Getting A Pedicure? Look For These Things

It is that time year again when our feet come out from their winter shoe hiding place and are free in flip flops, sandals, and open toed shoes. You may look down at your naked toenails and think "This will not do!" 
But you may be concerned about going to a nail salon to get a pedicure because of the horror stories you have heard from friends, family, and co-workers. Most people know about the dangers dirty salons can cause: fungus, cuts, and mishaps. 
It is crucial therefore that you go to a salon that uses clean practices. You can assume that there is always a chance for exposure to these fungi, bacteria, viruses, and pathogens. We see the effects of a pedicure gone wrong all the time in our offices- from patients who have had toenail fungus for years, botched cuticle cutting, and various other viruses. 
Don't become another victim of a foot condition from the salon. Here are some things you should look for in a good nail salon:

• Get to the salon 15 minutes early. It may be a pain in the neck to arrive 15 minutes early before your appointment, but the point is to give yourself time to check out the salon, even if you have been there before. Does the salon look professional and clean? Trash bins should never be overflowing, and neither should dust be collecting on shelves. 
• Find licenses. Each of the nail technician's, along with the salon's license, should be posted near the entrance so everyone can see them. Don't see the licenses? Ask your technician.
• How do they sanitize their tools? Tools should either be sterilized in an autoclave, a big device that sanitizes tools, or in liquid disinfectant. The solution should not be cloudy; if the solution is cloudy, it needs to be changed. Ask if they use test strips to make sure the disinfectant is working. 
• Look at the pedicure area. Are the footbaths being cleaned after every pedicure? After every pedicure the footbaths should be disinfected with hot, soapy water, filled with water again, along with disinfectant. The spa should run at least 10 minutes before being emptied out again and wiped down. 
• Check out the manicure area. Is your manicurist cleaning and disinfecting after every single client? new towels, cotton balls, disposable nail files, and wooden tools should all be replaced and thrown out.
• Watch out if you are getting acrylic nails or fillings. The manicurist should wash her hands before getting started and apply an antibacterial gel or spray to yours. Every tool should be sterilized. 
• Avoid cuticles. Cuticles should be pushed back but not cut. Your cuticles provide protection for your nail bed, so they should be kept. 
• Bring your own manicure kit. Many nail salons will let you bring your own manicure kit, as well as your own polish. But- you need to make sure they are cleaned and sterilized after each visit. 
• Visit a med spa. Still have doubts? Visit a med spa, where a physician is on staff and oversees the environment, tools, and equipment. 

Reference: Elle
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Former Costa Rican President Has Foot Surgery

Costa Rica's former president Oscar Arias Sanchez (1986-1990, 2006-2010) underwent surgery on his right foot last Sunday to repair a ruptured tendon. 
The surgery was performed at the Clinica Biblica, a private hospital in downtown San Jose, per instructions from Arias' personal physician. The former president and Noble Peace laureate said he has been suffering from recurring pain and discomfort for several weeks.
Arias' daughter, Silvia Aria, spoke with members of the media after the surgery, stating that the surgery began at 10:30 AM and lasted two hours.
Arias was accompanied to the hospital by his wife Suzanne Fischel and other relatives. The first medical report after surgery found Arias, 73, in good health.
Arias was president of Costa Rica twice and won the Noble Peace Prize in 2007 for his efforts to end and negotiate peace accords for years of civil wars in Central America. 
Reference: Tico Times
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Liam Hemsworth Injured On Set of Mockingjay

Liam Hemsworth fans across the world are hoping for a speedy recovery for the popular Australian actor.
Hemsworth injured his right ankle while filming The Hunger Games: Mockingjay 2 in Berlin this weekend. Production stopped on Saturday and resumed today. 
The actor was seen with his driver and two people from his entourage for a second-round check-up at the doctor's today, where he was for an hour and a half. Even though he was limping, Hemsworth was all smiles and was in good spirits. 
The rumor is that Hemsworth sustained the injury when he kicked a styrofoam stone dummy, but it has not been confirmed. 
Before getting injured, Hemsworth was showing off his dance moves at the Cannes Film Festival. The cast of Mockingjay 2 got dance fever at the 67th Festival, with Hemsworth the first to hit the dance floor. The crew boogied out to songs by Beyonce, Michael Jackson, and Macklemore and Ryan Lewis. 
References: E! Online and Perez Hilton
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Does Vitamin D Have To Do With Foot and Ankle Injuries?

In a new correlation study, those who have foot or ankle injuries are more likely to be deficient in vitamin D. This new relationship between vitamin D deficiency and the risk for foot and ankle injuries may help with dietary advice for seniors, athletes, and others with a propensity to have bone damage. 
Vitamin D has a dual purpose in our bodies: first to act as a nutrient and second to be a hormone. Traditionally it has been a main factor in helping to build and repair bone. Other research shows that vitamin D can reduce chronic conditions such as heart disease, cancers, multiple sclerosis, and infectious diseases. 
However, getting the amount of vitamin D you would need to promote your health is difficult. Dairy products and fatty fishes contain vitamin D, but most Americans do not consume enough of these to meet their daily intake requirements. Some foods now, like breakfast cereal, fortify their products with vitamin D. It is possible to get vitamin D through sun exposure, but one would have to sit outside every day for 15 minutes to receive the proper benefit. 
Those who do not receive enough vitamin D through their food intake will often be told by their physician to take a vitamin supplement. 
There is a debate going on among medical professionals as to how much vitamin D a person should acquire in a day. A 2010 study says that the USDA guidelines should be tripled to 600 IU per day. This is a level higher than what the average multivitamin contains, typically at 400 IU. It is unclear as to how much vitamin D is needed for optimum health.
The recent study published by Foot And Ankle International looked at the relationship between vitamin D and foot and ankle injuries. The study involved 75 people, all whom had suffered a foot or ankle injury. 47 patients had levels of vitamin D that would be considered insufficient (less than 03 ng/mL) and 13 percent were found to be vitamin D deficient. The study also found that those who had suffered a fracture had significantly less vitamin D than those who only sustained a sprain.
However, this was just a correlation study and there is no evidence to support the idea that vitamin D causes foot and ankle injuries or visa versa. Further studies would be needed with supporting evidence to prove this claim. 
Reference: Liberty Voice
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Should You Leave Your Shoes At the Door?

In many countries across the world, it is considered rude for a guest not to take off their shoes before entering a private home. A U.S. expert now says that it may not be beneficial.
Stephen S. Morse, a professor of epidemiology at the Mailman School of Public Health at Columbia University says that even when a person walks through a spotless office building, shoes pick up all sorts of germs and bacteria. 
Bacteria like E. coli and viruses that cause influenza like to attach themselves to shoes. For those who live in farmland or near exposed soil, harmful pathogens like to stick on shoes. Carpets and wet surfaces house our favorite fungi, which can cause Athlete's foot and plantar warts. 
However, these germs would "have to make their way into a human through a lesion on the skin, and that's a pretty far-fetched scenario," Morse told the Wall Street Journal. 
While the risk of catching any severe germs is low, who should enforce a no-shoes policy?
Those who have crawling babies should enforce a no-shoe rule, as babies love to put anything they can find in their mouths, or leave things behind for an adult to step on. Dr. Morse also offers this practical reason: wood floors and other surfaces look cleaner without shoe traffic. Dr. Morse removes his shoes in his home, "for the sake of keeping my marriage intact."
However, going barefoot is not for everyone. Diabetics and the injury-prone should either wear shoes in the house or socks and slippers. "You could step on a nail," Dr. Morse says. "But mostly the concerns are anesthetic."
Enforcing the no-shoe rule can be tricky, especially when it comes to repairmen or dinner guests, and Dr. Morse doesn't believe it's worth it. He thinks that a little dirt is a good thing: "The Hygiene Hypothesis says that one of the reasons we see asthma and allergies is because the immune system isn't being kept busy with fighting off the bad guys," he says. "There is evidence for both sides, and we epidemiologists debate this every week." 
As long as guests wipe off their shoes before they enter your home, you should be OK. "It might save your floors a lot of cleaning, but other than that, we have no reason to believe that shoes in the home are a real hazard."
Reference: Wall Street Journal
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Mental Health Tied To Foot Pain?

Is mental health tied to foot pain? Researchers in Australia believe so.
A new study published in Arthritis Care & Research suggests that poor mental health is a predictor of worsening foot pain. This study included 62 patients with foot pain, who underwent assessments for pain and mental health in 2008 and then again three years later.
Researchers from La Trobe and Monash University found that participants whose foot pain decreased in the interval were more likely to have better baseline mental health.
Authors found that age, gender, BMI, and physical disability were not factors with the change in foot pain. 
Baseline mental health scores for patients whose foot pain improved were in the normal range for the overall Australian population. This was in contrast to those whose pain deteriorated and had baseline scores far below normal.
"This study supports the theory that the outcome of foot pain may be affected by a person's mental status," the authors wrote. 
The psychosomatic response to pain is different for each individual and may explain how pre-existing conditions psychological factors influence the development of chronic pain conditions. 
It is also possible that chronic pain creates activity avoidance, which in turn perpetuates the persistence of pain.
More research would be needed to determine if mental health is the cause or effect of foot pain. 
Reference: Rheumatology Update
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Injury Or Fashion? Kesha Appears With Bandaged Ankle At Coachella

A picture taken of pop singer Kesha at Coachella over the weekend may lead some people to believe that she had a little too much fun. 
Kesha was posing with The Strokes' Julian Casablancas and Haim's Danielle Haim and appeared to be favoring a bandaged left ankle in the picture. One would think the singer had injured herself during the day's music activities, as she had appeared earlier in the day without the bandage. 
However, the bandage was just fashion related. E! News reported that the bandage was just a result of her strappy black and gold sandals.
Even with her shoe malfunctions, Kesha seemed to be enjoying herself at Coachella, looking happy and healthy in a pink and white floral romper.
The singer has been in good spirits since leaving a rehabilitation center last month after receiving treatment for an eating disorder. 
At the time she tweeted, "Happy to be back! Feeling healthy & working on tons of new music. I can't thank my friends enough for all the love & support you have given me. Life is beautiful. I'm so blessed to have u all."
Kesha has made a new start for herself, first by dropping the dollar sign from her name and changing up her Twitter account. She also cancelled her spring tour dates to focus on her recovery. 
"I was so looking forward to performing at these dates, but I need to follow my doctor's advice and get my health back on track," she said. "All of your support has been so amazing. I couldn't have done this without you all. I look forward to coming back stronger than ever on the next tour."
Reference: E! News
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Julie Andrews Gives Up Movie Roll Because Of Ankle Surgery

Julie Andrews was forced to give up a scintillating roll in Oscar-nominated The Wolf of Wall Street because she was recovering from ankle surgery.
The veteran British actress was offered a small roll that would have given her the opportunity to kiss leading man Leonardo DiCaprio. 
However, since the Sound of Music actress was recuperating from ankle surgery, the role of Aunt Emma went to Joanna Lumley instead. 
Andrews told Britain's Birmingham Post newspaper, "I've had problems for a long time with my ankle, after I twisted it many years ago. With general wear and tear it got worse, and eventually it just had to be taken care of. I was finding it very hard to walk, I was hanging on to anything I could find. I didn't like what I saw for the future.
"So I had the operation nearly two years ago. I'm fully recovered now, but I wasn't over it when I got the Wolf of Wall Street offer. I would love to have been part of the film but I couldn't alas. It was really a tough choice, but I didn't feel up to it. I was still having a hard time getting about, so regretfully I had to decline the offer. I'm sure Joanna Lumley was fabulous in the role."
Reference: News Net 5 Cleveland
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Do Laser Treatments For Fungal Toenails Work?

The New York Times recently published an article regarding the efficacy of laser treatments for fungal toenails. They came to the conclusion that there is little evidence these treatments work.

They cited a study published last year in The Journal of the American Academy of Dermatology where researchers from the University of Alabama at Birmingham found that laser treatments “provided no improvements in patients with toenail fungus, even after five sessions.”

Dr. Andrea Bershaw, the director of the nail procedure clinic at the Minneapolis VA Heath Care Systems says, “I think we want it to work, but the evidence just isn’t quite there yet. The studies have shown efficacy have been small, they haven’t been randomized controlled trials, and most of them have been funded by the actual laser companies themselves.”

For our podiatrists here at Connecticut Foot Care Centers, we would disagree with the statements above. The laser treatment we use for toenail fungus is the Noveon Podiatric Laser, different than other laser options. This particular laser treatment uses dual frequency wavelengths, two per toe,  that penetrates deep into the tissue surface. Unlike laser systems that use hand-held wands, our machine prevents human error by attaching laser pods to the toe.

Some patients are unable to take oral medications, and have seen little improvement with the topical medication alone. Laser treatment for toenail fungus is another option for those who have fungal nail conditions. It is important to remember that this particular treatment requires several visits, and results will be seen when the nail begins to grow out.

There are a wide variety of responses depending on equipment. We have seen favorable results, comparable to oral medication, with this dual frequency laser treatment, especially with patients who follow our at-home instructions and care guidelines. Long-term results are dependent on long-term care, with follow-up treatment of topical ointment. As with any treatment regimen, best results are seen when the patient follows their podiatrist’s recommendations to the T.

Reference: New York Times. 

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Lindsay Lohan Suffering From Athlete's Foot

Even celebrities have stinky feet!
Lindsay Lohan, recently out of rehab, has come down with an acute case of athlete's foot. Friends of the 27 year old actress say that this is nothing new- she has had this condition in the past!
The "Mean Girls" star, whose eight part documentary premiered on the Oprah Winfrey Network on March 9th, admitted that her feet are the most embarrassing part of her body.
"Lilo's horrified by her athlete's foot," revealed a friend. "She has no idea where she caught it because she's always so careful in communal bathrooms and spas. But she's suffered smelly feet ever since she was a teenager, and it's been a hugely embarrassing cross to bear.
"Last year she refused to dine at a traditional Japanese restaurant in New York because she had to take her shoes off."
Lohan has been plagued by athlete's foot in the past, most recently in 2010 when she was photographed leaving a friend's house in L.A. with a cloud of foot powder billowing out of her shoes.
"It's a recurring issue for her, but after that incident she doesn't use so much foot powder anymore," said another source. "Lilo's big enough to joke about it, though.
"Last month, she almost killed a private house party after taking off her shoes. She quickly put them back on, saying, 'Oh, did I put my foot in it again?'"
Athlete's foot, also known as tinea pedis, is a skin disease caused by a fungus that usually occurs between the toes. The fungus attacks the feet because shoes create a warm, dark, and humid environment that encourages fungus growth. Warm, damp areas around swimming pools, showers, and locker rooms are also breeding grounds for fungi.
Symptoms of athlete's foot include drying skin, scaling, itching, inflammation, and blisters between and on the toes. Athlete's foot can spread to the soles of the feet and to the toenails as well as other parts of the body, which is why timely treatment is so important.
You can prevent athlete's foot by:

• Not walking barefoot, particularly in public pools and locker rooms.
• Reducing foot perspiration by using talcum powder.
• Wearing light and airy shoes.
• Wearing socks that keep your feet dry, and changing them frequently if you perspire heavily.

While fungicidal and fungistatic chemicals are usually used to treat athlete's foot problems, they often fail to contact the fungi in the lower layers of skin. For persistent athlete's foot, a prescription topical or oral antifungal drug may be needed.
Reference: National Enquirer
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Bieber Unable to Walk the Line Because of Foot?

So what reason does Justin Bieber give now for his wonky walking during a sobriety test in Florida on January 23rd?
A hairline fracture in his right foot.
A summary of Miami Beach police documents says that Bieber told officers following his arrest in January he injured his foot skateboarding three months ago. The officer writing the report also commented that Bieber appeared to sway and have leg tremors during one of the tests, wincing in pain. 
The report noted that, "He appeared to have great difficulty," but adds that the injury to his foot was never brought up or noticed during the sobriety test. 
Biieber has pleaded not guilty to the charges of during under the influence and other charges. He told officers that he was not drag racing in a rented Lamborghini with R&B singer Khalil Amir Sharieff, who was driving a Ferrari when they were stopped. Bieber questioned why he was arrested in the first place, arguing with police officers and making condescending remarks. 
The police reports states that Bieber was "agitated and condescending", using profanity when brought to the police station. 
"He then got upset and said 'I'm 19 years old. I'm just out having a good time,'", Bieber said. He then asked police, "What were you doing when you were 19?"
The officer in charge replied that he was not driving a Lamborghini at that age. 
"Yeah, well, I bet you didn't have millions of dollars in your bank account either," Bieber snidely replied. 
To us, it looks like Bieber is using any excuse to get out the charges he faces. A hairline fracture in your foot would not make you sway or be unable to "walk the line". He was likely under the influence, either of drugs or alcohol, and therefore unable to walk a straight line. Normally, a hairline fracture would heal in fewer than three months, unless no treatment had been sought. But since Bieber knew he had a hairline fracture, he must have sought medical treatment. 
Our verdict: tell the truth and 'fess up. 
Reference: MSN
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Actor Timothy West Breaks Ankle

Veteran British actor Timothy West is confined to a wheelchair while he recovers from a broken ankle. 
The Day of the Jackal star received the injury in a fall and underwent an operation to repair the damage. 
His ankle was set in plaster and the actor has been using crutches and a wheelchair to get around.
Wst, 79, was concerned the injury would cost him his new job on the U.K. soap opera EastEnders, and was relieved when the TV bosses assured him they would accommodate his injury. 
Speaking on the U.K. TV show The Alan Titchmarsh Show, West said, "As you can see I'm on crutches which is not my permanent state- employers please note- I just happened to fall over and break my ankle... I had to... ring up the EastEnders people and say, 'Look, I've broken my ankle. I'm terribly sorry.' They said, 'Oh no, that's perfectly alright... we'll write that in.' I said, 'No, you don't understand- I've had an operation, I'm in plaster.' (They said) 'That's alright that doesn't bother us.' (I said) 'I have to move about in a wheelchair'- 'Alright we can get you a wheelchair'- they were terrific."
Reference: Contact Music
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Kit Harington Vows Says He'll Take Fewer Risks

Game of Thrones and Pompeii start Kit Harington says he'll take fewer risks after a drunken incident caused him to break his ankle last year. 
Harington spent months in a cast after breaking his ankle trying to get into his own home after a night partying in London. 
The injury meant an inconvenience for Game of Thrones producers, who had to juggle his schedule. A body double was required to play his character, Jon Snow, in several scenes. 
"As it happened I was pissed and I was trying to climb through a window and that's all over and done with now. I have to be more careful now," Harington told Confidential, while in Sydney to promote his new film Pompeii.
"I think you get one strike and you are out with certain injuries. I'm much more careful."
Being famous has also affected other areas of Harington's life. 
"I used to play a lot of rugby when I was younger and I stopped all that because of acting and not wanting to get injured."
While this incident happened more than a year ago, Harington has continued to keep his vow and be more careful.  Wise words, children. Wise words. 
Reference: Daily Telegraph
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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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