Posts for: January, 2017
Fix feet for weight loss success
(Reston, Manassas, and Leesburg, VA – 1/27/17) Many of the estimated 70 million obese Americans are trapped in a life-threatening vicious cycle: Obesity aggravates foot problems, like heel pain and flat feet; sore feet make it hard to exercise and lose weight; and without exercise, obesity worsens and exacerbates progression of diabetes, heart disease and other serious health threats. Today, a Northern Virginia foot and ankle surgeon urged obese adults to seek immediate treatment for chronic, activity-limiting foot and ankle problems to foster compliance with physician-directed exercise programs.
“It’s unfortunate obese adults get caught up in the vicious cycle of avoiding physical activity due to foot or ankle pain, thereby permitting cardiovascular disease and other life-threatening conditions to worsen as a result,” says Shaun Hafner, DPM, FACFAS, a member of the American College of Foot and Ankle Surgeons (ACFAS) in Northern Virginia. “For example, in many cases, chronic heel pain occurs from carrying too much weight. Left untreated, it becomes an impediment to physical activity and meaningful weight loss.”
Hafner says there’s no reason foot or ankle pain should stop obese patients from exercising. The first step toward breaking that vicious cycle is an evaluation by a foot and ankle surgeon.
According to the ACFAS consumer Web site, FootHealthFacts.org, many causes of foot pain can be relieved without surgery through stretching exercises, orthotics and athletic shoes with good shock absorption and support. If a bunion, heel pain or other condition requires surgery, patients can participate during their recovery in non-weight-bearing activities, such as riding a stationary bike, swimming or weight training.
For those moderately to severely overweight, Hafner says a thorough physical examination is mandatory before beginning an exercise program.
“Once cleared by your physician to begin exercising, don’t try to do too much too soon. Follow a gradual routine until your body adjusts to the stress of regular physical activity,” he says. “For example, I counsel overweight patients to avoid working out on treadmills or elliptical machines to minimize pounding and stress on their joints.”
Shedding excess pounds helps diabetic patients control their disease, but Dr. Hafner notes many who experience foot ulcerations and vascular problems caused by diabetes might think they shouldn’t exercise.
“Every diabetes patient needs regular foot exams to check for possible sore spots and assess nerve sensation,” says Dr. Shaun Hafner. “And with proper diabetic foot care and the right footwear, most patients can follow an exercise regimen that is safe and appropriate for them.”
Simple steps that help people with diabetes keep their feet healthy
A diabetes diagnosis can be daunting, but a simple attitude adjustment can make a world of difference in how well you fare while living with the disease. When people with diabetes take proactive steps to monitor key health indicators, experts agree that it’s possible to prevent some of the most severe risks of diabetes, including lower limb amputation.
People ages 20 and older who are living with diabetes account for about 60 percent of non-traumatic lower-limb amputations, according to the Centers for Disease Control and Prevention’s (CDC) 2014 National Diabetes Statistics Report.
“The CDC says the occurrence of diabetes-related foot and lower-leg amputation has decreased by 65 percent since 1996,” says Steven Gordon DPM, a podiatrist at Reston, Manassas, and Leesburg Foot an Ankle Centers and member of the American Podiatric Medical Association (APMA). “Working together, podiatrists and their patients with diabetes can reduce the number of amputations even more.”
People with diabetes may be less aware of cuts or wounds on their feet due to the nerve damage related to their disease, Dr. Gordon points out. “Regular and vigilant foot care can help catch problems before they develop into a health crisis.”
APMA offers advice to help people with diabetes protect their foot health:
Inspect your feet daily, checking the entire foot and all 10 toes for cuts, bruises, sores, or changes to the toenails, such as thickening or discoloration. Treat wounds immediately and see your podiatrist if a problem persists or infection is apparent.
Exercise by walking, which can help you maintain a healthy weight and improve circulation. Be sure to wear athletic shoes appropriate for the type of exercise you’re doing.
When you buy new shoes, have them properly measured and fitted. Foot size and shape can change over time, and ill-fitting shoes are a leading cause of foot pain and lesions. Certain types of shoes, socks, and custom orthotics are available for people with diabetes, and they may be covered under Medicare. You can find a list of podiatrist-approved footwear and products for people with diabetes on the APMA website, www.apma.org.
Keep your feet covered and never go barefoot, even at home. The risk of cuts and infection is too great.
See a podiatrist to remove calluses, corns, or warts—don’t tackle them yourself, and don’t ask an unlicensed nonprofessional to do it. Over-the-counter products can burn your skin and injure your foot. Podiatrists are specially trained to address all aspects of foot health for people with diabetes.
Get checkups twice a year. An exam by your podiatrist is the best way to ensure your feet stay healthy.
“For people with diabetes, taking charge of your own foot health can help you avoid foot-related complications like amputation,” Dr. Gordon says. “Working with today’s podiatrist will help you safeguard your foot health.”
Foot care advice for new moms and babies
Few things in life are as darling as a newborn’s little feet, and most new moms take great joy in counting 10 tiny, perfect toes. But foot health can be a source of anxiety for both new and expectant mothers, who may wonder about the best ways to care for their baby’s feet, and how to cope with changes in their own feet.
“Pregnancy creates many changes in the body and can even affect the size of a woman’s feet,” says Shaun Hafner DPM, a podiatrist at Reston, Manassas and Leesburg Foot and Ankle Center and member of the American Podiatric Medical Association (APMA). “And even though newborns aren’t walking yet, it’s understandable that mothers may have some concerns about how to best take care of their baby’s feet.”
The discomforts of pregnancy are common and well-known, ranging from back pain and frequent bathroom trips to feet that are swollen and sore.
“It’s not at all unusual for a woman to gain a shoe size while pregnant,” Dr. Hafner says. “Increased weight puts more pressure on the foot, the arch flattens a bit, and the foot elongates. Just a quarter-inch increase in foot length is enough to prompt a change in shoe size.”
While it’s probably impossible to completely avoid foot challenges during pregnancy, moms-to-be can take steps to minimize them:
- Control weight gain. Added weight is the most likely cause of foot expansion. Do your best to follow your obstetrician’s guidelines for how much weight you should gain throughout the pregnancy.
- Avoid high heels. Sure, you see celebrities accessorizing their baby bumps with stilettos, but a lower heel during pregnancy will relieve pressure on the foot. Also, lower heels will provide you with greater stability during a time when newly gained weight might throw off your balance. It’s easy to find plenty of pretty, stylish lower heels—1 to 2 inches in height—that will look and feel great while you’re pregnant.
- Comfort and support should be key considerations any time you choose footwear, but they are even more important for pregnant women. With extra weight and pressure on your feet for nine months, you need a shoe that provides support and cushioning. Avoid thin-soled shoes (including flip-flops and ballet flats); look for shoes with thicker soles and plenty of cushioning inside the shoes. Whatever shoe you choose, it should bend only at the ball of the foot, and you should never be able to twist the sole or bend it anywhere else.
While it’s common for women’s feet to enlarge during pregnancy—and remain that size even after delivery—generally that size increase occurs only with a first pregnancy. So you shouldn’t worry that your feet will continue to grow with subsequent pregnancies. Instead, many new moms will worry about their new baby’s feet.
“The good news is, as long as the baby’s feet are healthy at birth, most newborns won’t require special care for their feet,” Dr. Hafner says. “Caring for your baby’s feet is much like caring for the rest of his or her body.”
Don’t worry if your baby’s feet look discolored or wrinkled or even have flaky, peeling skin when he or she is born. After nine months in protective fluid within the womb, they’re bound to look a bit different from yours. Your pediatrician will look for any obvious abnormalities of your baby’s feet and legs and will let you know what to do if he or she finds any cause for concern.
Use baby nail clippers to keep your child’s toenails trimmed, cutting straight across to prevent ingrown toenails. Be sure to thoroughly dry baby’s feet after a bath, and choose soft, anti-microbial socks that don’t wrinkle or bunch to keep those little feet warm and protected.
When your baby starts to walk, bare feet are best inside the house as he or she learns the finer points of getting around. Outside, put him or her in a lightweight, flexible shoe made of natural materials.
If foot problems run in your family, have your child examined by a podiatrist when he or she begins to walk. Your podiatrist can inspect your child’s feet to ensure they’re growing normally.
Flip-flops and snow don’t mix: Winter foot-health advice
The holidays are over, but most regions of the country face a few more months of winter. Whether you’re slogging through deep snow and sub-zero temperatures in the north, or contending with dampness, chill, and muddy conditions in the south, it’s important to take care of your feet all winter long. You’ll want them to be healthy and ready for action when spring finally arrives.
Most Americans will have walked 75,000 miles by the time they turn 50, according to the American Podiatric Medical Association (APMA). Is it little wonder, then, that a 2014 APMA foot health survey found that foot pain affects the daily activities—walking, exercising, or standing for long periods of time—of a majority of Americans?
“Each season presents unique challenges to foot health,” says Steven Gordon DPM, a podiatrist at Reston, Manassas, and Leesburg Foot and Ankle Centers and APMA member. “Surveys and research tell us that foot health is intrinsic to overall health, so protecting feet all year long is vital to our overall well-being.”
APMA offers some advice for keeping feet healthy in common winter scenarios:
Winter is skiing and snowboarding season, activities enjoyed by nearly 10 million Americans, according to the National Ski Areas Association. Never ski or snowboard in footwear other than ski boots specifically designed for that purpose. Make sure your boots fit properly; you should be able to wiggle your toes, but the boots should immobilize the heel, instep, and ball of your foot. You can use orthotics (support devices that go inside shoes) to help control the foot’s movement inside ski boots or ice skates.
Committed runners don’t need to let the cold stop them. A variety of warm, lightweight, moisture-wicking activewear available at most running or sporting goods stores helps ensure runners stay warm and dry in bitter temperatures. However, some runners may compensate for icy conditions by altering how their foot strikes the ground. Instead of changing your footstrike pattern, shorten your stride to help maintain stability. And remember, it’s more important than ever to stretch before you begin your run. Cold weather can make you less flexible in winter than you are in summer, so it’s important to warm muscles up before running.
Boots are must-have footwear in winter climates, especially when dealing with winter precipitation. Between the waterproof material of the boots themselves and the warm socks you wear to keep toes toasty, you may find your feet sweat a lot. “Damp, sweaty feet can chill more easily and are more prone to bacterial infections,” Dr. Gordon says. “To keep feet clean and dry, consider using foot powder inside socks and incorporating extra foot baths into your foot care regimen this winter.”
Be size smart. It may be tempting to buy pricey specialty footwear (like winter boots or ski boots) for kids in a slightly larger size, thinking they’ll be able to get two seasons of wear out of them. But unlike coats that kids can grow into, footwear needs to fit properly right away. Properly fitted skates and boots can help prevent blisters, chafing, and ankle or foot injuries. Likewise, if socks are too small, they can force toes to bunch together, and that friction can cause painful blisters or corns.
Finally—and although this one seems like it should go without saying, it bears spelling out—don’t try to tip-toe through winter snow, ice, and temperatures in summer-appropriate footwear.
“More than one news show across the country aired images of people in sneakers, sandals, and even flip-flops during severe winter weather,” Dr. Gordon says. “Exposing feet to extreme temperatures means risking frostbite and injury. Choose winter footwear that will keep your feet warm, dry, and well-supported.”