will offer our well-rounded and comprehensive approach for all patients as we continue to foster an environment of excellence, hospitality and compassion.”
The new facility in Medina is in addition to the practice’s current location at 14200 Madison Avenue, Lakewood, Ohio 44107. To schedule an appointment, visit balancecle.com or call (216) 658-0111.
About Balance Foot & Ankle
Balance Foot & Ankle is a patient-centered, state-of-the-art practice led by highly trained and experienced surgeons who specialize in reconstruction and trauma of the foot and ankle with an emphasis on education, health and wellness.
Learn more at balancecle.com.
Should You Take 10,000 Steps a Day for a Balanced Life?
Should You Take 10,000 Steps a Day for a Balanced Life?
Is 10,000 the magic number? Well, it all depends on your current fitness level and your goals. The average American walks 3,000 to 4,000 steps a day, that’s about 1.5 to 2 miles. Understanding how many steps you walk now is a great way to establish your baseline to plan for the future. But before you do anything, it is important to first define your goals, such as to:
- Increase general health, wellness and fitness
- Decrease weight
- Maintain health
Increase general health, wellness & fitness
If you’re new to exercising or returning from an injury, you’ll want to start slowly to avoid burnout or further injury. After you have established your baseline, you can work up toward your goal by adding 1,000 extra steps a day each week. Meeting your goal could be as simple as an extra five-minute walk, or even parking further away in the parking lot at the grocery store.
Decrease weight
With a little math, you can determine how many steps you need to take each day to achieve your weight goal. The Academy of Nutrition and Dietetics recommends slow weight loss for lasting results. This translates to about 1/2 pound to one pound per week. Completing an extra 10,000 steps each day could burn about 2,000 to 3,500 extra calories each week. One pound of body fat equals 3,500 calories, so depending on your weight and workout intensity, you could lose about one pound per week simply by adding 10,000 steps each day.
Maintain health
Maintaining your desired goal could be just as challenging as achieving your goal if you don’t have the right plan in place. The 10,000-step goal could be right for you—and the benefits of a 30-minute daily walk are impressive, helping to reduce your risk of common health problems such as:
- Heart disease
- Obesity
- Diabetes
- High blood pressure
- Depression
Additionally, one study out of California State University showed that mood lifted in correlation with increased numbers of daily steps, and researchers at the Harvard School of Public Health found that 30 minutes of walking each day cut stroke risk by a minimum of 20%. It’s important to note ethat you will also burn calories and fat and enjoy vitamin D from the sun while you’re in the sun.
Simple Solutions
So, how can you include more steps in your day?
- Take the stairs
- Take the dog for a walk
- Walk while listening to music to make your walk more enjoyable and help motivate you to walk farther or faster
- Instead of sending a work email, walk to your colleague’s desk
- Have a walking meeting versus sitting in the office
- Walk while waiting: Take a walk instead of sitting while you’re waiting for an appointment
- Break up the day with workday walks by setting reminders on your calendar for short walking breaks to increase energy throughout the day
- Choose parking spots farther away from the entrance. If you take the bus, get off a stop early and walk the rest of the way.
Your goal will depend on your starting point. However, everyone can gain the benefits of walking more, step by step. We hope you find a balanced approach to improve your wellbeing from head to sole.
If you find that you need help along the way to care for any foot or ankle pain, or even injury, let us know. Together, we can find foot and ankle health and wellness solutions to help you move beyond the issues preventing you from achieving your wellness or exercise goals.
Harnessing Your Body's Natural Defenses
Harnessing Your Body's Natural Defenses
In recent years, doctors have learned that the body has the ability to heal itself. Autologous platelet rich plasma (A-PRP) therapy is a form of regenerative medicine that can harness your body’s own natural growth factors your body uses to heal tissue. At Balance, this method is used to harness your body’s own natural components and treat foot and ankle injuries.
A-PRP is a biological solution from the patient’s whole blood that has concentrated growth factors, high levels of platelet concentration, and proteins, that help your blood to clot. It also contains proteins that support cell growth. Researchers have produced PRP by isolating plasma from blood and concentrating it. The idea is that injecting PRP into damaged tissues will stimulate your body to grow new, healthy cells and promote healing. Because the tissue growth factors are more concentrated in the prepared growth injections, researchers think the body’s tissues may heal faster. Many famous athletes like Tiger Woods and tennis star Rafael Nadal have been known to use these injections to help heal injuries.
A member of the healthcare team at Balance will obtain a small amount of blood from your arm using a small needle and a syringe. The blood will be put through a “soft” centrifugation spinning process that will separate and concentrate the platelets and other beneficial components including growth factors. The platelets and growth factors are mixed within the plasma and are then applied to the treatment area. This A-PRP process is usually done in less than 15-20 minutes.
They are the main component of A-PRP and play a central role in hemostasis and tissue healing. Platelets are the architects of tissue healing as their presence at
an injury site initiates and guides the healing process.
Contact us and ask if A-PRP is the right treatment for you. The proper course of therapy will be determined upon examination and if the use of A-PRP may benefit you based on your injury.
There are three simple steps:
- Blood Draw: Using a small butterfly needle, a member of the Balance nursing staff will draw a small amount of blood from your arm into the Regen THT tube
- Load, Balance & Spin: The Regen THT tubes are inserted into the centrifuge and spun at high speed for 8 minutes to separate the various components of your own blood
- Platelet Preparation: After your blood is spun down and separated into its individual components, the platelet-rich plasma (the yellow area) is used by your healthcare provider to treat the injured area
