A new study conducted by researchers at Saarland University Medical Center in Germany focused on patients suffering from chronic bone heel spurs. The study showed that radiation therapy provided relief.
With millions of American suffering from heel pain, commonly often diagnosed as plantar fasciitis, this could be a new form of treatment. Plantar fasciitis is a common problem for athletes – with some dealing with it for years and others never beating it.
Plantar fasciitis (PF) is best described as an inflammation of the thick tissue on the bottom of the foot running from the heel to the toes. Those with a severe case of PF often experience extreme pain and it often compromises their ability to walk and stand. It is often most problematic in the morning.
The Saarland study looked at 62 patients followed for one year. Twenty-nine received a standard dose ot radiation therapy, and 33 received a low dose. The radiation therapy used was external bean radiation that delivers radiation only at a specific part of the body.
The patients receiving the standard radiation dose found pain relief to be “highly significantly superior” and of the 29 patients receiving this dose, 80% had complete pain relief. The pain relief continued or improved for as long as 48 weeks after their treatment.
Dr. Marcus Niewald, a radiation oncologist at Saarland said that, “Radiation therapy has been used for its anti-inflammatory effect for more than 60 years.” Researchers are, “… extremely encouraged by the results of the study because evidence of improved quality of life for patients in clearly evident with the standard radiation dose.”
The study also found no acute side effect or long-term toxicity from the radiation therapy.
The study was published in the International Journal of Radiation Oncology.
If you suffer from chronic plantar fasciitis, ask your podiatrist or doctor to research this study and see if it could be beneficial for you.
If you have persistent foot problems or recurring pain that you cannot resolve, seek medical treatment from a medical specialist. There are pedorthists, physical therapists, athletic trainers, massage therapists, and sports chiropractors that can provide assistance for strengthening, alignment, rehabilitation, and footwear design and fit.
Listen to your whole body; especially your feet. Be attentive to when the pain begins and what makes it hurt more or less. Then be prepared to tell the specialist about the problem, its history, what you have done to correct it, and whether it worked or got worse. Conditions that could require the services of a specialist include ingrown toenails, burning feet, cold feet, warts, arch pain, forefoot pain, heel pain, and severe cases of Athlete’s foot.
- Podiatrists are Doctors of Podiatric Medicine (D.P.M.), specialists who work on the feet up to and including the ankles. The American Podiatric Medical Association and American Association of Podiatric Sports Medicine.
- Orthopedists are orthopedic surgeons, experts of the joints, muscles and bones. The American Academy of Orthopaedic Surgeons and American Orthopaedic Foot and Ankle Society.
- Pedorthists work with the design, manufacture, fit, and modification of shoes, boots, orthotics, and other footwear. The American Orthotics and Prosthetics Association and Pedorthic Footwear Association.
- Physical therapists are licensed to help with restoring function after illness and/or injury. Most work in close relationship to medical specialists. The American Physical Therapy Association.
- Athletic trainers are licensed to work specifically on sports-related injuries. The National Athletic Trainer’s Association.
- Massage therapists work with athletes in reducing pain and tightness in muscles, tendons, and ligaments-the body’s soft tissues. The American Massage Therapy Association.
- Chiropractors are doctors of chiropractic medicine who specialize in the alignment of the body’s musculoskeletal system. The American Chiropractors Association and International Chiropractic Association.
It is easy to email others and seek answers, especially online forums, but there comes a time when professional help is needed. The above are the best at whet they do. Check out their web sites for more information.
Last week we were in Palm Desert and spent a day as spectators at the PGA Bob Hope Golf Classic. How does this relate to foot care? Read on.
Between one of the holes was a patch of sand where we had to walk to get to another green. As we walked across the sand, I must have picked up a few grains of sand. I didn’t notice it at first. We stood around, watching several rounds of golfers come through. Occasionally we moved back and forth between the 16th green to the tee box on the 17th hole – maybe 50 yards.
Then I felt an irritant in my right shoe. It was a small sharp pain under my heel. Not a big thing, but an irritant nonetheless. I ignored it but it made its presence know every time I walked. Finally I removed the shoe and found one small grain of sand. One grain!
Time after time, we find junk in our shoes and too often we ignore it. Over time, this junk, sand, dirt, a small stone, leaf, or piece of a branch, can cause trouble – for which you’ll pay. A hot spot, a blister, a tear in the sock, or a tear in the insole covering. Or, even worse, we alter our gait – and one thing leads to another – and our knee, hip, or back starts to hurt.
Maybe this seems like a no-brainer, but I have seen athletes suffer because of ignoring this advice. If you feel something in your shoe – stop and remove it. Your feet will be happier.
We often take our feet for granted. But as we age, painful feet can become common place. The following was sent as a press release. It is important enough to feature it in today’s blog posting. While you may not be a senior, I’ll bet you know a few. Please help them understand good foot care.
(Chicago , February 2, 2007) Senior citizens can reduce their risk for dangerous and deadly falls by having painful foot and ankle problems treated. That’s the message from experts with the American College of Foot and Ankle Surgeons (ACFAS).
Falls have become the leading cause of injury deaths among Americans age 65 and older, according to the Centers for Disease Control and Prevention. According to the ACFAS Web site, FootPhysicians.com, painful foot conditions such as arthritis, corns, bunions, hammertoes, and complications of diabetes can cause problems with walking and balance.
Lower body weakness and gait and balance problems are frequently-cited risk factors for falls among seniors. Exercises to enhance lower body strength can reduce this risk. But for seniors with painful foot and ankle conditions, exercise can be difficult.
“Reducing or eliminating foot pain in seniors improves their balance, coordination and stability when walking or standing,” says Molly S. Judge, DPM, FACFAS, a foot and ankle surgeon in northwest Ohio. “Just one fall can permanently rob a senior of their independence and dramatically reduce their quality of life.”
Judge says foot and ankle surgeons can recommend simple, effective pain-relief measures such as stretching exercises or padding for painful corns and hammertoes. But when surgery is the most appropriate treatment for a senior’s painful feet, simple surgical techniques often allow treatment to be performed on an outpatient basis.
“It’s just not true that foot pain is a normal consequence of growing older,” she says. “No one should let pain hold them back from leading a full and active lifestyle.”
For more information on pediatric foot and ankle conditions, or to find a foot and ankle surgeon, visit the ACFAS patient information Web site.
Many of us wear orthotics to help maintain the foot in a functionally correct position. They can help cure lower extremity ailments and are often prescribed for the treatment of plantar fasciitis, tendinitis, knee pain, shin splints, lower-back pain, Morton’s neuromas, and other conditions. Orthotics can correct gait irregularities and provide support for flat feet and pronation problems. They can also relieve pressure by providing support behind a problem area such as a callous, neuroma, or metatarsal injury. Mal-alignment problems such as leg-length inequality can also be helped.
Typically prescribed by a podiatrist or orthopedist, orthotics are medical devices made from cast impressions of your feet. A properly fit orthotic will control arch and pressure-point problems.
Signs that you may need an orthotic can include repeated overuse strains or injuries, excessive fatigue in your legs and feet, genetic structural problems (over- or under-pronation, bunions, differences in leg length, arch problems, etc.), or your shoes show different wear patterns or wear out quicker than usual. The need for orthotics may begin with pain in your feet, repeated blistering in the same place on your feet from pressure, or even problems in your knees or hips as your gait is changed due to biomechanical stresses.
An added benefit of orthotics is the way they support the body’s natural movements. This reduces the demands placed on the muscles when the body is out of alignment. The result is less work by the muscles, which translates to less fatigue, fewer injuries, and higher performance.
Next time we will look at the difference in custom made orthotics and those available over the counter.
On Sunday I helped at the finish line of the Ohlone Wilderness 50K Trail Run. This great event goes from Fremont to Livermore in Central California over lots of hills. The course is on trails and fire roads. This is one tough course—great for seeing what kind of shape you are in—as well as what shape your feet are in.
Of the 112 finishers, I only saw one or two who were favoring their feet when they crossed the finish line. I knew from the race information that they were running their first ultra. They were in new territory.
Let’s talk a moment about conditioning your feet. Most runners are aware of the common problems when running. Chafing between their thighs, at the armpits, and where their nipples rub on their tops. But, what about their feet?
Athletes can get their feet in shape by working up to longer distances over time. Don’t assume you can go out and walk or run a distance farther that you have trained to do. Your feet will rebel. By building up to longer and longer distances, your feet get in shape—just as your body does.
Your feet must be conditioned to endure the rigors and stresses of whatever the race throws at you. Rough trails and fire roads? Cross country bushwhacking over small rocks and uneven footing? Constantly changing terrain with the streams, rivers, and whitewater with the associated mud? Sand, grit and small stones that work their way into your shoes and socks? There are several answers.
Train in race conditions, in the shoes and socks you will wear on race day. You can get by with minimal foot conditioning for a short event but a multi-day race requires a plan of action. Your feet must be conditioned for mile after mile after mile of running and walking. Put in enough hours to help your feet adapt to the stresses to which they will be subjected. Toughen your feet with barefoot walking. If you constantly train by doing six-hour hikes, you will be really good at doing a six-hour hike. Learn from successful ultrarunners who know the importance of at least one long training session per week. Add a long session to your week’s routine. As you get closer to your event, make the session longer and more closely resemble an actual race. This will help condition the feet for long hours of a race.
Do short hikes with a pack on your back before taking off to tackle a multi-day race. Work up to distances that you will tackle in your event. Training with a ten-pound pack is different than with the 20-pound pack you will use on race day. The weight of your pack and the change it means to your gait will have a stressing affect on your feet. Just as important is learning to do back-to-back training days. Teaching your feet how to adapt to long sessions, on consecutive days, will further your odds of success.
Will your shoes still fit after three days or will you need a larger size? Do you have good socks and supportive insoles? Learn how to cut slits in the sides of your shoes with a knife to relieve pressure on a bad toe or bunion. Where possible, rest your feet by raising them above the level of your heart. Anytime you stop to eat or take a break, take off your shoes and socks to air your feet. The cold water in streams and rivers can work wonders to sooth tired and swollen feet.
Work Out the Kinks
Work out the kinks; find the best shoes and socks for what you will be doing. Learn how to trim your toenails and reduce calluses. Discover the proper insoles that provide support to relieve any pre-existing foot problems.
Strengthen your toes and ankles. Maneuvering over bad trails and roads, and going cross-country, with a loaded pack, is easier when your feet are used to such stresses. A turned ankle will ruin your chances of success.
Strong feet and ankles will make off road travel easier. After days of travel, even though your feet are tired and sore, they will still put out for yet another day. Because of conditioning, recover will be faster.
For two days last week I talked to runners at the LA Marathon. The setting was the marathon’s Expo at the huge LA Convention Center. I gave two seminars on foot care tips for marthoners, walked the aisles, and talked to people at the Zombie Runner’s booth. The hall was packed and at times it was hard to tell who was going to walk or run the marathon and who was just there to pick up free goodies.
At any rate, I talked to many people who seemed to be well prepared. They knew about blisters and what kind of socks to wear. They either had experience or were smart enough to want to learn more. Others seemed unconcerned or unprepared.
The main question was, “Are your feet prepared?” I handed out a half page of tips. Here are the tips. They easily can be applied to anyone running or walking a marathon, or doing any similar event. Are they magic? No. But many people, even athletes, seem to forget the common sense tips that can make their marathon a better experience.
Before the Race
• Toenails too long catches on socks – trim them short.
• Then file toenails smooth.
• Use a nail file to smooth calluses.
• Clean out lint and junk from inside shoes.
• Check your shoelaces and replace if frayed.
• Apply a layer of your favorite lubricant or powder.
• Smooth your socks around your feet.
• Avoid tying laces too tight.
During the Race
• If you feel a hot spot: apply a pad, a bit of tape, a dab of lubricant, or an energy wrapper between your sock and shoe.
• Loosen shoelaces if you have pain on the top of your foot.
After the Race
• Drain blisters only if they are in a pressure area.
• If you have blisters, soak your feet in Epson salts and warm water three times a day.
• Trim edges of loose skin around blisters.
• If feet are swollen, elevate and ice.
Note: Issues beyond my control have pre-empted my ability to publish for the past month. Bear with me and I’ll try to get back on track.
Morton’s neuroma is pain associated with a nerve inflammation usually affecting the third and fourth toes. It will sometimes be felt between the second and third toes. The nerves running between the metatarsal heads and the toes have become inflamed and irritated as they are squeezed at the base of the toes. The painful, swollen nerve is called a neuroma. There is typically tingling, burning, or a pins-and-needles sensation that radiates to the end of the toes. Some people describe the sensation as walking on a pebble. If you press with your thumb at the base of your fourth toe and feel pain, you could have a neuroma. If untreated, scar tissue forms around the nerve and it becomes more painful.
This condition can be caused by a shoe’s tight toe box that compresses the forefoot or by the nerves being pressured by the metatarsal heads and the bases of the toes. Sports that place a significant amount of pressure on the forefoot area can cause inflammation of the nerves. As we walk or run, we come up onto our toes and this motion can cause the ligaments supporting the metatarsal bones to compress the nerve between the toes. Limiting your activities for a few days may be enough to allow the inflammation to subside.
A runner friend’s bout with Morton’s neuroma over several years led him to study treatment options. He learned of the following treatments, from the least invasive to the most. When he wrote the list, he was down to the last step before surgery.
1. Try shoes with a roomy toe box in both height and width, and make sure your socks aren’t too tight.
2. Try off-the-shelf orthotics.
3. Try a metatarsal pad like those made by Hapad.com.
4. Try deep tissue massage.
5. Try a cortisone injection—but only one due to its effect on tendons and tissues.
6. Try custom orthotics.
7. The last resort is surgery. Find a surgeon who goes in from the top of the foot to lessen recovery time and allow you to be more active during recovery.
Morton’s Neuroma should not limit your activities. There are solutions. Try one if it doesn’t work, move down the decision list. When you have tried number four, it’s time to find a podiatrist—preferably one who works with athletes.
I have to write this. Today I was standing in a lobby of a building waiting for the start of a business meeting. Three women, who I knew, were waiting too. I couldn’t help but look at their feet. What I saw was scary.
Each had those pointy shoes. You know the ones. They seem to be all the rage these days. The very pointy toes extend at least three inches past the ends of their toes. One of the ladies, who is a tri-athlete, had on shoes that showed the start of her toes (no that’s not her feet in this picture). I’m sorry but it looked painful and certainly not good for her feet.
The heels were fairly high too. All three women’s toes were being pushed together towards the pointy end of the shoe. Maybe I am missing something, but they remind me of something an elf would wear.
Take a close look at the shoes in this picture. The try and guess the price. The answer is at the end of this post. I thought you’d like to read the text about the shoes, “Opalescent Black Evening Pointy Slingback – The perfect choice for a polished up look in dressy occasions, these slingbacks are glamorous with a sensual edge. Made in opalescent treated leather, they shine with a multicolor effect and sparkle with every move. The sole has a rubber toe to avoid slipping. Made in Italy.” Remember, try and guess the price.
Sure, people have worn cowboy boots for years—and they have kind of a long toe area—but not this bad. Is the pointy end important? Does it make a fashion statement? I guess so. More importantly, does your podiatrist know what you’re wearing on your feet? Can you spell bunions, metatarsal pain, nerve damage, toenail problems. To say nothing of the ankle, knee, hip, and back pain, because, after all, everything is connected. It’s a basic biomechanical fact.
Actually, a blog titled The Rage Diaries has a whole page devoted to comments on these shoes, even calling them, “pizza-slices with heels.” I love that! What a great analogy.
Another blog, by SwanShadow, comments, “What’s Up With That? #6: Pointy-toed shoes – Ladies, help a brother understand: I don’t get the pointy-toed shoe thing. Easily the dorkiest women’s footwear innovation since those backless sneakers that were all the rage a few years ago.”
Oh yea, the answer is $228.00
These unique comfortable closed cell foam structure shoes have a soft pliable feel, provide cushioning to your heels for all day wear, all the while massaging the bottoms of your feet with their textured footbed to promote circulation. They’re lightweight, warm in winter and cool in summer, with a vented design and anti-bacterial material to reduce foot odors. They’re Holey Soles!
OK, I’ll admit that some of you may look at the shape and say, “Hey, they’re clogs and they look funny.” You know what? Their benefits outweigh their look! I’d toss these on my pack for use as camp shoes without a second thought. One pair weighs in at 10.5 ounces! And since they are made from one piece of closed cell foam, they won’t come apart or break down. Choose from an open back shoe or one with a heel strap. The colors are as wild or sedate as you want. All this for around $20-$25.00 a pair.
These great shoes offer foot support with a molded foot-bed for arch, toe and heel support. Their tread is designed to grip and reduce slipping. The inside clings to your feet without toe curl.
The effects of heel impact when walking or standing can be felt as aches or pain in the ankles, knees, hips, and lower back. The cushioning system of Holey Soles is designed to dramatically reduce, and in many cases eliminate, those aches and pains. The key is the shock absorbent foam that is designed to cushion and protect heel impact through uniform pressure distribution.
Also, the foot-bed has been designed for toe, arch and heel support while at the same time gently massaging your foot-pad. This massaging action helps promote blood circulation and reduces foot swelling.
String them up through their holes on to your backpack. They won’t add any extra weight. They’re light and they’re rugged. They’re easy relief after a day of hiking and so very wonderful to have waiting outside your tent to slip on when you venture outdoors.
In the low tide, Holey Soles grip the sand and the rock while the water moves right through them. After your journey, hose them down or wear them right into the shower. They’re the best water shoe around!
Wear them when you’re walking your boat into the water. Then throw them into the boat and don’t worry if you miss the boat – they float!
Take them to the pool and then wear them to shower off. They’re dry in a minute, so you can throw them right into your gym bag.
Wear them while gardening, picnicking, walking to get the mail—you name it.
Holey Soles can be worn in the city too. They’ve been tested on cement and proven extremely durable. In the summer they breathe because of their creative ventilation. In the winter, wear contrasting socks.
I’ve got a pair and I love them. For those who must know – mine are light blue.
For those who like an alternative, check out the Crocs line. Very similar but a bit more expensive.