Dr. Berg's Foot Facts

Posts for: July, 2014

By Dr. Rion Berg
July 23, 2014
Tags: hiking  

If you’re a hiker you’re well aware of the risks you take when you head off for the trail. You may already know about the 10 essentials taught in every Mountaineers class and also recommended by REI. Now updated these include navigation tools, sun protection, insulation, illumination, first aid supplies, a way to start a fire, repair kit and tools, nutrition, hydration, and emergency shelter.

While all of these are extremely important I want to go over what I think you should include in your first aid kit for feet.

Prevention Musts

1. Socks – of course you should be wearing these and I’ve already gone over the importance of this item for hikers, but socks are still at the top of my list. No matter what you do after you hit the trail keep in mind that your best offense is a great defense. Check out my article on the best socks for hiking to get the information you need.

2. Blister Prevention Patches – blisters are one of a hiker’s worst enemies. Another prevention tactic in addition to wearing great socks is to don blister prevention patches available off my website or your local drugstore.

3. Moleskin – this product can help reduce friction and pain if you are prone to calluses. We have them, but so does your local drugstore. However, I really love all of Dr. Jill’s products. They work really well for my patients.

4. Orthotics – make sure if you need them, bring them and use them. You don’t want to risk a flare up of plantar fasciitis during a hike.

Injury Should Haves

5. Biofreeze – pain reduction for achy feet

6. Latex free adhesive tape and splints – if you injury a toe and need to buddy tape one to another. You can also purchase a special digit wrap for this purpose.

7. Sterile dressing pads – for cuts, blisters, or to stop bleeding.

8. ACE bandage for sprains

9. Antibiotic ointment for cuts and abrasions

10. Ibuprofen or other pain reliever recommended by your doctor

To make an appointment with one of our doctors, call us at 206-368-7000 or request an appointment online.


Are you wearing the wrong shoe size? If you’re like the typical British woman you probably are. Unfortunately many people and particularly women are trying to shove their feet into a shoe that is too small with the mistaken belief that small feet are more feminine.

Many people keep thinking that their feet should be a perfect size 6, 7 or 8 when the truth is that the average size of a women’s foot has increased by two sizes since the 1970s according to a new study by the College of Podiatry in England.

Twenty six percent of men and 41 percent of women have increased their shoe size during their adult life. Half of them say that increase in their shoe size is due to an increase in weight. Actually an increase in height also appears to be responsible.

As we gain weight our feet need to accommodate the additional pressure we place on them. If we don’t provide them with the right support than foot pain can arise through the development of plantar fasciitis and other foot conditions. This condition is particularly prevalent when there is rapid weight gain as in pregnancy.

Tight shoes can cause and exacerbate all kind of foot problems.

  • Bunions - tight shoes can cause bunions but they can also make bunions progress more rapidly.
  • Ingrown Toenails - tight shoes are a risk factor for painful ingrown toenails
  • Diabetic ulcers - people with diabetes have poor circulation. Sore spots and abrasions caused by tight shoes are less likely to heal resulting in life threatening ulcers.
  • Fungal toenails - tight shoes can cause the pressure on the nail which can lift up fromt the bed; this puts the nails at risk for infection from dermatophyes, the germs that cause toenail fungus.

Finding the Right Shoe Size

  • Increased awareness – most people aren’t aware that their feet can get larger over their lifetime and the role weight gain plays in this issue.
  • Get your feet measured – go to a shoe store that has staff trained to measure feet such as Nordstrom. Your podiatrist’s office also have staff that are trained to measure feet. Make sure you have both the length and width measured. Better shoes come in multiple widths and half sizes.
  • Bring your socks with you – sock thickness can make a big difference in how shoes fit.
  • Getting function and fashion – many companies including Naot, Keen, Taos, Aravon, Dansko, Munro, Merrill and Ecco offer comfortable shoes without sacrificing style.

Leandra Taylor is a medical assistant at the Foot and Ankle Center of Lake City who specializes in measuring feet and suggesting shoes that will work for your particular condition. To make an appointment call us at 206-368-7000 or request an appointment online


Many people think of toenail fungus as merely an annoying condition that they can just cover up with nail polish or socks. But it’s not. In the beginning stages fungal toenails may not be that bad. The dermatophytes or fungus that cause onychomycosis (the medical term for this condition) will turn your nails all kinds of lovely colors in the beginning--yellow, brown, maybe blackish but they haven’t been living in your nail bed that long to do much damage beyond a less than lovely color. However, once the buggers have set up shop they continue to do their dirty work causing the nail to lift, become disfigured, cause pain, and in some cases lead to ulcers of the toes (the latter usually occurs when someone has diabetes or another problem that causes poor circulation to the feet).

Toenail fungus can also be transmitted to other members of your family. After all it’s a fungus and it doesn’t just stay on your toes. You may have even gotten it from another person you know or from someone at your gym in the shower room.

The other problem with toenail fungus is that it’s chronic. As much as I want to tell my patients it will go away forever once we treat it, but the truth is that fungus is very hard to eliminate. Think about your teeth. It would be great if you could go to the dentist just once to get rid of all your plaque, but that’s not how it works. Not only do you have to go back to your hygienist annually you also have to brush your teeth daily.

Here are my recommendations to people with toenail fungus or for those who think they have it:

Is it Really Fungus?
Not all discolored nails are toenail fungus. When you make an appointment with a podiatrist or other provider who wants to treat you, ask them how they know it’s fungus. Sometimes you can tell it’s fungus by visual inspection, but sometimes a clipping of the toenail needs to be sent in for analysis. It doesn’t make sense to spend a lot of money getting treated for something that may not be fungus at all.

Is Nail Polish OK?
Don’t cover up your fungal nails with nail polish. According to my colleague Dr. Andrew Schneider nail polish can weaken nails making them more susceptible to toenail fungus. I agree. If you want to use polish, I recommend a Dr.’s Remedy Enriched Nail Polish which does not contain any of the nail weakening toxins.

Inform Yourself
Get as much information as possible when considering treatment for your fungal nails. In my Guide To Eliminating Ugly, Fungal Toenails, I discuss the pros and cons of each type of treatment.

Prevent Re-Infection
During treatment and even after treatment has completed it’s important to keep down the level of fungus in your shoes. We recommend the SteriShoe+ Ultraviolet Shoe Sanitizer  to all our patients with toenail fungus. It eliminates 99% of the fungal spores and takes only 45 minutes to do so.

Avoid Getting A New Infection
Unfortunately it’s hard to be sure that your nail spa is thoroughly sterilizing all of their equipment, so employing a DIY pedicureis really your best bet. Also, be sure to wear flip flops in the shower room at the gym or pool.

For more information about treating fungal nails, as your Seattle podiatrist I’d be happy to talk with you about your options. Call the Foot and Ankle Center of Lake City at 206-368-7000 or request an appointment online.


Kathy Lee Gifford former talk show host of Live with Regis and Kathy Lee and the current co-host of Today’s show with Hoda Kotb, had no problem talking about her bunions on her Facebook page. She recently started a Q & A and told her fans to ask her anything. One fan reminded her that she met her in Nantucket where they compared bunions. She asked her if she’d had surgery and Kathy let her know that she’d had both her bunions done 7 years ago.

You may be wondering if bunion surgery is something that you should consider.

As a conservative practicing Seattle podiatrist, I don’t do surgery unless I have to. Before getting into the nitty gritty about surgery, here are a few things to know about bunions.

Bunions progress over time. Tight shoes and high heels in particular can be the biggest culprit. Although they aren’t hereditary the propensity to get bunions is often due to faulty foot structure (flat feet for example) which can be. So if you took identical twins with the same foot structure, depending on activity level, shoe type, and other factors one could get bunions and one may not.

My goals for bunions are to

  • relieve pressure and pain caused by the friction
  • stop the progression.

Once we’ve tried everything, then and only then will we start to talk about bunion surgery described in detail on my website. You can also check out the testimonials of one of my patients who was quite young when she had the surgery.

Call us at the Foot and Ankle Center of Lake City if you or a family member is suffering from this condition. We’ll do a thorough assessment to determine next steps. You can reach us at 206-368-7000 or request an appointment online.


While their name implies comfort, flatform shoes, the latest trend in footwear (think Miley Cyrus and Katie Perry) may end up being anything but comfortable. Flatform shoes are half platform shoes, half ballet flat--supposedly the look of high heels with the comfort of flats. Originally introduced in 2011, these shoes are back in style now much to the consternation of this Seattle podiatrist.

Flatforms are bad for your feet because they 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 which it what Vogue writer Liana Satenstein experienced when she was in recently in Japan. As a result of her fall she tore a ligament. Apparently these trendy shoes have been all the rage in Japan for many years where flatform accidents are epidemic.

Shoes like these are the worst choice if you already have an unstable or unsteady gait. But even those with perfect feet and balance can be laid flat by this shoe with a torn ligament or a broken ankle. Torn ligaments are a usualy the result of an ankle sprain from a fall. How long you’ll be out of commission depends to a great degree on the height of the fall, how bad the ankle was twisted, and other factors.

Finding the right shoe for you is often a matter of really understanding your own individual feet and foot limitations. One way to do this is by joining Dr. Robyn Paloian and me at Nordstrom’s at Northgate in Seattle on Saturday, July 12th from 10am – 12 noon. We’ll be looking through the sea of the latest fashions to find something that will work for your particularly foot type.

To make a reservation for this event, contact us at 206-368-7000 or send an email to [email protected] with the subject line, "I want to go shopping with Dr. Berg and Dr. Robyn".