Athletic Shoe Guidelines

Ingrown Nails Got You Hanging?

If you have an ingrown toenail, you can relate when I say the pain and discomfort is beyond aggravating. Trying to find comfortable shoes is sometimes impossible. But what do you do about an ingrown toenail? Do you try to cut it out with a toenail clipper? Will it be there forever? Some people are scared to seek medical attention because they think they will have to get their nail removed. Though sometimes this is necessary, it is rare that one will have to lose their entire nail.

An ingrown toenail is a nail that digs into the skin and causes pain, swelling, redness, and sometimes infection. It can be caused by genetics, trauma, or improper trimming. Stubbing your toe or dropping an object on your toe may result in an ingrown toenail. Many people cut their nails too short. This encourages the skin to surround the nail and the nail can then pinch the close confiding skin.

A podiatric physician can do a simple in office procedure to remove the offending nail border. The nail will continue to ingrow unless the matrix or the root of the nail is destroyed. When only the outside border is causing problems, the doctor can remove that portion of the nail and only kill the root of that area of the nail. Thus you will still have a nail but a small portion will be removed and will not grow back. Those concerned with cosmetics will be happy to know that the removal of the border of a nail often goes unnoticed by others when the condition is minor. If there is a serious infection present, the root of the nail will not be killed due to the reaction of the chemicals used with the infectious tissue. The nail border is removed and the injury is allowed to heal until the tissue is healthy to undergo chemical cauterization.

Though some need to undergo more invasive surgeries to remove the matrix, most have their problems solved by a simple 15 minute visit to the doctor. The most important thing to do is to keep your hands off your toenails. Do not try to pick at it or cut it because a small problem can become a big problem if you do not remove it correctly.

Heel Pain

The most common cause of heel pain is a condition called plantar fasciitis. The plantar fascia is a ligament on the bottom of the foot that goes from the heel to the ball of the foot. The definition of-ITIS is disease or inflammation. So plantar fasciitis is inflammation or disease of the plantar fascia.

The plantar fascia ligament consists of 3 bands-the medial band in the arch of the foot, the middle band and the outside band. If you suffer from plantar fasciitis, you have inflammation and tightness usually of the inside or medial band in the arch of the foot.

If you have plantar fasciitis, you have a very tight ligament that acts like a rubberband. When you sit or sleep, the ligament tightens up and gets stiff. As soon as you get up and stand from sleeping or prolonged sitting, the arch in your foot drops, your foot lengthens and ultimately pulls that tight plantar fascia. This causes severe pain especially with the first steps in the morning after getting out of bed. That initial first step pain may ease up a little as you walk it out as the ligament stretches or loosens with less pain. The more pulling you get, the more inflammation develops and inflammation causes the pain.

There are numerous reasons why you can develop plantar fasciitis but a common source is due to overuse. The most common causes of heel pain from plantar fasciitis are unfavorable work conditions, exercise-induced or improper use of shoe gear. You are at-risk for heel pain, if you have an occupation involving a lot of walking and/or prolonged standing on hard floors. Nurses, dancers, athletes, runners, teachers, farm workers, construction works, just to name a few are prone to heel pain. Also if you are involved in a traumatic injury such as a car accident or fall at work, you are susceptible to having heel pain. If you recently started a new exercise or workout routine or change in your activity level, you may develop this heel pain condition. Even if you are a world-class athlete, you can 'overdo it' and develop plantar fasciitis. Finally, if you suffer from chronic low back pain, you can be prone to heel pain. Your back condition should be treated and monitored by a back specialist at the same time as seeing a podiatrist for the heel pain.

The symtoms of plantar fasciitis include pain in your arch, your heel or the entire bottom of your foot. If left untreated, your acute heel pain can develop into painful, long-term chronic heel pain.

If you have experienced these symtoms, it is crucial to see a foot and ankle specialist as soon as possible to prevent further pain and suffering. Diagnosis by a podiatric foot and ankle specialist will involve clinical evaluation and x-rays to further evaluate the heel bone and foot structure contributing to the pain. MRI is sometimes needed if a rupture of the ligament or other condition is suspected.

Good News! If you suffer from plantar fasciitis, it can be successfully treated without having surgery most of the time! Initially, the inflammation needs to be addressed and reduced first before the other treatments can work. Stretching and orthotics are very important but they can make your heel pain worse if there is a lot of inflammation and pain.

There are many ways to reduce the pain and inflammation such as Resting by reducing physical activities and 'babying' your foot, Icing your foot 20 minutes 2-3 times a day, Compression with a snug wrap or brace and Elevation of your foot. This can be summarized by the R.I.C.E. mnemonic. Also there are oral steroid and non-steroidal anti-inflammatory medications that can be prescribed by your podiatrist for pain relief. The most effective way to reduce the inflammation and pain by far is a cortisone steroid injection performed in the office of a podiatrist.

Comfortable, supportive shoe gear is important for heel pain relief in addition to wearing high-quality prefabricated or custom orthotics, which can be obtained by your podiatrist. A strapping or taping of the foot can also be performed by your podiatrist or therapist to support your arch. You should not walk barefoot not even around the house (not just socks) to aid in increased shock absorption and heel pain relief. Flip-flops and non-supportive shoes can make your heel pain worse.

Stretching the tight plantar fascia is imperative in the reduction of heel pain from plantar fasciitis. Stretching can be accomplished by using a combination of three different modalities: 1) home stretching exercises, 2) devices to stretch the ligaments and tendons called a night splint and day splint and 3) a formal program of physical therapy done 2-3 times a week by a trained professional.

If all else fails, there are a variety of other types of treatment for chronic, long-standing cases of plantar fasciitis.There is a new, non-invasive treatment of heel pain called the MLS laser. This laser therapy works by interacting with the tissues on a cellular level, speeding up metabolic activity to improve the nutrients crossing cell walls, promoting quick and healthy healing. This is done in the Willow Street Office of Henderson Podiatry with a series of 6 pain-free, quick 8-minute visits.

The last resort for heel pain relief is surgery to release the ligament. This minimally invasive procedure performed in a sterile operating room is called an Endoscopic Plantar Fasciotomy (EPF). It releases the tight medial band only of the plantar fascia.

Once the pain goes away, it can always return no matter what treatment you have had-even surgery. Maintenance to prevent the pain from coming back involves wearing a good, supportive pair of custom orthotics in your shoes, not walking barefoot and stretching the ligaments twice a day.

Athletic footwear should be fitted to hold the foot in the position that's most natural to the movement involved. Athletic shoes protect your feet from stresses encountered in a given sport and to give the player more traction. The differences in design and variations in material, weight, lacing characteristics, and other factors among athletic shoes are meant to protect the areas of the feet that encounter the most stress.

Well-fitted athletic shoes need to be comfortable, yet well-constructed and appropriate for a given activity. A good fit will mitigate blisters and other skin irritations.

Sports-specific athletic shoes are a good investment for serious athletes, though perhaps a less critical consideration for non-athletes. Don't wear any sport or other shoes beyond their useful life.

A running shoe is built to take impact, while a tennis shoe is made to give relatively more support, and permit sudden stops and turns. Cross training shoes are fine for a general athletic shoe, such as for physical education classes or health club exercising, such as on stair machines and weight-lifting because they provide more lateral support and less flexibility than running shoes. They also tend to be heavier than running shoes, but most people don't need light, flexible shoes for cross-training. If a child is involved more heavily in any single sport, he or she should wear shoes specifically designed for that sport.

Our practice recommends sturdy, properly fitted athletic shoes of proper width with leather or canvas uppers, soles that are flexible (but only at the ball of the foot), cushioning, arch supports, and room for your toes. Try a well-cushioned sock for reinforcement, preferably one with acrylic fiber content so that some perspiration moisture is "wicked" away.

Athletic shoes need to be replaced after one year, whether or not they are worn, and after a certain amount of repetitive load is placed on them and wears them down. The American Academy of Podiatric Sports Medicine advises replacing running or walking shoes after 300 to 500 miles of wear, and replacing aerobic, basketball, and tennis shoes after 45 to 60 hours of wear. Athletic shoes should also be replaced if they show signs of unevenness when placed on a flat surface, display noticeable creasing, and/or when the heel counter breaks down.