Health Education Series with Dr. Card

Join Dr. Card at the Women's Health Institute this week!

Ouch, My Foot!
A Discussion on Plantar Fasciitis and General Foot Care
Dr. Keith Card, DPM
Tuesday, September 27, 5:30-6:30 pm

Women's Health Institute (a service of Carson Tahoe)
1470 Medical Parkway
For more information, call (775) 445-5168 or www.carsontahoewomen.com.

Come with questions.  Leave with answers.

The Dangers of Ignoring Reoccurring Ankle Sprains

I know that many people don't want to head to the doctor for ankle sprains.  Sprains can often be treated with rest, ice, and a simple ace bandage.  However, if you have had multiple ankle sprains, you may have a more serious problem.  Repeated ankle sprains and other ankle injuries can lead to ankle arthritis and should be treated aggressively.

 

Ankle arthritis differs from hip or knee arthritis in that it usually results from trauma rather than the everyday wear and tear associated with old age. It has been reported that arthritis after a single or multiple injuries is the leading cause for end stage ankle arthritis. Most people don’t realize that reoccurring ankle sprains can eventually lead to severe pain and difficulty walking.

In a recent study of people with end stage arthritis in their ankles, 87% resulted from a specific or repeated injury and less than 1% was attributed to general wear and tear type osteoarthritis. Another study showed that 18% of the patients suffering from end stage ankle arthritis have a history of chronic instability, which can result in repeated ankle sprains. 

If you have ankle pain or frequent sprains, there are non-surgical options available through new and advanced ankle bracing.  Several surgical options are available as well.  Don’t ignore recurrent ankle sprains!

What To Do For Your Morning Foot Pain

Have you been ignoring that nagging heel pain that has you hobbling all the way to the shower in the morning?

Most heel pain is the result of inflammation of a ligament called the plantar fascia that runs along the bottom of the foot from the heel to the toe area. The inflammation of this ligament is called plantar fasciitis.  When the plantar fascia is strained beyond its normal limits, the soft tissue fibers of the fascia begin to tear.  This occurs especially where it attaches to the heel bone leading to inflammation, pain, and possibly the growth of a bone spur. (Spurs typically do NOT cause heel pain but rather are a sign of the inflammation.) 

Here are a few suggestions for your heel pain:

1. Stop going barefoot and throw away old or worn-out shoes.
2. Start applying an ice pack to the painful area after activities.
3. Do some stretching in the morning even before getting out of bed.  Most exercises that stretch the calf muscles are helpful.
4. Take a few days of rest from strenuous activities if possible.
5. Many foot cushions or arch supports sold in stores may be helpful but will not usually solve the cause of the pain.

 When foot discomfort occurs, early treatment usually results in the best chance for complete healing and a speedy return to your regular activities.    Call Dr. Card if these tips do not get you gliding painlessly into your morning routine.

Shape-Up Shoes: Do They Really Work?

I am asked by patients nearly every day regarding the newest shoes that claim to tighten your tummy, firm your buns, improve your posture, and alleviate pain. Are there any actual health benefits from these toning shoes or is it all hype?  Can shoes really do all that?

The common design element among the 15 or so brands currently marketing these “toning shoes” is a rocker sole which induces an element of instability.  This instability theoretically requires the wearer to activate more muscles and thus provide greater health benefits than walking in traditional shoes.

The rocker sole is certainly not a new concept. Doctors and therapists have been using shoes with a “rocker” type sole for decades in treating various foot ailments. It is only in the past decade that these types of shoes have been marketed to the public.  In fact the toning shoe is the fastest growing new trend in the shoe market since the seventies and has expanded to more than $1 billion annually in sales.  This recent popular trend began with the introduction of the MBT brand of shoes. 

MBT (Masai Barefoot Technology) is a Swiss company formed after an engineer observed the Masai Tribe in northern Africa and noted a lack of foot problems among the tribe despite a general avoidance of shoes.  His theory that the rolling walk in soft sandy soil native to the area where this tribe walked was the key to their foot health.  He designed the sole of his shoes to mimic this type of walking.  Since people in developed countries typically walk on much harder surfaces, MBT created a shoe to incorporate a soft curved sole that mimics the walking pattern of the Masai in soft dirt.  MBT was the first to popularize the toning shoe and with a $100-300 price tag, other shoe manufactures saw huge potential profit margins.  Many shoemakers jumped into this new market and developed their own models backed by enormous advertising budgets making claims that make Dorothy’s ruby slippers seem much less magical by comparison.

The current science reveals a little less steam than in Kim Kardashian’s recent Super Bowl commercial for Sketchers Shape-ups. 

The scientific studies are very mixed on the benefits of toning shoes.  First, several researchers have investigated the claims of increased muscle activation.  The American Council on Exercise found no increased muscle activity in toning shoes while other studies conducted by shoe manufacturers have shown small increases in muscle use.   Scientists have also looked at the second and likely more important issue of balance and instability while wearing this type of shoe.  There is consensus among the research that toning shoes do impact balance and that wearers of them tend to be less steady on their feet.  This could be considered a benefit to some and a potentially severe risk to others.  A third area of research is the effect toning shoes have on joint motion where considerable evidence indicates that these shoes do slightly change the amount of motion in the hip, knee, ankle, and other foot joints.   What the joint motion studies cannot say is if the change in motion is beneficial. 

So what does this research mean for you?  First, the claimed benefit of easy weight loss and getting into shape through new or increased muscle activation without effort is hype.  Those calories must still be worked off.  The potential weight loss benefit from increased muscle activity will likely wane after getting used to walking in these shoes.  The second issue of balance is a critical one.  Anyone at risk for falling should never wear this type of shoe.  Several class action lawsuits are currently pending for severe injuries sustained in toning shoes.  The third issue of joint motion increased by toning shoes is specific to each individual.  If you already have arthritis in a particular joint and a shoe increases the motion there, that can substantially increase your pain.   However, if a certain shoe minimizes the motion in an arthritic joint, this may decrease pain.  Because each model of shoe has a different rocker pattern and each patient has individual needs, it is impossible to make generalizations whether or not the changes in joint motion will be detrimental or beneficial.  

In summary there are potential benefits along with some substantial risks from wearing toning shoes.  It is important to remember that there are no shortcuts to good health.  Regular exercise and a healthy diet are much more important than what you have on your feet.   Check with your doctor prior to starting a new exercise program or if you have pain while walking.   While there may be some benefit to wearing toning shoes, care must be taken both in wearing them and in believing all of those fantastic claims. 

About Dr. Keith Card

Dr. Keith Card is a podiatrist with Tahoe Fracture and Orthopedic Medical Clinic.  He has office locations in Carson City and Gardnerville.

Dr. Card received his BS in Exercise Physiology from the University of Utah and his Doctor of Podiatric Medicine degree from the Temple University School of Podiatric Medicine in Philadelphia, PA.  He completed a four-year comprehensive surgical foot and ankle residency program at the University of Pennsylvania, PENN Presbyterian Medical center. This training included extensive vascular surgery and diabetic limb salvage, trauma management, joint replacement, and plastic surgery techniques applied to the foot and ankle.

Dr. Card resides in Carson City with his wife and their three young children.  He and his family are very active in outdoor sports including rock climbing, mountaineering, and cycling. His recreational pursuits have led him to such places as: Iceland, where he cycled solo through the volcanic central highlands and remote west fjords; Ecuador, where he summited the highest active volcano in the world; Cambodia, where he hiked the ancient ruins of Angkor Wat; as well as cycling across the United States from Canada to Mexico along the Pacific Coast Highway.