Comfort Shoes Make Knee Pain Worse, New Study Says

If you have knee pain, or arthritis in your feet, ankles, or knees, you may be more confused about what to put on your feet after reading this article. 
A new small study was recently conducted on people who suffer from osteoarthritis in the knee and the results indicate that wearing clogs and comfort shoes puts more of a strain on the wearer when compared to walking barefoot or in flip flops. 
So for anyone with this condition who has gone out and purchased expensive and specialty shoes this may have been a waste of their money. Examples of "comfort" shoes include Dansko, Ecco, Birkenstock, and Aerosoles and as a group they tend to include cushioning under the pad of the foot and insoles for the arch. However, the study says that when arthritis sufferers wear these shoes, they change the wearer's gait and cause them pain.
We typically recommend comfort shoes to patients who have foot pain, or specific foot conditions that would benefit from wearing these particular type of shoe, so we were surprised to hear of this new study. In general, before you purchase any shoes, it is important to know what type of foot you have- are you a high arch, flat footed, or have a normal arch? Do you have foot deformities that prevent you from wearing specific types of shoes? Not everyone's foot is designed to wear the exact same shoe. 
Just because a shoe is expensive doesn't mean it is a good quality or even right for your foot. When a podiatrist tells you to pick out a shoe that is supportive, you can often find these items at various price points- you don't have to run out and purchase the most expensive one. If you have any questions as to what types of shoes are best for your feet, make an appointment with a podiatrist to discuss your options. 
We'll be interested to see if this study, even though small, has any ramifications in the podiatric world. 
Reference: Medical Daily
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Fibromyalgia and Your Feet

Fibromyalgia is a painful condition that can affect all parts of your body, including your feet, ankles, and toes. Although this area of your body is not the most common place you will experience fibromyalgia pain, a paper published in the journal Arthritis Research and Therapy says that half of the 202 patients they studied had foot problems.
"Compensation for foot pain leads to pain in the knees, hips, and lower back," says Dennis Frisch, DPM, in practice in Boca Raton, Florida. Having foot pain is just one more thing you don't need when you have

fibromyalgia. As well, foot pain increases your likelihood of falling, having an injury, and being less active. 
Patients with fibromyalgia tend to have a greater awareness of pains throughout their bodies than those who do not have the condition. "In general, because people with fibromyalgia have higher sensitivity to pain and lower pain tolerance, they are more sensitive to pain everywhere," says Dr. Frisch.
No foot pain is directly related to fibromyalgia, but the pains associated with them can be increased because of the condition. A Morton's neuroma, an enlargement of the nerve between the third and fourth toes that causes shooting pain, can be exasperated by fibromyalgia. Plantar fasciitis, the inflammation of the plantar fascia, the large ligament that runs from your big toe to your heel bone, is an another example.
It can be very easy with fibromyalgia to stop physical activity. You likely feel fatigued, and even when you start to exercise, you feel discomfort in your feet and blame it on your fibromyalgia. Many stop exercising all together, and "usually, for fibromyalgia, the recommendation is walking," Dr. Frisch adds.
To avoid unnecessary foot pain and get moving again, here are some tips you can try:

• See your doctor. If you experience any pain in your feet, see your podiatrist. Before you start any exercise regimen, see your fibromyalgia doctor and speak with them about it. 
• Choose the right shoes. "Make sure you have the right shoe for whatever activity you are going to do," says Dr. Frisch. If possible, pay a little more for a quality shoe that will help support your feet and keep you pain free. You should look for shoes that have a wide toe box, a supportive arch, and a sole that provides stability and flexibility.
• Start slowly. We know it's easy when you're motivated to start exercising to go in whole hog. But you're more likely to sustain an injury when you start too quickly. And remember: fibromyalgia can be an unpredictable condition. Think moderation.
• Know you will have some discomfort. When you begin exercising, it's likely you will experience some discomfort. This is normal. However, if the pain persists, seek medical attention.
• Wear lower heels for everyday use. We know it's difficult to give up your beloved heels. But bringing your heel height down to an inch will significantly decrease your fibromyalgia symptoms. If you absolutely have to wear high heels, pack them for times when you are sitting or not standing for long periods of time. 

Reference: Everyday Health.
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How To Deodorize Stinky Shoes

We've all been there before: afraid to take off our sneakers, boots, sandals, or shoes because our shoes stink. We're so concerned someone with a discerning nose will pick up our shoe odor that we hide in the corner with our feet shoved under the sofa. Oh please don't smell my shoes and feet. 
So why do our shoes smell? Our feet sweat and create bacteria buildup that creates the bad odor. Athletes tend to have even stinkier shoes because they sweat more and therefore the bacteria builds up more and

faster. 
Sometimes, even when you throw your shoes into the washing machine, the smell doesn't come out! What's up with that??? And, to make it worse, your prized running sneakers may end up warped or ruined because you tried to deodorize them. So what's a person to do?
Put your shoes in the freezer. Freezing will kill the bacteria that causes the odors and it will freshen your shoes. To enhance the process, put some baking soda in your shoes before placing them in the freezer.
If you don't want to put your shoes in the freezer exposed, place them in a plastic bag. First, put some baking soda in your shoes, then put them in the plastic bag and into the freezer. Leave your shoes in the freezer overnight. In the morning, take them out of the freezer and allow them to come to room temperature before you wear them (otherwise you'll be unhappy!). Take the shoes out of the plastic bag and shake out the loose baking soda into the garbage can. It won't hurt you or your shoes if some baking soda is left in the shoes.
During times of the year when it's around or below freezing at night, leave your shoes outside overnight. Put baking soda in your shoes and then throw them in a plastic bag. Make sure when you put them outside you leave them in an area that won't be exposed to rain or snow, or where they could be stolen.
If you don't trust your shoes outside alone overnight, put them in your car. Your car gets just as cold overnight and will kill the bacteria in your shoes.
All of these tips can be done to your shoes several times without ruining the materials, unless they are made of a delicate fabric that cannot withstand cold temperatures. For those shoes, take them to a professional cobbler.
Reference: Yahoo.
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Stretches For An Ankle Sprain

'Tis the season for slipping, falling, and spraining. Every winter podiatry offices across America see a multitude of people, young and old, who have slipped on ice, twisted their ankles, or had a shoe mishap. 
Once you have visited a podiatrist and received an ankle sprain diagnosis, you should perform the following stretches and exercises to help with mobility, strength, and range of motion. These exercises should only be done when the initial pain and swelling have receded, typically after five to seven days. All exercises should be done twice a day. 

While seated, bring your ankle and foot all the way up as much as you can. 
Do this slowly, while feeling a stretch in your calf.
Hold this for a count of 10. 
Repeat 10 times. 

From the seated starting position, bring your ankle down and in. 
Hold this inverted position for a count of 10. 
Repeat 10 times. 

From the starting position, bring your ankle up and out. 
Hold this everted position for a count of 10. 
Repeat 10 times. 

From the starting position, point your toes down and hold this position for a count of 10. 
Repeat 10 times.

This stretch should be done only when the pain in your ankle has significantly subsided.
While standing on the edge of a stair, drop your ankles down and hold this stretched position for a count of 10.
Repeat 10 times.

Do this stretch only when the pain from your ankle sprain has significantly subsided.
Stand 12 inches from a wall with your toes pointing toward the wall.
Squat down and hold this position for a count of 10.
Repeat 10 times.

These stretches were provided by the American Orthopaedic Foot and Ankle Society.
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How To Pack Shoes For Travel

In this Thanksgiving week, many college students will head home for break, families will head across country, and friends will knock on friend's doors. Thanksgiving is one of the biggest travel holidays, and packing correctly for your trip is essential.
And if you're like a lot of travelers, especially women, you struggle with what shoes to pack, how many, and

how to pack them. Some women will decide to pack all of their shoes, simply because they can't decide, and end up with suitcases that too big to check. 
But being realistic is important on your journey. How many pairs of shoes do you actually need? Look over this checklist to help you decide

• Where are you going? Are you travelling to a warm climate, where you will be on the beach a majority of the time? Are you headed to a cold climate, where you will be watching the local Thanksgiving football game and enjoying time inside? Will you go to New York City for the Macy's Thanksgiving Day Parade, and walk around the city afterwards? While flip-flops may be appropriate in the beach location, in the colder locations boots and closed-toe shoes with support are necessary. If you're doing a fancy Thanksgiving dinner out at a restaurant, pack a pair of "dessert" shoes. You know, those shoes you can only wear when sitting down. If you're going to be doing a lot of walking, shoes with support should be packed in your suitcase. But don't think those adorable fashion sneakers will keep your feet pain free- walking sneakers are best for a trip that includes a lot of walking. You'll thank us. We promise. 
• What's the purpose of your trip? Are you doing sightseeing while you are away? Will you have a short business meeting? Headed to Disney World for the holiday? Going to the stadium to see your favorite football team play? Different shoes will be needed for each activity. If you have a lot of activities planned while you're away, or back home for Thanksgiving, plan shoes that can be used in a multitude of ways. Sneakers can be worn to the football game, but also while you are sightseeing in NYC. 
• Lay your shoes on their sides. Shoes and boots should be arranged on their sides when possible, heel to toe. Lay one shoe down and then place its pair so the heel is at the toe of the first shoe. This way the shoes will take up the least amount of space. 
• Keep pairs together. To ensure pairs don't get lost in the clutter of a suitcase, pack your shoes in a large resealable bag. If you don't have any bags, tie them together with a rubber band or twist tie. 
• Placement. The Transportation Security Administration recommends placing your shoes at the top of your suitcase for checked luggage, to expedite inspection, if need be. If your suitcase isn't going to be checked, arrange the shoes around the perimeter of your suitcase to distribute the weight evenly. 

Remember: don't overpack your suitcase with shoes! Pack lightly and economically.
References: Huffington Post and USA Today.
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Rocker Bottom Shoes Don't Reduce Back Pain

Ahh, those rocker bottom shoes. 
First, they're touted as a way to help you lose weight. Then they were marketed as a method of reducing your back pain.
Guess what?
They do none of that.
A new study has shown that rocker bottom shoes are no better than regular sneakers in reducing lower back

pain. 
The shoes were branded as a way to positively impact your posture, reducing back and joint pain. However, new research from King's College in London disproves this theory, stating that traditional sneakers may be more beneficial for back pain brought on by standing or walking. 
Lead researcher physiotherapist Dr. Sian MacRae studied 115 people with chronic lower back pain and asked them to wear rocker bottomed shoes or regular sneakers for at least two hours a day while standing and walking. 
Those in the sneaker group had less disability than those who wore rocker bottomed shoes after one year. Researchers also found that after six months, 53 percent of the sneaker group had a small improvement in their back mobility, compared to 31 percent of the rocker sole group. 
MacRae said that physicians can now say that there is little difference in wearing the rocker bottom shoes versus sneakers, as they will provide similar results in decrease of pain and disability. 
Researchers did add that if the patient experiences lower back pain when walking or standing they will see a decrease in pain when wearing sneakers rather than rocker soled shoes. 
Reference: Business Standard
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Cher To Have Foot Surgery

Pop singing icon Cher will have surgery to repair a problem she has suffered with for 16 years. 

The Sonny and Cher star recently told her fans on Twitter that she sustained a compound fracture in the late 1990's when a piece of equipment fell off the wall of her rehearsal studio and "crushed" her foot.
Cher admitted that every time she wears high heels she is in terrible pain (then why wear them???) and has resolved to take care of the problem. 
She was wearing stilettos Monday night for an appearance as a guest judge on a tribute show of Dancing With the Stars and revealed that she will have to wait until after Christmas to wear heels again. 
She tweeted on Tuesday morning, "Last Nite, WAS Last Nite 2Wear Heels Till After Operation... Sooo... I Bit The Bullet.. &.. Wore Them! Heaven & pain But Worth It... 6 wks till I'm running around on Stilettos (sic)!"
Having the surgery now gives Cher plenty of time to recuperate for her 49-date Dressed To Kill tour, which starts in March. 
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Why Can't I Find Shoes That Fit?

It's the groan heard in shopping malls across America on a daily basis: "Why can't I find shoes that fit?"
You would think that with all of the different shoe companies in business that women could find one brand that fit their foot. But finding that company is often as difficult as that proverbial needle in a haystack.
Over 60% of women in the USA are unable to find their size in the average shoe store. Problem is, fewer

than 5% of US shoe companies make larger and wider shoe sizes, limiting our options. In a time when people can have made to order cars and personalize just about everything under the sun, women with different shoe needs are unable to easily find footwear that is trendy and fits.
Barbara Thornton, AKA The Shoe Lady, a Harvard Business School graduate with over 15 years in the footwear industry and owner of AskTheShoeLady.Com has some answers as to why it's so hard for women to find shoes that fit:

1. Customers in general do not understand the width system in shoe sizing, or even that there are options other than medium. So when they need a different width, they don't ask for it. Women who need a size 8 extra wide will end up purchasing a 10 medium. 
2. Shoe companies bellyache about making additional lasts, the frame shoes are made on, beyond the basic sizes between 5 and 10. So they just don't make the extra lasts. Making just six lasts to create 10,000 shoes is much more cost effective, in their eyes, than making 85 lasts for 10,000 shoes. 
3. The shoe companies are cheap. Even if they did have the lasts to make different sizes, they would have to pay their workers additional time to switch out the lasts. The companies believe this switching out of lasts is distracting for the factory worker, leaves room for error, and increases production price. 
4. Shoe companies don't want to push factories to make styles in extra sizes and widths because they don't want to put a strain on their good relationship with the factories. 
5. Shoe companies believe they will be stuck with unsold merchandise at the end of the season because of all of the different options. 
6. Shoe companies plan for the current and next year based on the prior year's sales and how much they sold in each size/width. This is a practice they've been doing for a long time.
7. Shoe companies don't actually track real size trends in the population, but base their future plans on how many they sold previously. They also haven't factored in the change in women's average shoe size, which has changed from a size 7 in 1990 to size 9 in 2013. 
8. Shoe companies also don't track the sales lost because of the options they do not have available. Reports are based on sales per style, per color, per heel height, re-orders, and other data. What they do not track is number of shoes sold per width/size, the change over time in that category, and the estimate of sales they lost due to few options. 
9. Shoe stores base their pre-season ordering on what they believe will draw the customer in, not providing options for the customer. What will look best in the store window? Customers with certain needs will have to try to squeeze into the shoe or not wear it at all. 
10. Customers don't demand that their shoes fit properly. Many feel that what they see is what they get. Women need to actively demand from shoe companies and stores properly fitting shoes. 

Reference: Digital Journal
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"The Middle" Actress Breaks Foot

"The Middle" cast just celebrated their 100th episode and actress Eden Sher wasn't feeling up to par.

Sher broke her foot while on a surfing holiday recently. The 21 year old actress, who portrays Sue Heck on the ABC comedy, was seen wearing a brace on her right foot during an appearance on "The View" Wednesday. 
She joked that this accident would fit in with her on-screen character's storyline. "This is the most 'Sue' thing I've maybe ever done. I broke my foot surfing... I fell off my board and I flailed in the water and... the side of the board hit the side of my foot," Sher said. 
Instead of seeking medical attention right away, Sher waited three hours before getting help. She was convinced the pain was part of the surfing experience. 
She explained, "I was like, surfing is all about pain, right?"
Reference: Contact Music
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Can I Have A Second Toenail On My Pinky Toe?

Have you noticed at the side of your pinky toe what appears to be a second toenail? Looks weird, doesn't

it??? Maybe you've tried to pick it off, and then lo and behold, it returned. 
So what is this excess nail on your toe? It's actually not a nail, it's a corn. It's called a Lister's corn, named after Dr. Joseph Lister, a 19th century doctor who fought for clean conditions in operating rooms. And yes, he got a corn named after him. 
If you'll recall, a corn occurs when there is an excess amount of pressure or friction, usually from shoes, on an area of the foot or toes. The foot will try to compensate for this friction by creating an extra layer of skin to protect itself. That works out OK for a while, and then more.... and more... and more... and MORE skin becomes a bump on your foot. Now we have a problem of a different sort. 
Corns are not a serious foot ailment, but can be unsightly and painful at times. When you're putting on your favorite shoes your corn will make you do a little yelp. Corns can become infected from rubbing from shoes. 
A Lister's corn typically forms on the inside or outside of your pinky toe. This hard corn is different from traditional corns because it can form with or without shoe pressure. They develop because of pressure on the toe and the toe itself. Those with Lister's corns usually have small toes that roll outward, and the corn forms because of the constant rubbing against the ground.
So how do you know how have a Lister's corn? If you have a hard, thick, bump on the outside or inside of your toe, or what looks like an oddly shaped toenail, it's likely a Lister's corn.
To prevent Lister's corns from recurring, wear shoes that have a wide toe box that will let your toe lie flat. You can cover the corn with a pad as well to relieve some of the friction that is occurring.
For those who have Lister's corns that just won't go away, your podiatrist may do one of two procedures to relieve the pressure. When the corn is on the inside of the toe, they will do a condylectomy, where they file away part of the bone that's rubbing against the ground. Patients are typically back on their feet within a few days of this procedure. If the Lister's corn is on the outside of the toe, podiatrists will do a terminal Symes procedure, where they will remove the small bone at the top of the toe. Patients usually recover within a few weeks.
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Related articles

• Corns on Your Feet?

I Have A Short Fourth Toe

Brachymetatarsia is a condition in which one of the bones of the foot is significantly shorter than the others. This condition typically affects the fourth toe. When looking at the foot, the fourth toe is much shorter than those surrounding it, and it may also appear as if it is raised up, with the third and fifth toes touching below.

The condition may be as a result of a congenital defect or an acquired defect. Congenital causes include Aarskog syndrome and Apert syndrome among others, along with acquired trauma. Simply, the metatarsal bone fails to develop fully, or the growth plate closes prematurely. This condition appears 25 times more in women (1 in 1820) than men (1 in 4586). 

Diagnosis is easily done with an x-ray of the affected toe. Usually patients come in with concerns about the toe's appearance, looking for cosmetic surgery to correct the abnormal shape and size, but often learn that there is a significant defect in the bone. Patients may notice that the toe is not carrying its share of the weight, which results in pain and discomfort. They may also have a difficult time selecting shoes because of the toe's shape. 

In many cases brachymetatarsia causes no pain or discomfort and will require no treatment beyond careful shoe selection. For some, surgery may be needed. 

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Reality Star Kate Gosselin Breaks Foot

Even if you don't know much about reality tv, it's likely you know who Kate Gosselin is. 

Gosselin, the mother of eight children, and former star of Jon and Kate Plus 8, has been on Dancing With the Stars, blogged for various outlets, and been flamed on the media. 
Gosselin, who has taken up marathon running since her show Kate Plus 8 was cancelled will be holding off hitting the pavement soon. Gosselin recently tweeted, "Dear broken foot, My running shoes say they miss you terribly... I'm so frustrated I could cry that I can't pound the pavement for awhile :(."
The reality star suffered a mishap with her kitchen island, not surprising because of the amount of time she spends in the kitchen. Gosselin released a new cookbook called Love Is In the Mix, which has recipes like "Family Yuck Pie", "Cheesy Tuna Pockets" and others. She spends more than 80% of her time in the kitchen, so that was a likely place for an accident to happen. 
Gosselin revealed in an interview that she would love to get back on television. "I wake up every day dreaming of that second chance. I don't think I appreciated it though. But I would love to take what I learned and gosh, knock it out of the park next time." 
Gosselin is hoping her new cookbook will lead to another reality program, cooking show, daytime talk show, or even work acting. She's keeping her options open, as she's the sole provider for her brood of eight. 
References: Gather.com and TheStar.Com. 
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Overlapping and Underlapping Toes

Toe deformities are common in children. These conditions are generally congenital, with one or both parents with these problems. Toe issues are typically present at birth and will become worse over time. Unlike children who are "pigeon-toed", children rarely outgrow this deformity.
In infancy, toe deformities are not usually a sign of another condition. For parents, it's usually a cosmetic issue. But as the child grows, the toes transform from flexible to rigid and become symptomatic of another condition. Many toe deformities will respond to conservative treatment. Traditional treatment has been digital splitting and exercises, but those often do not lead to good outcomes. As the deformities progresses and the toes become more rigid, surgery is generally the only option.

Underlapping toes can be seen in both children and adults and typically affects the fourth and fifth toes. A special type of underlapping toes is called congenital curly toes, and is common among families. Toes three, four, and five may be affected.
The cause of the deformity is unknown, but may be due to an imbalance in muscle strength of the small muscles of the foot. Combined with a small abnormality in the placement of the joints of the foot below the ankle joint called the subtalar joint, it creates a pulling of the ligaments in the toes, causing them to curl. Weight bearing increases the deformity and the folding of the toes results in the formation of callus on the edge of the toe. Tight fitting shoes aggravate this condition.
Treatment depends on the age of the patient, degree of the deformity, and symptoms. When symptoms are minimal, most podiatrists will recommend waiting and seeing how the condition progresses. If surgery is required, the degree of the deformity determines the procedure. A flexible toe will only require a simple release of the tendon, but a rigid toe may necessitate the removal of part of the bone.
Overlapping toes are identified by one toe that lies on top of another toe. The fifth toe is most often affected, but the second toe can be as well. The cause of this deformity is not known as well, although it is speculated that the position of the fetus in the womb during development is a potential reason. Sometimes overlapping toes are seen in families.
Treatment for overlapping toes depends on how quickly the condition is diagnosed. For infants, passive stretching and adhesive taping is commonly prescribed. This treatment can take 6 to 12 weeks and recurrence of the deformity is likely. Like underlapping toes, this problem will rarely correct itself. Occasionally as the individual grows, the deformity will go away. If surgery is required, a skin plasty is required to release the contracture of the skin associated with the toe. A tendon release and release of the soft tissue around the joint at the base of the toe may also occur. Cases that are severe may require the toe to be held in place with a pin. The pin exits the tip of the toe and may be left in place for up to three weeks. During recuperation the patient must limit their activities and wear a surgical shoe or removable cast. Excessive movement will greatly affect the outcome of how the toe looks. Following removal of the pin splinting of the toe may be required for another two to three weeks.
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Yo, Ho, Ho, I Have Ship Foot

Back when sailing, fishing, whaling, maritime, and war ships were a larger part of our culture and livelihoods,

sailors would often drop heavy objects on their feet. Ouch! 
The term ship foot is believed to have originated with sailors on gun ships. After a cannon recoiled it would often strike the sailor's toe. The toe and toenail would then bruise and if the impact was strong enough, the toenail would die and fall off the toe. 
Today, this term can be used in any situation, not just ships, and can often accompany toe fractures. Symptoms may include discoloration of the toenail, usually bruising in blue, purple, black, or red. You may notice trapped blood under the toenail as well, along with blisters and cracked skin. 
Podiatrists will often recommend the R.I.C.E. course of treatment for a ship foot- rest, ice, compression, and elevation. Even if a toe fracture accompanies ship foot, your podiatrist will still recommend R.I.C.E. The discoloration of the toenail will eventually grow out. If the toenail is cracked or blood is coming from under your toenail it may be necessary to remove the toenail. 
While recuperating from this injury, you may experience pain in your foot, legs, or back as you alter your gait to take pressure off your injured toe while you walk. It is crucial to follow the R.I.C.E. procedure to avoid affecting other parts of your body. 
Reference: Wise Geek. 
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What Is Trench Foot?

If you've studied history, you've likely heard of trench foot before. Trench foot was a common condition soldiers during WWI developed due to prolonged exposure to cold, wet, and unsanitary conditions in the trenches of Germany and France. 
The term was first coined during Napoleon's time, during the Napoleonic Wars of 1812. It was during the retreat from Russia the condition was noted and has since become a problem for men who are in trench warfare in the winter, like in WWI, WWII, and the Vietnam War. It is said that people even developed trench foot during the 1998 and 2007 Glastonbury Festival, the 2009 Leeds Festival, and the 2012 Download Festival as a result of the muddy, cold, and wet conditions at these events. 
Affected feet will become numb, either by turning red or blue as a result of poor circulation to the feet. Feet may develop a particular decaying odor due to early necrosis setting in. As the condition worsens, the feet will begin to swell. Advanced stages of trench foot include blistering and open sores which lead to fungal infections, also known as tropical ulcer, or jungle rot. 
When left untreated, trench foot results in gangrene, which necessitates the need for amputation. If trench foot is caught early, a complete recovery is possible, but severe short-term pain may be felt when sensation returns to the appendages. Since you've had trench foot before, you are more susceptible to having it again in the future.
Trench foot can occur in temperatures as high as 60 degrees Fahrenheit; it does not have to be cold water for it to happen.
To prevent trench foot, keep your feet warm and dry. Make sure you put on clean and dry socks and shoes daily. Treat the affected part by applying warm packs or soaking in warm water for five minutes. When sleeping or resting, do not wear socks. 
For soldiers, regular foot inspections are a key preventative measure. They were paired and made responsible for the other's feet. When left by themselves, soldiers would leave their socks and boots on. As the war raged on, the time spent in the trenches decreased.
Reference: CDC
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When Should I Purchase New Walking Shoes?

Bonnie Stein, a racing coach in Redington Shores, FL says that "Walkers wear their shoes way too long. They'll show me their soles and and 'See, my shoes still have treads.' But well before your treads wear, your midsole shock absorbers die." At that point, you might as well be walking barefoot.
Here are a couple tips to help you determine when it's time to buy a new pair of shoes:

• If you walk 45 minutes to an hour three times a week, replace shoes after 5 months.
• If you walk 45 minutes to an hour four times a week, replace shoes after 4 months.
• If you walk 45 minutes to an hour five times a week, replace shoes after 3 months. 

Can't remember when you last purchased shoes? Get a new pair soon and write the purchase date on the instep so you'll remember.
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Was Your Child Born With A Clubfoot?

Clubfoot, one of the most common birth deformities, occurs in 1 out of every 1,000 live births and is when the foot turns inward and downward. It is congenital and may be passed down through families in some cases. Risk factors include a family history and being male.
The condition can range from mild and flexible to severe and rigid. Each case of clubfoot may appear different from child to child. It may also be difficult to place the foot in the correct position. The calf muscle and foot may also be smaller than normal.

The deformity is often diagnosed right after birth, when a foot x-ray may be performed to view the extent of the disorder. Often the problem is a very tight Achilles tendon, and a simple procedure can be done to release it.
Treatment should be started as early as possible, ideally right after birth when it is easiest to reshape the foot. The best method of treating clubfoot is moving the foot into the correct position and casting the limb to hold it in place. Recasting and gentle stretching will be done every week to improve the position of the foot. 5 to 10 casts are typically needed, with the final cast left on for 3 weeks. After the foot is in the correct position the child will wear a special brace all day for 3 months, then at night and during naps for up to 3 years.
Severe cases of clubfoot will require further surgery to correct the deformity if conservative treatments do not work or if the problem returns. A small number of defects may not be completely fixed and treatment will only improve the appearance and function of the foot. These cases are usually associated with other birth disorders. The child should be monitored by a podiatric physician until the foot is fully grown. Most cases are resolved with conservative treatment and the outcome is excellent.
If your child is being treated for clubfoot, call your podiatrist if you see any of the following:

• The toes swell, bleed, or change color under the cast. 
• The cast is causing the child pain.
• The toes disappear into the cast.
• The cast slides off.
• The foot begins to turn in again after treatment.

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Imaging Having Surgery Without Anesthesia!

Alex Lenkei is a hypnotist who makes his living hypnotizing his crowd and making them believe and do things they would not normally.
So when it was time for him to have ankle replacement surgery, Lenkei did what came naturally to himself: he hypnotized himself. And had his surgery without anesthesia. 
Yes, that's right, Lenkei had ankle replacement surgery without anesthesia. 
This was not the 66 year old's first time doing this; he's had six operations done this way. However, this was the first time for orthopedic surgeon Dominic Nielson. 
Dr. Nielson did the two hour operation, which involved cutting through Lenkei's bone, at Epsom Hospital in Surrey. 
"It was certainly a bit nerve-wracking making the first cut, not being sure whether he would be able to feel it, but once we got through that bit it became very much like doing any other ankle replacement," Dr. Nielson said. 
"He did amazingly well with the whole thing. To be honest, it was just like doing any other operation. Alex went through the whole process, which took a very short period of time, and he told us he was ready to go ahead... It sort of went out of my head that he was awake and able to correspond.
"He made a couple of comments during the operation which obviously reminded us that this was a strange experience. He commented at one point on the noise of the saws and was just asking how it was going. It was very strange."
An anesthesiologist was on hand just in case anything went wrong during the July 8th operation, but he was not needed. 
Lenkei said, "I'm not averse to anesthesia- it's just that my pain control is a hell of a lot better than the medical profession's and I heal a lot quicker because my body doesn't have to get rid of all of the chemicals. Most doctors are scared because obviously it is not something that they come across in the medical profession, as such.
"The brain is a very sophisticated computer and if you press the right buttons it will do amazing things- if you press the right buttons it will switch certain things off."
All we can say is "WOW".  
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Wretch 32 Has Foot Injury

British rapper Wretch 32 is suffering from a swollen foot. 
Wretch 32, real name Jermaine Scott Sinclair, was in agony while performing at England's Reading and Leeds Festival last weekend after sustaining a mysterious injury several days earlier. 
The Don't Go hitmaker told Britain's Daily Star newspaper, "When I came off the stage last week my trainer felt really tight on my left foot. I took it off and it was mad swollen and it kinda (sic) hurts. I'll be cool though. I'll have a little drink to numb it up."
Wretch 32 is set to release his upcoming album, Growing Over Life, later this year. 
Reference: Contact Music
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Tampa Bay Bucs Kicker Tynes Suffering From MRSA

MRSA and staph infections are not something you fool around with.
Not only does Tampa Bay Buccaneers guard Carl Nicks have a staph infection in his toe, kicker Lawrence Tynes does as well. 
Tynes initially had an ingrown toenail and the infection entered through there. The Bucs' facility, One Buc Place, has been sanitized several times since the outbreak, with no new infections beyond Nicks and Tynes. Tynes went to New York for a second opinion, since he worked for the New York Giants for years and is familiar with the doctors in that area. While there he had a PICC line inserted to help with his treatment. 
The Bucs are obviously looking for this story to fade away, as they reported earlier in the week that both Nicks and Tynes were "responding well" to treatment. 
Amanda Tynes, Lawrence Tynes' wife, has a different spin on the story. 
She tweeted a picture of her clearly unhappy husband at their home in Kansas City as he sits hooked up to a PICC line. She wrote, "I hear my husband is responding "well" to treatment.  LOL! He's NOT responding at all yet. This is our #bucslife."
Amanda is clearly displeased with the "everything is OK" line the Bucs are trying to promote, and her "This is our #bucslife" comment is steeped with sarcasm. And the two of them have a right to be displeased: the Bucs signed kicked Rian Lindell the same day Tynes was having surgery. Ouch. Poor taste on the Bucs part. 
Amanda followed up that tweet with this: "Thank you so much for all the well wishes. Lawrence finally has the right people in his corner. Right now he needs to rest and get healthy."
More reading between the lines?
Tynes is best known for the overtime kicks in two NFC title games that propelled the Giants to Super Bowls XLII and XLVI. The Giants signed veteran kicker Josh Brown to a one year contract in March, ending Tynes's six years with the team. 
Reference: Yahoo and New York Daily News. 
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I Have Webbed Toes And I'm Not A Duck!

Webbed toes are when two or more toes are fused together. We typically think of animals, like ducks and
frogs to have webbed toes, not humans. During our fetal development, we all have fingers and toes that are webbed. At six to eight weeks of development, an enzyme dissolves the tissues between our digits. But 1 in every 2,000 births results in webbed toes. Webbed toes can also be called duck toes, twin toes, or tiger toes.
The most commonly webbed toes are the second and third toes, and there are six types of webbed toes:

• Simple. Adjacent toes are joined by soft tissue and skin only.
• Complex. Bones of the toes are fused together. This is very rare.
• Complete. The skin joins the toes from top to bottom. 
• Incomplete. The skin is joined partially by skin, usually only to the first joint. 
• Fenestrated. Skin is joined for most of the toe, but there is a gap in the middle. 
• Polysyndactyl. There is an extra digit webbed to an adjacent digit.

This condition will not impair a person's ability to walk, run, jump, or swim, however many feel embarrassed or experience low self esteem.
The cause of webbed toes is unknown. Some people used to believe it was an inherited trait, but sometimes only one person in the family would have webbed toes. Studies suggest a woman's nutritional intake during early gestation and smoking during pregnancy may contribute to this deformity. Webbed toes are also associated with the following conditions:

• Down's Syndrome
• Apert's Syndrome
• Poland Syndrome
• Holt-Oram Syndrome
• Carpenter's Syndrome
• Edward's Syndrome
• Fetal hydantoin effect
• Miller Syndrome
• Pfeiffer Syndrome
• Amniotic Band Syndrome
• Smith-Lemli-Optiz Syndrome
• Aarskog-Scott Syndrome
• Bardet-Beidl Syndrome
• Cornelia de Lange Syndrome
• Familial syndactyl
• Timothy Syndrome

Diagnosis may occur even before birth with a sonogram, or at birth. Additional symptoms indicate there is an underlying syndrome.
Webbed toes can be separated surgically, even though this condition does not cause any health problems (unless there is an underlying condition). Your doctor will use a skin graft from your thigh, which fill in the missing skin, to surgically separate your toes. Results will vary on the severity of the webbing and the underlying bone structure. Surgery will begin with general anesthesia and the surgeon marking off the areas that will be repaired. The procedure can last from 2 to 4 hours, depending on the severity of the condition. Most patients are required to stay in the hospital for up to 2 days after surgery. Many patients experience swelling and bruising, but that is normal. Pain medication will be prescribed to deal with the pain and discomfort. Once you are released from the hospital you will have to keep your bandages clean and dry for up to 3 weeks. Skin grafts can be very dry, and using lotion will help moisturize the area.
Complications of the surgery may include scarring and webbing growing back. There may also be post-operative swelling, severe pain, numbness, bluish discoloration, and tingling toes. If you experience any of these symptoms, call your podiatrist right away. Other complications include:

• Skin graft damage, which may darken over time.
• Breathing problems
• Sore throat from tubation
• Excessive bleeding
• Infection
• Bad reaction to medications
• May need second surgery

If you have webbed toes, consider asking your podiatrist the following questions:

• Will I pass this on to my children?
• Do you recommend surgery?
• What are the risks?
• What tests should I anticipate?
• Are there non-surgical treatment options?
• What nutrients reduce the risk of my child having webbed toes?

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My Child Is Pigeon-Toed

Have you noticed when your child walks or runs, their toes turn inward instead of pointing straight ahead? This is called intoeing, or more commonly known as being "pigeon-toed".
You may first notice this when your child begins to walk, but a child of any age may show signs of intoeing. Severe cases of intoeing will cause the child to stumble or trip as they catch their toes on the other heel. There is not usually pain associated with this foot deformity, nor does it lead to foot arthritis, as is popularly speculated.
For the majority of children under the age of 8, this condition will correct itself on its own, without the use of braces, casts, surgery, or other special treatment. Children who are suffering from pain from their intoeing, or there are signs of swelling or a limp should be seen by a podiatrist.
The cause of intoeing typically comes from an alignment issue from some area of the body. Three common conditions associated with intoeing are:

• Curved foot
• Twisted shin
• Twisted thighbone

These conditions often run in families, but can occur on their own or in conjunction with other orthopedic problems. Prevention is not an option since those conditions occur from developmental or congenital disorders.

Curved foot, or metatarsus adductus, is when a child's feet bend inward from the middle part of the foot to the toes. This is different than clubfoot, but severe cases may look like one. Some cases may be mild and flexible, but others may be severe and stiff. Curved foot typically improves on its own over the first 4 to 6 months of a child's life. Babies over 6 months who still have this condition, which may have progressed, may be treated with casts or special shoes. Surgery to correct the deformity is rarely used.

Twisted shin, or tibial torsion, is when the child's lower leg (tibia) twists inward. This can occur before birth, as the legs rotate to fit in the tight space of the womb. After birth, most infant's legs rotate to align properly. When the lower leg remains turned in, twisted shin occurs. As the child begins to walk, their feet turn inward because the tibia in the lower leg points the foot inward. The tibia can untwist as the bone grows taller. Tibial torsion almost always improves on its own, usually before the child goes to school. Splints, special shoes, and exercise programs do not work. If the child is 8 to 10 years old, with a severe walking problem or limp and still has this condition, surgery may be required to reset the bone.

Twisted thighbone, or femoral anteversion, is when the child's thighbone turns inward. It will appear most obvious when the child is 5 or 6 years old. The top part of the thighbone, near the hip, has an increased twist, which allows the hip to turn in more than it should. If you watch your child walk, both their toes and their knees will turn in. When sitting, children with this condition are often in a "W" position, with their knees bent and their feet flared out behind them. Most cases of twisted thighbone correct themselves, often spontaneously. Like tibial torsion, special shoes, braces, and exercises do not help. Surgery is not usually considered unless the child is 9 or 10 years old and the deformity causes tripping and an unsightly gait. Surgery involves cutting the femur and rotating it to the correct position.
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Singer Jenny Frost Breaks Foot

Former Atomic Kitten singer Jenny Frost doesn't get much time to party anymore with a 5 year old and baby twins.
So Frost probably went overboard several weekends ago when she got some time off and went to a party in Ibiza with girlfriends. Frost ended up with a broken foot after a nasty accident on August 10th. She was hospitalized after falling over with friends on the Spanish party island.
After the accident, Frost is wearing a cast on her right foot. Frost tweeted pictures of her casted foot and wrote, "What an absolute numpty! What an absolute plonker I am!" She thanked the staff at the beach club in San Antonio for helping her after the accident occurred.
Frost recently celebrated her second anniversary to Spanish scuba diver Vicente "Vinnie" Juan Spiteri. She posted a photo montage on Twitter of their wedding day, tweeting, "2 years ago today I married the best person I know... @activedive. Love you baby x #bestdayever."
Reference: Daily Mail and Star Pulse.
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Spider-Man Cast Member Suffers Foot Injury

"Spider-Man: Turn Off the Dark" should just turn off the lights and call it a day.

From the very beginning, this Broadway musical has hosted many injuries, so many that one would think this show is cursed. 
The latest injury victim was dancer Daniel Curry, one of the show's nine costumed Spider-Man dancer/acrobats in the highly technical production with a lot of aerial wirework. Curry, a LaGuardia High School of Music & Art Performing Arts graduate in his 20's, was hurt in the second act when his foot become caught in one of the "elevators," the automatic lifts that rise and drop to create openings in the stage. 
The performance at the Foxwoods Theater came to an immediate halt and the rest of the show was cancelled as crew members came out with a privacy curtain and worked to free Curry. Firefighters also arrived at the scene to help. 
As of Friday, Curry was still in the hospital. "Daniel Curry remains in the hospital in stable condition, having sustained an injury to his foot," said show spokeman Rick Miramontez in a statement. "Friday's performance will go on as scheduled. The technical elements of the show are all in good working order, and we can confirm that equipment malfunction was not a factor in the incident. Our thoughts are with Daniel and his family." 
The injuries on the show have become the butt of several jokes. At the 2011 Tony Awards, host Neil Patrick Harris quipped, "Pretty soon they'll be turning the name to 'Spider-Man: Turn Off the Lawsuits' and 'Spider-Man: The Only Show That Warns You About Strobelights and Falling Actors.'" 
References: The Wrap and Newsday. 
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Actor Joshua Jackson Has Foot Injury

Fringe actor Joshua Jackson hobbled through security at Los Angeles airport on Monday on crutches with a mysterious foot injury.
The Vancouver native and his longtime girlfriend, actress Diane Krueger were at LAX catching a flight to London.
The former "Dawson's Creek" star was seen with a special brace on his right foot with his big toe heavily bandaged.
It is unknown how the 35 year old actor injured his foot, as he was seen Friday at a Whole Foods store with Krueger and he was walking fine.
Reference: Global News
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You Don't Hammer With Mallet Toes

A mallet toe occurs when the joint at the end of the toe will not straighten. This is different from a hammertoe

because in a hammertoe, any joint can be affected. Excessive rubbing of the deformity against the top of a shoe will lead to the development of a corn and pain. The tip of the toe is often turned down against the shoe, causing pressure and discomfort. Those with mallet toes are often embarrassed by this deformity because it can stick out like a sore thumb. When left untreated, the pigment of the skin on the mallet toe can become dark and circular.
Causes of mallet toes include:

• If you are on your feet all day. 
• Participate in sports regularly.
• Have arthritis
• Have nerve damage in your back, leg, or foot.
• Have very high or very flat arches.
• Wear shoes that don't fit
• Were born with a toe deformity.

Other factors include poor circulation, diabetes, edema, and wearing non-leather shoes. Complications of the mallet toe can lead to puss, infection, and swelling, as well as a change in gait pattern because of pain.
Conservative treatments for mallet toes include:

• Wearing shoes with a large, square toe box.
• A toe crest or buttress pad.
• Gel toe caps or shields.

If your mallet toe is causing significant pain or has progressed to an infection, call a podiatrist to make an appointment. Surgical treatments a podiatrist may try are:

• Amputation of the tip of the toe (only if gangrene or severe infection is present).
• Joint fusion of the toe.
• Partial bone/joint removal.
• Flexor tenotomy or lengthening.

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My Second Toe Is Very Long!

If your second toe is longer than your first toe, you have a type of foot called Morton's toe, or Greek foot. It is a form of brachymetatarsia, which promotes an anterior position of the second toe in relation to the big toe. This deformity may or may not result in the second toe extending past the big toe.
The name Morton's toe was given by American orthopedic surgeon Dudley Joy Morton, who included it as part of the Morton's triad: a short first metatarsal bone, a hypermobile first metatarsal segment, and calluses underneath the second and third toes. Morton's toe can also be confused with Morton's neuroma, which involves a nerve between the third and fourth toes. Morton harkened back to prehistoric humans, who probably used their toes for grasping.
The Greeks believed this type of foot to be beautiful, and it appears in sculptures and art. As well, it persisted as an aesthetic standard through Roman, Renaissance, even modern times- the Statue of Liberty has a Greek foot!
Morton's toe is a common foot type, but can be considered a deformity as well. The symptoms associated with Morton's toe include discomfort and callusing along the top of the second toe. This is because the big toe would normally bear the weight of walking, but these forces are transferred to the second toe because of its length and position. With shoes it can be a problem when trying to fit a shoe to the second toe.
Morton's toe affects 20% of the population, but 80% of people with it have foot pain. The reason for this high ratio is because of excessive pronation (weight bearing). Excessive pronation causes the leg to be shortened or lengthened, and the leg is rotated internally. Other problems associated with Morton's toe are: metatarsalgia, hammertoes, mallet toes, bunions, Morton's neuroma, and heel pain.
Treatment is often orthotics to realign the foot to its proper position and relieve some of the pressure from the second toe.
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Claw Toes Are Not Just For Birds!

Toe deformities often get blamed on wearing shoes that are too tight or too small, which can be the case in

hammertoes and mallet toes. However, claw toes are the result of nerve damage from diabetes or alcoholism, which weakens the muscles in your foot. Claw toes claw at the soles of your shoes, creating painful calluses. Without treatment this deformity can become worse over time, even becoming a permanent problem.
Symptoms of claw toes include:

• Toes that are bent upwards from the joint at the ball of the foot. 
• Toes bend downward at the middle joints towards the sole of your shoe.
• Toes may also bend at the top joint, curling under, like mallet toes.
• Corns on the top of the foot or on the ball of the foot.

A podiatrist can effectively diagnose a claw toe, using tests to determine if the cause is neurological, or trauma or inflammation.
In the early stages of a claw toe deformity, the toe will be flexible. However, the longer the condition progresses, the more rigid it will become. If the deformity is caught at an early stage, simple taping or splinting may be prescribed to retrain the toe to the correct position. Your podiatrist may also recommend:

• Wearing shoes with roomy toe boxes and avoiding tight shoes and high heels.
• Use your hand to stretch the affected toe to the correct position. 
• Exercise your toes by performing towel pick-ups or marble pick-ups with your feet.

Claw toes at an advanced stage will require other, more complex treatment:

• A special pad to redistribute your weight and relieve pressure on the ball of your foot, like an orthotic.
• Extra deep shoes with additional space in the toe box to accommodate the claw toe.
• Have your shoes stretched.
• Surgery to correct the deformity.

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Can Children Have Bunions?

When we think about bunions, we think of our mothers and grandmothers. Their feet, deformed after years

of wearing inappropriate shoes and having bad feet. But would we ever think of our young daughters? Juvenile bunions affect children and teens, especially girls, between the ages of 10 and 15. For the most part juvenile bunions are without symptoms of pain because they do not have the degenerative changes adults face. The first sign that your child may have a problem with a bunion is they will have trouble putting their feet into shoes. Some children will feel self-conscious about their bunions. Other symptoms will include:

• A big toe joint that is red or swollen. 
• Complaints of foot pain when walking, running, or playing.
• Problems moving the big toe joint.
• A thickening of the skin on the bottom of the foot.

Juvenile bunions are more severe as the onset of the foot deformity is earlier and it progressives very quickly. When left untreated, it can cause significant deformity and disability. They are typically treated aggressively to prevent recurrence in later years. Roughly 50% of juvenile bunions are associated with flexible flat foot, as the flattening of the arch and the large big toe are secondary to hypermobility of joints.
When it comes to foot wear and children, ensure your child does not wear ones that are too small or too tight. Young girls with juvenile bunions should stay away from heels and narrow/pointy shoes because this increases the risk for bunions to increase.
Treatment for a juvenile bunion depends on severity, degree of pain, and how quickly the bunion is progressing. Growth plates in children tend to close when girls are around the age of 16 and boys when they are 17. Closing of growth plates dictates when surgery can be accomplished safely.
Conservative treatment options for juvenile bunions include:

• Custom orthotics, which control excessive motion
• Changes in shoes, to take pressure off the bunion
• Padding/taping, use to relieve irritation and discomfort
• Anti-inflammatory medications to help with the pain.
• Physical therapy to help with pain relief. 

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What Is Jackson-Weiss Syndrome?

Jackson-Weiss Syndrome is a rare condition, so rare in fact there are no published statistics. The condition is a genetic disorder that is caused by a mutation in chromosome 10, the FGFR10 gene, and is responsible for defects in the face, feet, and head.
It affects both males and females equally and may appear as the first time in a family, or be passed down from generation to generation. Intelligence and life expectancy are typically normal. Babies born with Jackson-Weiss Syndrome have a skull that fuses together too early, called craniosynostosis. This causes a bulging forehead, misshapen skull, widely spaced eyes, and a very flat middle section of the face.
Foot deformities are common in those who have Jackson-Weiss Syndrome and may include:

• Wide, short, big toes. 
• Big toe bends away from other toes.
• Bones of some toes may be fused together.
• Webbing of toes.

Treatment is generally surgical and targets the specific deformity.

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Amniotic Band Syndrome In the Feet

Amniotic band syndrome is a congenital disorder caused by fetal limbs or digits getting caught in fibrous amniotic bands while in utero. Amniotic banding happens in every 1 in 1,200 live births and is likely responsible for 178 in 10,000 miscarriages. About 50% of cases also have other congenital deformities, including cleft lip, cleft palate, and clubfoot. It is considered an accidental occurrence and does not appear to be genetic or hereditary.

Constriction of appendages by amniotic bands may result in:

1. Constriction rings around the digits, arms, and legs.
2. Swelling of the extremities distal to the point of constriction.
3. Amputation of digits, arms, and legs.

Many who have ABS will have clubfoot, which occurs in roughly 31.5% of cases. Disfigured feet in general are a common deformity in this disorder.
Some researchers believe that ABS is caused by early amniotic rupture, which leads to the formation of fibrous strands that entangle limbs and appendages. Treatment occurs after birth and involves plastic and reconstructive surgery, ranging from the simple to the complex. Prognosis depends on the location of the amniotic bands. Bands that are wrapped around fingers, toes, feet, or hands can result in syndactyly or amputations of the affected area.
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