Dr. Berg's Foot Facts

Whether you're a weekend warrior or the parent of a kid just getting back to into sports at school, you should be aware of the most common sports related foot and ankle injuries. Sever's disease, ingrown toenails, and turf toe are common in young athletes who play soccer. Stress fractures and Morton's neuroma are frequently found in women athletes. Achilles tendonitis and plantar fasciitis can occur with a rapid increase in sports participation particularly in athletes who have flat feet and tight calf muscles. Sprained ankles and an Achilles tendon rupture can affect athletes involved in soccer, football, volleyball and other sports with rapid direction changes.

To prevent these foot and anle problems from occuring, be sure to use these 7 hacks.

Keep your body in shape throughout the year
Prevention of foot and ankle injuries starts by participating in a variety of sports throughout the year. Weightlifting at the gym, yoga, and an aerobic activity such as swimming, cycling or light jogging will keep your body strong and flexible.

Proper footwear
Proper shoes are your best defense against foot and ankle injuries. These days there are specific shoes made for every type of sport. For example basketball shoes are designed to protect ankles that need to twist, running shoes protect feet that repetitively hit the ground, and soccer cleats prevent athletes from slipping.

Although it may be more cost effective to pass shoes down from older to younger children, it's a bad idea for sports shoes in particular. One of the main purposes of athletic shoes is to provide the best support possible for the type of sport you play. Shoes that are worn out or worn down differently from a previous owner can be detrimental to the next person who uses them.

It's also important to pay attention to your foot type when picking out a pair of sports shoes. A good sporting goods store, such as Super Jock N Jill for runners, will take this into account when suggesting a shoe. You should also test the shoes before you purchasing them by watching my video "How to Test Any Shoe for Stability".

Proper warm-up and cool down exercises
Warm up your legs by jogging in place for at least 10 minutes before you stretch. Engage in a variety of stretches. Try using Dynamic Warm-up and Cool Down exercises to get yourself ready to play sports.

Increase training gradually to prevent overuse injuries
Weekend warriors are often at risk for overuse injuries caused by occasional play, however, anyone can develop an overuse injury if they increase their sports activities by more than 10% per week. Our bodies aren't able to adapt to rapid increases in running and other sports activities and this is particularly true as we age.

While proper warm-up and cool down exercises are important for all athletes, they are essential for athletes over 50 and for those who may participate in the occasional pick-up basketball or softball game.

Check for unsafe field surfaces/wet slippery fields
Most sports-related ankle sprains are caused by jumping and running on uneven surfaces. Check playing fields for dips, holes, stray objects, and too much water. Non-professional fields in public parks can be the worst offenders since you have no control over what takes place there. Alert coaching officials to any irregularities.

Get a pre-season physical exam
Kids and adults alike should go to their podiatrist or primary care physician for a pre-season physical. Have any previous injuries checked out and given the OK by your provider before engaging in sports.

Listen to your body
Our bodies are designed to feel pain so that we avoid more severe injuries. Keep this in mind and teach your kids to recognize when pain is not normal. Some muscle pain is common with new activity but pain that lasts over many days is a warning to stop and rest. It's also time to make an appointment with your Seattle podiatrist.

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.

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By Dr. Rion Berg
September 07, 2018
Tags: warts   ingrown toenails   in-toeing   out-toeing  

With your kids just starting back to school, it's important to be aware of potential foot problems they may have so they get off to the right start. Kids can't learn or play with other kids when they're in pain. And for kids who play soccer or other sports, foot pain is a non-starter.

Foot problems are not always obvious. Pain is not the only indicator that something might be wrong. Your kids may shy away from playing with their friends or avoid showing you their feet. A child that frequently trips and falls can also have a foot issue.

Other things you may see in a child under five are toe-walking, in-toeing and out-toeing, and flat feet. In a child age six or older you may hear them complain of knee, shin, or ankle pain or you may observe poor posture or knocked knees.

Painful Foot Conditions In Kids

Ingrown Toenails
Kids can develop ingrown toenails any time of year but they are more prone to develop them in the fall. Kids have been barefoot or in sandals most of the summer. Now when school starts they're in closed toed shoes and starting back to playing sports. Wearing shoes that are too short, repetitive trauma during sports and family history are the main culprits for young kids. Fortunately ingrown toenails can usually be resolved in one or two office calls through a short surgical procedure. Prevention of this foot problem includes purchasing new shoes for kids in a timely fashion and cutting their toenails straight across.

Warts
Children and especially teenagers are more susceptible to warts than adults. Warts are caused by human papilloma virus (HPV). They are harmless but can be painful when found on the bottom of your kid's feet. Warts can spread easily to other parts of their body and to other kids through sharing clothing and towels. Warts are often treated with a topical medication or surgery. To prevent warts kids should avoid sharing towels with other kids or their siblings if they are already affected.

Plantar Fasciitis
If you have plantar fasciitis caused by flat feet it's not uncommon for your kids to suffer from this type of heel pain as well. Flat feet are inherited and the tendency to develop plantar fasciitis as a result is common.

Kids who don't outgrow their flat feet by ages four or five have a condition called developmental or pediatric flatfoot. They will have flat feet for the rest of their lives. To prevent plantar fasciitis and other conditions that result from flat feet, kids as young as four or five can be fitted with specially designed orthotics called Little Steps®. Older children will eventually need custom orthotics to keep their feet in proper alignment.

 

Sever's Disease
Another cause of heel pain in children is Sever's Disease. Muscle strain and inflamed tissue in the heel most often occurs when the heel plate is not fully closed (common in pre-adolescents and adolescents) and participation in sports adds stress to this part of the foot. Reduction of activity and custom orthotics will help greatly with this condition.

Frieberg's Disease
Injury to the growth plate in the ball of the foot is the cause of Frieberg's Disease. Girls are three times more likely to develop this condition than boys. Running and other activities can make the pain worse. Left untreated this condition can cause painful arthritis. Non-surgical treatment of this condition includes a combination of non-weight bearing, orthotics, wearing rocker bottom shoes, and stretching.

Toe-walking

Most kids will outgrow toe-walking. For those who continue to toe-walk after age two, some can walk flat footed but other children won't be able to due to the development of tight calf muscles and Achilles tendons resulting from toe-walking. Most toe-walking has no known cause. The podiatrist will check the child for any neurological problem to rule out a specific cause. Casting and bracing are the primary treatments for toe-walkers who cannot walk flat footed.

In-toeing

In-toeing or "Pigeon toes" are very common in young children and they usually outgrow this condition. In-toeing shouldn't cause any pain, but if it does your child should be evaluated by a podiatrist. Treatment for this condition depends on the cause. There are three types of developmental problems that cause in-toeing. Only severe metatarsus adductus (feet bend toward the middle part of the foot to the toes) is treated with casts or special shoes. Other causes of this condition resolve on their own.

Out-toeing

Out-toeing is much less common than in-toeing. It can run in families, affect older children, usually resolves on its own, and can have many causes. Often children who out-toe have no pain or problems with function. In some cases children limp or have pain in the hip, thigh, knee, or foot. Even if the out-toeing doesn't resolve most children are pain-free and can participate in sports. The need for surgical intervention is uncommon.

If your child is experiencing foot pain or your concerned about how they're walking, 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+

 

As the summer winds down you're very likely planning one last trip. No matter what kind of vacation you take it will certainly entail more walking or hiking than you normally do. To prevent a whole host of foot problems, use the following guide to help you prepare successfully for your vacation. 

Give Your Shoes Road Time Before Your Trip

Although a lot of shoes and boots these days don't necessarily require break-in time, some do. It's best not to bring your new kicks on vacation no matter how pretty they are. If they're shoes you're planning to wear all day long make sure to give them some road time before you take off for your trip.

Keep in mind that shoes should not fit tightly in the shoe store. You should have at least a thumbs length of wiggle room in the toes. And be sure your heels don't slip or you'll end up with blisters.

Shop for shoes toward the end of the day when feet are most likely to swell.

Choose the Right Shoe for Your Activity

Make sure you have sturdy shoes or sandals that won't easily bend in the middle or twist easily when you try to wring them out like a rag. For a demonstration of how to test your shoes for stability watch my video.

Avoid wearing flip flops except on the beach. Wearing flip flops for long distances can lead to plantar fasciitis and neuromas. Better sandals are those with an arch and with straps that secure your foot.

Ballet flats and other flat shoes should also be avoided except for casual wear.

Be sure to bring appropriate hiking boots for the type of terrain you plan to hike on, tennis shoes for tennis, and so on.

Choose the Right Socks

Equally important as choosing the right shoes are wearing the right socks. Avoid cotton socks and instead choose socks made with synthetic fibers or wool; these materials wick away moisture, decrease friction, prevent blistering, and reduce odor. Good examples are Yingdi Copper Socks made for men and women which contain copper fiber, a synthetic called SUPPLEX, and spandex or Darn Tough Hiking Socks made of merino wool, nylon, and spandex.

In addition, to reduce fatigue you might consider buying a support stocking. Although that might conjure up an image of granny in her rocking chair, today these socks are also used by nurses who spend long hours on their feet and athletes who want to improve their performance.

They are also very helpful if you're going to spend many hours on a plane. Support socks work by providing a mild squeezing action to support enhanced blood flow and reduce swelling. Some examples of this type of sock are Copper Compression Socks made by FuelMeFoot or the more colorful compression socks by L-lweik.

Purchase an Over-The-Counter Orthotic

To reduce the stress on your feet while travelling, it's a really good idea to purchase an over-the-counter orthotic. Many people wear sneakers for the majority of their vacation time. Supportive sneakers are great; however, the inserts that comes with them do not provide any additional support. You can purchase either Powerstep orthotics or Superfeet. These inserts are also a good prevention tool if you tend to develop mild plantar fasciitis.

Don't Forget Your Custom Orthotics

For travelers with flat feet who tend to develop moderate to severe plantar fasciitis, don't leave home without taking your orthotics with you. You'll need them more than ever as you put in the extra miles. If your orthotics are giving you pain, don't feel quite right, or are over seven years old it's time to see your podiatrist for an evaluation. Orthotics that are worn down and painful won't provide proper support. If your orthotics look shabby but still feel fine, your podiatrist can refurbish them for you.

Bring a First Aid Kit for Your Feet

No matter how hard you prepare to have a safe trip and prevent your feet from hurting, it's always a good idea to pack a first aid kit for your feet. Be sure to include bandages, blister pads or surgical tape, a topical antibiotic, tweezers and toenail clippers.

Tips for Air Travel
Airports and airplanes have their own hazards when it comes to your feet. Be sure to wear socks with your shoes or sandals so when you go through security. That way you aren't walking barefoot where other people with fungus and bacteria might have tread.

In addition to wearing compression socks on the plane--drink plenty of water, flex your feet and toes, take several walks, and avoid crossing your legs to reduce swelling and soreness.

Tips for Sight Seeing

Having good supportive shoes are essential but so is watching where you're going. No shoe will prevent you from twisting an ankle if you slide off a curb or trip over a stone. If you're headed to the beach be sure to pack your sunscreen and lather up your feet as well as your face and arms to avoid painful burns.

Don't Ignore Foot Pain

If you're experiencing foot pain for the first time, don't leave for vacation without seeing a podiatrist. Very likely walking longer distances will just make things worse.

For some painful conditions you can initially try self-care. For example you might find relief for mild heel pain by using a frozen water bottle or Theraband Foot Roller to simultaneously ice and massage the bottom of your feet. Sometimes a heel lift will also provide relief since it effectively reduces the pull on the plantar fascial tissue that is injured. You can also try an over-the-counter orthotic as mentioned above.

Still experiencing foot pain even after trying the pain relieving tools above? 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
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+

 

 

 

 





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