Dr. Berg's Foot Facts

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What's the best approach for treating fungal toenails? First let's look at the history of how fungus of the toenails has been treated. For many years the only available treatment was topical medication. And while somewhat helpful these medications had to be applied daily for up to a year. With all that effort, only 20% of patients saw clearing of their fungal nails.

In the 1960s and 70s the pharmaceutical industry developed an oral medication. Initially these medications were harmful to the liver. Eventually they developed a medication called oral Lamisil which had fewer side effects. The patient took one pill a day for three months and with that the success rate was about 75%. To be safe patients got their liver enzymes tested after one month.

However, even with testing the liver many patients were still hesitant to take the oral medication. Also, fungus would reoccur in some patients (as with any fungal nail treatment). Something that was non-invasive that had the potential to work better was needed. That's why laser treatment was developed. When we first started using laser in 2012 we found a success rate of 60%-70%.

After we added in topical medication for the skin and nails and put in place a program where patients used a UV light sanitizer in their shoes our success rate went up to 75%. Finally this year we added a one month course of oral medication and grouped our laser treatments closer together. Then our success rate went up to 80%-90%.

If you're looking to get rid of your fungal toenails in time for the 2019 sandal season, now is the best time to start. With treatment your clear nails will still need to grow out which can take nine months or longer.

Call us today at 206-368-7000 for evaluation. You can also request an appointment online. We'll test your nails to make sure you have fungus before we start treatment.

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.

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By Dr. Rion Berg
June 28, 2018
Category: family foot care
Tags: Untagged

Finding and wearing the right shoes is a topic I broach with almost all of my podiatry patients. Whether a person comes to me because they are having plantar fasciitis due to repetitive injuries from running or someone with diabetes is having issues with wounds a discussion of shoes is critical to preventing and treating their foot condition.

Our feet spend most of their waking hours in shoes. That's why it's so important to be sure the shoes we wear are the right size, a good match for our foot type, and complement the activities we engage in. In addition, shoes need to accommodate our foot condition so we are not making it worse or suffering unnecessarily.

Of course many of the conditions I see require procedures, devices, and/or other products to begin the healing process. However, in addition the right shoes are a must for preventing further injury or pain to the feet.

Finding the Right Shoe Size

Recently I read that Meghan Markle is sporting heels slightly larger than her foot size. The article assumed she was doing this to help prevent foot pain. I don't know where Prince Harry's wife got this information but it is incorrect.

Wearing the correct shoe size is very important to ensure you don't have foot pain. Many people know that a child's foot size changes constantly and are vigilant about getting their kid's feet measured. But few are aware that their own feet can also increase in size.

Many of us gain weight as we age. For women rapid weight gain is most common during pregnancy. An increase in weight affects our feet by adding pressure during every step. Over time this causes our arches to lower and our feet to go up a half to a whole shoe size or more. Weight gain can also increase the width of our feet.

For this reason, getting your feet measured every time you buy a new pair of shoes is important. Also, shoes are not necessarily consistently sized between shoe companies. It's best not to rely on a past size to determine what you should buy today. For in store and online purchases be sure you know the companies return policies so you know how long you can try out the shoes and whether you can wear them outside.

Selecting the Right Shoe for Your Foot Type

Foot type is another thing to consider when buying a pair of shoes.

Your foot width is one aspect of your foot type. Not all shoes will accommodate a particularly wide or narrow foot. Nordstrom and other specialty stores can be a big help if you have either of these foot types.

Arch type is also important to take into account when purchasing shoes. Arch types are either normal, high, flat or somewhere in between.

You're fortunate if you have a normal arch. You'll still need supportive shoes but not to the same degree as someone who has flat feet.

People with high arches tend to supinate or roll their feet out as they walk. Foot problems that can arise from this foot type are hammertoes and metatarsalgia. Often woman will seek out a high heeled shoe because initially they'll feel more comfortable. However, high heels put more pressure on the ball of the foot which can cause worsen problems like metatarsalgia and cause other's like Morton's neuroma. The best shoes for high arches are ones with a lot of flexibility, a firm heel counter, and ankle support when hiking or playing a sport with lots of motion changes.

People with flat feet tend to be most at risk for multiple foot conditions. Flat feet pronate or roll in when walking or running. Foot conditions that arise as a result of flat feet are heel pain, bunions, and hammertoes. Even young children can develop a condition called Developmental Flat Foot between ages four and five. Buying shoes with an arch and avoiding flat shoes are important for people with flat feet. Running shoes usually have a good arch and some shoe companies make shoes with good arches, i.e. Dansko. Most people with flat feet will require additional arch supports to prevent their feet from pronating and causing other foot problems.

Selecting the Right Shoe for Your Activities

Equally as important as getting the right shoe for your foot type is purchasing the right shoe for the type of activity you engage in. Whether you walk around Greenlake, run 10Ks at races, play soccer or another sport it's essential to buy the shoe that will best support your feet and are designed for your particular sport or activity.

Specially designed shoes for most of the sports you play are available for purchase. Shoe companies design these shoes to help promote better play and prevent foot and ankle injuries. It's best to purchase these types of shoes at a store that specializes in that activity. A knowledgeable sales person can make a big difference in ensuring you buy a shoe that works best for you and your sport. For example, in the blog I wrote called How to Buy the Best Running Shoes I go into detail about what a good salesperson should be asking you.

Selecting the Right Shoe for Your Foot Condition

As mentioned above, certain foot types can put a person at greater risk for a particular foot condition. While it's important to choose the right shoe for your foot type it's also a good idea to purchase the right shoe for your foot condition. For example, if you're prone to plantar fasciitis it will be important to purchase supportive shoes that will prevent your foot from pronating.

If you have bunions or hammertoes, you'll want to avoid shoes with a higher heel as these can worsen your condition. In addition, you'll want to find shoes that are wider in the toe box and/or are made out of flexible leather or cloth to prevent pain caused by friction.

People with diabetes may need to purchase special diabetic comfort shoes to decrease the chance of developing foot ulcers.

How and When To Shop for Shoes

Everyone should know the basics about how and when to shop for shoes. In addition to all of the other guidelines already described in this blog, there are a few more key factors that can make a big difference when looking for a shoe.

It's important for everyone to buy a supportive shoe. Shoes with no support may be fine for very casual wear (little or no walking) or for people with no foot problems or a normal foot type but most of us are going to need a shoe that can go the extra mile. To test out shoes before you purchase them visit my video "How To Test Any Shoe for Stability".

Shop for shoes towards the end of the day. As the day goes on our feet tend to swell. If you buy your shoes early in the day you could end of up with a shoe that is too small.

Buy shoes with a roomier toe box. Shoes that are pointy can cause bunions to worsen and other conditions like Morton's neuroma to develop.

Replace running shoes every 500 miles and check to see if the soles of your leather shoes are worn out and needed to be re-heeled. Wearing shoes with worn out heels can't provide the support you need to prevent ankle sprains and other foot problems.

Choose heels that are one inch or less or limit the number of hours you spend in taller heels. High heels are a major culprit in many foot conditions and should be worn in small doses. Always take a lower pair of shoes with you if you plan to wear high heels to an event.

If you're 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.

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.

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By Dr. Rion Berg
April 25, 2018
Category: foot conditions
Tags: Untagged

You may have recently discovered a lump or bump on your foot that wasn't there before. It may be painful or not. But you're still concerned.

Bumps and lumps on your feet can result from a variety of conditions. Some of them are fairly benign and can be dealt with in my office, but others can be quite serious and require surgery.

Because feet are often the last part of our bodies we pay attention to, certain cancers can progress more rapidly than if they were found on another part of the body.

Here are 5 lumps or bumps you may find on your feet and what to do about them.

Bunions
Bunions are extremely common particularly among women who wear high heels and also have flat feet. Flat feet are inherited. For that reason it's very likely if your mother had bunions and flat feet, you will too.

Part of bunion treatment is preventing them from getting worse. Anyone with flat feet should avoid wearing heels higher than one inch. Heels along with pointy toes can cause bunions to get worse when worn frequently.

Although bunions can be removed surgically, orthotics can help with foot alignment relieving the pain of bunions and preventing them from getting worse. Even children as young as four or five can benefit from orthotic treatment.

Ganglion Cyst
Ganglion cysts are soft, fluid-filled, benign (non-cancerous) lumps connected to tendons and joints. Often they are found near an ankle joint, top, and side of the foot. Most cysts cause mild pain as a result of the pressure created by wearing shoes. But when they enclose or press on a nerve, the pain can be sharp.

The best way to prevent cysts from forming is to wear well-fitted, comfortable shoes and avoid repeated foot injuries. Ganglion cysts can be drained or injected with steroids but often come back. Surgical removal is an option to prevent reoccurence.

Cancer
Sometimes a bump or lump is cancerous. In our office if we suspect cancer, a biopsy will be done and sent for testing. Although most tests will come back as benign or non-cancerous, certain types of cancer found on the feet progress more rapidly than cancer found elsewhere on the body.

Malignant melanoma is one of those cancers. It is estimated that approximately 30 percent of melanomas occur in the lower extremities, and that 3 percent occur in the feet. Although it makes up only one percent of skin cancers, malignant melanoma accounts for over 60 percent of skin cancer deaths. Rapid discovery and treatment of this cancer is essential.

Exposure to sun increases risk for skin cancer and so using sunscreen on your feet is essential for prevention.

Pump Bump (Haglund's deformity)
Haglund's deformity or "pump bump" most commonly affects women who wear rigid pump style shoes. In addition to wearing this specific shoe type, high arched feet, tight Achilles tendon, and faulty foot mechanics also puts people at greater risk for this condition.

Plantar fibromas
Plantar fibromas are benign tissue tumors or growths found under the arch of the foot. Unlike plantar warts, which grow on the skin, these grow deep inside the plantar fascia ligament. Often these lumps are painless, but when there is pain treatment can include orthotics to remove pressure on the arch, steroid injections, or surgical removal.

If you've discovered a lump or bump on your foot, 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+

 

Jordan Hasay made a stunning debut at the Boston Marathon last year with the fastest first marathon by an American woman. She came in 3rd overall.

What a disappointment this year when she found out that she couldn't run in the annual race due to a heel injury.

She tweeted: Unfortunately @JordanHasay has a stress reaction in the heel and will not be able to run. "Despite my team working to give me every chance to make it to the starting line, I won't be able to join you. I'll be cheering everyone on and hope you enjoy this historic race."

For most of her running career Hasay has been injury free. It was only a couple of years ago that she developed plantar fasciitis. After much preparation and training for this year's marathon, an MRI revealed that she should sit this one out as doctors labeled her injury a "stress reaction".

Although many people are speculating the stress reaction is related to her plantar fasciitis, a stress reaction can also be a stress fracture.

What's the difference?

If Jorday Hasay is suffering from the lingering effects of plantar fasciitis the cause and treatment would be vastly different from a stress fracture.

Although both would require she sit out the Marathon, that's where the similarity stops.

Stress Fractures

Stress fractures are tiny, hairline cracks in the bone. In the feet they most often affect the metatarsals of the foot (mid-foot) and can also affect the heel. They are common in athletes due to the repetitive nature of running, a rapid increase in training, and/or worn out shoes.  They are also more frequent in women who are too thin, lose their periods, and don't get proper nutrition.

Treatment for a stress fracture is very straightforward; keeping the foot immobile with a walking boot (sometimes non-weight bearing) and refraining from physical activities. Long term women should make sure they get proper nutrition including Calcium and Vitamin D, best through food but also through supplementation if recommended by their physician. Training should increase gradually and shoes should be replaced every 500 miles.

Plantar Fasciitis

Plantar fasciitis is an injury of the plantar fascia which is a large ligament that runs from the front of the foot along the bottom and inserts into the heel. When the fascia gets overstretched, micro-tears develop at the point where the fascia inserts into the heel causing inflammation and pain. It is very common in runners due to the pounding and repetitive nature of the sport. Treatment for plantar fasciitis also known as heel pain often takes a multi-pronged approach. The goal is to relieve the inflammation to start the healing process. First weight is removed from the fascia through taping and use of an air heel. Inflammation can also be reduced by use of ice, anti-inflammatory medication, and sometimes a cortisone injection.

Depending on the person's foot structure inserts or orthotics may be needed for long term pain relief. People with tight calf muscles will also need to begin and maintain a stretching program. Tight calf muscles are often a large part of the cause. Supportive shoes designed for the runner and running distance are also a very important preventive measure.  

Additional Resources:


Preventing Painful Foot Pain Conditions in Women Runners

6 Ways For Running Moms to Prevent Foot Pain

How New Runners Can Prevent Foot and Ankle Problems

If you're a runner and experiencing heel 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".

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+

 

 

 

When I opened my laptop this morning I was greeted by an article about a surgeon that shortens people toes so they can fit into their favorite shoes. Yikes! Apparently Hollywood stars are taking the plunge. I can't say I'm that surprised.

Then I scrolled to the bottom of the page and caught the reaction of one podiatrist whose handle is Marty Pod and I loved what he said. "Make the shoe fit the foot not the other way around." I couldn't agree more.

Just like so called Cinderella surgery, I would never do this kind of surgery to my patients. And yes it would be doing it to them, not for them. Everything I do is for the health of my patients, not some special look they're trying to achieve. Of course I'll do surgery to get a hammertoe back to its proper position and bunion surgery if it's necessary, but I never take any surgery lightly.

Before talking to my patients about surgery I'll exhaust every other option. For hammertoes and bunions that could be fitting them with a pair of orthotics to correct their foot mechanics and relieve their pain.

Educating people about the types of shoes to wear with these conditions is also top on my list. Shoes with a wide and deeper toe box can be of tremendous help since symptoms are caused by the foot protrusions rubbing against the shoes. I often recommend patients go to Sole Perfection or online to Barking Dog Shoes for a solid recommendation for their bunions or hammertoes.

If you're experiencing pain from a bunion, hammertoe, or any other 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.

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+