Dr. Berg's Foot Facts

Posts for category: preventative foot care

By Dr. Rion Berg
July 30, 2019
Tags: Untagged

When a new patient comes to my office, it's more likely to be a woman than a man. While it's true that women are more likely to see a doctor for a health issue sooner than a man, women are also at greater risk for many common foot problems. In this guide I'll be discussing the 1) types of foot problems women are likely to encounter, 2) the role of foot type and shoes in developing foot problems, 3) the role of exercise in women's foot and ankle problems, and 4) how to prevent and treat foot and ankle problems in women.

The Role of Foot Type in Women's Foot Problems
All of us have a particular foot type: either a flat arch, normal arch, or high arch. If you have a normal arch, you're fortunate. Although people with normal arches can still develop foot problems they are far fewer than those who have a flat arch or high arch.

It's important to know what kind of foot type you have so you can prevent some of the foot conditions that plague women. Your foot type is inherited, so if your parents had a specific foot type you're more likely to have it as well.

To determine your foot type, wet the sole of your foot. Step onto a blank piece of paper or a shopping bag. Step off the paper or shopping bag to examine the shape of your footprint and compare it to the photo to the right.

If you have flat feet you'll tend to role your feet inward or pronate. Pronation can increase your risk for many painful foot problems such as plantar fasciitis, bunions, neuroma, and hammertoes. High arches can put you more at risk for ball of foot pain.

Painful Foot Conditions More Common to Women
You might wonder why women are more likely to have painful foot conditions than men. While flat feet contribute to foot problems in both men and women, women get them more often for three reasons:
1) a greater amount of weight gain throughout life, 2) rapid weight gain during pregnancy, and
3) improper shoe choices.

Weight Gain Can Cause Foot Problems
Weight gain places more pressure on the feet causing the arch to flatten out. For women who already have a flat arch, weight gain can make them flatter. Women who gain weight are more likely to develop plantar fasciitis, bunions, and posterior tibial tendon dysfunction. Shoe size also increases with extra weight due to the flattening of the arch. It's important for women who have gained weight to get their feet measured when buying new shoes to avoid foot pain caused by wearing a shoe that's too small.

Pregnancy and Foot Problems
Weight gain
Rapid weight gain during pregnancy can bring on plantar fasciitis and Achilles tendonitis. Wearing a supportive shoe during this time is imperative.

Swelling
Another common foot and ankle issue in pregnancy is swelling. In addition to retaining extra fluid, weight from the growing uterus compresses lower extremity veins, impeding their function of returning blood to the heart.  While this usually goes away when baby arrives, it can be incredibly uncomfortable.  Elevating the feet and wearing compression stockings help to control edema. Physical activity, including walking, reduces swelling by activating the leg muscles, which act as pumps on the deep veins. It's important to avoid tight shoes and instead wear shoes with a wide toe box to help prevent other foot problems during that time.

Loss of balance
Weight gain and changes in body shape shifts a women's center of gravity forward. Hormonal changes cause loosening of the foot ligaments. This combination can throw off a women's balance. For that reason women should never wear high heels when pregnant since this type of shoe is already less stable then a lower heeled option. Wearing more stable, low-heeled shoes are essential to prevent falls.

Shoe Choices That Can Cause Foot Problems
Women often make shoe choices that can cause painful foot problems.

Frequent high heel wear can increase your risk for ball of foot pain including bunions, neuromas, and hammertoes. When wearing high heels your weight is placed primarily on the ball of the foot which places a lot of stress on the metatarsals, the toes, and the nerves.

Tight shoes or shoes that are too short can increase your risk for ingrown toenails and fungal toenails. When the toenail is pushed against the front of the shoe, hiking boot, or ski boot an ingrown toenail can result. Shoes that are too tight or too short can cause damage to the nail plate, making it easier for fungus to set up shop.

Flat shoes can increase your risk for plantar fasciitis and Achilles tendonitis. Flat shoes with no arch support can be problematic for anyone but particularly women who have flat feet. When walking or engaging in other activities such as dancing or running the arch will flatten out causing the plantar fascia to stretch beyond its limits. This can result in pain and inflammation in the heel and at the Achilles tendon.

Shoes with no support can also cause foot pain. Women who have had problems with their feet in the past or have flat feet or high arches should not wear these types of shoes.

Pumps can be problematic for women who develop a bony enlargement called Haglund's deformity or so called "pump bump", due the location of the deformity and the rigidness of pumps. Any shoe with a rigid back can cause problems for anyone with this type of foot problem.

Flat flip flops with no arch support can lead to a myriad of foot problems for women. Flip flops were only created to be worn at the beach, swimming pool, gym locker rooms, and shower rooms. Unfortunately flip flops have become extremely popular and women wear them for long walks and for other activities that require a much more supportive shoe. The constant gripping at the toes to keep the shoe on, the flatness and lack of support, and absence of protection make flip flops problematic for women to wear off the beach. They can cause blisters, hammertoes, Achilles tendonitis, neuromas, heel pain, and worsen bunions. Their dearth of support can also lead to sprained ankles. A better choice is a Vionic sandal which is a flip flop with great support. Even better is a water sandal that has foot support and straps.

Preventing and Treating Women's Foot Conditions
Prevention
Many women's painful foot problems can be prevented or reduced by wearing proper shoes. It's important to select shoes that work well for your foot type, the kind of athletic activity you prefer, while avoiding heels higher than one inch and shoes that are too tight. Shoes also need to provide proper support. To test any shoe before you buy it, watch this video.

Treatment
While treatments vary widely by foot problem, some treatments can help resolve several types of painful foot issues. That's because several foot problems have a similar cause.

Flat feet and pronation
Earlier we talked about how foot type can play a role in women's foot problems. Flat feet and lower arched feet tend to pronate. Together these factors can cause a variety of foot problems such as plantar fasciitis, Achilles tendonitis, ball of foot pain, bunions, hammertoes, and neuromas.

Orthotics can correct the faulty biomechanics of a flatter foot providing relief from heel pain and Achilles tendonitis and preventing bunions and hammertoes from worsening. Initially I suggest patients with mild foot pain start with an over-the-counter insert such as Powerstep. If pain continues then a prescriptive custom orthotic will be required to control the abnormal foot motion.

Tight calf muscles
Heel pain, plantar fasciitis, and Achilles tendonitis will also require adequate stretching of the calf muscle since a tight calf muscle also plays a big role in development of these conditions. Learn more about how to reduce tight calf muscles by reviewing this information and these videos.

Inflammation
Inflammation plays a big role in many chronic foot problems including plantar fasciitis and Achilles tendonitis. Visit our website to learn how to reduce inflammation for these foot problems.

For acute injuries to the foot or ankle such as stubbing your toe or spraining your ankle, it's important to take immediate action to reduce the pain and swelling. The most effective treatment is a protocol called “RICE”. RICE is an acronym for rest, ice, compression, and elevation. 

  • Rest – Stop all activity. Keep weight bearing to a minimum, making sure ankle strength and stability have returned before attempting physical activities.

  • Ice - Apply an ice pack or a package of frozen peas to the affected area (use a layer of cloth between your skin and the ice) 20 mins on and 20 min off for up to 48 hours after the injury.

  • Compression - Hold it in place with an elastic bandage to provide compression.

  • Elevate - the ankle slightly higher than the heart to keep down swelling.

High arches

High arches come with their own set of foot problems. High arched feet primarily contact the ground in the heel and the ball of the foot. Pain can develop in three regions of the foot due to this foot structure.

Ball of Foot
Metatarsalgia or ball of the foot pain can occur with prolonged standing or exercise. Hammertoes can also form as a result of extra weight on that part of the foot.

Heel of the Foot
Pressure on the heel of the foot can lead to plantar fasciitis and Achilles tendonitis.

Middle of the Foot
Because most shoes don't support the middle of the foot, high arches can result in pronounced midfoot pain.

Supportive shoes with good arches are essential for preventing problems in the high arched foot.

Ball of foot pain
Many different conditions cause ball of foot pain including neuromas, metatarsalgia, hallux rigidus, sesamoiditis, and capsulitis. For a complete review of the causes, symptoms, and treatment for these conditions, visit our website.

Nail and Skin Problems

Nail and skin problems of the feet are most often caused by tight and poor fitting shoes, and physical activity, and diabetes.

Ingrown toenails result from shoes that are too tight and by cutting the toenails on an angle instead of straight across.

Toenail fungus is more common in women who wear tight shoes, participate in sports such as running, go barefoot in pool showers and gym locker rooms, or are exposed at nail salons. Sometimes trauma to the nail can look like toenail fungus. It's best to see a podiatrist who can test the nails to be sure it is fungus. Treatment methods include topicals, oral medications, laser therapy, and methods to keep nail fungus low. To avoid toenail fungus it's important to follow these recommendations. If you already think you have fungal toenails, visit our Seattle Fungal Toenail Center to learn more about how it's treated.

Diabetes is hereditary and also more common among women who are overweight, don't exercise, and have a diet high in fats and sugars. People with diabetes are at greater risk for developing wounds or ulcers of the feet which can be very dangerous. Dry skin on the feet is very common in people with diabetes and is treated with special moisturizers. An annual visit to the podiatrist to get a Comprehensive Diabetic Foot Exam is essential to prevent ulcers from forming.

Foot and Ankle Problems in Women Who Are Physically Active

Women who are physically active are more prone to foot and ankle problems due to the repetitive movements, high impact, constricting or unsupportive footwear, or increased risk of trauma due to the nature of the sport. It's important to understand the particular risks of a sport to help prevent pain and injury.

Women runners are at greater risk for plantar fasciitis, Achilles tendonitis, neuromas, and stress fractures. Purchasing supportive running shoes at a store that specializes in running, switching out the shoe insert for a better insert such as Powerstep, avoiding high heels, and doing dynamic warm-ups will help prevent many foot problems in women runners. Here's a more complete description of foot problems in women runners.

Women hikers need to assess the type of hiking they'll be doing before purchasing boots. The right socks are also extremely important in preventing blisters. Check out my "Definitive Guide to Prevent and Treat Heel Pain in Hikers".

Learn how to prevent foot and ankle injuries in other sports such as Zumba, martial arts, soccer, and tennis.

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

You can also download the following book for runners.

"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!

As summer approaches we'd all like to make sure our feet will take us where we want to go and allow us to fully participate in the sports activities we love. Unfortunately some of us are more prone to developing certain types of foot problems, such as Achilles tendonitis.

What is Achilles tendonitis?

The Achilles tendon located in the back of your ankle is the largest and strongest tendons in the body; it can withstand up to 1,000 pounds of force. When this structure, also known as the heel cord, becomes inflamed Achilles tendonitis develops. If you ignore this pain, it can rupture which will require surgical intervention.

What Are the Risk Factors?

Many factors can lead to Achilles tendonitis:

  • Faulty foot structure such as flat feet

  • Equinus or tight calf muscles

  • Overuse mainly through physical activity

What You Can Do To Prevent Achilles Tendonitis

Fortunately there's a lot you can do to prevent Achilles tendonitis. Some of these fixes are mechanical in nature. For example, if you have flat feet getting fit with custom orthotics will prevent your feet from pronating, which can cause undo pulling on your Achilles. In addition, if you have tight calf muscles you can use special stretching techniques to alleviate this problem.

All the other prevention techniques are related to how you exercise.

Purchase Shoes Made for Your Sport
Buying supportive shoes is essential and wearing shoes that are designed specifically for your sport is a must. Be sure to go to a store where employees are trained to fit shoes to different types of feet. Shoes should also be replaced every 500 miles.

Vary Your Terrain
In Seattle you have lots of opportunity to get a great workout on hills. But don't overdo it or you'll increase you Achilles tendonitis risk. Vary the type of terrain you run or hike on from day to day or even on the same day. Do hills one day and run Greenlake another day. Mix it up.

Don't Forget to Warm-up
Both new and veteran athletes should warm up before working out. Dynamic warm-ups for runners are a great way to go.

Gradually Increase Your Training Time
You might want to get ready to run that race with your friends and end up overdoing it. Unfortunately your Achilles can't adapt that quickly to a huge increase in your training regimen. Do your Achilles a favor--increase training time by no more than 10% a week to avoid injury.

Change Up Your Exercise Routine
You might love to run but it's great to take a break by swimming or cycling to reduce strain on your Achilles.

How to Treat Achilles Tendonitis

At home

  • Pay attention to your body. If you're feeling pain in the back of your heel, back off from your exercise

  • Icing the back of your heel will help reduce inflammation

  • Toss your worn out shoes

  • Taking nonsteroidal anti-inflammatory medication for a period of time. Note: Please consult your physician before taking any medication.
     

At the podiatrist's office

  • Immobilizing the foot can reduce imflammation and pain; this is most commonly done with a walking boot
  • Getting fit with custom orthotics - see above.
  • Receiving MLS laser therapy for pain relief and reduction of inflammation
  • Getting referred to physical therapy for strengthening exercises, soft-tissue massage/mobilization, and gait and running education.

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.

Even though most of us know that a problem in one part of our body can cause pain in another part often those connections go unrecognized, even by physicians. This is particularly true when it comes to the link between our feet and the rest of our body. While some of my patients who complain of foot pain don't experience it elsewhere in their body, many do identify pain in their back, hips, ankles, and knees. Some people even experience migraines as a result of foot problems! Experts say that 25% of all migraine headaches are caused by issues with posture.

The importance of taking care of our feet can't be overstated when they can have such a great impact on the rest of our bodies and our wellbeing.

You might wonder why our feet can cause so many other body problems.

The biggest reason is faulty foot mechanics. When your foot mechanics aren't correct it throws off your gait and your posture. Our bodies are like a chain, with one link—or bone—connecting at the joint to another link. Think about what would happen if the first link in the chain was out of position. The point at which it meets the next link would eventually overstress that link and adversely affect the entire chain.

Flat feet are the most frequent type of faulty foot mechanics I see when it comes to pain in other parts of the body. People with flat feet pronate, or roll their feet in, with every step they take.

Assessing Your Feet and Treatment

If you're wondering whether your feet could be causing your low back pain or headaches, you can start by learning whether you have flat feet. To determine your foot type, wet the sole of your foot. Step onto a blank piece of paper or a shopping bag. Step off the paper or shopping bag to examine the shape of your footprint and compare it to the photo on the right.

When you visit my office, I'll also assess your gait by watching you walk to determine your level of pronation.

Fortunately custom orthotics can make a huge difference for people with flat feet and body pain. At our office we'll take a 3D image of your foot with a computerized scanner. These images will be used to make orthotics with the highest level of support for your feet. The orthotics will correct the position of your foot so you can walk normally, correcting your posture and eliminating your body pain.

Custom orthotics can also be adjusted for the highest level of comfort for your feet.

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
May 07, 2019
Tags: Untagged

To keep your feet safe from injury when working in the garden this Spring, watch my latest video!

 

By Dr. Rion Berg
April 02, 2019
Tags: women's shoes  

Women with painful feetHave you ever purchased a shoe that caused foot pain? You're not alone. While problems with high heels and stilettos have been all over the internet, there are many other women's shoes that can put your feet in jeopardy. Different shoes can cause different kinds of foot pain. Learn about the culprits and the solutions you can use to prevent painful foot problems.

Tight Shoes, Short Shoes, and Narrow Toed Shoes
Tight or short shoes can cause your feet to hurt. But they can also increase your risk for ingrown toenails and fungal toenails. When the toenail is pushed against the front of the shoe, hiking boot, or ski boot it can become ingrown. Shoes that are too tight or too short can cause damage to the nail plate, making it easier for fungus to set up shop. Narrow toed shoes can lead to Morton's neuroma, bunions, and hammertoes.

Solution:

  • Get your feet measured every time you shop for shoes. It's very common for adults to experience an increase in shoe size.

  • Buy shoes that give you enough wiggle room in the toe box.

Flat Shoes
In the last several years, ballet flats and other flat shoes have been all the rage. Many people have gotten the message that heels are bad, so they've flocked to shoes at the opposite end of the spectrum. But very flat shoes can be almost as bad as heels, particular for people with flat feet. They can increase your risk for plantar fasciitis and Achilles tendonitis. When walking or engaging in other activities such as dancing or running the arch flattens out causing the plantar fascia to stretch beyond its limits causing micro tears, inflammation, and pain.

Solution:

  • Avoid flat shoes if you have flat feet, low arches, or any other foot problems.

  • Buy flat shoes that have some arch support such as the Rockport Cobb Hill Mary Jane Flat.

Flip Flops
Flat flip flops with no arch support can lead to a myriad of foot problems for women. Flip flops were only meant to be worn at the beach, swimming pool, and locker and shower room. Unfortunately flip flops have become extremely popular and women wear them for long walks and for other activities that require a much more supportive shoe. The constant gripping at the toes to keep the shoe on, the flatness and lack of support, and absence of protection make flip flops problematic for women to wear off the beach. They can cause blisters, hammertoes, Achilles tendonitis, neuromas, heel pain, and worsen bunions. Their dearth of support can also lead to sprained ankles.

Solution:

  • Choose a flip flop with great support such as a Vionic sandal.

  • Even better, buy a water sandal which has foot support and straps.

Flexible Shoes
Flexible tennis shoes and other shoes like them certainly look comfortable. But looks can be deceiving. Flexible shoes are fine if you're walking no further than your mailbox or going food shopping. But a walk or run around Green Lake is a non-starter as flexible shoes offer no support; they can easily bend in half and be twisted from side to side. Women who've had problems with their feet in the past or have flat feet or high arches should not wear these types of shoes. I've had many patients come in with heel pain who were wearing them.

Solution:

Pumps or Rigid Back Shoes
Pumps can be problematic for women who develop a bony enlargement called Haglund's deformity or so called "pump bump", due the location of the deformity and the rigidness of pumps. Any shoe with a rigid back can cause problems for anyone with this type of foot problem.

Solution:

  • Avoid stiff backed shoes; instead look for shoes with a soft back such as a Munro Traveler.

  • Use heel lifts and heel pads can help with the irritation.

  • Get custom orthotics from a podiatrist to control the foot motion and change how the foot sits in the shoe.

Flatform Shoes
Flatform shoes are half platform shoes, half flats--supposedly the look of high heels with the comfort of flats. They sound good, in theory. However, flatforms are inflexible so your foot can’t do what it was intended to do which is flex when you walk. This makes them very unstable. When you can’t walk properly you’re more likely to fall and end up with an ankle sprain or fracture.

Solution:

You can still buy a shoe with a platform as long as your foot rolls forward properly. Fortunately there are now rocker shoes beyond the Hoka sports shoe that can meet that need. A good example is the Jafa's Women Sandal.

High Heels and Stilettos
You might still wonder, what's so bad about high heels and stilettos? While some women can get away with wearing these types of shoes infrequently, daily wear can increase your risk for ball of foot pain including bunions, neuromas, and hammertoes. When wearing high heels your weight is placed primarily on the ball of the foot which places a lot of stress on the metatarsals, the toes, and the nerves. Constant high heel wear can also shorten your calf muscles putting you at greater risk for plantar fasciitis.

Solution:

  • Limit your high heel wear by walking to work in lower heeled shoes.

  • Carry lower heels shoes with you so you can switch if you need to.

  • Wear heels that are one inch or lower

  • Wear heels with a rounded toe box to prevent added pressure on your toes

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.