Dr. Berg's Foot Facts

Posts for: June, 2013

By Dr. Rion Berg
June 27, 2013
Category: foot conditions

Last week I got a call from number one son, ensign Alex Berg of the U.S. Coast Guard. He was away from his base in Portsmouth New Hampshire training in San Diego when he had sudden onset of foot pain. Using his iPhone, he sent me a picture of the location of the pain on the bottom of his foot.

He described it as sharp pain brought on by running. He was miserable whenever he had to stand for prolonged periods, a frequent occurrence in his job with the U.S. Coast Guard.  Knowing his lower extremity anatomy fairly well, which is unfortunately similar to mine, I knew that his calf muscles were extremely tight.  He runs duck footed and mostly on his heels. 

My phone/video diagnosis was “Cuboid Syndrome”. The pain with this syndrome is well forward of the heel not quite to the middle of the foot, where there is a bone shaped like a cube.  Because of the location, it is not plantar fasciitis or heel pain.  The lateral side of the foot (side toward the baby toe) has a muscle that comes down from the leg (peroneus longus) dives under this bone in a groove, and travels all the way over to the base of the first metatarsal bone, (long bone behind the great toe connecting to the middle of the foot). 

In Alex’s case his tight calf and flat foot caused the tendon to be overworked and constantly inflamed.  It’s like his foot was saying “Hey it’s time to get out of the barn and on the road to propulsion, and you guys back in the calf won’t let me move forward. I’m going to give you something to remember!”

Thanks to my father and his vintage podiatrist training, he taught us to use a simple pad 1/8 to ¼ inch thick specially placed on the bottom of the foot to push up on the cuboid bone. This relieves the tension on the peroneal tendon and the pain can be reduced almost immediately. My son could only get thin moleskin, some kind of padding and probably duct tape, but with the help of my diagrams, his pain resolved immediately and ensign Berg didn’t have to report to the infirmary.

Amazing what we could do via phone, texting pictures, and web based learning.   Of course I advise caution in treating yourself without consultation, but I do encourage learning about common foot problems before you come in for an evaluation.

Finally, it’s important to keep our country safe and that means keeping our servicemen and women healthy on the job.  


By Dr. Rion Berg
June 11, 2013

Investing in the right shoe for the right foot will go a long way to saving your sole by the end of a long work day or athletic activity. Keep in mind the following six tips when making a shoe purchase.

#1 All shoes were not created equal.  Regardless of the activity you do, your feet will feel better when the shoe you wear:

  • Bends at the ball and not in the middle
  • Has a firm heel counter
  • Doesn’t twist easily from side to side


#2 Choosing the right shoe for the right activity depends on:

  • Your weight
  • Your work/exercise
  • Your foot type
  • The surface you are on

#3 The more flexible and flatter your foot, the more likely you are will require a firmer shoe with rigid shank.  The more rigid and higher your arches, the more midfoot support and shock absorbing the shoe will have to be.

#4 Whenever possible, replace the insert that comes with your shoes with either an over the counter insert such as Superfeet or Powerstep, or a prescriptive orthotic.

#5 Match the type of shoes to the activity you are doing. Slip on backless Merrills, Crocs, and flip flops are casual wear that are not meant for long distance walking, hiking, or working.  Use them after work to take a break from your enclosed shoes, but remember, the less the shoe, and the less the lacing, the less support you will have.

#6 Even excellent shoes wear out. The midsole of the shoe is made of a shock absorbing material. As such, it is meant to last approximately 400-600 miles of average use. While you might not be able to look at the shoe and detect this, you should replace your shoes after approximately one year. 

Come in and have one of our foot specialists measure your feet to ensure you have the appropriate shoe size.for free. Call us ahead of time at 206-368-7000.


By Dr. Rion Berg
June 06, 2013
Category: family foot care

Did you know that less than 10% of all people with foot problems ever seek medical attention from any medical specialist? I find that amazing and appalling, when so many foot problems can be resolved without surgery. What are the key elements that contribute to foot pain?

#1 Weight

#2 Work

#3 Foot Type

#4 Shoes

#5 Lack of adequate support or stretching for the activity performed

Weight loss is not an easy thing to accomplish. In fact, it’s often the desired weight loss that drives a person to increase their exercise, only to find out that their feet and legs aren’t prepared to do it. Given that your work is your work, and you’re stuck with the foot type you were born with, your down to two areas that you can work on--your shoes, and the support you add inside them.

There is not a week that goes by that I’m not able to totally resolve someone’s foot pain with a simple change in shoes, a stretching program designed to match their needs, and either an over the counter arch support or prescriptive orthotics.

So, make yourself, your family and your friends part of the 10% of advantaged people who resolve their foot pain through a few easy steps. Visit your podiatrist today. They’re experts in evaluating and treating the mechanical disorders of the foot and ankle.