Dr. Berg's Foot Facts
By Dr. Rion Berg
December 09, 2019
Category: foot care
Tags: Untagged

Dr. Rion Berg interviewed Jason Brown owner of Sole Perfection Shoes in Shoreline about the best shoes and boots for fall 2019.

JB: I'm Jason Brown with Sole Perfection in Shoreline. We're here today to talk about new fall items.

DB: It's definitely no longer the weather for open toes and Oofos and flip flops and Birkenstocks. What are you suggesting for all of these people now this time of year?

JB: The biggest thing for fall is boots. What we look for of course is good arch support. For example this cute little boot here (Taos) is very trendy and kind of fun. It's got a zipper on the side to help with access but of course you always have to have good arch support (Jason removes arch from boot to demonstrate).

Boots are often known for being really hard to get into so what they'll often do is open up the back of the heel to have a little bit of slippage. Boots often have a little more play in the heel but as long as it's holding you and you're walking naturally you're OK. So whether it's a boot with a lower heel like this one or a nice tall boot (pulls a Dansko off the shelf) you want to be able to get into it and then stay in it.

DB: One of the issues I find that occurs as people move into the fall and they move into boots is the harder sole. What can you put inside the shoe or is part of the shoe itself to combat the tendency for overuse in the ball of the foot?

JB: It's a great question and it's a real problem. You're absolutely right, because a lot of boots are just leather (on the bottom) and they're very hard with very little cushion. We focus on shoes that have a removable foot bed, so if needed we can add extra cushion. (An example of a boot we carry) is Dansko which is waterproof and comes with.. "feel the cushion on that". It's way better than a lot of other boots.

As you're out there and you're trying to find good boots you do have to keep an eye out for that. They'll (boots will) look super cute and might even feel comfortable but do they have enough cushion? And if they don't can you add cushion? Because you're right I'm sure you see it a lot when the ball of people's feet just gets beat up or tender.

DB: Well this is nice because both of these styles which are two different brands have removable inserts which allow for either more shock absorbing over the counter support or if need be, prescriptive orthotics.

JB: Yes, we really specialize in that because it is important especially if you have orthotics you often feel restricted and all you can wear are tennis shoes. Maybe you want something a little more fashionable it can be hard. That's why we focus on that. Every single fall shoe we carry with the exception of a few has a removable foot bed.

I do want to show one that is kind of unique. The brand has been around for a long time.  Alegria. But this is a new sole, a new boot. It's slip resistant, non-marking and also has some good tread; maybe we'll get some snow. But the other thing that makes it a really, really special brand is the removable foot bed and look how cushioned that is (hands it over to Dr. Berg).

DB: Oh wow! That's amazing.

JB: Lots of cushions and it's replaceable. The first thing to wear out are usually the insoles. It just loses its cushion. Getting the exact same thing to go back into it (into the shoe) can be hard and next to impossible. So with this brand you can get the exact same foot bed.

DB: This also has quite a substantial outer sole and its shock absorbing. It's a rubber sole.

JB: And in order for a sole to say slip resistant on it, they have to get it tested. And so if it says it on the sole then you know it's been tested and you know it's going to be better than one that doesn't say it. There are a lot of boots out there and shoes that are slip resistant it's just that the company didn't want to pay the money to get it tested.

DB: I notice in the same brand (Alegria) we move down to walking shoes it looks like almost the same tread and it's slip resistant. I assume a similar insole.

JB: It's identical, yes. The new collection from them everything under the foot is the same as you'll get in that boot and they also scotch guard all their leather, so it's really great for the Northwest. In fact, talking about the Northwest I call them Northwest dog walking shoes. I want to highlight just a couple. There are shoes like this, a Dansko shoe (Paisley) that's great with blue jeans it's just a nice little kick around. It's slip resistant and look at this foot bed. It's got a great insole in there, a good arch. But the fact that it's completely waterproof, you can walk the dog and wet grass won't bother your feet. You can walk the neighborhood. It's just really great for the Northwest. We have a lot of shoes like that. Whether it's (like) this, or (something) a little more athletic. You want to feel good but you also want to look good.

There're a lot of good shoes out there for fall you just have to take the time to find the right one and get the right fit. And then of course if you have any foot problems or issues talk to the doctor (Dr. Rion Berg) and find the right solution.

Dr. Berg interviewed Dr. Jason Brown at Sole Perfection Shoes in Seattle.

JB: I'm Jason Brown with Sole Perfection in Shoreline. We're here today to talk about new fall items.

DB: It's definitely no longer the weather for open toes and Oofos and flip flops and Birkenstocks. What are you suggesting for all of these people now this time of year?

JB: The biggest thing for fall is boots. What we look for of course is good arch support. For example this cute little boot here (Taos) is very trendy and kind of fun. It's got a zipper on the side to help with access but of course you always have to have good arch support (Jason removes arch from boot to demonstrate).

Boots are often known for being really hard to get into so what they'll often do is open up the back of the heel to have a little bit of slippage. Boots often have a little more play in the heel but as long as it's holding you and you're walking naturally you're OK. So whether it's a boot with a lower heel like this one or a nice tall boot (pulls a Dansko off the shelf) you want to be able to get into it and then stay in it.

DB: One of the issues I find that occurs as people move into the fall and they move into boots is the harder sole. What can you put inside the shoe or is part of the shoe itself to combat the tendency for overuse in the ball of the foot?

JB: It's a great question and it's a real problem. You're absolutely right, because a lot of boots are just leather (on the bottom) and they're very hard with very little cushion. We focus on shoes that have a removable foot bed, so if needed we can add extra cushion. (An example of a boot we carry) is Dansko which is waterproof and comes with.. "feel the cushion on that". It's way better than a lot of other boots.

As you're out there and you're trying to find good boots you do have to keep an eye out for that. They'll (boots will) look super cute and might even feel comfortable but do they have enough cushion? And if they don't can you add cushion? Because you're right I'm sure you see it a lot when the ball of people's feet just gets beat up or tender.

DB: Well this is nice because both of these styles which are two different brands have removable inserts which allow for either more shock absorbing over the counter support or if need be, prescriptive orthotics.

JB: Yes, we really specialize in that because it is important especially if you have orthotics you often feel restricted and all you can wear are tennis shoes. Maybe you want something a little more fashionable it can be hard. That's why we focus on that. Every single fall shoe we carry with the exception of a few has a removable foot bed.

I do want to show one that is kind of unique. The brand has been around for a long time.  Alegria. But this is a new sole, a new boot. It's slip resistant, non-marking and also has some good tread; maybe we'll get some snow. But the other thing that makes it a really, really special brand is the removable foot bed and look how cushioned that is (hands it over to Dr. Berg).

DB: Oh wow! That's amazing.

JB: Lots of cushions and it's replaceable. The first thing to wear out are usually the insoles. It just loses its cushion. Getting the exact same thing to go back into it (into the shoe) can be hard and next to impossible. So with this brand you can get the exact same foot bed.

DB: This also has quite a substantial outer sole and its shock absorbing. It's a rubber sole.

JB: And in order for a sole to say slip resistant on it, they have to get it tested. And so if it says it on the sole then you know it's been tested and you know it's going to be better than one that doesn't say it. There are a lot of boots out there and shoes that are slip resistant it's just that the company didn't want to pay the money to get it tested.

DB: I notice in the same brand (Alegria) we move down to walking shoes it looks like almost the same tread and it's slip resistant. I assume a similar insole.

JB: It's identical, yes. The new collection from them everything under the foot is the same as you'll get in that boot and they also scotch guard all their leather, so it's really great for the Northwest. In fact, talking about the Northwest I call them Northwest dog walking shoes. I want to highlight just a couple. There are shoes like this, a Dansko shoe (Paisley) that's great with blue jeans it's just a nice little kick around. It's slip resistant and look at this foot bed. It's got a great insole in there, a good arch. But the fact that it's completely waterproof, you can walk the dog and wet grass won't bother your feet. You can walk the neighborhood. It's just really great for the Northwest. We have a lot of shoes like that. Whether it's (like) this, or (something) a little more athletic. You want to feel good but you also want to look good.

There're a lot of good shoes out there for fall you just have to take the time to find the right one and get the right fit. And then of course if you have any foot problems or issues talk to the doctor (Dr. Rion Berg) and find the right solution.

pregnant women doing tree poseYou just found out you're pregnant. Along with the joy of having a new baby comes the uncertainty about your health and how well you'll adapt to your changing body. For many women this is a smooth transition, while others have to contend with swollen feet and plantar fasciitis.

One problem that's rarely discussed is the increased likelihood of falls. About 25% of women fall during pregnancy and 10% fall more than once. Falls pose a risk to both the baby and the mother. So learning more about what to do to mitigate this risk is essential.

Why Pregnant Women Fall

In addition to weight gain, your center of gravity changes making it harder to maintain stability when you walk. Hormones also increase during pregnancy. One of those hormones relaxin helps to loosen ligaments and other body structures in preparation for childbirth. It also increases the force on joints, increases pelvic tilt, and loosens ligaments in the feet. All of these factors contribute to changes in balance which increases risk for trips and falls.

A study in 2019 that tracked 15 pregnant women found that their balance worsened as their pregnancy progressed. Women in the study with poor balance before pregnancy had the worst balance during pregnancy. Another study found that balance during walking decreases throughout pregnancy.

What You Can Do To Prevent Falls

Fortunately, you can reduce your risk of falling by conditioning your body to adjust to the changes in your balance and by wearing supportive shoes.

Exercise to Prevent Falls During Pregnancy

Regular exercise during pregnancy helps improve your posture and decreases discomfort and fall risk. Maintaining a strong core, thighs, and hips creates a solid foundation for your changing body and its balance. Make sure you talk to your doctor before taking on a new exercise program.

Exercises recommendation by the American College of Obstetricians and Gynecologists include walking, swimming, riding a stationary bicycle, prenatal yoga and Pilates classes.

In addition to engaging in the exercises above, some specific strength and balance exercises to do are:

  • Pelvic tilts- these maintain and build core strength.

  • Squats - strengthen quads, glutes, hamstrings, and calves.

  • Hip extensions - strengthen hip and lower back muscles.

  • Alternate standing on one leg and then the other, with a chair for balance if you need it.

For additional exercises, check out these offered by Therapeutic Associates Physical Therapy to strengthen pelvic floor, core, and posture.

Proper Foot Support

Proper foot support is essential during this delicate time. The following tips will help ensure your shoes can help reduce your risk for falls.

  • Make sure your shoes fit well - when purchasing new shoes, be sure to have your feet measured. It's not uncommon for pregnant women to experience an increase in shoe size.

  • Don't wear shoes with worn out soles - turn your shoes over. If you see an uneven wear pattern you very likely need new shoes. Worn out shoes won't support you during your pregnancy and can increase your chance for a fall.

  • Struggling with swollen feet? - buy shoes that will accommodate them but are also sturdy. A good example of a shoe that does both is the SAS shoe called Bliss.

  • Consider inserts or custom orthotics if you pronate - even if you don't have heel pain or plantar fasciitis it's still a good idea to replace your insoles with an over-the-counter insert like Powersteps, particularly if you tend to pronate when you walk. If you are experiencing foot pain not alleviated by an over-the-counter insert you'll likely need a custom orthotic.

  • Shop for shoes at the end of the day - you may already have swollen feet, but they'll be even more swollen towards the end of the day. Shop too early and you risk buying a shoe that's too small.

  • Be sure to avoid any exercises that increase your risk of falling.

  • Avoid wearing high heels as they can throw off your already precarious balance.

  • Test your shoes for stability - shoes should bend at the toe not in the center, be difficult to twist when you try to wring them out, and have a stiff heel counter that you can't move easily. For more information, watch the video: How to Test Any Shoe for Stability.

If you're pregnant and 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.

For more information about foot and ankle problems, download our eBook, "No More Foot Pain".

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 Pinterest.

 

 

By Dr. Rion Berg
October 23, 2019
Category: Fungus toenails

autumn leavesYou know the old adage--out of sight, out of mind. While this phrase dates back to the 13th century it's even more relevant today since so much of our lives are lived at warp speed. We have to continually remind ourselves to take care of the big and little things in life or they can easily fall off our radar.

The same is true for our feet. Unless we're experiencing pain or discomfort we typically won't take action when it comes to going to the doctor. Toenail fungus is one of those things that we forget about once we shelved our sandals and tucked our feet into socks and boots for the winter.

And it's too bad really. Because fall is the best time to start killing toenail fungus.

Why?

It takes a good 9 months for your nails to completely grow out. If you get started now, you'll have beautiful nails this summer.

How do I know its toenail fungus?

Not all discolored or ugly nails are fungal nails. Trauma from wearing tight shoes or running can also cause toenails to change color. To ensure its fungus we'll take a sample of your nail and send it to a special lab.

How do I get rid of toenail fungus?

I'm glad you asked. While there is a bunch of hype out there about using everything from Vicks to Vitamin E, onychomycosis (the scientific name for nail fungus) is quite difficult to eliminate.

Why?

Nail fungus doesn't just live on the top of your nails where topicals are most effective, but beneath the nail in the nail bed and in your skin surrounding your nails.

We've found that using a combination of laser treatment, topicals, a short course of oral medication, and an ultraviolet shoe sanitizer provides the most effective treatment for killing toenail fungus. The PinPoint laser penetrates the nail bed to destroy the fungus. Topical medications destroy the fungus on the top of the nail and on the skin surrounding the nail. Oral medications treat the fungus systemically. And the shoe sanitizer kills fungus in the shoes.

How long does the treatment take?

You'll receive three laser treatments over three months. The treatment involves passing a laser beam over the infected nails and surrounding skin. The doctor will repeat this several times until enough energy has reached the nail bed. Your nail will feel warm during the treatment. A single treatment session takes about 30 minutes. Healthy new growth will be visible in as little as 4 months but will take up to 9 months for your nails to completely grow out.

What will it cost?

Because laser treatment for fungal nails is not covered by insurance, we make it as affordable as possible. Your first visit is covered by insurance. At that visit you'll have plenty of time to talk to Dr. Berg to determine if this treatment is right for you.

What are our patients are saying?

"Although I did have to take the oral medication for toenail fungus, it was a lesser amount than is typically taken. That plus the laser did the trick!"

- Jay N.

"This office is efficient and caring.  The treatment for toenail fungus includes 3 laser treatments and a topical to apply twice daily.  This is a long process but so far is working well."

-Sandy P.

If you or a loved one has toenail fungus, call us today at 206-368-7000 for an appointment. You can also request an appointment online.

For information about other foot and ankle problems, download our eBook, "No More Foot Pain".

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 Pinterest.

youth athletesAs a parent of kids who play sports, you want to do everything possible to make sure your child has the best equipment and plays safely. While there's been a lot of news coverage about the problems kids can suffer as a result of concussions, there's scant information about the impact of foot and ankle injuries on youth athletes.

That's why I wrote this guide. I see far too many kids in my office with foot and ankle conditions and injuries that could have been avoided.

Heel Pain in Youth Athletes

While kids can develop the same type of heel pain as adults, namely plantar fasciitis, a condition called Sever's disease is much more common, particularly among youth athletes. This condition affects kids ages 8-14 who have an open growth plate on their heel bone. When this plate is still open it's susceptible to bruising and inflammation during activities like soccer.

To address the problem, I advise young athletes and their parents to ease up on their activity level, reduce their inflammation and pain through use of anti-inflammatory medications and ice, use of heel lifts to help absorb impact, use of over-the-counter inserts or custom orthotics, and go for physical therapy.

To prevent Sever's disease in your youth athlete, start by purchasing supportive shoes that are designed for their particular sport (see below for more information), stretching the Achilles tendon to reduce stress on the heel if they are prone to this condition, and avoiding play beyond your child's abilities.

Stress Fractures in Youth Athlete

Another overuse injury common in young athletes are stress fractures. When muscles are too tired to take on the additional stress of play it's absorbed by the bones. Stress fractures can occur in the lower legs, ankles, and feet.

Youth athletes most at risk are those who play sports that involve running, jumping, and repetitive movement such as gymnastics, basketball, and track and field. Ramping up sports activity too quickly, without rest in between to adequately condition the body, can also increase the chance of a stress fracture.

To prevent stress fractures in youth athletes make sure they do the following:

  • slow and proper conditioning for their sport

  • eating balanced, nutritious meals rich in calcium and Vitamin D

  • drink plenty of water throughout play

  • adequate warm-up and cool-down

  • stop playing when in pain and visit to podiatrist

  • alternating types of physical activities

  • go for a sports physical before the season starts

  • replace athletic shoes every 500 miles

Ankle Sprains in Youth Athletes

Ankle sprains are common in youth soccer, basketball, and other sports. In fact, researchers have estimated that ankle injuries account for 10 to 30% of all sports related injuries in young athletes. It's almost impossible to tell if your youth athlete has broken a bone or sprained an ankle without imaging--these include X-rays for identifying broken bones and ultrasound to find out the degree of soft tissue damage. Sometimes an MRI will be necessary.

While minor injuries can be treated with rest, protection of the site, and time away from the field, more severe ankle sprains will require immobilization and also rehabilitation through physical therapy. Sometimes surgery will be required.

Ingrown Toenails in Youth Athletes

Another common problem in kids who play sports are ingrown toenails. Tight shoes or cleats in soccer and other sports combined with repetitive actions such as kicking are the major culprits.

Ingrown toenails need to be treated by a podiatrist. To help ease your child's pain in the meantime, soak their foot in room-temperature water with Epsom's salt and gently massage the side of the nail fold to help reduce inflammation.

Nail surgery for treatment of an ingrown nail can be done in the office. Prevention of ingrown toenails includes wearing shoes that fit properly, avoiding tight socks, purchasing (soccer) cleats that aren't too tight, and proper toenail trimming (trim straight across, no rounded corners).

Shopping for Athletic Shoes

Buying proper athletic shoes for your sports minded child is one of the most important things you can do to prevent them from getting foot and ankle injuries on the field.

  • Buy new shoes-it’s important to start out the season with a brand new pair of shoes. Old shoes will not provide the support your child needs to avoid injury and be his or her best on the field.

  • Get your young athlete’s feet measured- these days many parents purchase kids shoes off the shelf or online. Although this is an easy solution it circumvents the need to get your kids feet measured properly. Getting a good fit is always a good idea but its imperative when your kid plays sports. In addition to getting their feet measured, be sure that the shoe is at least one thumb’s length between the top of the big toe and the end of the shoe. Always choose the larger size if one foot is larger than the other.

  • Buy the shoe designed for their sport-choosing the right shoe for their sport is essential. Athletic shoes are designed specifically for the sport they are intended, providing just the right stability and flexibility.

  • Check shoe stability-don’t just go by the name brand of shoe when you purchase it. Even great name brands provide a range of support and may not meet the requirements your child needs. Test the shoe by holding it by the heel and toe. Attempt to bend it in half. It should only bend at the ball of the foot, not in the middle. Then try and twist the shoe. It should not easily twist from side to side.

Checking the field

Many sports-related foot and ankle injuries can be avoided by checking the field before play. The field should be checked for dips, holes, stray objects, and too much water.  Alert coaching officials to any irregularities.

If your youth athlete is experiencing foot or ankle 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.

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

For chronic heel pain, download our eBook, "Stop Living With Stubborn Heel Pain".

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 Pinterest.

 





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