Dr. Berg's Foot Facts
By Dr. Rion Berg
August 01, 2018
Tags: melanoma  

While it's extremely rare for someone who is young to develop nail cancer, it did happen to Miss Illinois Karolina Jasko. She was only in high school when she found a vertical line under her fingernail. She didn't go to the doctor until it became infected. Then she was diagnosed with melanoma.

She was fortunate. She only lost her nail. Melanoma can spread to the entire body and can be deadly. Survival of melanoma is even more uncertain if it's found on your feet and toenails. That's because it's usually detected at an advanced stage when treatment might be too late.

While melanoma of the toenail is rare no matter what your age, it's important to be seen by a podiatrist if you have bruise under your toenail that doesn't go away.

Other Symptoms

  • A new brown or black band in the nail

  • Dark color is spilling over the skin next to the nail

  • Signs of infection such as drainage, pus, and pain

  • A bruise, splitting, or bleeding of the nail without any trauma

  • A bruise under the nail that doesn't go away with time even with trauma

Although some dark bands can be non-cancerous and caused by a bacterial or fungal infection it's important to get it checked out as soon as possible.

Sixty percent of these types of melanoma are found in the fingernails and 40% are found in the toenails. Most commonly it's found in the hallux nail or big toenail.

Risk Factors

  • Over 50

  • Personal or family history

  • Personal or family history of atypical moles

  • People of color

Unlike melanoma of the skin, melanoma of the nail is not cause by sun exposure.

Prevention

Although it's not possible to prevent the condition, early identification and treatment provides the best chance for effective treatment and survival.

Treatment

Treatment options depend on how early the melanoma is detected. They include surgery, chemotherapy, and radiation.

If you have a unexplained bruise or streak in your nail that won't go away, call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

Your free foot book "No More Foot Pain" is waiting to be sent to your home.

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Google+

 

By Dr. Rion Berg
July 26, 2018
Category: Heel pain
Tags: plantar fasciitis  

As a Seattle hiker every year you look forward to summer. You know there's nothing like putting on your backpack, leaving the city behind, and taking in the wonders of the forest and the mountains.

That's why when you're having heel pain the idea of not being able to hike is so distressing. I've put together this definite guide for hikers prone to heel pain to empower you to prevent this condition from reoccurring.

What Causes Heel Pain?

Most heel pain is diagnosed as plantar fasciitis so for the remainder of this guide I'll use the term heel pain and plantar fasciitis interchangeably. Any discussion of preventing plantar fasciitis must begin by understanding its cause. Let's start with a description of your foot and calf anatomy.

The foot has a long band of tissue that originates at the heel, travels across the arch, and connects at the base of the toes called the plantar fascia. This structure helps support the arch and your body weight as you hike. The Achilles tendon is connected to the bottom of your heel and to your calf muscle. Tightness in the calf muscle can strain your Achilles tendon and your plantar fascia.

Heel pain is caused by an inflammation of the plantar fascia. The inflammation develops as the result of stress on this tissue causing micro-tears at the bottom of the heel where it inserts. It's brought on by a combination of repetitive strain on the tissue, faulty biomechanics of the foot, and tight calf muscles.

Hiking is an activity that can cause the plantar fascia to become inflamed due to its repetitive nature and the added weight of carrying a backpack.

If you're a hiker with faulty foot mechanics (i.e. flat feet) you're more at risk for developing plantar fasciitis. Why? People with flat feet tend to over pronate or roll their feet inward which pulls on the plantar fascia.

In addition, if you also have tight calf muscles this will put even more strain on the plantar fascia.

What Hikers Can Do to Prevent Plantar Fasciitis

As a Seattle podiatrist there's a lot I can do in my office to help alleviate your heel pain and prevent it from reoccurring. However, there's also a lot you can do to keep it at bay.

Shoes and Boots
One of the most important things you can do to prevent heel pain is to ensure you have hiking shoes or boots that provide the support and stability you need for the type of trails you hike on.

1. Assess the type of hiking you'll be doing before purchasing your shoes or boots. A lightweight hiking shoe may be perfect for an easy hike like Lake 22 in the Cascades but a heavy duty hiking boot will be needed for hikes with more elevation gain and rougher terrain.

2. Your shoes or boots should fit snugly but not too tightly and provide enough room in your toes so that you have wiggle room. Make sure to have your feet measured when purchasing your footwear.

3. Take your foot type into account when purchasing shoes or boots. For example, if you have flat feet shoes and boots with good arch support are a must.

4. Shop for shoes toward the late afternoon when feet tend to swell.

5. Purchase socks at the same time you purchase boots to ensure a good fit. Here's information about the best socks for hikers.

6. Try different lacing techniques to ensure a proper fit.

7. Make sure you break in new boots before you go hiking. While hiking shoes won't need break-in time, leather boots will.

8. Don't attempt to buy boots online unless you've had experience with a particular brand and size. Go to a reputable store like REI and work with their boot experts.

Replace Your Insoles
Most shoes and boots have insoles that aren't supportive enough to prevent you from pronating and developing plantar fasciitis. Buy a high volume insole for a boot and a medium volume insole for a lightweight hiking shoe. Superfeet makes insoles specifically for hiking boots called Trailblazers. Regular Superfeet or another insole called Powersteps can be used in hiking shoes.

Increase Your Hiking Distance and Level of Difficulty Gradually
Since plantar fasciitis is a repetitive strain injury, it's important to build up to longer and more difficult hikes slowly. Your body needs time to adjust and will serve you much better if you take it easy at the start of hiking season.

Warm-ups and Stretching
While doing warm-ups and stretching is important for all hikers it's particularly important if you're prone to developing plantar fasciitis. Calf muscles can tighten up after sitting in a car for longer than an hour. At the very least perform the traditional standing calf stretch against a tree or even your car by putting one foot forward and then stepping back with the other foot. Place most of your weight on your back foot and slowly lean into the tree or car until you feel a stretch at the back of your calf. Hold for 30 secs to one minute.

Another type of stretch that will give you more benefit is a dynamic stretch. Here are some dynamic stretches for hikers.

Avoid Going Barefoot
If you have a tendency toward getting heel pain, it's important that you avoid going barefoot even when you're at home. We recommend sandals by Vionic or another pair of sandals that provide arch support.

Weight Loss
Overweight hikers are also more at risk for developing plantar fasciitis. Even losing five pounds can make a big different in the amount of pressure you put on your feet and may help prevent plantar fasciitis.

Self-Treatment for Hikers with Mild Plantar Fasciitis

For mild heel pain you'll very likely need to stop hiking until the pain goes away. Unfortunately with every step you take your re-injurying your plantar fascia. To prevent it from getting worse it's important to stop the inflammation from occurring.

However, there are some specific things you can do to help reduce your inflammation and help your feet heal more rapidly.

1. Icing
Icing is one of the most important things you can do to reduce inflammation (swelling) and pain. You can begin doing this before you come in to see a podiatrist. It's extremely important to ice your heels after hiking if you plan to continue doing so.

There are two methods you can use to ice your heel.

  • Ice cup massage- fill a Dixie cup ¾ full of water and freeze. Peel the top down so that about .5 inches is showing so you can easily massage the affected area while holding onto the cup. Ice for about 7-10 minutes three times a day.

  • Use frozen peas as a cold pack- frozen peas are inexpensive and conform to your foot.

2. Heel lifts
Heel lifts may be a good initial solution. Heel lifts raise the heel in the shoe decreasing the Achilles tightness by effectively shortening it.

3. Biofreeze
Biofreeze can provide temporary relief of heel pain.

4. Anti-inflammatory medication
Anti-inflammatory medication acts to reduce pain and swelling.

In addition, it's important to follow all the recommendations for preventing heel pain to help reduce your current heel pain.

Treatment for Hikers with Moderate to Severe Pain Plantar Fasciitis
For pain that's more than mild, you should make an appointment with a podiatrist to get properly evaluated. In addition to the inflammation reducing methods described above, at the Foot and Ankle Center of Lake City we provide the following services to treat mild to severe plantar fasciitis.

1. Custom Orthotics
Even though over-the-counter insoles can work well for mild heel pain, you'll likely need custom orthotics for moderate to severe heel pain. Custom orthotics provide the highest degree of support, controlling abnormal motion in the foot and helping with postural alignment. Depending on how much you hike, prescriptive orthotics can last from 3-7 years. Your foot is scanned in our office and then orthotics are made by a professional orthotics lab. When you return to our office the orthotics are adjusted to fit your feet.

2. Low Dye Taping
Low dye taping is typically used during your first visit to our office. People often feel immediate pain relief because the tape prevents your plantar fascia from pulling when stepping on the ground. The tape usually lasts about three days if covered when showering. To continue to tape your feet until you receive orthotics our office has tape that can be easily applied at home.

3. Use of a walking boot or AirHeel device
Both of these products will reduce direct pressure on the affected area and allow healing to begin.

4. Cortisone injections for acute pain
For patients in extreme pain or who are taking a trip and don't have time to have other treatments, cortisone shots in the heel can reduce inflammation quickly. This is only a short term solution.

5. Using a splint
As mentioned earlier, tight calf muscles are often part of the reason people who hike develop plantar fasciitis. Although the methods for stretching described earlier work well to prevent plantar fasciitis, once you have the condition using a splint provides the additional time needed to more fully stretch the calf muscle. The splint is used during the day for 20-30 minutes on each side while watching TV or reading. This video explains how the splint is used.

Call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

Your free foot book "No More Foot Pain" is waiting to be sent to your home.

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Google+

 

 

 

 

By Dr. Rion Berg
June 28, 2018
Category: family foot care
Tags: Untagged

Finding and wearing the right shoes is a topic I broach with almost all of my podiatry patients. Whether a person comes to me because they are having plantar fasciitis due to repetitive injuries from running or someone with diabetes is having issues with wounds a discussion of shoes is critical to preventing and treating their foot condition.

Our feet spend most of their waking hours in shoes. That's why it's so important to be sure the shoes we wear are the right size, a good match for our foot type, and complement the activities we engage in. In addition, shoes need to accommodate our foot condition so we are not making it worse or suffering unnecessarily.

Of course many of the conditions I see require procedures, devices, and/or other products to begin the healing process. However, in addition the right shoes are a must for preventing further injury or pain to the feet.

Finding the Right Shoe Size

Recently I read that Meghan Markle is sporting heels slightly larger than her foot size. The article assumed she was doing this to help prevent foot pain. I don't know where Prince Harry's wife got this information but it is incorrect.

Wearing the correct shoe size is very important to ensure you don't have foot pain. Many people know that a child's foot size changes constantly and are vigilant about getting their kid's feet measured. But few are aware that their own feet can also increase in size.

Many of us gain weight as we age. For women rapid weight gain is most common during pregnancy. An increase in weight affects our feet by adding pressure during every step. Over time this causes our arches to lower and our feet to go up a half to a whole shoe size or more. Weight gain can also increase the width of our feet.

For this reason, getting your feet measured every time you buy a new pair of shoes is important. Also, shoes are not necessarily consistently sized between shoe companies. It's best not to rely on a past size to determine what you should buy today. For in store and online purchases be sure you know the companies return policies so you know how long you can try out the shoes and whether you can wear them outside.

Selecting the Right Shoe for Your Foot Type

Foot type is another thing to consider when buying a pair of shoes.

Your foot width is one aspect of your foot type. Not all shoes will accommodate a particularly wide or narrow foot. Nordstrom and other specialty stores can be a big help if you have either of these foot types.

Arch type is also important to take into account when purchasing shoes. Arch types are either normal, high, flat or somewhere in between.

You're fortunate if you have a normal arch. You'll still need supportive shoes but not to the same degree as someone who has flat feet.

People with high arches tend to supinate or roll their feet out as they walk. Foot problems that can arise from this foot type are hammertoes and metatarsalgia. Often woman will seek out a high heeled shoe because initially they'll feel more comfortable. However, high heels put more pressure on the ball of the foot which can cause worsen problems like metatarsalgia and cause other's like Morton's neuroma. The best shoes for high arches are ones with a lot of flexibility, a firm heel counter, and ankle support when hiking or playing a sport with lots of motion changes.

People with flat feet tend to be most at risk for multiple foot conditions. Flat feet pronate or roll in when walking or running. Foot conditions that arise as a result of flat feet are heel pain, bunions, and hammertoes. Even young children can develop a condition called Developmental Flat Foot between ages four and five. Buying shoes with an arch and avoiding flat shoes are important for people with flat feet. Running shoes usually have a good arch and some shoe companies make shoes with good arches, i.e. Dansko. Most people with flat feet will require additional arch supports to prevent their feet from pronating and causing other foot problems.

Selecting the Right Shoe for Your Activities

Equally as important as getting the right shoe for your foot type is purchasing the right shoe for the type of activity you engage in. Whether you walk around Greenlake, run 10Ks at races, play soccer or another sport it's essential to buy the shoe that will best support your feet and are designed for your particular sport or activity.

Specially designed shoes for most of the sports you play are available for purchase. Shoe companies design these shoes to help promote better play and prevent foot and ankle injuries. It's best to purchase these types of shoes at a store that specializes in that activity. A knowledgeable sales person can make a big difference in ensuring you buy a shoe that works best for you and your sport. For example, in the blog I wrote called How to Buy the Best Running Shoes I go into detail about what a good salesperson should be asking you.

Selecting the Right Shoe for Your Foot Condition

As mentioned above, certain foot types can put a person at greater risk for a particular foot condition. While it's important to choose the right shoe for your foot type it's also a good idea to purchase the right shoe for your foot condition. For example, if you're prone to plantar fasciitis it will be important to purchase supportive shoes that will prevent your foot from pronating.

If you have bunions or hammertoes, you'll want to avoid shoes with a higher heel as these can worsen your condition. In addition, you'll want to find shoes that are wider in the toe box and/or are made out of flexible leather or cloth to prevent pain caused by friction.

People with diabetes may need to purchase special diabetic comfort shoes to decrease the chance of developing foot ulcers.

How and When To Shop for Shoes

Everyone should know the basics about how and when to shop for shoes. In addition to all of the other guidelines already described in this blog, there are a few more key factors that can make a big difference when looking for a shoe.

It's important for everyone to buy a supportive shoe. Shoes with no support may be fine for very casual wear (little or no walking) or for people with no foot problems or a normal foot type but most of us are going to need a shoe that can go the extra mile. To test out shoes before you purchase them visit my video "How To Test Any Shoe for Stability".

Shop for shoes towards the end of the day. As the day goes on our feet tend to swell. If you buy your shoes early in the day you could end of up with a shoe that is too small.

Buy shoes with a roomier toe box. Shoes that are pointy can cause bunions to worsen and other conditions like Morton's neuroma to develop.

Replace running shoes every 500 miles and check to see if the soles of your leather shoes are worn out and needed to be re-heeled. Wearing shoes with worn out heels can't provide the support you need to prevent ankle sprains and other foot problems.

Choose heels that are one inch or less or limit the number of hours you spend in taller heels. High heels are a major culprit in many foot conditions and should be worn in small doses. Always take a lower pair of shoes with you if you plan to wear high heels to an event.

If you're experiencing foot pain, call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

Your free foot book "No More Foot Pain" is waiting to be sent to your home.

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Google+

 

By Dr. Rion Berg
June 15, 2018
Category: Neuroma
Tags: Morton's Neuroma  

If you're feeling a sharp pain between your third and fourth toes you may have developed a foot condition called Morton's Neuroma. What's that you wonder? It's a problem caused by any irritation which leads to thickening of tissue surrounding the nerve that travels to the third and fourth toes.

Recent research at the Royal College of Surgeons of Edinburgh found that Morton's neuroma has climbed by 115% percent (more than doubled) in women between 40 and 69 in the past 10 years. Women who wore high heels greater than 2 inches were at greater risk.

Although it's true that high heels are often the culprit--neuromas develop four times as often in women than men--avoiding heels aren't the only way to prevent this condition. Men and woman who wear shoes that are too tight or have a narrow toe box or participate in sports activities such as running are also more likely to develop this painful condition.

But no need to worry. At the Foot and Ankle Center of Lake City we've helped men and women resolve this problem hundreds of times.

Of course as a Seattle podiatrist my first recommendation will be to limit your high heel use. But even if you don't refrain there are several other solutions to this problem.

  • Ice - to initially relieve the pain and swelling

  • Padding - this relieves the pressure on that stubborn nerve that is causing all your pain
     
  • Orthotics - shoe inserts either over the counter or customized for your feet, if padding is not sufficient.

  • Roomier shoes - if your shoes are squeezing your tootsies, purchase shoes with a wider toe box. Be sure you get the proper fit for running shoes as well dress shoes.

  • Injections with alcohol - guided alcohol injections can work well to shrink the neuroma.

Related articles

Alcohol Injections Nip Neuroma Pain in the Bud
Painful Foot Conditions In Women Runners
When Neuromas Get in the Way of Summer Fun

Call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

For more information about heel pain in runners download our eBook, "The Complete Guide to Stopping Heel Pain in Runners".

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Google+

 

 

By Dr. Rion Berg
June 01, 2018
Category: Bunions

Summertime is walking and hiking time. But for people with bunions the thought of stepping out to do anything active can be fraught with worry. If you're one of those people you already know how painful it can be to do any activity that means putting pressure on your bunions.

How can you keep your bunions from ruining your summer?

Wear Sturdy, Supportive Sandals

While they won't solve your bunion problems, wearing a sturdy, supportive sandal with adjustable straps can help make your summer more enjoyable.

Why sturdy and supportive? If you're like many people with bunions, you probably have a flatter arch or no arch. Supporting the arch is important to prevent your bunions from getting worse. A sturdy sandal is one that can't easily be bent in half or twist. Sandals like these can be used to walk and sometimes hike longer distances while preventing ankle sprains and foot pain.

Sandals that fit this description are the Ecco Yucatan sandal, Atika Maya, or Chaco Z2 Classic. There are many other sandals that can work just as well. Learn to test any sandal before you buy it, by watching my video "How to Test Any Shoe for Stability".

Wear Sandals That Can Take An Orthotic

Many of my patients get pain relief once their foot mechanics are corrected with a custom orthotic. While orthotics fit into most tennis shoes not that many can fit into sandals. Here are some sturdy, supportive sandals with removable foot beds.

Avoid High Heels

Wearing high heels no matter how sturdy will cause more bunion pain and cause your bunions to get worse. If you can't avoid a high heel, wear one with a roomier toe box.

If you're experiencing bunion pain and want to enjoy your summer call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

For more information about heel pain in runners download our eBook, "The Complete Guide to Stopping Heel Pain in Runners".

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!





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