Posts for: June, 2015
In honor of Mother’s day this month, I thought it would be fitting to address the topic of foot care during pregnancy. Pregnant moms and expectant fathers have a lot to think about and a lot to do as they prepare for the arrival of their new baby. Moms are busy decorating the nursery, making frequent visits to their OB/GYN, sending thank you cards for baby shower gifts, changing diets, and thinking about names. Expectant fathers are giving their wife a little more TLC, making frequent trips to the grocery store to satisfy insatiable cravings, working on action lists, and making dry rehearsal drills for the moment they get “the call!” All these things are essential, but far too little attention is given to Mom’s feet, and how to get them fit to carry both her and baby during pregnancy.
As the natural weight gain increases the center of gravity changes, adding excessive pressures to the knees, ankles, and feet. Edema (swelling) and over-pronation (flat feet) are two of the most common foot problems that are overlooked. In order to make the pregnancy period more comfortable, it is important to learn about foot care, and what can be done to relieve aches and pains.
Many of my pregnant patients tell me that their feet are noticeably swelling and ache with pain. Some even tell me their feet feel as though they are stretching like a balloon and ready to pop. A certain amount of swelling is normal during pregnancy because more water is retained, and there is a change in blood chemistry causing fluid to shift into the tissue. As the uterus expands, pressure increases in the pelvic veins and large vein (vena cava) on the right side of the body that carries blood from the lower limbs to the heart. As the return of blood from the legs is decelerated, fluid is pushed from the veins into the tissues in the feet and ankles.
Some women also experience swollen feet and a larger shoe size due to the release of a hormone called relaxin. Although the feet appear to be growing, it is really a false illusion because the hormone causes the ligaments to become lax and stretched out.
Roughly 75 percent of pregnant women experience edema, especially by the time they reach their third trimester. Edema is considered to be worse during the summer and at the end of the day. Edema is more strenuous for women who are carrying multiples, or for those who have excessive amniotic fluid.
Edema is annoying, to say the least, but it is normal and generally harmless. It is important to pay close attention if there is excessive or sudden swelling to the feet, hands, face, and puffiness around the eyes. Call your doctor promptly if these symptoms are present because it could be a sign of preeclampsia, a pregnancy-induced hypertension that occurs five to 10 percent of the time. Also, contact your doctor immediately if one leg is significantly more swollen than the other or if there is pain in the calf area. These conditions could be a sign of a blood clot.
The good news is that most women’s feet will be fine following childbirth and should return to their normal size.
Here are some tips to minimize edema:
*Keep the body hydrated and drink plenty of water to flush your system of excess sodium and other waste products.
* Eat a well-balanced diet with low salt content.
*Elevate your feet and relax.
* Lie on your left side to improve circulation to your lower extremities.
*Avoid long periods of sitting or standing and take breaks if you are on your feet a lot.
*Do not cross your legs or ankles when sitting.
*Take several short walks if you are sitting for any length of time and elevate your feet when sitting.
*Stay away from uncomfortable shoes (high heels) or shoes that constrict circulation.
*Measure your feet regularly and wear shoes to accommodate changing foot sizes.
*Wear seamless stockings that do not restrict circulation and sock fabrics, such as cotton instead of nylon, which allow your feet to breathe.
*Waist-high maternity support stockings are helpful but should be put on early in the morning.
*Walk regularly and exercise with modification.
*Use proper foot care hygiene by trimming your toenails, removing calluses, and using moisturizer to avoid dry and cracked skin.
*Give yourself a foot massage or ask your partner, family member, or friend to help.
*Take regular footbaths and apply lotion to your feet.
*Use laser therapy on your feet, ankles, and calves to reduce edema and aches and pain.
Over-pronation (flat feet) is another common problem that occurs during pregnancy as a result of added weight gain. It occurs when a person’s arch flattens out during weight-bearing movement (like walking) causing the feet to turn in abnormally. The dense band of tissue that extends from the heel to the forefoot (plantar fascia) becomes strained and inflamed due to increased flattening of the feet. Walking can become very painful, and women may experience increased discomfort and strain on the feet, calves, and back. Regular exercise and proper footwear are the most helpful ways to minimize over-pronation. Helpful exercises include:
*Straight-Knee Calf Stretch — Place the palms of your hands on the wall. Move one foot forward about 12 inches. Keeping toes pointed forward and both heels on the floor, lean toward the wall.
*Bent-Knee Calf Stretch — Place the palms of your hands on the wall. Move one foot forward about 12 inches. Keeping toes pointed forward and both heels on the floor bend both knees and lean forward.
*Ankle Circles — Sit straight-legged on the floor or another firm surface. Rest your calf muscles on a rolled-up bath towel or blanket. Rotate your ankles in each direction for two minutes.
*Reverse Calf Raise — After removing your shoes and socks, sit with your heel at the edge of a telephone book or block of wood that is at least three inches high. Raise the front of your foot as far as you can, then lower it back down.
*Standing Calf Raise — Using a sturdy counter for balance, stand and lift on floor, so you are supported by the other foot. Rise up on the ball of your foot and toes and onto your heel.
*Exercise Regularly — Walking, swimming, or riding an exercise bike is recommended. Water aerobics classes are also excellent.
*Select the proper footwear and avoid going barefoot or wearing sandals or flip-flops because they do not provide support for your arch.
*Wear low-heeled shoes that are soft, comfortable, and provide room to move.
*Use ready-made orthotics or custom orthotics to provide arch support and shock absorption.
*Wear seamless socks that do not constrict circulation.
*Use laser therapy on your feet and ankles if you are experiencing plantar fasciitis, tendonitis, achiness, and pain.
Pregnancy should be a pleasant, enjoyable experience, but your feet need to be in good shape to carry you and your baby. Understanding the causes of foot pain and learning easy home remedies can help. Contact Dr. Sigle at 217-787-2700 to schedule an appointment. The Foot & Ankle Center of Illinois/Illinois Laser Center is located at 2921 Montvale Drive, Springfield, IL and at St. Mary’s Hospital in Decatur, IL. Visit myfootandanklecenter.com to view a short video on cutting-edge MLS laser therapy for reducing edema and pain management. Also, learn about the benefits of custom orthotics.
Most people look forward to the summer but some are in distress and ashamed of how their feet look. This time of year, most people transition to sandals and flip-flops or go barefoot. In our society however, most people have a perfect body image of themselves that begins at their head and extends down to their toes.
In 2008, the American Podiatric Medical Association retained Kelton Research to survey 500 women about their feet. Fifty-seven percent of them were embarrassed by the way their feet looked. Kelton Research referred to it as “The Embarrassing Epidemic” and claimed that foot shame affected 84 percent of all women across the country. A quick review of social media confirms this feeling remains strong in 2015. There are numerous “feet hate” groups on Facebook. The largest site had more than 30,000 likes. There are also a few “feet lover” groups on Facebook. The largest site had 21,000 likes.
In my practice, approximately half of the female patients are embarrassed about the way their feet look. Forty percent of males share the same concerns.
Most of these patients have nail dystrophy (poor nail formation) that is usually caused by a fungal infection in the nail bed or nail, trauma, or skin disease such as psoriasis. Nails are typically brittle, flaky, split, discolored, painful and unsightly. Nail dystrophy is not a welcome condition because the nail appearance is unattractive and the condition is difficult to manage.
The good news is major innovations have been introduced into podiatry within the past decade to address these problems. These include laser treatment, new nail restoration processes and shoe sanitizers.
Laser technology effectively kills toenail fungus, 70 to 80 percent of the time, and treatments are relatively pain-free and simple. An exam is given by a podiatrist to confirm the presence of the fungus. Nails are trimmed and debrided prior to treatment. Three treatments are scheduled within a 30- to 45-day intervals and evaluated by the podiatrist over a year to ensure the fungus is killed and to assess new nail growth. New healthy nails typically clear within six to nine months.
A new Keryflex nail restoration process is commonly used in conjunction with laser treatment to restore nails to their natural looking appearance. The treatment is also done for a wide range of nail dystrophies. The KeryFlex nail restoration system uses polymer resins and special activators that bond to damaged toenails to create a durable, yet flexible, natural-looking nail when exposed to a certain frequency of ultraviolet light. The procedure takes around 15 to 30 minutes. Most of the damaged nail is removed and a bonding agent is applied to the nail. A resin, which has a gel-like consistency, is applied to the nail bed. Then, a special ultraviolet light is used to harden the resin. This procedure is repeated to create a natural-looking appearance in place of the damaged nail. The KeryFlex gel is available in three colors: opaque, clear and natural. If the treatment is done in conjunction with laser treatment, patients no longer have to wait for six to nine months for new nails to emerge. Patients literally walk out of the clinic with new natural looking nails. Treatments are scheduled every 30 to 45 days until the new nails emerge.
Special shoe sanitizers are used as an added safeguard to kill fungus, bacteria and odors in shoes. Other antifungal crèmes and lacquers may be recommended for use as well
The Foot & Ankle Center of Illinois/Illinois Laser Center is the first podiatry clinic in Decatur and Springfield to offer this premium treatment protocol. To learn more about these exciting new innovations visit myfootandanklecenter.com. The website provides short videos of laser and Keryflex treatments; and before and after photos. The Foot & Ankle Center of Illinois/Illinois Laser Center is located at St. Mary’s Hospital in Decatur, IL and at 2921 Montvale Drive, Springfield, IL. Call (217) 787-2700 to schedule an appointment.
As we approach the warm summer months, many people have a natural tendency to pitch their shoes in favor of sandals and flip-flops. Although sandals and flip-flops have been around for centuries, their popularity has grown and become a part of the mainstream. The cheap rubber thongs of the '60s that were once used during backyard car washes and beach outings have become a summer craze. They have transcended from the drug store specials and are sold everywhere. Today, flip-flops are fashionable and used for everyday wear. It is not uncommon to see runway models and movie stars wearing designer flip-flops, or professional athletes promoting them in advertising. People of all ages are using them for almost any occasion. It seems like everyone has a couple of pairs on hand to wear for different occasions. Despite their popularity, flip-flops are not a safe bet for anyone, at any age. The long-term effects of flip-flops can cause serious injury.
Probably the biggest cause of foot and ankle pain is improper footwear. Many experts claim that flip-flops are the most dangerous shoes on the market because of their lack of support. Typically, there is a significant rise in plantar fasciitis problems during the early summer months as people transition from supportive winter-type shoes to flip-flops. The lack of support causes abnormal stretch to the arch which leads to heel pain. We also see a considerable amount of tendonitis in other areas of the foot and ankle as well as arthritic pain in the middle of the foot caused by non-supportive shoes; however, the dangers of flip-flops should not go unnoticed because flip-flops can cause other serious problems.
RISKS OF EXPOSED TOES: Flip-flops expose your feet to thousands of bacteria, such as staphylococcus, and viral (including warts, human papillomavirus, and contagious fungal infections such as athlete’s foot and toenail fungus). A past study at the University of Miami discovered that flip-flops harbored thousands of bacteria. Exposed toes are also subjected to blunt trauma, torn nail beds, or toe fractures. The friction caused by the toe straps on the skin can also lead to terrible blisters or open wounds.
FOOT PAD PROBLEMS: The rubber or fabric strap that extends from the toe post to the sides of the flat rubber sole does not sufficiently hold the foot in place. Consequently, movement of the foot on the base of the flip-flop causes blisters and a burning sensation in the foot pad.
INJURED TENDONS: Repetitive toe gripping can also cause the tendons that connect the muscles to the bones to become inflamed, torn, or ruptured. Improper arch support can cause the foot to flatten out or over-pronate, resulting in plantar fasciitis. Extreme heel pain can also result because the heel is able to rise off the back of the shoe in a repetitive manner. The thin layer of rubber does not provide ample shock absorption. Typically, a lack of support adds to soft tissue pain and ultimately to bone pain. Long-term arch and heel pain can lead to bone spurs and extreme ankle pain.
INJURED BONES: Stress fractures in the bones of the feet can result from the lack of shock absorption and proper cushion for the feet. They are also unstable and nonsupportive and may lead to much more serious problems, especially if the tip of the flip-flop on the non-supporting swing leg catches the ground. This often results in a blunt trauma to a toe, a torn nail bed, or toe fracture. It can also result in ankle sprain or fracture.
ALTERED GAIT PROBLEMS: Flip-flops cause you to walk different (altered gait) than your normal walking pattern when wearing supportive shoes. Stride patterns are shortened and the normal weight bearing (from heel to toe) is altered. Flip-flops alter your bio-mechanics and posture too. When your feet do not provide the proper support, your body joints have to compensate and may result in problems in your ankles, Achilles tendon, knees, hips, and lower back. An altered gait can also hamper your balance and increase the risk of tripping.
HELPFUL HINTS: Overall, flips-flops are not a safe bet and can cause serious foot problems; however, if they are to be worn consider limiting their use and selecting a higher quality flip-flop that provides arch support and a heel cup.
Sandals are a better choice than flip-flops because they offer more support and protection. The best designs have soles that extend beyond the toe box and provide a strap across the mid-foot and back of the heel.
Parents should be aware of the problems that flip-flops present for their children. They should not be worn when playing outdoors activities like running and bicycling.
Seniors should pitch their flip-flops for higher quality sandals that provide better support and stability. This will help prevent foot problems and reduce the risk of falling.
As a wise blogger on the New York Times once posted in response to an article on flip-flops and foot pain, “Long live flip-flops and those who know how to master their use. Enjoy your summer by making safe and sensible footwear selections.”
For more information on pain relief from heel pain, plantar fasciitis, and ankle arthritis, call Dr. Sigle at 217-787-2700. The Foot & Ankle Center of Illinois clinics are conveniently located at St. Mary’s Hospital in Decatur, IL, and at 2921 Montvale Drive, Springfield, IL. Visit myfootandanklecenter.com to obtain information from the patient education library on these subjects.
Treating an array of problems of the foot and ankle at Foot & Ankle Center Of Illinois, we put the best of technology to work in diagnosing many biomechanical injuries and abnormalities that cause pain and discomfort when walking or running.
After extensive research and new advances in podiatric technology, there are now faster and more accurate ways to asses a patient's feet and administer the most appropriate treatment. In fact, many foot problems can be treated most effectively by addressing their mechanical function, and at Foot & Ankle Center Of Illinois, we offer our new Computerized Gait Analysis technology that helps us identify biomechanical faults faster and more accurately than ever.
Assessing Your Gait
Our Computerized Gait Analysis is an advanced method used to assess the way an individual walks or runs to highlight biomechanical abnormalities. While many of these common problems are treatable with modern medicine, assessing motion, and more specifically how you walk, has always been limited until the recent development of the Computerized Gait Analysis.
A Computerized Gait Analysis uses pressure mapping technology to identify pressure points in the feet as a patient walks or runs. A podiatrist can observe and analyze the way an individual moves, looking in particular at the feet, ankles, knees and hips to determine the problem. This can then be relayed to a computer screen where slow motion and freeze frames can be used to carefully assess your running or walking style. By assessing the condition in the actual environment that causes that particular problem, we can actually identify what is happening while you walk and give you the best treatment for your condition based on this data.
By analyzing the mechanics of a patient's stance, postural alignment, and flexibility of the hips and back, recommendations can be made for orthotics, shoe modifications or a course of physical therapy designed to strengthen core muscles. Many times, with the right treatment, surgery can be avoided, thus diminishing the recovery time from a variety of injuries or disorders. With the new foot pressure measurement technology, our office can identify foot abnormalities more accurately than ever before.