A common problem among construction workers is having foot problems caused by their safety footwear such as sore feet. These foot problems extend beyond just the construction industry, as people across all trade industries, from construction to mechanics, complain their safety footwear is uncomfortable and does more harm than good for their feet.
Here are some of the foot problems related to work boots.
Sore Feet and Legs
Given that safety boots are heavier – due to being made from heavy materials such as steel and leather – they can wear down your feet and legs more than regular shoes. The good news is that your body gets used to them over time, and exercising to strengthen your leg muscles helps ease the soreness and pain, possibly eliminating it entirely.
Chafing
Safety footwear typically has a steel toe and steep plates placed into the instep area. By their nature, work boots aren’t flexible. Wearing incorrectly sized shoes causes the steel plates and the toe to cut into feet, causing chafing. This is very uncomfortable and can leave you unable to stand properly. The chafing usually presents itself as a burning sensation in the feet. For loose fitting boots, this problem can be temporarily solved by putting a soft insert into the heel or insole area of the shoes. The ideal solution, however, is to have boots that fit properly in the first place.
Corns
Tight boots can lead to problems like corns, neuromas, calluses, hammertoes, and blisters. These are debilitating conditions for people working on their feet all day. These conditions could be avoided by wearing the right fitting boots. There should be enough room to wiggle your toes from the moment that you buy your work boots.
Bunions
Wearing tight work boots everyday for long hours can cause bunion development. Tight work boots, especially in the toe box area, can put excess pressure on your toe joints which can eventually lead to protrusion in the big toe joint area. Bunion is a painful condition which can hamper your everyday work and may require surgery to eliminate the problem. Invest in comfortable work boots with big toe box area to avoid such a condition.
How to Avoid Foots Problems caused by Work Boots
It’s important to get the right size boot because poorly fitting shoes blister and chafe feet and can be very painful. The right sized shoes mean a happy and healthy foot.
Find the right size and proper fitting for you by trying a range of boots. Boots that are too small are obviously going to be uncomfortable and painful, but even oversized boots cause problems. Having the right width is also important when choosing shoe sizes.
Other than fitting you should also invest in quality comfortable steel toes because the cheapest boots can cause pain, slows you down, and leads to an overall reduction in productivity.
It’s always better to take precaution than wait for the problem to get aggravated. Contact the podiatrist and get the treatment done if you continuously have foot pain, discomfort or any unusual symptom.
With warm weather finally on the horizon, it’s almost time to take your feet out of hiding and let them bask in the open-toe-sandal glory of spring. But now that they’re out and on display, it might be time to address a problem a lot of us suffer from: peeling skin.”Peeling feet is definitely common, and there are various reasons why,” says Rebecca Pruthi, a doctor of podiatric medicine and owner of Foot Care of Manhattan. “We’re on our feet all the time and the constant pounding and walking can cause cracking and scaling of the skin,” she says.But peeling feet can be about more than just pounding the pavement. Here are seven reasons why your feet might be peeling.
According to Pruthi, the most common reason patients have peeling feet is a fungal infection (like athlete’s foot)—although they might not always realize it. “A lot of times it just presents itself as peeling skin and patients don’t have the itchiness, so they don’t know it’s a fungal infection,” Pruthi says. So if your skin starts mysteriously peeling all of a sudden, get it checked out sooner rather than later. Once you have a fungal infection on your skin, it can easily infect your toenail, which Pruthi warns can be very difficult to get rid of.
“What I find that happens is that the skin infects the nails, the nails re-infect the skin, back and forth, back and forth,” she says. “So whatever presents itself first, you want to knock it away.”
Excess perspiration and moist environments often cause these foot infections, which lead to peeling. That might mean that your gym regimen, especially if there’s some hot yoga thrown in, can contribute to your peeling feet. Pruthi warns that “anything you’re doing barefoot, or if you’re sharing mats, or if you’re doing hot yoga in a moist environment” can lead to this bacterial or fungal infection. See a doc if you think you have it. (Dance your way fit with High-Intensity Dance Cardio, the first-ever socanomics DVD!)
Many women, including Pruthi, love to wear strappy shoes in the summer. But as anyone who hasn’t properly broken in her new heels knows, snug footwear can cause some serious friction. “Anything that causes friction can cause blisters, which can also result in scaling or peeling of the skin,” Pruthi says. “Don’t wear shoes for too long, wear natural materials that kind of mold to your feet, and as soon as you start to feel friction, change your shoes. Don’t allow too much of that to dig into your skin.” And you shouldn’t only focus on the impact of your heels. Flip flops are also a culprit of foot discomfort and peeling.
Nobody goes to the beach with the intentions of getting a beet-red, painful-to-touch sunburn. But while you might be good at remembering to lather sunscreen onto your face, back, and shoulders, Pruthi notices that “the feet always get the short end of the stick.” So when you just dip your feet in the ocean and assume your lotion has stayed on… maybe reapply. Sunburns lead to peeling and other scary things. Don’t let your feet be on the receiving end of dangerous UV rays unprotected!
“Eczema is a skin condition that manifests through scaling of the skin,” says Pruthi. It can cause peeling, itching, and dryness all over the body—including the soles of your feet. Although many have experienced eczema since childhood, people can also develop the skin condition as an adult. Luckily there are many topical remedies available through podiatrists and dermatologists.
Although there can be some eyebrow-raising reasons why your feet are peeling, it’s not always a bad thing. “Naturally your body wants to slough off skin,” Pruthi says. “So I always tell patients to get a pumice stone and just kind of in the shower rub your feet and get dead skin cells off so that it regenerates new skin.” So show your feet a little love—and they’ll love you right back.
11 hacks that will make walking in heels less painful
• A pair of bad heels can lead to lower back pain, knee pain, and calf pain.
• In-sole cushions or a platform heel can help make high heels less painful.
For some the higher the heels, the better. For others, a pair of black flats is much more appealing than some stilettos. Whether you’re a fan of heels or not, you might find yourself wearing them at some point, so it can’t hurt to have some tips on how to make heels less painful. It’s no fun to suffer for the sake of fashion, but luckily, if you like to add a little height to your outfits, there are certain ways to do so without stumbling home with bloody calluses and sore arches.
“High heels, if worn incorrectly, can change the way the small muscles in your feet fire, which could lead to overuse syndrome,” says podiatric surgeon Dr. Dana Canuso over email. “Overuse syndrome can cause pain and possible tearing. Also, bad heels can lead to lower back pain, knee pain, and calf pain.”
Whether you just bought a pair of shoes that are disappointingly uncomfortable or you have a favorite pair that you can’t wear more than a few hours, there’s hopefully an easy to solution to make your high heels experience a little bit better. Here are 11 tips on how to make walking in heels more comfortable.
Get The Right Size
“As simple as it sounds, the shoe needs to fit,” says podiatric surgeon Dr. Rebecca Pruthi over email. You want to make sure there is space between the longest toe and the end of the shoe. “When shoe shopping, buy at the end of the day when your feet are already swollen,” suggests Pruthi. “Also, look at your width of your feet. I see too many women with wide feet cramming into a narrow shoe. This will help avoid bony changes and damage that can lead to bunions, neuromas and hammertoes.”
Break Them In
Before you wear your heels out on the town, break them in first at home. “Wear socks at home while wearing shoes for a few hours, or use shoe stretchers,” says Pruthi.
Choose Leather
When buying your heels, it’s important to look at the material they’re made of. “Wear shoes that give — that are made of leather rather than synthetic — so they can stretch,” says Pruthi.
insoles Jet.com
Use An In-Sole Cushion
Walking in heels is much less painful when the in-sole is well-cushioned. “This helps in absorbing shock in the ball area while walking and provides comfort,” says footwear designer Radhika Jain over email. “These insole cushions can be made either of eva foam/latex foam or memory foam, which is the best. Nowadays you can buy them online or at a shoe store with foot-care accessories.”
Shave Down The Heel
If you’ve got a favorite pair of heels that are agonizing to walk in, consider getting part of the heel shaved down. Go into a shoe repair store and ask for them to take a look at the shoe. They will usually shave off about 1/2 inch to 1 inch maximum to maintain the integrity of the shoe, but that small amount could still make a difference.
Learn How To Walk Properly
How you walk in heels should not be the same as how you walk in sneakers. Walking with the correct posture can help minimize the impact as well as pain on your joints and muscles. Stand up straight, use your core muscles as you walk, and each time you step, land on the outer border of the heel and toe off, according to Today.com.
Use Deodorant To Prevent Chafing
Say “bye-bye” to blisters by rubbing a little bit of deodorant on the backs and sides of your foot. The deodorant acts as a barrier and helps prevent too much friction, according to Good Housekeeping.
Try Moleskin
“Moleskin can be used on bony areas of the foot to protect from friction,” says Pruthi. It can be cut to any size and used on targeted areas of discomfort. “Unfortunately, this still won’t do anything to alleviate the calf, knee, or back pain that results from posture changes caused by wearing heels,” she says.
woman takes off shoes Shutterstock/Africa Studio
Take Some Breaks
Wearing heels once on a fancy night out won’t have long-term damage. But if you’re wearing uncomfortable heels daily, you might want to consider taking some breaks. “Change your shoes throughout the day,” says Pruthi. “Wear heels only for periods of time and give your feet a break.”
feet Shutterstock/Yeko Photo Studio
Tape Your Toes
Taping together the third and fourth toe of each foot takes the pressure off the ball of the foot, which can help ease pain, according to The Guardian. Use medical tape to prevent cramping and numbness by keeping these two toes bound together.
Opt For Platforms
If added height is the main reason you wear heels, you might want to consider switching to platforms. “Platform is used to ease off some body weight pressure from the heel part and distribute it to the ball area,” says Jain. “The higher the platform height, the more will be the comfort level.”
19 Entrepreneurs Impart Their Best Small-Business Advice
By Alexia Chianis
Whether you’re brainstorming a new venture or already have one up and running, listening to small-business advice from successful leaders can pay off. Not only can their knowledge help you avoid critical mistakes, it can also help you make more informed decisions and help your business reach its full potential.
We asked nineteen successful business leaders to share their small-business advice about everything from starting a small business to running it effectively. Here’s what they had to say.
Figure out who you want to impress every single day, every single hour. Picture that person and how you can make her life easier. Once you figure out who you’re willing to bend over backwards for, you’ve found your customer base. —Jovim Ventura, founder, InoPrints
Start with the end in mind.Envision what you want your business to look like ten or fifteen years down the line. . . . From there, work backwards to the present in building a business plan with well-defined milestones and benchmarks that systematically lead to the ideal version of your future business. —Jeremy Schaedler, president and founder, Schaedler Insurance Agency, Inc.
Look for problems. Problems are the best-disguised opportunities for making money. . . . You have to ask yourself, what problem am I solving for the customer? That is what separates businesses that are successful from the other ones. —D. Anthony Miles, founder of Miles Development Industries Corporation, entrepreneur and best-selling author
Do not be afraid to ask the hard questions you don’t have a clue how to answer.Instead of being paralyzed by your lack of knowledge, distill your questions into the one specific question you need answered to move forward with your business. Then, find the best possible expert or resource to answer that question and ask it. Listen to the answer, write it down, think about it, and then implement it and continue on your journey. —Danielle Tate, founder and CEO, MissNowMrs.com
Take your time when choosing your co-founders. Get clear up front. Document your founders’ agreement, including roles, responsibilities, and equity. Better to hash that out before you get started than to try to clarify expectations once you’ve started. —Tony Loyd, founder, Culture Shift Companies
hiring Advice on Hiring
Don’t be afraid to hire people smarter than you. Some entrepreneurs think they need to know all the answers. Don’t let personal insecurity limit the potential of your business. Surround yourself with people who can challenge you. They will be able to share their knowledge and skills with the rest of your employees, and raise the bar of your team. —Bob Ellis, founder and owner, Bavarian Clockworks
Hire wisely. Find people who match your business style, but who also push you in ways that make you see opportunities or your business differently. Don’t only hire clones of yourself, but make sure you are compatible. —Deborah Sweeney, CEO, MyCorporation
Target candidates with high potential and focus on training and development. In today’s competitive war on talent, not many startups can afford to pay for “A players.” Meanwhile, there are plenty of high-potential, but unproven candidates. . . . When you do eventually scale your business, the “A players” will start coming to you. —Jordan Wan, founder and CEO, CloserIQ
marketing Advice on Marketing
Invest in SEO. Either educate yourself on how to optimize your website for search engines or contract with a marketing agency that specializes in SEO. . . . If you are running a small company, you should have a strong online presence. Customers need to be able to locate your business, and many times this process begins with a search in Google. —Sophie Knowles, founder and CEO, PDF Pro
Be memorable. Keep your efforts constant, deliver above and beyond, and try your best to provide long-term care for your existing clients. Satisfied customers are worth more than any other marketing strategy. —Jacob Bayer, CEO, Luminext
Write about what you do. Having an online presence is everything these days. However, that doesn’t just mean having a website. I try to keep patients in the loop by contributing to a blog about various topics within my specialty. This is a way to reach out to the public and offer information on a new topic or just about anything I find interesting within my field. —Dr. Rebecca Pruthi, owner, Foot Care of Manhattann
Get the sale. You cannot run a business idea up the hill of success unless you get out there and sell. . . . Social media . . . is not the same as warm calls, face-to-face, and direct, detailed emails that show you care about someone. —Ken Yager, president, Newpoint Advisors Corporation
Promote the possibilities and the dreams of your target audience. People don’t purchase things for the things themselves. They buy items and services because they’re hoping it will enhance the
ir lives in some way. . . . They’re thinking about . . . the end result—the possibilities. —Jean Margaret Walker, co-founder and CCO, The Regear Group, LLC
financial-management Advice on Financial Management
Live by the penny, die by the penny.Don’t compete on price alone. Quality is the hardest thing to knock off. —Craig Wolfe, president, CelebriDucks
Be prepared to sacrifice.I sold most of my wardrobe online and in consignment stores, raising nearly $75,000. . . . It’s going to cost three times more than you think [to run your business] . . . so you’ve got to be super creative when it comes to footing the bootstrapped budget. . . . Every extra dollar I earn is an additional dollar that can be used to spread the word about Cheekd. —Lori Cheek, founder and CEO, Cheekd
Focus on revenue, not expenses. . . . Your goal should be to spend the majority of your time figuring out ways to make money rather than spend it. . . . Your obsessive focus should be on making money by developing relationships, building products, and closing deals. —Ben Brooks, founder and CEO, PILOT
Choose a vendor with the right fee. Small-business owners must be constantly thinking about increasing revenue and reducing expenses. Price matters and the pennies count. Find a vendor with a fee structure that works for you and make sure the contract you are asked to sign does not have hidden fees or acceleration clauses, and be comfortable with the duration of the terms. —John C. Woodman, Creditor/Debtor Rights and Business Litigation Attorney, Sodoma Law, P.C.
having-a-support-team Advice on Having a Support Team
Think about the 2–3 people who are willing to be your sounding boards. Who will challenge you to see things differently, encourage you when you need a lift, warn you when you’re floating off course, etc. It can feel lonely, and having a cadre of people at your back makes a huge difference. —Colin T. McLetchie, president, Five Ways Forward
Find a mentor. As business owners, we’re so close to our businesses that it can be hard to see the forest through the trees. That’s why it’s important to find an advisor, mentor, or coach who can provide an outside perspective. —Nadine Pizarro, co-founder, Keyword Marketing
One trait of good leadership is determination, and following these tips can help you navigate the challenges of small-business ownership—and keep you going when you feel like giving up. Implement some or all of their suggestions and set your small business on the path to success.
Entrepreneurship is a way of life for Alexia. She’s owned a handful of small businesses—ranging from a bicycle tour company to a brewpub and beyond. Drawing on her real-life experience and love of technology, Alexia writes articles that help small-business owners thrive.
4 Tips to Run Smarter This Summer
by Rebecca Pruthi, DPM
For many of us, summer is a time to increase our physical outdoor activity. Recently, I was approached by a group of health editors on the topic of foot “heaviness” as a common complaint amongst women who are boosting their exercise and running routines. Here are some of my thoughts on how to keep you moving, and to stay light on your feet this summer!
1. Keep the flow. If you are used to sitting most of the day, especially with your legs crossed, you could be impeding circulation. At work, if you are sedentary, change positions, move around and stretch whenever given the opportunity. When starting running, ease into it. Warm up first and then begin a light jog before picking up your pace to a full run. Other issues, including diabetes, smoking, and varicose veins are also contributing factors that may cause pain in legs and calf. See your medical doctor for an exam to make sure there are no underlying medical problems.
2. Keep it cool. This is more of a general rule for running in the summer. Wear light colors, sweat-wicking materials, and avoid running during peak hours. Try to run as much as possible in the shade, and don’t forget the sunscreen! Urban running is usually hotter due to asphalt and pavements. Opt to run in parks or areas with trees and grass when you can. After your run, do a light jog to cool down, as stopping too quickly can lead to heat exhaustion or possible fainting.
3.Stay hydrated. Increased heat means loss of fluids and electrolytes, which can lead to muscle cramping. Also, a vitamin or mineral deficiency such as not enough magnesium, iron, or folate in your body can cause a tired, heavy feeling. Drink plenty of fluids and take a multivitamin regularly. Avoid alcohol, and don’t forget although caffeine is a stimulant, it is also a diuretic, which can dehydrate you before a run.
4. Move efficiently. Running should be smooth and efficient. If your feet pronate (meaning they roll in when you strike the ground) or if you supinate (roll out when your strike the ground), you may not be as moving as efficiently as you could be, making your feet tired. Try running with a short stride and quick cadence to help facilitate movement. Change sneakers approximately every 400 to 500 miles. See a podiatrist or visit a running store for a gait analysis, which will monitor how your feet hit the ground when you run and can help you choose a proper pair of sneakers for your stride. For severe gait issues, talk to your doctor about a foot exam to see if you should be fitted for custom, molded orthotics that will help correct your form.
and final most important tip is to remember to have fun!!!!!!!
Related topics: Exercise | Fitness | Foot Health | Summer | + OZ EXPERTS
7 Reasons Why Your Feet Feel Heavy When You Run—and How to Fix It
heavy feet while running
Running is, without a doubt, one of the best forms of cardio. You can do it anywhere and the crazy endorphin release is amazing (hello, it’s called a runner’s high). Yet despite all that, many women still hate running.
Among the many reasons people avoid hitting the pavement: It’s hard to get in the zone when your feet feel like cinder blocks.
Here’s what’s up with that and what you can do about it.
via GIPHY
1. You’re Not Getting Enough Circulation
If you sit at a desk all day and keep your legs crossed most of the time, a sudden change in activity could cause feelings of heaviness in your lower legs, says Rebecca Pruthi, M.D., a podiatrist specializing in sports injuries and owner of Foot Care of Manhattan. Other circulatory issues, such as diabetes, varicose veins, or smoking could lead to a heavy feeling in your stems, too.
RELATED: Run Your First 5K Like a Boss: The 4-Week Training Plan You Need
The fix: Start out slow, says Atlanta-based exercise physioligist, Janet Hamilton, C.S.C.S., founder of Running Strong. If you’re a new runner, she suggests you warm up with five minutes of walking and stretches that keep you moving, such as walking lunges for your quads, side stretches for your core, and calf raises for your hamstrings. Then, transition to a light jog and eventually start running. (Work some low-impact yoga into your routine at home with Women’s Health’s Flat Belly Yoga DVD.)
If you’re sedentary at work, try changing positions. Try taking a quick lap around the office and stretching at your desk. You can do a standing thigh stretch, pulling your heel to your butt with the arm on the same side. Another option: a sitting lower-back stretch, hugging a bent leg to your chest. If the issues persist, see a doctor to make sure there are no underlying issues.
via GIPHY
2. You’ve Gained Weight
“If you recently gained weight from pregnancy or just life, you’ll feel a lot of stress on the feet and legs,” says Pruthi. “This results in a pounding feeling when running,” she says. It’s important to think of weight gain as relative to the individual, says Hamilton. “Most people report feeling a difference after gaining 2 percent of their body weight,” she says. Since a smaller weight gain is often caused by fluctuations in water retension, try to pinpoint why you’re a little bloated. Maybe you’re eating more carbs or salty food than usual, which can cause your body to hold onto excessive amounts of water, says Hamilton.
The fix: Try briskly walking or using lower impact exercises to shed some of the extra weight, before you start running. If you suspect you’re holding on to more than just water weight, check out these tricks to burn more calories during any workout.
3. You’re Vitamin Deficient
If you’re not getting enough magnesium, iron, or folate in your diet, it can make you feel a stronger gravitational pull, says Pruthi. Iron, for example, is what your blood requires to produce hemoglobin, a.k.a. the part of your red blood cell that carries oxygen. So if you have an iron deficiency, it could mean that having less oxygen in your blood stream is causing a general feeling of fatigue.
The fix: Incorporate these vitamins into your daily diet through whole foods that are naturally packed with them, like leafy greens, legumes, and seafood. As far as supplements go, proceed with caution. “It’s a good idea to get your blood tested by a physician to identify any specific deficiencies rather than just jumping on the supplements,” says Hamilton. “Too much iron can be problematic.”
via GIPHY
4. You’re Not Drinking Enough Water
As with any form of exercise, dehydration and a lack of electrolytes will make you feel sluggish. The reason you notice it more when you run is because it’s a high-impact activity, says Pruthi. High-intensity activities make you sweat more, and when you drip you lose electrolytes and water. That lack of electrolytes messes with the functionality between your muscle contractions and nerve conductions (the electrical signals that your brain uses to communicate with your nerves), making it difficult to run, says Hamilton.
When you’re dehydrated, your blood volume depletes. And since blood is responsible for fueling muscles with oxygen and cooling the core, your body has to choose between these two functions. Ultimately your body will choose the most necessary function, cooling you down, so your muscles get the shaft and you’re left feeling exhausted, says Hamilton.
The fix: Get your daily dose of recommended H2O—and we don’t mean that age-old eight glasses a day. Hydration is not one-size fits all, says Hamilton. I always tell my clients to drink to thirst, meaning if you’re thirsty, go ahead and drink. Another great way to monitor if you’re getting enough water is to look at your pee. Is it dark? that means you’re not getting enough water. Simple as that. If you’re going on a run longer than 30 minutes in the summer heat, bring a water bottle with you, she says. And if you’re somewhere extra hot, have a sports drink containing extra electrolytes before hitting the road.
RELATED: 6 Ways You Could Be Damaging Your Feet
via GIPHY
5. It’s in Your Bones
If your gait (the manner in which you walk) is off, that will be exacerbated during running, says Pruthi. “If you pronate (roll your foot inward) or if you supinate (roll your foot outward), you may need to be fitted for orthotics to help you stride in a neutral position.”
The fix: Rather than focus on what part of your foot hits the ground when, put your efforts toward monitoring your cadence, says Hamilton. Your cadence is the amount of beats (i.e. steps) you take per minute while running. The best way to monitor your cadence is by running on a treadmill barefoot for one minute, taking down your cadence number, then comparing it to your cadence after a minute with shoes on. Your cadence with shoes on will likely be lower than that with shoes off. You want to get your cadence with shoes on as close as possible to that of when you have shoes off for a more efficient run. Hamilton says we have better form running barefoot because we’re more likely to keep our feet under our bodies and pick them up quickly. The next time you run, try listening to a song that has the desired beats per minute you’re trying to reach (Spotify has a tool for that). If that doesn’t work, see a podiatrist for a gait analysis and foot exam. They may fit you for custom molded orthotics.
via GIPHY
6. You Need New Kicks
As any runner will tell you, it all comes down to the shoe. If you’re experiencing heaviness, you may need a more supportive, cushioned shoe. This prevents excess stress on your joints, so you don’t get worn out as fast. Pruthi also suggests a lower-heeled option for a smoother run. And don’t forget to switch out your sneaks every 500 miles for maximum comfort, she says.
RELATED: 9 Life-Changing Tricks to Make You A Better Runner
The fix: If you’re not sure what shoe to buy, hit up your local running store where the employees know their stuff. You can tell them your current activity level, goals, and sensitive areas, and they should be able to fit you properly with a shoe you’ll love. Or, just check out our running shoe guide.
7. Your Form Is Off
“When the foot strikes the ground, it should be light and quick,” says Pruthi. “Your foot should not be extended out in front of you with a locked knee.”
The fix: Keep your foot close to your body rather than over extending your stride, says Pruthi. This facilitates a smoother, lighter-feeling run. The easiest way to make this correction is by starting out running on flat, unobstructed surfaces, like a flat street in your neighborhood or a track. You can transition to non-flat surfaces when the flat paths begin to feel too easy, says Hamilton. Start slowly, incorporating hills, and keep in mind that you don’t need to do a super strenuous path every day. Try hills and longer routes for days when you want a challenge and shorter flatter runs in between. That way you don’t over fatigue your muscles, says Hamilton.
2016
Mar 28
8:30 AM
WELLNESS
By Lisa Mulcahy 6 Red Flags That You’re Nail Salon Isn’t Hygienic Enough
A nasty infection could ruin your next mani-pedi. Here’s how to play it safe.
Getting your nails done is so relaxing, we bet you’ve never thought too much about the germ potential your favorite salon might pose—so here’s a reality check. Even the nicest salons can practice less-than-stellar cleanliness procedures. And if you have the misfortune of visiting a dirty salon, it can be way too easy to catch something nasty.
Love a good pedi? According to the Centers for Disease Control, a whopping 97 percent of nail salon footbaths tested in one study contained the bacteria M. fortuitum, an icky bug that can cause scarring boils on the skin. Fungal infections are another potential problem. “Fungal infections may infect the skin, like with athletes foot, or the nails, which can be extremely difficult to get rid of,” says Rebecca Pruthi, M.D., a board certified podiatric physician and surgeon practicing in New York City. “You can also contract viruses from nail salons—the result of which may be plantar warts, caused by HPV. Plantar warts are not only unsightly, but they can become very painful and can spread to other parts of the body.”
What’s more, recent media reports have uncovered serious salon infection issues. One customer in Galveston, Texas, got a pedicure-related toe infection so severe her nail needed to be surgically removed. A D.C. man suffered a life-threatening bacterial infection from a nail instrument puncture, and nearly lost a leg. Even scarier, the potential, while considered really rare, is there for blood-borne diseases to be spread. “Cutting into skin could cause secretions such as blood to get on nail instruments, and if another customer is exposed to that blood—if they get a cut in their skin, for example, and contaminated blood enters that cut—this is a potential route of transmission for diseases, theoretically including hepatitis or HIV,” Aaron E. Glatt, M.D., an infectious disease specialist and spokesperson for the Infectious Diseases Society of America, tells SELF.
Are you now so freaked out you’re swearing off salon visits forever? No need to neglect your nails—but you should be proactive about making sure you’re safe. Read on to learn smart steps you can easily take to make sure your next nail appointment will be hygienic and healthy.
1. First, do a visual cleanliness check.
Does the salon look spotless? It should. Clean surfaces are indicative of good hygiene practices overall. So no grime on countertops, no streaky mirrors, not even the tiniest stray nail clipping should be visible. Head into the ladies’ room and make sure it looks nice and sanitary. You should also check the dates on magazine stacks, to see how often customer reading material gets tossed. Old magazines are a mecca for germs if lots of fingers are flipping through their pages.
ADVERTISING
inRead invented by Teads
2. Watch the technicians.
Are they wearing neat clothing? If your manicurist is wearing a stained uniform or apron, she’s sending a pretty clear message that professional cleanliness is not a priority for her, which should make you wonder how clean and safe her tools and equipment are. (While you’re peeping, check out her storage tray—the tools inside should look totally clean, too.) Are the technicians very focused on their work, or do they look lax when it comes to thoroughly cleaning or properly filing a customer’s nails? An alert technician is much less likely to do unhygienic work, or accidentally cut a customer mid-manicure.
3. Look out for safety signs.
Optimally, there should be posted safety rules regarding salon procedures that can be clearly seen by the salon staff.
4. Get the lowdown on those footbaths.
“Speak to the supervisor at the salon regarding what type of foot baths are used,” says Pruthi. “A lot of micro organisms are lingering within the jets of the whirlpool. Pipe-free whirlpools are better.” You can sometimes see the difference between pipe or pipe-free whirlpools yourself, too: A pipe-free system has what looks like a fan or propeller attached to it, while a whirlpool with pipes is surrounded by, well, pipes. Also, “find a facility that uses a liner in their foot bath and make sure that liner is changed in between each client,” urges Pruthi.
5. Make sure tools are disposable—and disposed of.
In addition to the bubbly kind, there are non-whirlpool plastic foot basins that can easily be tossed between customers. Some salons still reuse things like metal files, so you want to request single-use files and buffers. It’s totally OK to ask the technician to open a package in front of you to get your single-use tool out, too. Watch to make sure all disposable tools are thrown away immediately. (If they got tossed after they were used on you, chances are they got tossed after the person before you, as well.)
6. Ask about an autoclave.
When it comes to making sure non-disposable tools are safe, “disinfection and sterilization are not the same,” explains Pruthi. An autoclave sterilization device, which is now available in better nail salons, is guaranteed to kill any bug and is much more effective than disinfecting solution (like that blue stuff you might see at a hair salon or barber shop), which doesn’t kill all bacterial spores.
You don’t have to rely on your manicurist’s hygiene scruples to stay safe. Here are a few ways you can take your mani into your own hands:
Bring your own instruments.
This eliminates any danger of getting an infection from a prior customer. Another good practice: “Clean your own instruments at home beforehand, too. You can wipe down something like a pair of scissors with alcohol, or wash them with soap and water,” says Glatt. Even if you’re the only person using them, cleaning your instruments before using them takes away any risk from surface dirt they make have picked up in a drawer or on a table.
Don’t shave your legs for 24 hours before your treatment.
Even if you don’t think you nicked yourself, microscopic cuts can be easy entry points for infection.
Don’t be afraid to voice your concerns.
If something doesn’t look or feel right, voice your opinion to the salon owner—not only will you be protecting yourself, but other customers as well. Then find another salon. There are many great facilities out there that put their customers’ health first.
Pretty toes or medical woes? Who doesn’t love the way their feet look after a fresh pedicure? Although you may think you are practicing good hygiene by indulging in a foot spa treatment, you could be increasing your risk for infection.
According to the American Academy of Dermatology, pedicure health risks include fungal infections and bacterial skin infections, including MRSA (Methicillin Staphylococcus Aureus), a potentially serious antibiotic-resistant staph infection.
Watch: Oz Investigates: Nail Salon Dangers
Additionally, viruses, such as those that cause plantar warts, can be found in spas and pedicure facilities. I often see many of these conditions in my office.
How can you minimize your risks during a pedicure? Here are some useful tips:
Check it out: A salon/spa may “look” clean, but keep in mind you can’t see a bacteria, virus, or fungal spore. The first thing I tell patients is to find out about the practices of the facility. Are they cleaning in between clients? How are they cleaning the instruments and footbaths? What measures do they use to minimize infections?
Avoid crowds: Stay away from overcrowded salons. Go in the morning, preferably on a weekday. According to American Podiatric Association, salon footbaths are usually cleaner earlier in the day before they’ve been heavily used.
Stop the bubbles/foot bath: Many of the microorganisms adhere to moist surfaces or the insides of the jets (even after the tub is cleaned!). This makes whirlpool baths a potential haven for germs, especially when the jets are turned on, encouraging the microorganisms to move from the nozzles to the tub, and infect your feet. Turn off the bubbles. Some of the newer facilities have protective liners for the footbaths, or foot baths without pipes and jets.
BYOI: Bring your own instruments: Medical sterilization techniques may not be implemented and nail polishes may also be contaminated (double-dipping is an understatement!). Bring your own surgical steel instruments and polish to decrease contamination. Disposable tools, such as buffers and files, should be discarded between clients.
Keep the stubble: Avoid shaving, waxing, and using depilatory creams on your legs and feet 24-hours beforehand. Small abrasions or cuts to skin can get infected. If you need to shave your legs, wait until after the pedicure.
Avoid cutting skin and cuticles: The cuticles are there for a reason; they serve as protective barrier. Avoid cutting them as it can predispose one to infection. Also, the pedicurist should use a pumice stone or foot file rather than a blade or razor to remove calluses or hard, dry skin. Improper use of razors can lead to infections. Diabetics, smokers, people who are immunocompromised, or anyone suffering from peripheral arterial diseases should take extra precaution since cuts on the feet can lead to serious wounds and infections.
Finally, remember afterwards to check your feet after getting a pedicure. If you notice any skin changes, irritations or wounds go see your podiatrist. Taking a few extra precautions is a sure way to keeping your feet beautiful and healthy.
Rebecca Pruthi, DPMBy Rebecca Pruthi, DPM
Doctor of Podiatric Medicine and Surgery and Foot Health Expert
Getty
About seven percent of in-flight medical emergencies result in a diversion, according to a 2013 study.
This is what goes on after a flight attendant asks, “Is there a doctor on board?”
When traveling at 30,000 feet, you probably don’t expect to have a sudden health scare. But mid-air medical emergencies happen more frequently than you might think. While the Federal Aviation Administration (FAA) doesn’t track medical events on planes, in a 2013 study published in the New England Journal of Medicine, researchers estimated that there is an in-flight medical emergency in one out of 604 flights, or 16 medical emergencies per one million passengers. According to the researchers, the most common ailments that arise on planes include passing out (loss of consciousness due to a drop in blood pressure), trouble breathing, vomiting, and cardiac symptoms.
So, what happens when there is a sick passenger on a plane? The FAA requires all U.S.-based commercial airlines to have automated external defibrillators and emergency medical kits that are stocked with basic resuscitation equipment and medications on flights, as well as CPR, first aid, and defibrillator training for all crew members. But of course, in a true medical emergency, having a doctor on your plane is a massive relief—and frequently, there is one. “The latest review found that 30 to 60 percent of flights have a medical professional on board,” says J.D. Polk, D.O., an osteopathic physician and senior medical officer with the National Aeronautics and Space Administration (NASA).
Still, doctors are, not surprisingly, limited to what they can do on a plane. William Brady, M.D., a professor of emergency medicine at the University of Virginia Health System, has been called on for medical emergencies mid-flight several times. He stresses that it’s important to remember a commercial aircraft is not a flying medical unit, and it’s possible that “you may have a gifted physician[on board] who is an expert in treating a specific medical problem and has not treated the issue at hand for years.” But this hasn’t stopped physicians from stepping up when a flight attendant’s voice has announced over the loud speaker, “Is there a doctor on board?” Here’s what happened when these medical professionals answered the call:
MID-FLIGHT SCARE
“One of my more memorable calls to duty was on a flight from the U.S. to Australia. Midway across the Pacific Ocean, a young woman had chest pain, which is a daunting complaint if the patient were to require time-sensitive treatment thousands of miles from a hospital. I opened the supply box and I immediately felt naked, surrounded by non-medical personnel and a somewhat random collection of supplies…. I was armed with a Fisher Price-looking stethoscope in one hand and a bag of mini pretzels in the other trying to decide which would be more effective in treating this patient while passengers gawked at me like it was an accident on the side of a highway. Luckily for the patient, her chest pain was a combination of asthma and anxiety and was easily treated with an inhaler, cool compresses, body positioning, and emotional support. When I went back to my seat in coach, the flight attendant thanked me and put a fruit plate on my tray. She said, ‘Nice job. If you had placed an IV, we would’ve upgraded you to first class.’ Maybe next time.” —David J. Mathison, M.D., MBA, pediatric emergency physician and Mid-Atlantic regional medical director for PM Pediatrics, in Bethesda, Maryland
A CRUCIAL CALL
“I’m a podiatrist. When I was in my first year of residency, I was flying with my sister from Puerto Rico to Newark and there was an announcement asking for a doctor to please come to the front of the plane to help a sick passenger…. There I was coming back from vacation in ripped jean shorts, my hair braided with beads from the beach, dressed as a teen, being called as the ‘doctor on board.’ The passengers on the plane stared as I stood up and made my way to the front. The patient was a middle-aged man who had just had major surgery and had left the hospital, against medical advice, to get home for the winter holidays. He was sweating profusely, having difficulty breathing and chest pain, and he had a rapid pulse. I administered oxygen but he was worsening…. The first thing that came to my mind is that he was having a pulmonary embolus (a clot to the lung. The pilot asked me, ‘What do you want to do?’ Because I was so young, I was a little bit overwhelmed, but you don’t know what you’re capable of until you’re put into that situation. So, I explained that the situation was life threatening and we had to land. After I came out of the cockpit, he made the announcement that we would land in Bermuda. I’ll never forget when we landed, one passenger pointed at me and loudly announced, “That’s the girl who brought down the plane!” —Rebecca Pruthi, DPM, podiatric physician and surgeon, Foot Care of Manhattan
She said, ‘Nice job. If you had placed an IV, we would’ve upgraded you to first class.’
BABY ON BOARD
“In December of 2009, I was on a Southwest Airlines flight from Chicago to Salt Lake City when they asked if there was a doctor on board because a woman was in labor. Now, it’s relatively common to have medical emergencies on board but a delivery on board is extremely rare. I felt a little panic because I’m an internist and I care for adults primarily…but I put my hand up to help. I went to the back of the plane to the flight attendants and the lady in labor on the floor, who turned out to be about four weeks from her due date, traveling to Salt Lake City for an adoption where the intended parents lived. A psychiatric nurse and pediatric nurse volunteered to help too. We were about an hour away from touch down in Salt Lake City and I saw that the baby’s head was crowning…. It was just a matter of 15 minutes, and a healthy baby boy was born. One of the nurses had a pair of makeup scissors with a rounded tip, so we used those to cut the umbilical cord and I used my shoelaces to tie [it]. Some passengers with children also gave us blankets. The pilot announced the birth and said jokingly, ‘We have a security breach—we’ve found an extra passenger on board with no ID and no luggage.” Everyone clapped and it felt really joyous. Because it was a private adoption, to this day I don’t know the lady’s name. But a year later, I got a letter in the mail with a picture of a one-year-old boy in an Air Force flight jacket. The mom and dad who had adopted the baby boy thanked me for delivering him and told me his nickname was ‘The Jet.’ I was so grateful for that bit of closure.” —John Saran, MDVIP physician affiliated with Edward Hospital in Naperville, Illinois
FEELING THE PRESSURE
“A young man had suddenly gone blind in one eye as we got to cruising altitude. When I got to his seat, I saw that he had a dilated pupil, and he told me he’d just had an ophthalmologic procedure done to repair a detached retina. I was aware that the procedure required an ophthalmologist to inject a gas bubble into the middle of the eyeball, which would lightly press against the detachment for a few weeks until a seal could form between the retina and the wall of the eye. Under normal circumstances, the eye absorbs the gas bubble over time. The problem here was that when the aircraft reached cruising altitude with a cabin pressure of 8,000 feet, it caused the bubble in his eye to expand and press against the artery at the back of his retina, which collapsed the artery and blinded him…. I asked the pilot if he could reset the cabin pressure from 8,000 feet to 2,000 feet. Because of my background in aerospace medicine, I realized that would increase the amount of air in the cabin, and the engine would need to work a little harder and burn more fuel, but it would help the patient. Fortunately, the pilot calculated that they had enough fuel to make that adjustment and he reduced the cabin pressure. It allowed the gas bubble in the passenger’s eye to shrink, and he immediately regained sight.” —J.D. Polk, D.O., an osteopathic physician, senior medical officer with the National Aeronautics and Space Administration (NASA), and previous assistant secretary for health affairs and chief medical officer of the U.S. Department of Homeland Security
We were about an hour away from touch down in Salt Lake City and I saw that the baby’s head was crowning…
A BIG RELIEF
“Four years ago, when I was a surgical intern, I was on a flight from Tokyo to Los Angeles when I answered the overhead page for a doctor. The flight attendant led me to the back of the plane where there was a 65-year-old man who was unable to urinate. He looked extremely uncomfortable, and said he had a history of an enlarged prostate. He’d also taken a Benadryl to sleep, which I knew can cause a blockage in the neurotransmitters that help the prostate relax. Since the urethra passes right through the prostate, if the prostate doesn’t relax, you can’t urinate, which can result in severe pain and possibly bladder rupture. We were about four hours into the flight and it would be more than six hours until landing, so I got the medical kit and miraculously, it had a Foley catheter. As an intern, I was used to putting in a ton of Foley catheters before surgery. So we went upstairs to the first-class dining area where it was more private and I had him lie down. I sterilized the catheter as best I could, and used lidocaine from the kit to help numb the catheter when I inserted it. It immediately started draining urine, and I found a water bottle to put at the other end of the catheter to collect it. He immediately started feeling better. About an hour later while I was sleeping, the flight attendant brought over a handful of snacks and a champagne bottle from first class.” —Hyuma Leland, M.D., resident physician in the division of plastic and reconstructive surgery at the University of Southern California
TRAGEDY IN THE SKIES
“Around Christmas time 1997, I was on vacation with my wife and kids flying from New York to Miami when the flight attendant announced that they were looking for a doctor. I asked what I could do and the flight attendants brought me to a 25-year-old woman who had passed out in the aisle. She was traveling alone and was unresponsive when I got there. A newly trained paramedic also got up to help. We started administering CPR immediately on the floor of the aisle, but we had none of the equipment we needed to keep her alive. At the time, the in-flight medical kits had no oxygen, no breathing tube, and no device to pump oxygen into the lungs. And there was no defibrillator. The pilot asked if I’d like to make an emergency landing into Miami and I said yes. I continued doing CPR throughout the descent…to keep her heart pumping…but I didn’t think she was going to make it. As soon as we landed, the paramedics were there to take her to the hospital where she was pronounced dead. I was so affected by this, and so disturbed that I didn’t have the tools that could have made the difference. She had no prior history of cardiac issues, and it turned out that she had suffered an arrhythmia (an irregular heartbeat), and she would have done very well with a defibrillator. Immediately after the incident, I lobbied Congress, the National Transportation Safety Board, and the FAA to ask that airlines expand their medical kits and change their protocol. In 1998, Congress passed the Aviation Medical Assistance Act, which requires that all airlines carry expanded medical kits and an automatic defibrillator. I am gratified every time I get a letter from someone thanking me and telling me that their life was saved because of the defibrillators and medical kits that are now on planes.” —John Knight, M.D., hand and wrist surgeon, and director of the Hand and Wrist Institute in Los Angeles
¿Qué tan propensa eres a desarrollar juanetes? Descubre si estás en riesgo de padecerlos Por: Redacción Cosmo @cosmopolitanmx Contrario a lo que muchos piensan, esas pequeñas y molestas protuberancias óseas que se forman en el dedo gordo del pie, conocidos como juanetes, no son sólo un problema para la abuela y sus zapatos ortopédicos. Casi un tercio de los adultos las tienen, y por desgracia, se puede desarrollar a cualquier edad. Esto es lo que necesitas saber acerca de ellos. Un juanete es en realidad una ligera ampliación de los dos primeros metatarsianos (huesos) de los pies, dice John Mancuso, Dr. especialista en medicina podológica de la ciudad de Nueva York. ¿Que tus tacones favoritos son los causantes?… ¡Falso! (Amantes de Louboutin, ¡Brinquen de alegría!) Son 100 por ciento hereditarios, gracias, mamá. En realidad, son bastante comunes, dice Rebecca Pruthi, Médico cirujano en podología de Nueva York. Y mientras son hereditarios, hay ciertos factores que elevan el riesgo de padecerlos. De acuerdo con la Asociación Americana de Medicina Podológica, los que tienen pies planos, arcos bajos, artritis o enfermedades inflamatorias de las articulaciones, son más propensas a desarrollarlas. Si tienes un trabajo que requiera estar de pie mucho tiempo, también eres más susceptibles a los juanetes, dice Pruthi. Mientras hombres como mujeres tienen una predisposición a desarrollar juanetes, según un estudio publicado en la revista Arthritis Care & Research encontró que los juanetes son más frecuentes en las mujeres. Mancuso dice que alrededor del 85 por ciento de sus pacientes son mujeres. Aquí es donde la elección de los zapatos se vuelve importante: Mientras que la herencia es la principal causa de los juanetes, los tacones muy altos los pueden desencadenar más fácilmente, ya que ponen mayor presión en la parte delantera del pie, donde se forman los juanetes, dice Pruthi. Mancuso dice que los ejercicios que fortalecen los arcos de los pies (como los levantamientos de pantorrilla) pueden retrasar la difusión de los huesos en el pie. Asegurarte de que llevas el calzado adecuado (amplios, anchos y con profundidad para el pie) también puede ayudar a minimizar las posibilidades de desarrollarlos. Pruthi sugiere buscar zapatos hechos de materiales naturales como el cuero que cede un poco para un ajuste más cómodo. Los juanetes también pueden llegar a ser especialmente molestos para los corredores, ya que tienden a causar una pronación grave (meter hacia adentro el pie al caminar o correr). La cirugía es la única verdadera solución. “La mayoría de la gente piensa que la cirugía de juanete consiste simplemente en tomar un martillo, un cincel y golpear la protuberancia”, dice Mancuso. “Eso es sólo una parte de ella.” El trabajo de un cirujano podólogo es cortar el hueso para poder realinear la articulación y volver a juntar los huesos. Así que ¿Cuándo es necesaria la cirugía? Todo depende de qué tan molesto sea el juanete. “Si llega a ser doloroso, se te dificulta caminar o incluso usar zapatos, son las tres razones que consideramos para la cirugía”, dice Pruthi. La gente está empezando a considerar la cirugía cada vez más jóvenes. Mancuso dice que la mayor parte de sus pacientes están entre sus treinta y tantos y principios de los cuarenta. “Cuanto más joven lo hagas, la cirugía es menos necesaria”, dice Mancuso, quien explica que el procedimiento es mucho más sencillo si se realiza antes de que el pie haya desarrollado una seria propagación. Debes tener en cuenta que es posible que el juanete vuelva a aparecer incluso después de la cirugía. “Dado que la gravedad varía con cada juanete, existen diferentes procedimientos quirúrgicos para corregirlo”, dice Pruthi. “Si se lleva a cabo el procedimiento adecuado, es poco probable que vuelva a aparecer. Si lo hace, toma años y por lo general es menos grave”. Comparte la nota English Translated version: How you are prone to developing bunion? Find out if you are at risk of suffering By: Writing Cosmo @cosmopolitanmx Contrary to what many think, those small, annoying bony protrusions that form in the big toe, known as bunions, are not just a problem for grandma and orthopedic shoes. Almost a third of adults have, and unfortunately, it can develop at any age. This is what you needknow about them. A bunion is actually a slight extension of the first two metatarsals (bones) of the feet, says John Mancuso, Dr. specialist in podiatric medicine at New York City. What your favorite heels are responsible? … False! (Louboutin lovers, Hopskip of joy!) Are 100 percent heritable, thanks, Mom. Actually, they are quite common, says Rebecca Pruthi, Medical podiatry surgeon in New York. And while they are hereditary, there are certain factors that increase the risk of suffering. According to the American Podiatric Medical Association, those with flat feet, low arches, arthritis or inflammatory joint diseases, are more likely to develop. If you have a job that requires standing long time, you are also more susceptible to bunions, says Pruthi. While men and women have a predisposition to develop bunions, accordinga study published in the journal Arthritis Care & Research found that bunions are more frequent in women. Mancuso said that about 85 percent of his patients are women important. This is where the choice of shoes becomes While heredity is the main cause of bunions, very high heels all can trigger more easily because put more pressure on the forefoot, where bunions are formed, said Pruthi. Mancuso says the exercises that strengthen the arches of the feet (such as calf raises) can slow the spread of the bones in the foot. Make sure you wear the right (broad, wide and deep to the foot) shoes can also help minimize the chances of developing. Pruthi suggests looking shoes made of natural materials like leather that gives a bit for a more comfortable fit. Bunions can also become especially troublesome for runners, as they tend to cause severe pronation (inward put your foot when walking or running). Surgery is the only real solution. “Most people think that bunion surgery is simply to take a hammer, a chisel and hit the bump” says Mancuso. “That’s just a part of it.” The job of a podiatrist surgeon is cutting the bone to realign the joint and the bones back together. So When surgery is necessary?all depends on how annoying is the bunion. “If it becomes painful, you difficult walk or even wear shoes, are the three reasons we consider for surgery” says Pruthi. People are starting to consider surgery getting younger. Mancuso says that most of his patients are among their thirties and early forties. “The younger you do, surgery is less necessary” says Mancuso, who explains that the procedure is much easier if done before the foot has developed a serious spread. You must keep in mind that it is possible that the bunion reappears even after surgery. “Because gravity varies with each bunion, theredifferent surgical procedures to correct” says Pruthi. “If carried out the proper procedure, it is unlikely to appear again. If it does,takes years and usually is less severe.” Share the note
Getting your nails done is so relaxing, we bet you’ve never thought too much about the germ potential your favorite salon might pose—so here’s a reality check. Even the nicest salons can practice less-than-stellar cleanliness procedures. And if you have the misfortune of visiting a dirty salon, it can be way too easy to catch something nasty.
Love a good pedi? According to the Centers for Disease Control, a whopping 97 percent of nail salon footbaths tested in one study contained the bacteria M. fortuitum, an icky bug that can cause scarring boils on the skin. Fungal infections are another potential problem.
“Fungal infections may infect the skin, like with athletes foot, or the nails, which can be extremely difficult to get rid of,” said Dr. Rebecca Pruthi, a board certified podiatric physician and surgeon practicing in New York City. “You can also contract viruses from nail salons—the result of which may be plantar warts, caused by HPV. Plantar warts are not only unsightly, but they can become very painful and can spread to other parts of the body.”
What’s more, recent media reports have uncovered serious salon infection issues. One customer in Galveston, Texas, got a pedicure-related toe infection so severe her nail needed to be surgically removed. A D.C. man suffered a life-threatening bacterial infection from a nail instrument puncture, and nearly lost a leg. Even scarier, the potential, while considered really rare, is there for blood-borne diseases to be spread.
“Cutting into skin could cause secretions such as blood to get on nail instruments, and if another customer is exposed to that blood—if they get a cut in their skin, for example, and contaminated blood enters that cut—this is a potential route of transmission for diseases, theoretically including hepatitis or HIV,” Dr. Aaron E. Glatt,an infectious disease specialist and spokesperson for the Infectious Diseases Society of America, told SELF.
Are you now so freaked out you’re swearing off salon visits forever? No need to neglect your nails—but you should be proactive about making sure you’re safe. Read on to learn smart steps you can easily take to make sure your next nail appointment will be hygienic and healthy.
1. First, do a visual cleanliness check.
Does the salon look spotless? It should. Clean surfaces are indicative of good hygiene practices overall. So no grime on countertops, no streaky mirrors, not even the tiniest stray nail clipping should be visible. Head into the ladies’ room and make sure it looks nice and sanitary. You should also check the dates on magazine stacks, to see how often customer reading material gets tossed. Old magazines are a mecca for germs if lots of fingers are flipping through their pages.
Related: People With This Personality Trait Are More Likely to Cheat
2. Watch the technicians.
Are they wearing neat clothing? If your manicurist is wearing a stained uniform or apron, she’s sending a pretty clear message that professional cleanliness is not a priority for her, which should make you wonder how clean and safe her tools and equipment are. (While you’re peeping, check out her storage tray—the tools inside should look totally clean, too.) Are the technicians very focused on their work, or do they look lax when it comes to thoroughly cleaning or properly filing a customer’s nails? An alert technician is much less likely to do unhygienic work, or accidentally cut a customer mid-manicure.
3. Look out for safety signs.
Optimally, there should be posted safety rules regarding salon procedures that can be clearly seen by the salon staff.
4. Get the lowdown on those footbaths.
“Speak to the supervisor at the salon regarding what type of foot baths are used,” Pruthi said. “A lot of micro organisms are lingering within the jets of the whirlpool. Pipe-free whirlpools are better.”
You can sometimes see the difference between pipe or pipe-free whirlpools yourself, too: A pipe-free system has what looks like a fan or propeller attached to it, while a whirlpool with pipes is surrounded by, well, pipes. Also, “find a facility that uses a liner in their foot bath and make sure that liner is changed in between each client,” Pruthi urged.
5. Make sure tools are disposable—and disposed of.
In addition to the bubbly kind, there are non-whirlpool plastic foot basins that can easily be tossed between customers. Some salons still reuse things like metal files, so you want to request single-use files and buffers. It’s totally OK to ask the technician to open a package in front of you to get your single-use tool out, too. Watch to make sure all disposable tools are thrown away immediately. (If they got tossed after they were used on you, chances are they got tossed after the person before you, as well.)
Related: The Easiest Way (Ever!) To Find Out If You’d Look Good With Short Hair
6. Ask about an autoclave.
When it comes to making sure non-disposable tools are safe, “disinfection and sterilization are not the same,” explained Pruthi. An autoclave sterilization device, which is now available in better nail salons, is guaranteed to kill any bug and is much more effective than disinfecting solution (like that blue stuff you might see at a hair salon or barber shop), which doesn’t kill all bacterial spores.
You don’t have to rely on your manicurist’s hygiene scruples to stay safe. Here are a few ways you can take your mani into your own hands:
Bring your own instruments.
This eliminates any danger of getting an infection from a prior customer. Another good practice: “Clean your own instruments at home beforehand, too. You can wipe down something like a pair of scissors with alcohol, or wash them with soap and water,” says Glatt. Even if you’re the only person using them, cleaning your instruments before using them takes away any risk from surface dirt they make have picked up in a drawer or on a table.
Don’t shave your legs for 24 hours before your treatment.
Even if you don’t think you nicked yourself, microscopic cuts can be easy entry points for infection.
Don’t be afraid to voice your concerns.
If something doesn’t look or feel right, voice your opinion to the salon owner—not only will you be protecting yourself, but other customers as well. Then find another salon. There are many great facilities out there that put their customers’ health first.
MORE FROM SELF:
18 Things You Should Never Put In Your Vagina
4 Things Men Hide From Their Wives
8 Sneaky Ways To Debloat In Just One Day
10 Ways to Guarantee You Get Up for That A.M. Workout
Peyton Manning, the quarterback for the Denver Broncos, has been suffering with plantar fasciitis for several weeks as was revealed when his condition progressed to a partial tear during a recent game. In many cases, a partial tear may result in more pain than a full tear. Manning was sidelined during the game against Kansas City after sustaining this injury. His brother Eli Manning, the quarterback for the New York Giants, has sustained a similar injury before, with a total tear of the fascia back in 2009.
Plantar fasciitis is a common condition often seen with overuse and stress on the foot. The fascia is a tough band of connective tissue that attaches from the heel bone to the base of the toes. The fascia is one of the key players in creating tension in the shock-absorbing arch of your foot. Microtears are thought to contribute to pain in athletes and runners and are believed to be a result of significant inflammation. Abrupt force on top of this chronic underlying injury may occasionally cause the fascia to rupture. Sometimes, cortisone injections treating the inflammation caused by fasciitis can also induce a tear because it can weaken the connective tissue that holds the fasciae together.
Many cases follow steroid injections that can help with plantar fascia pain. A tear usually requires an abrupt dynamic force that is followed by acute pain. It may be seen in athletes, but it can also appear in people suffering from chronic plantar fasciitis. Other conditions that require steroid medications or fluoroquinolone and antibiotics like levofloxacin or ciprofloxacin may also precipitate a tear. Although both Manning brothers sustained tears of the fascia, it is still considered a relatively uncommon condition. Some of the signs of a torn fascia include:
Intense pain in the heel or arch while walking or at rest
A painful lump in the arch of the foot or heel with swelling or bruising
Hearing or feeling a pop or tearing in the foot
The collapsing of the arch
Pain when toes are bent upward
Treatment for a plantar fascia tear or rupture is typically nonoperative. Since it can be accompanied by excruciating pain, you should see a podiatrist right away. A common treatment plan includes rest and immobilization in a walking boot or cast followed by slow stretching over the course of a few weeks. Platelet-rich-plasma (PRP) injections, an experimental treatment, may be considered in certain cases as determined by your doctor to help with healing. This is an injection of some of your body’s own blood plasma injected back into the injury site. Healing time from fascial tears can vary from several weeks to months; for example, the NBA’s Pau Gasol was out for six weeks after a plantar fascial injury. We wish Manning a speedy and full recovery!
Adorable early-walker shoes for babies that won’t hurt their feet
When it comes to Baby’s first shoes, it can be overwhelming to figure out which ones to pick. With so many adorable choices out there, what should parents be looking for (beyond super-cute fashion)?
NYC podiatrist Dr. Suzanne Fuchs explains that when it comes to little baby feet, barefoot is actually best for your early walker! But when you leave the house and aren’t so keen on letting Baby walk around a public area with their sensitive soles, there are some rules of thumb for those first walker shoes.
When it comes to keeping those tootsies warm and protected, soft, flexible and wide shoes are best, because they help feet to develop naturally, Fuchs says.
“When kids’ feet are put into stiff, narrow and confining shoewear, this can lead to feet conforming to the shape of shoes and becoming deformed — think bunions, hammertoes, curled toes and pigeon-toe gait,” she explains. “If you think your child might have a foot condition, take them to a qualified podiatrist for assessment. Don’t assume that certain shoes are better without seeing a professional.”
Fellow NYC podiatrist Dr. Rebecca Pruthi offers a few key tips for picking out shoes:
Don’t buy shoes too early. Wait until after Baby starts to walk (10-18 months).
Get a shoe that fits. The shoe should fit, shape and mold to a child’s movement.
Try on shoes with socks and at the end of the day, when your child’s foot is most swollen.
Babies are naturally flat-footed, so avoid arch- and ankle-support shoes like hightops.
Replace shoes frequently, when your child first shows signs of outgrowing.
Looking for some good picks for your first pair? Here are some that meet the criteria!
Fall fashion has made its way from the runway to the streets. Sky-high heels that were part of Fashion Week are now trending as today’s look. There is no doubt that heels can complete an outfit, but what about the pain? There is an old adage that without pain one cannot achieve beauty. I think our feet may disagree on this one.
Whether it is to complete work attire or for fashion, heels make legs look longer and leaner and boost a woman’s height. High heels change standing posture by causing an increased arch of the back, pushing the pelvis forward. This causes the calf muscles to tighten and shorten. Some of the catwalk movements are actually the body trying to compensate for the changes in gait your body needs to make during the walking cycle.
According to the American Podiatric Medical Association, wearing heels three inches or above on a regular basis can contribute to shortening of the Achilles tendon, the tendon in the back of the leg, causing tightness and chronic pain in the calves. Other issues such as neuromas, hammertoes and bunions can also result from long-term wear. Gait changes may also lead to knee, hip, and back pain and can even accelerate arthritis in these joints. With that knowledge, still some cannot ditch the heels, so what can be done?
Choose the right size shoe.As simple as it sounds, the shoe needs to fit. Make sure there’s some space from the longest toe and the shoe. When shoe shopping, buy at the end of the day when your feet are already swollen. Also, look at your width of your feet. I see too many women with wide feet cramming into a narrow shoe. This will help avoid bony changes and damage that can lead to bunions, neuromas and hammertoes.
Break them in.Wear socks at home while wearing shoes for a few hours, or use shoe stretchers. Wear shoes that give, that are made of leather rather than synthetic, so they can stretch.
Cushion inside the shoe.A gel cushion in ball of the foot (also known as metatarsal padding) can do wonders! Moleskin can also be used on bony areas of the foot to protect from friction. Unfortunately, this discomfort won’t do anything to alleviate the calf, knee, or back pain that results from posture changes caused by wearing heels.
Switch it up.Change your shoes throughout the day. Wear heels only for periods of time and give your feet a break.
Wear a platform and find shoes with a thin rubber sole.Choose wedges over stilettos, a lower heel over sky-high, and one that encompasses the ankle, allowing for more support.
For the time, heels are here to stay. The good news for women is that the physics of high heels are now being more closely studied. Biomechanics as well as gait changes are finally being considered in shoe development. Let’s hope this will lead to a shoe that looks killer on the runway, but that does not kill our feet!
How Likely Are You to Develop Bunions?How Likely Are You to Develop Bunions?
RELATED: 5 Things That Happen to Your Body When You Stop Wearing HeelsThey’re actually quite common, says Rebecca Pruthi, M.D., a podiatric physician and surgeon in New York City. And while they’re hereditary, there are certain factors that up your risk if they do run in your family. According to the American Podiatric Medical Association, those with flat feet, low arches, arthritis, or inflammatory joint disease are most prone to developing them. If you have a job that requires you to be on your feet a lot, you’re also more susceptible to getting bunions, says Pruthi.While men are just as likely to have a predisposition for bunions as women, a study published in the journal Arthritis Care & Research found that bunions occur more frequently in women. Mancuso says about 85 percent of his patients are female.That’s where your choice of shoes comes in: While heredity is the underlying cause of bunions, high heels can trigger one since they put more pressure towards the front of the foot, where bunions form, says Pruthi.
Mancuso says exercises that strengthen the arches of your feet (like calf raises) can slow the spreading of the bones in your foot. Making sure you wear the right shoes (roomy ones that have wide and deep toe boxes) can also help minimize your chances of developing one.
Pruthi suggests looking for shoes made from natural material like leather that offer a little give for the most comfortable fit. Bunions can also prove to be particularly bothersome for runners, as they tend to cause serious pronation (an inward rolling of the foot when you walk or run). So you should try arch supports or special kicks that accommodate for pronation. Surgery is the only true fix, though.
RELATED: The 10 Most Repulsive Runners’ Feet Photos You’ll Ever See
“Most people think that bunion surgery just involves taking a hammer and chisel and knocking off the bump,” says Mancuso. “That’s only part of it.” Fixing the underlying cause means narrowing the forefoot where the bones have spread apart. A podiatric surgeon will cut the bone so that they can literally realign the joint and bring the bones closer together.
So when is surgery worth it? It all depends on how bothersome the bunion is. “If it becomes painful, difficult to walk, or difficult to wear shoes, those are the three reasons we consider for surgery,” says Pruthi.
And people are beginning to consider surgery younger and younger, say experts. Mancuso says the bulk of his patients are in their mid-thirties to early forties. “The younger you do it, the less surgery is necessary,” says Mancuso, who explains that the procedure is much easier if it’s performed before the foot has done serious spreading.
RELATED: 5 Things You Should Know Before Having Foot Surgery
Just keep in mind that it is possible for your bunion to come back even after surgery. “Since severities vary with each bunion, there are different surgical procedures to correct the bunion,” says Pruthi. “If the appropriate procedure was performed, reocurrence is unlikely. If it does, it usually takes years and usually is less severe.”
—
Macaela MacKenize is a writer, runner, and (aspiring) yogi. Thanks to her inner nerd, she’s researched everything from the weirdest health and fitness trends to the behavioral economics of our love lives to what happens when we donate our bodies to science. When she’s not writing, you might find her singing in a rock ‘n’ roll cover band.
We’ve all been there: Sitting down at the table and suddenly you get a weird whiff and realize that there’s an unsettling odor coming from down below. No not, I’m not talking your lady parts (although there are ways to know if your vagina smells healthy). No, not that: We’re talking about what to do if you have smelly feet. Summer’s skyrocketing temperatures almost ensure that you’re sweating more everywhere, including your feet. Extra sweat means extra odor, and unfortunately, you’re gonna have to find a few ways to get rid of that stinky foot smell if it’s really bothering you.
“Naturally we all sweat,” Dr. Rebecca Pruthi, a New York City podiatrist tells me. “Under normal conditions when it’s hot out, if you have shoes on for an extended period of time, your feet aren’t breathing and sweating is a normal bodily function. That odor, under normal circumstances, it’s not something that you should be concerned about.”
However, there are times when that odor can linger a little longer than a steamy summer day. If you have an infection, for instance, that can lead to an unpleasant lingering odor. In that cause, Dr. Pruthi suggests patients get in to see a doctor quickly, especially if they have additional medical issues such as diabetes, as the infection could be more serious.
However, if you just have run-of-the-mill smelly feet, here are some ways to mask the unpleasant scent of sweaty tootsies.
1. Load On The Foot Deodorant
And no, not your dad’s SpeedStick. Instead, opt for an aerosol spray variety with antiperspirant.
“The antiperspirant will actually stop the sweating before it starts, which can help you avoid odor altogether,” Dr. Pruthi says. (Axe Dry Action Deodorant Anti-perspirant, $5.53, Amazon.com)
2. Break Out The Black Tea
While drinking it can be delicious, you’re going to need more than just one tea bag to get the full effects of this scent-stopping method. The high levels of tannins, or tannic acid, in the tea, creats an unfriendly environment for the foot bacteria.
“Over time, this can actually help reduce sweating in the feet as well and reduce size of the pours,” Dr. Pruthi says. (Royal Tea Black Organic 100 Bags, $8.98, Amazon.com)
3. Get A Prescription
Similar to the aerosol deodorant spray, there are prescriptions that can treat foot odor. Pruthi only suggests looking into these in highly offensive cases, in which patients may need additional treatment or even surgery to treat overactive sweat glands.
4. Make It Better With Baking Soda
Hello, foot’s best friend. Adding baking soda to your beauty regimen can do wonders for your skin, hair, and nails, but it can also help with your stinky feet sitch. Plus, it will help soften your feet. Simply combine 1/4-cup baking soda with eight cups warm water and your favorite aromatic. My pick? A few drops of lavender oil. (Arm & Hammer Baking Soda, $7.49, Amazon.com)
5. Fancy The Right Footwear
What you wear on your feet can also have a heavy hand in the scent you are greeted with at day’s end.
“Don’t wear 100 percent cotton socks,” cautions Pruthi. “When the cotton gets wet, it stays wet, and you wind up creating more moisture. Try a cotton acrylic or synthetic blend. The synthetic part allows the moisture to whick away.”
As for your shoes, those made of natural materials that breathe will be best.
“If you’re wearing a vinyl shoe, your feet can’t breathe,” says Pruthi. “Also make sure to change your shoes. If you’re wearing the same shoes every day, that’s not a good thing either.” (Hue Women’s Fairisle Cable Quilt 3 Pack Boot Sock, $21, Amazon.com)
Summer is the perfect time to let your feet have some fun in the sun! Between sandals and being barefoot on the beach, our feet finally get a little air after months of being shoved into heavy boots and sneakers. Although polished nails for many might be considered part of your regular beauty regime, our natural nail condition may provide valuable clues to our underlying health. Medical issues typically do not always first appear in the nails, but abnormal growth or discolorations of our nails could indicate an underlying condition of which we are unaware. Here are some warning signs to look out for:
Yellow nails:Yellowing and thickening of the nails in the feet or hands can be indicative of a fungal infection. This is the most common nail condition that I see in my office. As the fungal infection progresses, the yellowing may turn darker and the composition of the nail may change. The nails can become thick and brittle which eventually leads to pressure on the nail bed, causing pain. Other, more serious conditions associated with yellowing of nails include thyroid conditions (with cracked nails), diabetes, psoriasis, or lung conditions.
Lines:These lines may be referred to as Beau’s lines which lie horizontally across the nails and can appear as tiny depressions. This is where the nail stopped growing, or growth was interrupted in certain areas. Trauma to the nail, illness, malnutrition, or chemotherapy can create these lines. Other conditions that may be associated with these lines are diabetes, high fevers, and peripheral vascular disease.
Spooning nails:These nails have raised ridges and grow thin, and scoop outward. This appears depressed in the middle (concave) like a spoon. Spoon nails appear after conditions such as iron deficiency anemia, liver problems where the body is absorbing too much iron, heart disease or hypothyroidism.
Streaking in nails:Dark streaks appearing in the nail could be a very serious sign of melanoma. I always mention melanoma because it can be so easily overlooked. (Please review my previous blog for more onmelanoma of the foot). The dark streak can be indicative of skin cancer. Also, any dark pigments near the cuticle could indicate melanoma, a very serious condition where early detection is key.
These are just a few conditions in which nail changes maybe present. Any abnormalities in color, shape, or growth should be examined closely. While relaxing on the beach, take a quick look at your toenails. In between visits to the salon, take a breather, and let the nails have a break from the polish. If you see any changes, be sure to follow up with your physician for an evaluation.
Clocks have moved forward! As we impatiently wait for the first signs of spring to appear, some of us may be eager to throw on a pair of running shoes and spring into action. According to the 2014 State of the Sport – Running Industry Report from Running USA, there are record numbers of people participating in running with 70% overall growth over the past decade. With so many more people running, the number of injuries has also increased. Unfortunately, the enormous amount of information out there can be overwhelming when you’re trying to find a fix for a sore knee or aching foot. Here are a few basic tips for beginner runners to help prevent injury.
Get Good Running Shoes
I always start by telling patients to get a good pair of good running sneakers. Invest in a decent pair of shoes and make sure they fit properly. One foot may be longer than the other, so make sure you have enough space in each shoe. You should have at least a half inch of empty room in front of the longest toe of each foot. In addition, the toe box should be nice and roomy so that your toes have space to spread out. A good pair of running sneakers should last you around 500 miles or until you start to see significant wear on the soles. Wearing socks when running can also help prevent blisters. Those that pronate or supinate might benefit from a pair of orthotics. Try some of the over-the-counter ones first. If those don’t help, you can ask your podiatrist if custom orthotics might be worthwhile.
Warm Up
Your muscles need to warm up before you begin your workout. There are mixed opinions regarding the amounts of stretching, and the benefits are still controversial. However, improving your overall flexibility can help improve your running form and make your stride more efficient. You can start with light stretching before you run and save the deeper stretching for afterward. Incorporate walking for several minutes before and after the run. Begin at a slow pace and gradually ease into your goal pace. Also remember to ease into your running routine. A gradual increase in your running will strengthen and toughen your muscles, tendons and ligaments. But if you haven’t been running, a sudden increase can overstress them and cause injury. If you were a couch potato all winter, begin slowly.
Ease Into Routine
Most running injuries, like stress fractures, plantar fasciitis and tendonitis, result from doing too much too soon. Slowly increase the intensity and length of each subsequent run and give your body ample healing time. Cross training is especially recommended during these early stages. Doing so will help you maintain your cardio gains while allowing your muscles to recover. Building strength in the rest of your body will also help your overall strength and conditioning and will help with muscle imbalances. Beginners should start at an easy pace. Keep in mind, repetitive motion can lead to injury. Change up the routine by varying the surfaces you run on, the shoes you run in, how hilly the course is and how fast you go.
Recovery and Cool-Down
The cool-down allows your heart rate and blood pressure to come down gradually. End the run with a jog or brisk walk. Make sure to allow for adequate muscle recovery in between runs and to drink enough water. You should be taking at least one or two days off a week from running. Doing more than that can lead to injury and overtraining. Finally, I always stress that you listen to your body. You should enjoy the run. If you’re in pain, slow down and let your body build up to what you can handle. If you suspect injury, see your medical doctor or podiatrist to prevent further problems from developing or any current ones from getting worst.
For those of us living the Northeast, as well as many other parts of the U.S., this winter has brought us its fair share of snowy conditions and cold temperatures. Whether you are a city dweller facing the cold terrain of the city streets or someone who loves outside winter sports, the sub-zero temperatures can wreak havoc on your feet. Here are some tips to keep your feet protected, warm and cozy.
Appropriate shoes. When walking, wear warm boots or shoes. I often see people walking around in shoes that are inadequate for cold temperatures. Ditch the heels, fashion dress shoes and flimsy sneakers and put on a good pair of warm winter boots. Rubber boots should be lined with a warm sock or liner to protect from cold temperatures. Perspiration can worsen cold, so get a drying foot powder or anti-perspirant spray if your feet tend to sweat. This will reduce odor and chance of infection.
Get fitted! For winter sports, it is important to get fitted for the appropriate sportswear. Skating, skiing and snowboarding all have specific shoes. Be sure to get the right size! According to the American Podiatric Medical Association (APMA), boots should immobilize the ball of the foot, the heel and the instep but there should be adequate room to move your toes. You can also use an insole to help control the movement of the foot inside the boots and skates. Properly fitted shoes for winter sports can prevent a variety of injuries and can reduce the chances of getting blisters or chafing.
Stretch to increase circulation. Since the toes are one of the first to experience numbness during cold temperature, it’s a good idea to keep the blood circulating. Stretching the intrinsic muscles of the feet before going outdoors will keep them warm and supple. While outside, keep your toes wiggling in your shoes. Constant blood flow will reduce the chance of numbness and keep those toes warm. Toe warmers (activated heat packs) can also be placed in shoes. Diabetics and smokers should be extra careful since they may have poor circulation in their feet and may not feel the cold as well as others because of nerve damage.
Moisturize. Cold temperatures and dry heat can lead to dry skin. Get a good foot moisturizer and apply to your feet daily. Dryness can lead cracking of the skin, which can be painful and lead to infection. Daily moisturizing will help keep your skin soft, smooth and flexible.
The winter may be brutal, but doesn’t have to be to our feet. Keep these tips handy to protect from cold and injury.
We all strive for beautiful, healthy skin. The market is full of thousands of skin products and moisturizers focusing on maintaining healthy skin for our faces and bodies. What about issues that affect the skin of our feet? Since our feet sustain our entire body weight when we walk, the skin on our feet may become rough and tough over time. Similarly, our feet may be susceptible to viral, fungal and bacterial skin infections. That means skin disorders of the feet may require special attention. Here are some common conditions that frequent my office.
Athlete’s Foot
Everybody has heard of athlete’s foot, but it’s not only specific to athletes. Athlete’s foot is caused by different strains of fungal infection of the skin. Frequently it appears in a “moccasin” formation around the foot, in severe cases with blistering. It may also appear in between the toes. Redness, itchiness and pain may all be associated with this condition. Keeping your feet clean and dry is essential in avoiding these infections. Changing socks and shoes regularly, as well as drying in between the toes, are also helpful. Once the infection is fully underway, though, a prescription from your podiatrist may be necessary.
Dry/Cracked Heels
Dry heels are extremely common and usually worsen during the cold winter months. When cracks in the heels deepen, they can form fissures that can be painful and bleed. Ouch! Moisturizing your feet regularly and keeping hydrated are essential for healthy skin. Since the feet are the furthest from the heart they receive the least blood flow, which can make healing of cracks more difficult. That means our feet need a little extra TLC. There are some great prescriptive topical medications that contain products like urea and lactic acid that are effective in softening that tough hard skin.
Plantar Warts
I know. Nobody wants to talk about warts on their feet, but this condition is extremely common. “Plantar” refers to the soles of our feet. Therefore, plantar warts are specific to the bottom of the foot. Warts in this area may differ from those elsewhere on the body because they typically grow “inward” due to body weight from standing. Because of this and the fact that warts are caused by a virus, they may be difficult to treat with just over-the-counter medications. Typically your podiatrist will use several modalities including shaving, freezing and chemical burning to kill the virus. Sometimes the warts will resolve on their own, but they can also spread. As a result, early treatment is always recommended.
Other skin conditions include calluses, dry skin and ulcers. Smokers, diabetics and other people with weakened immunity may be even more susceptible to these sorts of problems. If you suspect any of the above conditions, it’s best to get it checked out right away. Seeking professional medical attention for any skin disorder is always recommended in keeping those feet healthy and beautiful.
RELATED TOPICS: FOOT HEALTH | + OZ EXPERTS
Rebecca Pruthi, DPMBy Rebecca Pruthi, DPM
Doctor of Podiatric Medicine and Surgery and Foot Health Expert
Here is a recent post on Brides.com January 13. 2015:
4 Ways to Keep Foot Pain Out of Your Wedding Day
Tuesday, January 13, 2015 by Carolyn Hsu
Of all the things you’ll experience on your wedding day (love, excitement, extreme happiness…), the one feeling that is most definitely not welcome is foot pain. Although it seems inevitable (you are on your feet for eight to 10 hours after all), there are ways to wear your gorgeous new stilettos and dance in them too!
Here, podiatrists Dr. Suzanne Levine, founder of Institute Beauté and author of My Feet are Killing Me, and Dr. Rebecca Pruthi, owner of Foot Care of Manhattan, share their best advice on how to take care of your feet on your big day.
Vary your heel size throughout the day.
“The ‘healthiest’ heel size is one to two inches,” says Levine. “That, of course, doesn’t lend itself to the sexiest shoe, so brides that want to walk down the aisle in something taller should bring a lower pair of heels and alternate between them throughout the day. Every three hours or so, make sure you change it up to give your feet a break. Don’t wait until your foot’s killing you before you ditch the stilettos.”
See More: Wedding Shoes You’ll Want to Wear
Pick a shoe that fits you at the end of the day.
“Dancing plus alcohol plus being on the go all day means that your feet will swell — sometimes even up to half a size larger — by the end of the night,” explains Levine. “So when you are trying on shoes for fit, make sure they don’t feel too snug, or they’ll be even more restrictive by the time your reception starts.”
Try on your heels later in the day and make sure they still comfortable before you commit to them, or get a pair of heels that are a little bit bigger and cushion them with arch support or padding for the balls of your feet. Another way to deal with swelling is to elevate your feet whenever possible, says Pruthi. “Even taking an anti-inflammatory such as Motrin the morning of your wedding can go a long way with helping with foot swelling.”
Avoid blisters by keeping your feet dry.
Sweaty feet (read: friction) and a tight shoe is a guaranteed recipe for blisters. “Keep the bathroom stocked with a bit of talcum powder or spray deodorant and apply to your feet as needed,” says Levine. “If you naturally perspire a lot, try soaking your feet in Epsom salt the morning of your wedding to dry them out a little.”
See More: What Your Wedding Shoe Says About You
Look for more supportive shoes.
While the shoe you pick is a matter of personal preference, there are some styles that are a bit more forgiving than others. First, a shoe that is made of natural material, such as leather, is more breathable, says Pruthi. “Anything with a slightly thicker heel gives more support overall and a shoe with a closed back or straps are better at supporting the ankles.” And what to avoid? “Stiletto mules, which are the worst types of shoes in terms of support and most likely to cause some kind of injury.”
Throughout the day, our feet are the recipients of constant pounding and stress. Whether from the hard pavements of the streets or cramped conditions of work heels or dress shoes, our feet frequently take a good beating. Dramatic daily overuse can occasionally cause fractures in our feet called stress fractures. Stress fractures are the result of chronic overuse or repetitive force, which can lead to small hairline cracks in the bones of the foot.
The most common sites of these stress fractures are in the weight bearing bones of the feet. In my office, I frequently see stress fractures on the metatarsals, which are the long bones in the middle of the foot. However, they are also common on the heel and the midfoot bones. Here are some of the reasons fractures like this occur.
Increase in impact. While these injuries are more common in athletes, any high-impact activity will add foot stress. Anyone starting a new exercise regimen, including any increase in frequency, duration, or intensity of an activity, is at risk. This also includes inadequate conditioning. The muscles in your feet need time to strengthen and adapt to the new pressures exercise brings. Too much activity too quickly will result in muscle fatigue and can eventually cause fractures or breaks in the bone.
Improper shoes. It sounds unlikely, but fractures from improper footwear are more common than most would think. Shoes that lack padding or are too stiff can lead to symptoms of chronic overuse. High heels can also cause stress on the ball of the foot, leading to stress fractures of the metatarsals. Podiatrists recommend wearing a different pair of shoes every day and also wearing walking shoes for the daily commute, changing into office shoes upon arrival. Hard pavement can lead to stress on the feet, so soft, padded shoes should be worn whenever on these surfaces.
Change in walking pattern. Any injury to the lower extremity can alter walking patterns. For example, if one has sustained an ankle sprain, tendon injury, or a bunion, walking may be altered to avoid pain on the injury site. This can change the biomechanics during the gait cycle, putting new stress on previously unloaded parts of the foot. This compensation may eventually result in a fracture.
Weakened bones. Reduced bone density seen in older individuals can result in fractures. A discussion with your doctor about your risk factors and a bone density test can determine if you are prone to these injuries. Women with abnormal or absent menstrual periods are at risk, as well as those suffering from osteoporosis. Patients with low body weight, and low calcium levels also may be more at risk for injury.
Because these fractures typically occur without a traumatic incident and because the associated pain symptoms can sometimes be vague, many patients delay seeing their foot doctors. Delayed diagnosis can lead to delays in healing time. If you are experiencing any pain, it is best to see your podiatrist as soon as possible to avoid complication and further injury.
Club managers prefer women who wear heels, but they will never dare make it part of the dress code.
Donning high heels for a night out partying is the fashion equivalent of legal tender – the higher the heels, the richer you are and the faster a doorman lets you past the velvet rope.
But what if you decide to nix your Louboutins (don’t we all own a pair?) in favor of more sensible footwear, like flats? Suddenly, your night out comes to a screeching halt.
High heels are a major part of nightclub culture because, aside from the sexiness factor, they help attract men with money. The law of the dance jungle goes like this: well-dressed sexy dames attract well-paying males, which elevates a club’s popularity and status and – ultimately – its profits. Face it: in the club culture, women are looked at as pieces of meat on stilts – dancing shish kabobs.
When it comes to acknowledging the heel requirement, however, many establishments, particularly upscale Manhattan hotspots, keep mum about it. They’ll never explicitly state, “Women must wear heels!” for fear of a discrimination lawsuit. Nightclubs know it would be the ultimate sexism to bar a female patron just because her soles are closer to the ground. Even posted dress codes stick to vague words like “smartly dressed.”
All of this is a bit ironic since heels were originally created for men, not women. Dating back to 16th century Persia (now Iran), male horseback riders wore heels on their shoes to maintain balance while shooting arrows at their enemies.
The trend spread to Europe where noblemen wore heels to show status and to demonstrate machismo. The fanciful appearance of high heels set rich men apart from commoners.
“One of the best ways that status can be conveyed is through impracticality,” Elizabeth Semmelhack, from the Canada-based Bata Shoe Museum, recently told the BBC. Women eventually adopted male fashion trends while men abandoned heels to a large extent. Once women began wearing them by the time the Enlightenment rolled in the 1700s, men decided heels were simply ridiculous.
(Photo : Flickr/Krishna
Many European nobles wore heels, including King Louis XIV of France, shown here at his wedding to Maria Theresa in the 17th century.
Three hundred years later, heels are still looked upon as symbols of status even if nightclub officials won’t admit it.
“These things aren’t really explained that well,” Lauren Menache, a representative from Jay-Z’s upscale sports lounge 40/40 Club, said of the unspoken high heels code.
The sports bar, located in New York’s Flatiron neighborhood, doesn’t have an official dress code for the traditional Friday or Saturday nights out and doesn’t require heels. Ladies and gents get in as long they are smartly dressed – with a few exceptions. There’s that term again.
“We’ve turned girls away that don’t look presentable,” Menache said. “If she is wearing sneakers or flip-flops, that’s definitely not going to fly.”
But the right amount of fashion currency – a T-shirt, tight jeans and a pair of sky-high pumps – can buy any bouncer’s yes vote.
At the Gansevoort Hotel in Manhattan’s Meatpacking district, its rooftop Plunge Bar + Lounge follows a similar dress code. While rooftop manager Jimmy Turon says they do not require heels, it was all too obvious that a woman had been denied entry on a Saturday night in early July because her shoes – heel-less – were inappropriate.
“If you say that happens here, I don’t know about that,” said Turon referring to the incident, adding that not all sandals are acceptable, which means her shoes may not have been up to par.
The doorman never said the denial of entrance was because the woman wasn’t wearing heels, but it is, after all, “at the doorman’s discretion,” Turon said.
The rule about wearing heels may indeed be unspoken, but managers are generally quick to admit that heels are good for business. They attract “ballers” – club-speak for men who race inside, ready to gush, swoon and spend big bucks to impress females parading around in platforms and sling-backs.
(Photo : Flickr/Nathan Rupert)
Clubs may not require heels, but it’s ultimately up to the doorman to decide if you have on the appropriate footwear.
“Women are much classier in heels,” said Turon, who personally believes women shouldn’t be forced to adhere to the footwear rule. As a 10-yearclub industry veteran, he knows what any sensible club promoter covets the most. “They want tall people,” Turon said. “They want tall women.”
“It’s status,” said Menache, who also disagrees with having an established heel requirement.
“You want your clientele – on certain nights when they will be spending money – to look good.” If a baller comes in wearing a three-piece suit, “You can’t have a woman in there in sneakers,” Menache said.
The same applies at the Plunge Bar + Lounge.
“We just want you to be presentable because we do have a higher clientele that we cater to,” Turon said.
Nightclubs aren’t the only ones that benefit from high heels; in terms of confidence building and simple pleasures, some women revel in the sheer joy of adorning their feet and attracting attention.
“I absolutely agree with them,” said Jasmin Martinez, who can emphasize the point anytime she wants by flashing the stiletto-heeled shoe she had tattooed on the inside of her wrist. “If I spend as much time as I do with heels you can’t come into the club with combat boots,” she said during a recent Thursday happy hour at Copia NYC in Midtown.
It must be said, however, that walking in heels absolutely sucks.
“From a medical standpoint, they’re dangerous,” said Dr. Rebecca Pruthi, Rebecca Pruthi, DPM. a podiatrist , and director of Foot Care of Manhattan.
Heels can lead to a slew of medical issues, including blisters, inflammation of the foot tendons, ankle sprains and stress to the neck, shoulders and back, Pruthi said.
In extremely rare cases “you can develop spurs in your feet,” meaning extra bone growth, said Pruthi, who also runs a blog for Dr. Oz. The same happened to heel connoisseur Sarah Jessica Parker, whose foot doctor once told her, “You’ve created that bone.”
(Photo : Twitter)
Christian Louboutin shoes, with the trademark red bottom, are one of the most coveted in the world of high-end footwear.
One ’20s-themed restaurant and club named ProAbition in California actually tried enforcing a heel rule last year.
“Ladies: No flat shoes or sandals. Must have heels. Exception will be made if injured,” reads an advertisement for its June 2013 grand opening, according to The Press-Enterprise.
It wasn’t long before the restaurant was forced to apologize and hastily reversed the dress code due to public outrage.
“When it happens to you and you’re turned away, it feels sexist,” said Menache, who along with a group of friends was once turned away from a club in Miami for not wearing heels. “It feels like you’re being ostracized as a woman.”
She’s right of course. But Menache also summed up the culture of shame that comes with being that one woman who shows up to dance wearing sensible flats amid a sea of gals in stunning stilettoes.
“It’s like a scarlet letter,” Menache said. “It’s like painted on your chest.”
Sure, but, as Hawthorne himself wrote: “If truth were everywhere to be shown, a scarlet letter would blaze forth on many a bosom!” That goes double for achy feet.
Have you ever stepped out of bed with a painful soreness or ache on the bottom or back of the heel? During the walking cycle, the heels sustain tremendous amounts of force at impact. Over time, this can lead to excessive soreness and pain and may become disabling. See if your pain might be caused by one of these common sources.
Plantar Fasciitis or Heel Spurs
The plantar fascia is a thick, fibrous band of connective tissue that connects from the heel to the ball of the foot. It helps maintain the arch of the foot. This band may become strained and inflamed due to overuse or injury, which is commonly seen in athletes, those who walk in unsupportive shoes and those with recent weight gain, or with general overuse.
When the plantar fascia is strained and inflamed along the heel area, a spur may develop. This is a bony growth that may extend up to an inch and a half from the bottom of the heel. Heel spurs tend to occur in patients with prolonged bouts of plantar fasciitis. The heel spur itself may not be the original cause of pain but rather reflects irritation and inflammation of the fascia and, once present, helps perpetuate the pain.
Arch Height
Arch height can alter walking patterns. Excessive pronation may lead to strain on the bottom of the foot as it bears weight while walking. Pronation occurs when our feet “roll inward” during gait. Some amount of pronation is normal, but when there’s too much, overstretching of the ligaments and muscles attached to the heel bone occurs. This is a biomechanical problem usually found in patients with flat feet. Excessively high arches can also cause pain.
Stressful Impact
High impact on the heels or repetitive stress can result in soreness and pain. Standing in one place for too long especially over concrete or a hard surface may also cause pain because of the increased pressure on the heels. Obesity and pregnancy may contribute by increasing pressure on the heels. Additionally, the natural fat pad in our heels starts to atrophy as we age. Less padding means more pressure and potentially more pain. The pain also may be worse when wearing shoes without support or in those who suddenly increase their activity.
Achilles Tendonitis
The Achilles tendon is located in the back of the leg and attaches to the heel bone. As opposed to the above causes of pain, the heel pain of Achilles tendonitis occurs in the back of the heel instead of at the bottom. This is an overuse injury occurring commonly in athletes. It may also occur in people with tight calf muscles or those who overstress their muscles with sudden increases in activity. If left untreated, it may develop into a heel spur.
Arthritis, fractures or bursitis are additional but less common causes of heel pain. Fortunately, there are plenty of treatment options. If you suffer from chronic heel pain, talk to a podiatrist about your options for treatment and the best next step for resolving your pain.
With the long days of summer continuing, many of us are spending more time outdoors. Lounging around the pool or the beach often includes kicking off our sandals and letting our feet do the walking. While this activity may seem natural, there are some risks to ditching our shoe protection from hazards on the ground.
Plantar Fasciitis
This is one of the most common foot conditions in my office and can develop in situations where our feet are put under more stress than they’re used to. Most of us wear shoes all year and may not have the muscle strength our feet need for long periods of being barefoot. The stress of barefoot walking may cause strain on the bottom of the foot and heel and lead to tightness, pain and inflammation. Walking on uneven surfaces without adequate support can also exacerbate this condition.
Skin Burns
Unprotected feet are also more susceptible to burns on hot surfaces. Patients who suffer from diabetes are at greater risk, since they may not adequately feel temperature or pain when their feet are in trouble. When walking on hot surfaces (such as sand or pavement), footwear is always recommended.
Melanoma
As discussed in a previous blog, feet are often overlooked when it comes to protection from the sun. Application and reapplication of sunscreen, wearing protective water shoes or staying in the shade all help reduce the sun’s harmful effects and protect against this deadly disease.
Skin Wounds or Trauma
These injuries are much more common in the summer months. Walking barefoot can lead to cuts, scrapes and puncture wounds from glass and other sharp objects. Footwear is the best way to protect against these kinds of injuries.
Infections
Whirlpools, hot tubs, public showers and saunas can be havens for certain bacteria, fungi and viruses that cause a foot infection. A pair of supportive sandals or flip-flops keep your feet off of dirty surfaces that could lead to unwanted infection. Protect your feet this summer and have fun!
With the popularity of designer shoes on the market, “designer feet” are now being created to fit into our designer shoes. While dozens of cosmetic procedures are performed all over the face and body; are foot procedures part of a growing trend? A New York Times article, was published describing various surgical foot procedures women are undergoing in order to fit into their designer shoes. What are some of these procedures being performed?
One procedure mentioned is the Cinderella procedure, or hallux abducto valgus procedure. This is basically a bunion procedure. A bunion is a structural problem originating from the big toe causing a bony bump or protrusion. They can become red, swollen and painful, as well as unsightly. Once it develops not only may it be painful to walk, but it may also be painful just to put on a shoe. Simply put, the procedure involves cutting the bone and repositioning it into a more aligned position using a screw or other hardware.
Toe shortening: A very long toe may develop into what is known as a hammer toe. Hammer toes can be very painful, and can cause difficulty in walking. Women who wear constricted shoes and high heels are more prone to this deformity. This is when the toes contract and curl. When a hammer toe procedure is performed, a small amount of bone can be removed to reduce the “curling” and straighten the toe. By removing bone, the toe can shorten.
Foot tuck/Fat pad augmentation: As we age, we do unfortunately lose our natural padding or fat in our feet. For some patients, it may actually feel as if they are walking “on their bones.” Injections to temporarily ease symptoms of fat pad atrophy include injectable fillers into the bottom of the feet. Since long term studies of use of these injections in the feet are limited, there are mixed opinions about safety and efficacy. Repeated injections are required since they last for a short duration. Other injections include Botox and Myobloc for sweating.
How radical are these procedures? Typically if a bunion or hammer toe procedure is being performed, the patient was likely developing a structural and /or functional problem inducing pain. In such cases, it is may be more of a medical necessity than a cosmetic one. For many, wearing high heels is necessary, for job-related or other reasons. I can tell a woman to reduce the number of hours in her heels, or wear a lower heel, but the truth she will likely not stop wearing them. (I am also guilty as charged!) Therefore, in such cases, if pain persists, surgery may be the best option.
As long as fashion dictates what we wear on our feet, the surgical trend to fit into them may likely follow. Choosing an experienced surgeon who understands the needs of the individual patient is important. The surgeon should evaluate all aspects of the condition so that he or she may choose the best procedure in obtaining the best possible outcome.
As spring makes its long awaited arrival, we can finally start drifting away from winter’s heavy boots and start shifting to lightweight spring footwear. Recently, I was asked about what shoes women should wear during their daily commutes to work. The ballet slipper or a low heeled shoe? Here are some of the differences associated with the two choices.
Can a ballet flat cause damage? Personally, I love my ballet flats. However, ballet slippers may not be the best choice. Because ballet slippers lack in support, they can cause conditions such as shin splints, plantar fasciitis, and Achilles tendinitis. Over time, this may lead to compensation that may put stress on our ankles, knees, hips, and eventually, the back and spine.
Since the arch is usually not protected in a ballet flat, there is more stress on the foot. Pronation may be exaggerated and the gait cycle may be altered. Long term, this causes more stress on all the other body joints, and can lead to fatigue, muscle imbalances, and issues with proper alignment. Also ballet flats can be very thin, so sharp objects piercing through could be a hazard.
Why might a low heeled shoe be better? A low heeled shoe can help take the stress from the arch and reduce overall stress on the foot and the Achilles tendon. Also usually they have more rigidity and some have arch support which may further provide for better stability.
When seeking out a low heel, optimal height is less than 1.5 inches. A wider heel is better than a very narrow one. Low heel wedges are better since there is more surface area with the ground. Rubber soles obviously can give you a better grip on the ground and minimize slipping.
If a woman chooses to wear ballet flats, an added insole with arch support may help. I like custom-molded versus over-the-counter, since they are specifically tailored for each individual’s foot type and can help correct for abnormal gait patterns. Also ballet flats are better if worn for short periods of time. Strengthening and stretching is also recommended to build up the foot muscles.
I also recommend switching shoes whenever possible. Remember, however, the correct shoe is the one that fits properly. So step out this spring, get a proper foot measurement and make sure the shoe you choose is the right one.
The content provided on this blog by Dr. Pruthi is for general informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. If you have or suspect you have a medical problem, promptly contact your professional health-care provider.
Watching the Winter Olympic games at Sochi, perhaps for some of us, might have been inspiration to get out on the slopes this cold winter season. However, not all of us are trained to know the hazards associated with our favorite winter sports, especially as it relates to our feet and ankles. Here are some ways to protect yourself from injury while enjoying your favorite winter activity:
Ankle sprains/Tendonitis: Skiing, snowboarding, and skating may lead to increased risk for ankle injury. Tendons, ligaments and nerve fibers may all be damaged, which can result in swelling and bruising. Close-fitting ski and skate boots with correctly adjusted bindings (skiing) are helpful in preventing ankle injury. Also, poorly placed blades or blades that are too sharp (especially for beginner skaters) may result in further injury.
Snowboarder’s ankle: This injury, according to current research, is 15 times more likely to occur in snowboarders. This is an ankle fracture (fracture to the lateral talus bone), though it may initially be mistaken for an ankle sprain, therefore it is important to seek medical treatment early to prevent further ankle injury. Small non-displaced fractures may heal with just immobilization, but larger more complicated injuries may require surgery including screws or hardware.
Stress fractures: Stress fractures are common and occur due to chronic overload of stress on the bones of the foot. This is different from a traumatic injury or fall. It can occur when there is a sudden increase in activity, long-term heavy activity or even when doing a simple activity (non-sports related) such as shoveling the snow. If caught early on, these fractures are usually treated by immobilizing with a cast or walking boot.
Prevention Aside from proper fitting shoes and bindings, other helpful tips:
Warm up muscles: Conditioning our muscles and warming up beforehand may be beneficial. Depending on the sport you choose, there are different stretches. Light jogging, lunges, and squats are good ways to potentially reduce spasms and tears.
Wobble boards are used for helping in proprioception. This is the body’s ability to sense where our limbs and joints are in space. Practice balancing is important, as well as learning how to fall.
Treatment The mnemonic R-I-C-E: Rest, Ice, Compression, Elevation is often a good place to start. For some common sprains or other mild injuries, this treatment may be sufficient. However, if there is a significant injury, it is important to see a podiatrist or doctor quickly for diagnosis and treatment. Of course, for a fracture or other emergency, go to a hospital as soon as possible. In certain cases, surgery may be necessary.
Finding the Olympian in you may be all you need to get out there. Learning safety and injury prevention will keep you staying active longer, while allowing you to have more fun!
The content provided on this blog by Dr. Pruthi is for general informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. If you have or suspect you have a medical problem, promptly contact your professional health-care provider.
Diabetes is a continuing problem that is increasing in numbers worldwide. According to the American Diabetes Association, approximately 26 million children and adults currently have diabetes. Diabetes may affect several systems in the body, and sometimes the first signs people notice appear in the legs and feet. So if you are at risk for diabetes, you may want to remember moderation is the key before grabbing that extra sugary treat.
How does diabetes affect the feet? What to look for:
Nerves: One of the ways in which diabetes may affect the lower extremity is by affecting the nerves of the legs and feet, either by causing pain and tingling, or loss of sensation to pain, heat or cold. This is referred to as neuropathy. When visiting your podiatrist or physician for an exam, he or she can do a simple test in the office using a monofilament wire to evaluate if there is loss of sensation. Many diabetics simply lose feeling in their feet and toes. This may cause an increased risk of injury and infection, which makes even small cuts and blisters potentially dangerous. Therefore a simple measure, like checking your shoes for small pebbles or foreign objects before wearing them, can be a lifesaver.
Other nerve changes from neuropathy can cause permanent changes to the bone structure or muscles of the feet. Improper fitting shoes may lead to further destruction. Your podiatrist can recommend special therapeutic shoes in such instances.
Circulation: Healthy circulation is of extreme importance in patients with diabetes. However, it is frequently reduced as a result of this disease. Smoking, high blood pressure and cholesterol can further decrease circulation to the feet and lower limb. Your doctor can perform an exam on your feet and legs to help determine whether or not you have healthy circulation. Look for signs that include loss of hair growth, non-healing wounds and coolness in the feet and legs. Without adequate circulation, tissues usually cannot heal, and in severe cases this may lead to tissue death or limb loss.
Skin changes: These include dryness and calluses, which are commonly seen in diabetics. Nerves that control moisture and oil of the skin may no longer function properly and callus build up may result from friction. Calluses should only be treated by your physician to avoid ulcers or open sores from developing. Also, you should avoid chemical agents that may burn skin and lead to infection. After bathing, feet should be dried and then layered with a thin film of moisturizer, avoiding between the toes.
The feet can be a tell-all in the condition of diabetes. Therefore, it is important to know what to look for. If you have or suspect you have diabetes, follow up with your podiatric and medical physician.
Between the holiday parties, and the New Year’s celebrations, our feet may begin to feel like they are working overtime in our fancy party shoes. For those of us who run around all day and are stiletto-ready by the evening, that extra bit of dancing or mingling may take quite a toll on our little toes. Here are some tips and suggestions to get keep those feet swaying through the holidays and into the New Year.
Find a shoe that fits!: As obvious as this may sound, how many of us buy the wrong size shoe for the sake of fashion? Improper fitting shoes (too wide or large) can cause feet to slide, increasing friction. This can lead to corns and callouses. Shoes that are too tight may cause blisters, and in the long term contribute to bunions and hammertoes. There is nothing cute about a woman who is limping in her heels! Get a proper foot measurement and buy shoes more toward day’s end to accommodate for swelling.
Pad and cushion: As we age, we lose fat; unfortunately I’m referring to the fat in our feet. Our natural padding starts to wear away, and we have less natural protection from ground forces. If you are wearing heels, invest in a pair of silicone metatarsal pads. This can be placed in the ball of the foot and can help to simulate your natural cushioning.
Switch shoes: Another obvious tip is to switch shoes throughout the day. For daily commutes, wear sneakers or a supportive cushioned shoe. For evening wear, choose a shoe that has built in padding or add a thin insole. Keep the high heel wearing to a minimum, carry an extra pair of flats, and switch, switch!
Choose the right heel: The heels are getting higher and higher. The higher the pitch, the more strain we are putting on our feet, ankles and other joints. Many high heels have raised platforms in the front of the shoe. This platform actually decreases the pitch angle. If high heels are the only option, try choosing one that has one of these front platforms. In general, platform shoes provide more stability than a regular high heel.
Boots over stilettos: I prefer wearing a fashionable boot over a stiletto. They can be just as sexy, if not more, and fashionable. Boots provide more ankle stability than a typical stiletto and it may be easier to accommodate for an orthotic or insole. Look for those that have a rubber soled bottom. That little extra stability may be the extra boost you need to carry you from a busy day into wee hours of the night.
So what is it that causes smelly feet? Malodor of the feet begins with sweating, which provides a good environment for bacteria. This may happen to everyone from time to time, but chronic or severe odor of the feet may be associated with a medical condition known as plantar hyperhidrosis, or excessive sweating of the feet. Mildly, it may just be embarrassing, but in severe cases, excessive sweating may become such an issue that it interferes with daily living.
The cause of excessive sweating is not clearly known but is thought to be hereditary. Most people begin to perspire due to overheating from lack of “breathable” socks and shoes, or from warm weather conditions. However, the patient who suffers from hyperhidrosis may sweat persistently, even in cooler temperatures. Constant moisture can also lead to bacterial and fungal infections.
Daily foot hygiene is extremely important. For those who perspire excessively, it is even more important to make sure socks and shoes are changed regularly. As I mentioned in a previous blog, pure cotton socks actually trap moisture and should be avoided, as do nylons. Moisture wicking athletic socks work well, and may be made of a cotton-synthetic blend. Airing out feet whenever possible is also helpful. Also, avoid shoes made of synthetic non-breathable materials as well.
One home remedy is to try caffeinated (black) tea soaks. The caffeine and tannins in tea have been found to help prevent the sweat glands from over-producing. Daily soaks are recommended in order for this to be effective.
Prescriptive medications are available for treatment. A simple trick, however, is to get an over-the-counter antiperspirant spray. This can be used daily before putting on footwear. If over the counter products are not strong enough, prescriptive sprays are also available. Remember to dry feet and between toes after showering.
Another treatment is a technique called iontophoresis. This is a treatment which uses water to conduct a mild electrical current through the skin. Studies have shown this method to be effective if repeated a few times a week. People can buy iontophoresis machines for at-home use.
For very severe cases, Botox injections are becoming more widely used, though they are not yet FDA approved for plantar hyperhidrosis. In such cases, Botox is injected into the feet in the doctor’s office under local anesthesia. The toxin in Botox works by temporarily blocking the neurotransmitters that stimulate glands to produce sweat. Since the toxin is eventually degraded in the body, this treatment has to be repeated and can last about 3-4 months.
Other factors leading to excessive sweating can also be diet or stress related. If you suspect you have hyperhidrosis, it is best to seek medical advice. Your doctor will determine the underlying cause and choose a treatment best for you.
As if there aren’t already a hundred reasons to quit smoking, here’s another to add to the list: cold feet? Smoking cigarettes may be a contributing factor. According to the CDC, a current smoker is someone who has smoked at least 100 cigarettes in their life and currently smokes some days or every day. How does smoking cigarettes lead to decreased temperature in the extremities?
When you inhale a cigarette, it causes narrowing of the blood vessels. This reduces blood flow to our extremities. As a result, fingers and toes may become pale or blue in color. Reduced blood flow to the extremities means fewer oxygen and nutrients are being delivered to the cells and tissues. This eventually can lead to pain or numbness and can further spread to the arms and legs.
Peripheral arterial disease is the name given to the condition that causes arteries to narrow and harden due to plaque buildup. Smokers are at much higher risk for PAD. Studies have also shown that chemicals in cigarette smoke may trigger changes in the blood vessels putting one more at risk. Some of the changes that may occur with PAD include hardening of the artery walls, decreasing expansibility of the vessels, clot formation, and rising blood pressure. Pain in the legs and pain after walking and rest (also known as intermittent claudication) may also be associated with this condition.
Another condition related to cigarette smoking, although not as common as PAD, is known as Buerger’s disease. Unlike PAD this condition is not caused by plaque formation, but by inflammation of the vessels which may cause arteries to become blocked. Patients with this disease almost always are smokers. However, patients who have this disease may also get it from other forms of tobacco. Researchers are still trying to understand how tobacco causes this disease.
Symptoms of circulation problems in the lower extremity include:
Pale, red, or bluish toes
Severe pain in feet
Pain in legs, ankles, and feet after walking, also pain in the arch
Skin changes, including painful sores, or possible ulcers.
“Getting cold feet” from smoking could be the hallmark of a worsening condition. The obvious answer to reducing risk is to quit the cigarettes. If you feel that you are already experiencing the cooling of your feet and toes, don’t ignore it. Get it checked out by your podiatric or medical physician, it may save you from developing a more serious condition in the future.
Frequently, conditions of the feet may go unnoticed as it may be one of the more neglected body parts. Additionally, patients may delay a trip to the doctor if they don’t feel “prepared” for their first podiatry visit. Here is short list of some dos and don’ts before seeing your friendly foot doctor.
Don’t: Don’t feel the need to shave your legs. My female patients often apologize for not shaving before their visits. The truth is that hair on the legs and toes is often a good indication of healthy blood flow. Absence of hair could be related to certain conditions associated with diabetes or smoking. Having hair is healthy – it’s a good thing!
Don’t: Don’t feel the need to get a pedicure. This is a big one. Often, patients think that they need to get a pedicure to be “presentable” for their visit. Most pedicure facilities are not medically sterile. Viral, bacterial and fungal infections are not uncommon after getting repeated pedicures. Patients think they are practicing good hygiene, when in fact it may be causing their conditions to worsen.
Don’t: Similarly, don’t polish nails before your visit. Conditions such as fungal nails require a clinical examination and possibly a culture. Therefore, do not trim the nails, since your podiatrist may have to send a sample to the lab. Clear nails (without polish) will allow your podiatrist to assess your nails’ health.
Do: Take notes on your condition. If, for example, you have foot pain, keep a log of when the condition started, what aggravates it, and what alleviates the pain. If you are coming in for changes in skin, take note of the size, shape or change in color of any concerning marks or rashes. Also any x-rays, MRIs or recent test results related to your condition should be brought with you.
Do: Keep a list of all your medications, new and old, as well as allergies. Patients sometimes think certain medications are unrelated to their foot diagnosis. Remember, all medications are important in understanding your overall health.
Do: Do bring your shoes for assessment. If you wear orthotics or any assisted walking device, bring them with you for examination as well. Your podiatrist may want to look at the wear patterns of your shoe as well as assess your walking patterns (gait).
Do: Take a proactive approach to your health. As mentioned, the feet are probably the most overlooked body part. If you suspect an infection, especially if you are diabetic, do not wait for the condition to worsen. Even the slightest callus or corn may lead to something more serious, so don’t think that because it appears “small”, it isn’t worth being examined.
Do: Finally, do ask questions! There is so much information on the internet, but there is plenty of false information out there. Talk to your podiatrist about your condition and treatment plan. Make sure you understand what your doctor has recommended, and don’t be afraid to ask questions. Remember an informed patient is always a “step” ahead!
At some point, most of us have experienced some level of foot pain. As a result, we may have found ourselves in the pharmacy aisle wandering our way to the world of foot products. There are hundreds of products on the market claiming to alleviate foot pain. How do we know which works best? What is the difference between over-the-counter shoe inserts and custom-molded orthotics?
Shoe inserts are any non-prescription foot supports that are placed into the shoe. Let’s take a look at some of these products available on the market:
Over-the-counter shoe insoles: You will notice over-the-counter insoles made of various materials, including gels, foams and plastics. Most over-the-counter insoles provide only padding and cushioning. They may provide temporary relief, but they usually do not correct the biomechanics of the foot. Also, they can wear out quickly and are best used for short-term use.
Arch supports: As the name implies, this product may provide some support to the arches of the feet. However, arch supports are usually designed for the average foot type. If you have a high arch and tend to supinate (roll outward) while walking or if you are very flat-footed and pronate (roll inward), they may not provide too much benefit. The level of reinforcement an arch support provides depends on how it fits each individual.
Heel cups and foot cushions: Heel pads and cups provide extra cushioning for the heel. They can be especially helpful because the natural fat in our heels may thin as we age. Foot cushions can be used to provide an extra barrier against friction.
This brings us to the custom-molded orthotic. What is a custom-molded orthotic and how does it help ease foot pain?
Custom-molded foot orthotic: This is an individually tailored device placed into the shoe to support, align and correct the function of the foot. Our feet contain 26 bones, 33 joints and more than 100 muscles, tendons and ligaments — very complex! When shoes do not offer support, tendons and ligaments may strain and we may begin to compensate by altering our gait. Biomechanically, we may no longer walk in a neutral position. This may not only lead to foot problems but may also affect our other joints, including ankles, knees, hips and back. Orthotics are designed specifically for each individual to correct and realign the feet and to provide long-term relief. They are usually made with durable materials that may last for years.
When to choose over-the-counter products versus custom orthotics: If you are just looking for generalized comfort from mild pain or arch discomfort, over-the-counter inserts might just do the trick. Conditions such as plantar fasciitis, bursitis, tendinitis, structural issues and foot ulcers are likely to do better with a custom-molded orthotic and should be evaluated by your podiatrist. Conditions that may affect feet such as diabetes and circulation issues should also be evaluated by a professional. Although over-the-counter products may provide temporary relief, clinical research has shown that prescribed orthotics have been successful in decreasing foot pain and improving overall foot function.
Yes, that is Dr. Oz, helping women choose more comfortable shoes.
Dr. Oz Show
You know it’s premiere week when a world-renowned heart surgeon dresses up as a woman. As part of his September 10 talk show, Dr. Mehmet Oz got in touch with his feminine side and slipped into a sexy woman’s suit to talk with shoe shoppers about the merits of choosing comfortable shoes rather than stylish ones.
Is there something behind that soul-ful gender swap? Well, sort of. Dr. Oz went through this exercise to literally walk his talk in terms of a message about the dangers of high heels for your feet. Damage from high heels ranges from spine concerns to knee aches to bone bruises in your feet (ouch). Bottom line: Go for low (not high) heels for your health.
Dr. Oz expert Rebecca Pruthi, DPM urges women to educate themselves on the different types of foot products to alleviate that pain:
Over-the-counter shoe insoles: Although they can ease pain, they don’t change the biomechanics of your foot and tend to wear out quickly.
Arch supports: These shoes can support your arches if you have average feet. But if you have high arches or are flat feet, it may not be helpful.
Heel cups and foot cushions: Want extra cushioning? These options can help.
Custom-molded foot orthotic: Rebecca feels these help dramatically. “This is an individually tailored device placed into the shoe to support, align and correct the function of the foot. Our feet contain 26 bones, 33 joints and more than 100 muscles, tendons and ligaments — very complex! When shoes do not offer support, tendons and ligaments may strain and we may begin to compensate by altering our gait. Biomechanically, we may no longer walk in a neutral position. This may not only lead to foot problems but may also affect our other joints, including ankles, knees, hips and back. Orthotics are designed specifically for each individual to correct and realign the feet and to provide long-term relief. They are usually made with durable materials that may last for years,” she explained.
We are constantly applying stress to our feet by cramming them in tight shoes, walking on hard pavements and stressing them in our stilettos. Foot conditions such as plantar fasciitis, arch pain, and Achilles tendonitis are some of the common issues that may result. Simple stretching is key to relieving tightness and in helping to stimulate blood flow in the lower extremities. Whether you are at work or at home, you can incorporate simple stretches and strengthening exercises to keep your feet and legs limber. Kick off those shoes for a few minutes and try some daily desk routines.
Bottle or ball roll: A cold or frozen water bottle or a tennis or golf ball underneath your desk is all you need. Take off your shoes and roll your foot and arch back and forth over the cold bottle or ball. Roll for at least ten minutes per foot.
Leg raises: You can be seated in your office chair or sofa at home. Simply keep your back straight and sit at 90 degrees. Raise your leg and feet parallel to the floor. Flex and point toes, repeat.
Pencil lifts: Drop a pile of unsharpened pencils or a group of small objects on the floor. Take your shoes off, and pick up each object and drop to another pile. This will help strengthen and improve flexibility.
Ankle stretches: Imagine you are writing each letter of the alphabet from A-Z using your foot. By the time you hit letter Z, you have stretched out most of your ligaments and tendons. Repeat with lower case letters.
Step stretch: If you have access to a raised platform or step, with shoes removed, balance the ball of your foot onto the step and slightly lower your heels below the level of the step. This will stretch the posterior leg muscle group as well as the bottom of the feet and arches. Make sure you have a railing or something to keep you steady and be careful you don’t lose your balance.
In addition to stretching and strengthening, don’t forget to walk! It’s simple but sometimes we get so bogged down in our work or stuck on a computer, we remain sedentary. Switch from office shoes and throw on a pair of sneakers during lunch and take a brisk walk. Take stairs instead of the elevator. It may take a few more minutes a day, but remember walking increases circulation. Incorporating simple daily exercises will not only help with foot pain, but may also help in preventing future injury.
The content provided on this blog by Dr. Pruthi is for general informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. If you have or suspect you have a medical problem, promptly contact your professional health-care provider.
With extended outdoor activity in the sun and heat, our little feet may need a little extra TLC. Showing off those summer toes in open footwear comes with the territory. Here are a few tips to keep those feet from being beat and looking healthy and beautiful.
1. Moisturize cracked heels
Backless and unsupportive shoes can cause more stress on the fat pad of the heel. This, along with not wearing socks, can cause heels to crack. Superficial cracks should be moisturized daily with moisturizing treatment and an exfoliant. You can use a pumice stone in the shower 2 or 3 times a week to help keep those heels smooth. Deeper skin fissures or other skin conditions such as fungal infections, diabetes-related conditions and psoriasis should be treated by your podiatric physician.
2. Sweaty feet
It can be embarrassing, but it is a very common complaint. With the heat, odor and sweaty feet are hard to avoid. Avoid nylons and pantyhose. Try wearing socks that are of cotton and synthetic blend. The synthetic will act as a “wick” to keep away moisture from the skin. If your feet continue to sweat, try a drying foot powder or antiperspirant spray. Change your socks daily and keep dry in between toes.
3. Blister protection
Strappy sandals can cause quite a pinch. Avoid painful irritation that may lead to blister formation. Try keeping an extra product on hand (or foot!): a simple band-aid, moleskin or blister stick can do wonders. Also gel pads and anti-chafing lubricants may be applied. Larger blisters should be attended by your podiatrist. Remember to switch shoes whenever friction occurs.
4. Try a safe pedicure
Pedicure facilities are known to harbor a plethora of microorganisms and should never use a razor or blade on your feet. Try a safe home pedicure using a formaldehyde-free nail polish. Intermittently remove polish and give the nails a breather from harsh staining pigments found in some of the polishes.
5. Foot bath
After being on our feet all day, our feet may swell. Also, our feet may need relief from shoes that may become tight or restricted with ill-fitting straps. Try cool to lukewarm water, add peppermint oil, and Epsom salt. Soak your feet and let them relax. The cooler bath will reduce the end of the day swelling and refresh “tired” feet.
Also at day’s end, remember to air out and elevate your legs and feet. Your feet will thank you!
In a previous blog we talked about risks and prevention of melanoma of the foot. Since melanoma of the foot may frequently go undetected, knowing what to look for when performing a self examination is vital.
Detection: Check out those feet! Take an extra 60 seconds and inspect your body and your feet. Remember, melanoma can occur anywhere on the body, even areas not often exposed to the sun. Make sure to look in between toes, the soles of your feet and around and underneath the nails.
Melanoma frequently appears as a dark and discolored area: usually black, blue or brown. However, red, pink, or any pigmented skin lesion with recent changes in appearance should be suspect. A mole or freckle that has recently changed should also be examined. The guidelines below can be used in the foot or elsewhere on the body.
Follow the ABCDE’s of melanoma, a simple guideline for self examination :
A- Asymmetry – irregular shape or unevenness of the each side of the lesion suggest asymmetry
B- Border-Irregular borders, blurred, notched or jagged, difficult to define
C- Color-multi-colored lesions or change in colors (or uneven distribution of color)
D- Diameter – change in size or greater that 6mm in diameter
E- Evolution – know the evolution of your moles, note any changes in size or shape
New symptoms such as elevation, itchiness, and bleeding should all be evaluated. Plus, make sure you remove nail polish in between pedicures and take a look at the toenails. Look for dark streaking or hyperpigmentation. The late reggae musician, Bob Marley, died of complications from melanoma that originated under his toenail and metastasized to other parts of his body. Although rare, it does occur!
If you suspect any of the above changes, it is important you seek medical attention. There are several types of melanoma that may present in the foot. Aside from prevention, in all cases, early detection and screening are critical for successful treatment and improved prognosis. Remember to protect, inspect and don’t forget those feet!
The content provided on this blog by Dr. Pruthi is for general informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. If you have or suspect you have a medical problem, promptly contact your professional health-care provider.
The summer heat is in full swing. As we are spending more time on the beach and by the pool, most of us are taking a proactive approach in protecting ourselves against diseases such as melanoma. We all know that wearing hats, sunglasses and sunscreen are helpful in minimizing UV exposure from the sun’s harmful rays.
However, despite our knowledge, one area of the body is still sometimes overlooked. You guessed it, our lower extremities and feet! Similarly, when melanoma occurs in these areas, it often goes undetected.
Malignant melanoma, while it is not the most common of skin cancers, it can be the most deadly. Melanoma of the foot is of even greater concern because it may go undetected in its early stages. Frequently, by time it is diagnosed, it may have already advanced and metastasized to other parts of the body. Mortality rate of melanoma of the foot is much higher than elsewhere in the body. According to the American College of Foot and Ankle Surgeons (ACFAS), half of all people diagnosed with melanoma of the foot will die within five years because of late diagnosis. If melanoma is detected early enough, it is almost always curable. Therefore understanding how to prevent and detect are invaluable.
More than half, 65% of melanoma is caused by harmful UV rays. Therefore we need to Protect, protect, protect!
Here are some basic beach reminders:
Use adequate broad spectrum sunscreen (remember to check the new sunscreen guidelines) that protects from UVA and UVB radiation at least 20 minutes before going outside. Reapply every few hours even if it states that it is waterproof. Do not neglect the tops of the feet, toes, around toenails, and non-sun exposed areas like the soles.
Try wearing water shoes over flip-flops. They are comfortable and provide more protection. Rubber clogs are another alternative.
Stay in the shade. During peak sun hours, keep yourself and those feet under the umbrella! Use extra caution near the water. Reflective properties from water and sand can increase sun damage.
Avoid tanning beds. There is an increase chance of developing melanoma from artificial UV radiation as well as natural exposure. Keep in mind that getting a “base tan” before going on vacation will not protect you; It will increase your chances of developing melanoma.
Using the above measures will help decrease some risk. Although everyone is susceptible, risks are higher in individuals with lighter skin, those having a history or family history of melanoma, and those with links to certain genetic factors. Darker skinned individuals are more at risk in the nails and soles of the feet. In the next blog, we will discuss early detection and warning signs for skin changes. Take precaution and stay tuned for part two!
The content provided on this blog by Dr. Pruthi is for general informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. If you have or suspect you have a medical problem, promptly contact your professional health-care provider.
Think bunions are just for “little old ladies”? Think again. The truth: Bunions are extremely common in young, active people, both men and women alike. In my practice, it is one of the most common structural foot disorders treated. Most of these patients are working people who are generally “on the go.” Unfortunately, this condition doesn’t just go away and early treatment works best.
What exactly is a bunion? A bunion is a structural problem originating from the big toe causing a bony bump or protrusion. The first long bone in the foot is known as the first metatarsal. This metatarsal starts to deviate in one direction (medially), while the big toe begins to deviate in the opposite direction (laterally). This deviation creates the “bump” which frequently becomes red and swollen over time. This bump is commonly known as the bunion, or medically as Hallux Abducto Valgus. Bunions may become painful and may cause difficulty in wearing certain shoes, or in some cases, can even prevent normal walking.
What causes a bunion? There may be different risk factors for developing a bunion. There could be a genetic predisposition, structural foot type, nerve conditions and congenital disorders all which may lead to further development. Another risk factor could be the shoes we wear. The prevalence in women is much higher than men likely due to wearing high heels, restrictive shoes or shoes without proper support. For many women, there is just no getting out of the stilettos, until … it’s unfortunately, too late!
When and why should I get treated? Aside from them being brazen and unsightly, they can also cause functional problems. Because it’s a structural bone alignment issue, they simply just don’t go away. If it’s already become painful, a visit to your podiatrist is strongly recommended. Prolonging treatment may cause the condition to not only worsen, but may alter gait patterns affecting the way you walk, or possibly causing pain in other joints of the body.
Treatment for bunions has come a long way. It may begin conservatively but could lead to surgery depending on certain factors. There are a lot of myths relating to bunion surgery. Therefore, I strongly encourage you to speak with your podiatrist. If you suspect you have risk factors, or are already experiencing some discomfort or pain, be proactive! It’s better to seek treatment early for the best prognosis and long-term results.
Humans have been running barefoot since the beginning of mankind. After all, we weren’t born wearing shoes. So what’s the current fascination with running barefoot?
There is a debate on whether or not barefoot running, or natural running is good for our soles and feet. Barefoot running or running with minimalist “barefoot” shoes have become extremely popular over the last few years. You may see runners wearing thin shoes or “glove-like” shoes which mimic being barefoot. After decades of running with high tech shoes, elite runners started to question the effectiveness of wearing shoes at all, except for a thin layer of protection. This brought about the exploding barefoot or minimalist phenomenon. But which is better: Shoes or no shoes?
There have been multiple studies fueling the debate. Early chatter was prompted by a Harvard University study in 2010 that focused on foot strike patterns and the impact of running barefoot or with shoes. The study showed that people were able to land safely when in barefoot footwear by landing first with the ball of the foot before striking their heels. Runners in regular cushioned sneakers more likely landed on their heels first when their foot hit the ground.
A newer study published earlier this year showed results involving two groups of runners: those that ran with minimalist (barefoot) shoes and those that ran with regular shoes. After a 10 week follow up, it tested the two groups: The results of the study showed more than half of those runners wearing minimalist (barefoot) shoes showed an increased likelihood of bone injuries. They were more prone to swelling around the bone, and some resulted in stress fractures. However, more research is needed to provide conclusive evidence.
What does all this mean? With various studies, there is not enough conclusive evidence to determine if natural running is better or harmful. More importantly, if you want to start running naturally, it’s best to start gradually to reduce risk of injury. Muscles in your feet, calves and legs may have to overwork. Stress on the plantar fascia and on the Achilles tendon is increased, so it’s key to ease into this activity. You should know your limits. Complete barefoot (without any minimalist shoe) may result in further injury, like being prone to sharp objects or burning when running on a hot surface
The barefoot running debate has prompted the need for further research in understanding what is truly healthier for our feet. If you are prone to injury, or are a beginner, consult with your doctor. If you feel discomfort, ease into this activity, and do not over do it. Remember, although this method may have worked well with our ancestors, our modern day feet may need a gradual transition.
Do you remember those funny ads depicting a fungus trying to break through a toenail and create infection? Are fungal toenails that common? Fungal nails or “onychomycosis” affects approximately 36 million Americans yearly. That means every time you walk barefoot around a pool or in a gym locker room, or perhaps getting a pedicure, there is a chance that someone near you could be infected, and that little fungal spore could be searching for a new place to call home, your toenails!
What are the best treatment options out there for this condition? Here are some of the methods currently being used to tackle this condition.
Topical Medications
Natural products with tea tree oil have been found to contain some antifungal properties and have been used with treatment of superficial nail infections. Many prescriptive topical and nail lacquers may be used for very mild to moderate cases. Topical medications, since their efficacy rates are relatively low, are better when used as a part of combination therapy with oral medications. Researchers are currently working on new drugs with better efficacy rates.
Oral Medications
This is the most effective treatment for infection. Medication is usually taken orally for three months under direct supervision by your physician. Current literature show recent developments of newer medications have even higher improved cure rates of onychomycosis over the past few years. However, there have been some side effects associated with oral medications, namely with effects on the liver. A thorough patient history along with blood tests are usually performed prior and during treatment.
Lasers
This is the latest in treatment options. The FDA has approved non-ablative lasers for temporary clearing of mild to moderate fungal nail infections. These lasers deactivate the fungus from further growth without destroying skin. Many patients prefer this treatment since side effects are less than those associated with oral medications. Treatment through lasers is promising but more studies and research are needed in understanding how well lasers work for long-term success.
Removal of the Nail
This can be performed by your physician in the office. A nail removal or “avulsion” usually will heal quickly in a healthy patient. Topical antifungals needs to be applied during the entire time a new nail is regenerating (this can be up to nine months). This is ideal for healthy patients that have an early infection in just one nail.
Preventative treatment works best: If you already suspect infection, get treatment early. These infections can be stubborn and may become more resistant. There is no single treatment that is 100% effective. Wearing appropriate shoe protection (e.g. flip flops in the gym locker room) and avoiding direct contact to moist environments is key. Remember to regularly change socks, shoes and keep those feet dry! Fungi, bacteria and viruses are found throughout the environment. Be aware of your surroundings; precaution and protection are your best attack keeping those nasty fungal infections away!
Summer is just around the corner. For most of us, that means tossing our heavy boots aside for our fun summer sandals and bright slip-ons. However, many people are unaware of the perils associated with our favorite summer footwear. As a woman, I know it’s hard to resist a “cute” shoe. But, as a podiatrist, I frequently see that these shoes can be extremely unsupportive, eventually leading to problems such as plantar fasciitis, heel spurs, or other painful conditions.
Plantar fasciitis may result from overuse of the connective tissue band known as the plantar fascia on the bottom of the foot. When this band is unsupported or overused, it can become inflamed and painful. Therefore understanding and choosing the right shoe can be important in preventative care.
Flip Flop: Of course, this is our favorite and most common shoe worn around the pool and on the beach. Unfortunately, the average flip flop offers very little to no support. They are usually extremely flat, with nothing securing the front or the back of the foot. This puts a lot of stress on the musculature of the foot and heel. Some of the newer versions of the classic flip flop offer some support which may provide some benefit for short-term wear on the beach and poolside.
Ballet Flats: There may be more support on the front and back end of the shoe, but as the name implies, they are flat with minimal cushioning or protection between your foot and the ground. There is a force known as a “ground reaction force” that occurs when your foot hits the ground during walking or (gait cycle). Without proper support or cushioning, this force may cause tension on the bottom of the foot, ultimately leading to inflammation and tightness of the fascia – a real pain! Minimize walking in ballet slippers to short distances, and look for those that offer rubber soles and cushioning, if possible.
Summer Sandal: These can vary a great deal. They can range from extremely flat to high heels, which may lead to other foot conditions. Sandal straps can also cause pain especially if they are impinging on certain areas of the foot. The best sandal is made from soft material, has a soft sole, deep heel cup, arch support, and in some cases, a small wedge heel.
Sneakers: Surprise, surprise! Sneakers offer the best support from this list, but not all sneakers are the same. Patients already diagnosed with plantar fasciitis, may also benefit from a custom molded orthotic to be placed into the shoe or sneaker, not visible for anyone to see. This provides support of the arch and allows the patient to walk in a more neutral position rather than rolling on the inside or outside of the foot.
Conditions such as plantar fasciitis, heel spurs, and bunions can all be exacerbated with certain summer footwear. With all the trendy and sexy shoes on the market, it is easy to be tempted to purchase those that may cause harm. On the flip side, with a bit of awareness, you can make foot-savvy decisions, keeping your feet happy and healthy for the long term.
The content provided on this blog by Dr. Pruthi is for general informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.
