New Year, New You? Here’s 5 Tips For Runners to Avoid Heel Pain

We are now two weeks into 2019, and if this is the year that you’ve decided to take your fitness seriously we want to make sure your feet stay healthy so you can reach your goals! It doesn’t matter if you’re brand new to running or have participated in 10 marathons, you need to take proper steps before running to avoid foot pain — especially in the heel area. Heel pain is very common for people who participate in high-impact activities like running.

While some people will want to jump right into their workout so they can start losing weight or seeing results immediately, others will use caution and ease into the process. Taking the time to stretch or finding the right shoe is crucial in avoiding heel pain, but there’s more to it than that. Here are some steps you can take in order to avoid heel pain or any related injuries:

1. Buy Proper Running Shoes

Running shoes should provide support for your arches and cushion to reduce that impact between the ground and your feet. Avoid shoes that are too tight or ones that rub or irritate your heel bone. Be sure to walk around the shoe store and even try running before purchasing any new shoes.

2. Don’t Forget to Warm Up

Warming up before taking a run is a great habit to get into, especially when it comes to preventing heel pain. Try stretching out your feet from a seated position or rolling a ball under your foot for at least two minutes. This should loosen the muscles and help prevent any pain/soreness.

3. Look at Running Surfaces

Hard surfaces like concrete can take their toll on your feet over time. Consider changing your route to include a grass, sand or dirt surfaces to reduce the impact on your feet.

4. Take Advantage of Orthotics

Even if you have the most comfortable running shoe possible, the support or cushioning might not be enough to protect your heels. Custom orthotics are made specifically for your feet, so they are more effective than over-the-counter shoe inserts.

5. Rest

Just because you’ve set a New Year’s resolution, it doesn’t mean you have to accomplish it in a week. Like the other muscles in your body, your feet and the muscles within need periods of rest between activities. Don’t be afraid to take a day off if you are sore.

If heel soreness or pain doesn’t go away on its own, it could be a structural issue with your foot or it could be a condition like Plantar Fasciitis or Heel Spurs. In these cases, your podiatrist at Foot & Ankle Associates can diagnose and offer a treatment plan that will get you back out and running ASAP. Click here to schedule a consultation online or click below to call the office that is most convenient for you.

Mooresville Office:  (704) 662-3660

Huntersville Office (704) 892-5575

Denver Office:  (704) 966-1338

Charlotte Office:  (704) 971-7100

4 Winter Foot Care Tips

Even when you are in full holiday-mode a couple weeks from now, it’s important to remember to take extra care of your feet during these colder months. Because we are often wearing warm socks or boots, it’s easy for feet to get sweaty and uncomfortable. Mix that with the dry air of winter and there can be problems. That’s why it’s crucial to protect your feet and ankles from the elements of wintertime.

Most people assume that simply wearing boots and keeping their feet warm is the key to keeping feet healthy. While it certainly helps, there is a lot more that goes into keeping your feet healthy during the wintertime. If you want to make it through the holiday season without any issues, check out the four helpful tips we’ve outlined below!

Wash Twice a Day

During the winter months, it’s important to add to your personal hygiene routine by washing your feet twice a day — once in the morning and once at night. As warm and comfortable as your boots and socks may be, they actually create a warm, dark environment  the perfect breeding ground for fungus and other bacteria. To counteract this, wash your feet twice daily with soap and warm water. Then make sure to dry thoroughly afterward. Doing so can help prevent toenail fungus and other related foot/skin conditions.

Moisturize

The cold, dry winter air is the main cause of dry skin, but we also contribute by spending time in homes or offices with forced air. Dry skin on your feet can lead to the build-upof calluses which can eventually cause painful sores that can become easily infected. Foot infections are especially dangerous for diabetic patients.

So in addition to washing your feet more often, be sure to moisturize your feet regularly. The skin on your feet is actually thicker than the skin on the rest of your body, so don’t be afraid to moisturize often. You can use over-the-counter products or visit your foot doctor at Foot & Ankle Associates if you need something stronger.

Don’t Forget the Nails

Keeping toenails properly trimmed is important for preventing conditions like ingrown toenails and toenail fungus. This is especially true during the winter months because our feet are often confined to closed-toe shoes and large boots. It can be difficult to notice any infections or fungal growths because our feet are always covered. That’s why it’s important to not only manicure nails properly, but also perform self-evaluations and visit your podiatrist at Foot & Ankle Associates Mo0resville, Huntersville, Denver or Charlotte, NC offices for treatment as soon as you think there’s a problem.

Adjust Stride and Stretch

If you are a runner and enjoy running outside to the point where you don’t stop during the wintertime, there are some precautions you should take. Winter often brings dangerous running conditions like ice. When there are dangerous conditions, try shortening your stride to maximize stability. Colder weather also means less flexibility because your muscles become stiff more easily. While your first inclination might be to just run until you are warmed up, muscles actually work more efficiently when they are warm. Running without warming up could be a big problem — so be sure to stretch before starting.

If you have feet problem this winter or have questions about winter foot care, visit our experienced podiatric team at any of Foot & Ankle Associates North Carolina locations. Click the office links below to schedule an appointment online or call the office most convenient for you to speak with a member of our front office team.

Mooresville Office:  (704) 662-3660

Huntersville Office (704) 892-5575

Denver Office:  (704) 966-1338

Charlotte Office:  (704) 971-7100

FAA Sponsors Go Beyond Challenge

Foot & Ankle Associates recently sponsored a table at the 1st Annual GoBeyond Challenge on November 7, 2015. Dr. Joe Ades and Dr. Francesca Zappasodi participated at the event.  GoBeyond is a rundraising arm of Above & Beyond.  To learn more about the mission of Above & Beyond, please visit the website at http://abovebeyond.cc.  Foot & Ankle Associates has locations in Huntersville, Mooresville and the University area to serve all of your foot and ankle needs.  Please feel free to contact the office at (704) 662-3660 to make an appointment or request an appointment via our website homepage.

Welcome Dr. Zappasodi

We are proud to introduce our newest physician at Foot & Ankle Associates, Dr. Francesca Zappasodi.

Dr. Zappasodi recently moved from Orlando, Florida where she completed a three-year surgical residency program in foot and ankle surgery at Florida Hospital East Orlando.  She also served as chief resident during her surgical training at the well-regarded podiatric residency program in Florida.  Her surgical training included areas such as ankle arthroscopy, flatfoot reconstruction, and lower extremity trauma.

She is experienced in the non-surgical and surgical treatment of athletic injuries, arthritis, flatfeet, diabetic foot conditions, bunions, hammertoes, heel pain, ingrown toenails and other foot and ankle conditions.

Dr. Zappasodi received her graduate degree, doctor of podiatric medicine, at Des Moines University in 2012 and received her undergraduate degree in Microbiology & Molecular biology at the University of Central Florida in 2008.

Dr. Zappasodi is Board Qualified in foot surgery by the American Board of Podiatric Surgery, is an Associate of the American College of Foot and Ankle Surgeons, and is a member of the North Carolina Foot and Ankle Society and the American Podiatric Medical Association.

In her free time, she enjoys long distance running and has participated in several half and full marathons.

Dr. Zappasodi has privileges at Lake Norman Regional Medical Center in Mooresville and Novant Hospital in Huntersville.

Dr. Zappasodi is currently accepting new patients at our Mooresville and Huntersville clinics.  Please feel free to call the office at (704) 662-3660 to schedule an appointment.

Hypocure Subtalar Implant for Flat Feet

The shape of your feet and its effects on foot function has been well documented.  Specifically Flat Feet can cause an increase pressure in the soft tissues that support the twenty eight plus bones in one’s feet.  Flat Feet has been shown to increase the stress experienced because of abnormal shape and abnormal motion (excessive pronation). If you ever had any kind pain in your feet, you know that persistent pain can also lead to compensation and overuse of other parts of your feet, ankles or legs.  Multiply this by the reported 5000-10,000 steps taken day to day, and you have a recipe for chronic pain.  Flat Feet have been linked to Bunion Deformities, Joint Pain, Posterior Tibial Tendinitis, Plantar Fasciiits/Heel Spur Syndrome, Achilles Tendonitis, Stress Fractures and even Ingrown toenails to name several foot and ankle problems.

Unfortunately, Flat Feet can significantly affect your quality of life.  Many working hours have been lost to chronic pain associated with flatfeet, especially those that have to stand on their feet for the majority of their job.  Athletes often have to miss time with their respective sports because of issues associated with flatfeet.  As we have seen in our practice, this problem can also affect children and can significantly impact their activities of daily living, resulting in tired legs, muscle fatigue, arch pain, and heel pain. Having Flat feet certainly increases the chances of having foot related issues at one point in time.

Typical non surgery related treatments include rigorous stretching, over-the-counter inserts, custom made orthotics, nonsteroidal anti-inflammatory and steroidal anti-inflammatory oral medications, physical therapy and, steroid injections.   Treatment considerations are dependent on what your foot and ankle specialist finds during his or her clinical examination.  Here at The  Foot and Ankle Associates, we offer many treatment options before procedures. Sometimes, however, these treatments are not enough despite exhausting conservative therapy.

A relatively simple option available to some patients is a device called Hyprocure.  Think of this as an internal orthotic. The Hyprocure Implant is a device that can help some patients slow or stop the chronic pain cycle they experience from their flatfeet.  Studies have shown this device capable of blocking abnormal motion and decreasing the stress placed on the joints, bones, ligaments and tendons of your feet. It is a titanium alloy device that helps with the positioning of foot, preventing a bone that is part of your ankle joint from collapsing .With local anesthesia and IV sedation, this device can be easily placed within your foot in less than 15 minutes.

Not everyone is a candidate for this device and your doctor at the Foot and Ankle Associates Clinics can help you make this determination.  Some people’s feet have experienced too many adaptive changes for so long that they cannot have this device without additional procedures.  Even if you are not a candidate for this procedure, your Foot and Ankle Associates Doctor, with his or her expertise or associated doctors within the practice, could help improve your lifestyle.

Orthotics

Do you have pain in your feet? Have you ever tried an orthotic to treat this pain? Many people have bought orthotics or shoe inserts from a sporting goods store or drug store to try and treat their foot pain and for many people these temporary generic orthotics do provide some relief. But for others this does not meet their pain relief expectations. For these people a custom made orthotic from a foot and ankle specialist may be indicated.

Custom orthotics from a foot and ankle specialist can be used to treat a plethora of foot and ankle ailments. Some of these indications include but are not limited to plantar fasciitis (heel or arch pain), Achilles tendon pain, bunions, hammertoes, neuroma, athletic injuries, calluses, and corns to name a few. Custom orthotics place your foot in an ideal position for your body to function in and can relieve pain throughout your body.

Not all “custom” orthotics are the same. Only a medical professional specializing in foot and ankle pathology, such as a podiatrist, can truly analyze your feet for subtle biomechanical abnormalities and design the correct custom orthotic for you.

Don’t be fooled by poor imitations claiming to be “custom” orthotics, make an appointment today with our physicians Dr. Ades, Dr. Shapiro, and Dr. Robinson. If you think a custom orthotic may help your foot and ankle pain please contact our office online at www.footandankleassociates.com or by phone at (704) 662-3660.

PRP Therapy for Heel Pain

Do you have or know anyone with Chronic Heel Pain (Plantar Fasciitis/Heel Spur Syndrome) or Achilles Tendon ailments?  These respective problems are usually managed quite well with conservatives measures, such as avoidance of non supportive shoes, anti-inflammatories, ample rest, stretching, and avoidance of aggravating activities.   In rare instances, if first and second line of treatments fail to gain significant relief for patients, cast immobilization and physical therapy may be needed.  Luckily, these measures are able to effectively manage upwards of 90% of people with these ailments.

Unfortunately, there are a small percentage of patients that have exhausted standard and reasonable treatments. Traditionally, surgery has been a viable option when all else fails.  However, in recent years, physicians have been able to offer their patients with these ailments with alternative non surgical treatments, with one being called Platelet Rich Plasma.

Platelet rich plasma (PRP) is a great non surgical treatment for Heel Pain due to Plantar Fasciitis(Heel Spur Syndrome) and chronic conditions of the Achilles Tendon.  The idea is that these ailments are stuck in a chronic inflammatory or degenerative state, resistant to the normal healing process. PRP has many growth factors or components that can help heal these conditions stuck in chronic phases. It is obtained by using a patient’s own blood which is drawn at the office and spun to separate the different components of whole blood.  After separation of blood components, your doctor will inject the PRP obtained from the sample of blood into the area of problem after local anesthetic block.

Heel Pain due to Plantar Fasciitis (heel spur syndrome) and problems of the Achilles Tendon are not the only ailments that could benefit from Platelet Rich Plasma (PRP).  PRP also has an application in major surgeries of the foot and ankle for those patients deemed a risk with healing problems, as determined by your doctor and medical history.  Also, the diabetic population with chronic wounds can benefit from the healing properties of PRP.

In short, Platelet Rich Plasma can be a viable alternative treatment.  If you or someone you know has chronic heel pain or Achilles problems, this may be a great alternative to surgery.

For more information regarding Platelet Rich Plasma, please call the office @ (704) 662-3660 to schedule an appointment.

Foot & Ankle Associates Welcomes New Physician

Dr. James Robinson recently moved from Youngstown, Ohio where he completed a three year residency in foot and ankle surgery at Valley Care Health System, one of the oldest and most well-regarded podiatric residency programs in the United States.  Dr. Robinson received his doctorate of podiatric medicine from the New York College of Podiatric Medicine in New York City in 2008.

Dr. Robinson is Board Qualified in foot surgery by the American Board of Podiatric Surgery, is an Associate of the American College of Foot and Ankle Surgeons, and is a member of the North Carolina Foot and Ankle Society and the American Podiatric Medical Association.

Dr. Robinson is experienced in the non-surgical and surgical treatment of athletic injuries, arthritis, flatfeet, diabetic foot conditions, bunions, hammertoes, heel pain, ingrown toenails and other foot and ankle conditions.

Dr. Robinson enjoys sports, cooking, reading and spending time with his wife and daughter.

Dr. Robinson has privileges at Lake Norman Regional Medical Center in Mooresville and Presbyterian Hospital in Huntersville.

Dr. Robinson is available to see patients in our Mooresville, Huntersville and University clinics.  Please feel free to call the office at (704) 662-3660 to make an appointment.

Footwear

Proper footwear can reduce foot problems

From ancient Egyptian times down through the centuries, footwear has been designed to meet mankind’s real and perceived needs—protection, support, comfort, sturdiness, and stylishness.

Feet endure tremendous pressures of daily living. An average day of walking brings a force equal to several hundred tons on them. They are subject to more injury than any other part of the body, underscoring the need to protect them with proper footwear.

Doctors of podiatric medicine are health care professionals trained for both palliative and surgical care of the foot and ankle. They also are fully qualified to recommend selection of the right pair of shoes, or address other aspects of foot health, for all members of the family.

Children’s Shoes

When a child begins to walk, shoes generally are not necessary.  Allowing an infant to go barefooted indoors, or to wear only a pair of socks, helps the foot grow normally and develop its muscles and strength, as well as the grasping ability of toes.

As children grow more active, and their feet develop, the need for shoes becomes apparent. It becomes necessary to change shoe sizes at a pace that frequently surprises and even dismays parents, to allow room for growth.

When purchasing shoes for children, remember these tips:

  • Examine the shoe itself. It should have a firm heel counter (stiff material on either side of the heel), adequate cushioning of the insole, and a built-in arch. It should be flexible enough to bend where the foot bends—at the ball of the foot, not in the middle of the shoe.
  • The child’s foot should be sized while he or she is standing up and fully weight-bearing.
  • There should be about one-half inch of space (or a thumb’s width) between the tip of the toes and the end of the shoe. The child should be able to comfortably wiggle his or her toes in the shoe.
  • Have the child walk around the store for more than just a few minutes wearing the shoe with a normal sock. Ask the child if he or she feels any pressure spots in the shoe. Feel the inside of the shoe for any staples or irregularities in the glue that could cause irritation. Examine where the inside stitching hits the foot. Look for signs of irritation on the foot after the shoe is worn.
  • Shoes should not slip off at the heels. Children who tend to sprain their ankles will do better with high-top shoes or boots.
  • Both feet should be measured, and if they are two different sizes, shoes should be chosen that fit the larger foot best.

Women’s Shoes

Women inflict more punishment on their feet in part from improper footwear that can bring about unnecessary foot problems. Some of the problems result from high-heeled shoes (generally defined as pumps with heels of more than two inches). Doctors of podiatric medicine believe such heels are medically unsound and attribute postural and even safety problems to their use.

To relieve the abusive effects of high heels, women can limit the time they wear them, alternating with good quality sneakers or flats for part of the day.

They can also vary heel height. There are comfortable and attractive “walking” pumps (also called “comfort” or “performance” pumps) for work and social activities, that blend fashion considerations and comfort.  These pumps offer athletic shoe-derived construction, reinforced heels, and wider toe room.

Activity has a bearing on the considerations; wearing the right shoe for a particular activity is probably as important a factor in the choice of shoes as any.

Perhaps the best shoe for women is a walking shoe with laces (not a slip-on), a polymerized composition sole, and a relatively wider heel with a rigid and padded heel counter, no more than three-quarters of an inch in height.

Men’s Shoes

The best shoes for men are good quality oxford styles, shoes ordinarily associated with wing-tip or cap toe designs. Also suitable are slip-ons, dressy loafers, and low dress boots.

Men as well as women should buy shoes for work, leisure, and special activities, matching the shoe to the activity.

Male (and female) office workers should earmark three to five pairs of shoes for business hours—general oxfords and loafers for men; pumps and oxfords for women. Cushioned-sole shoes that give good support are essential for those who spend most of their working days on their feet.

There is no question about the need for foot protection for those who work in heavy industry. Safety shoes and boots—those that are waterproof or water-resistant, with insulated steel toe caps and soles of non-conducting materials—help prevent injuries to the feet and reduce the severity of injuries that do occur.

Shoes for Athletics

Different sports activities call for specific footwear to protect feet and ankles. Sports-specific athletic shoes are a wise investment for serious athletes, though perhaps a less critical consideration for the weekend or occasional athlete; nevertheless, it’s a good idea to use the correct shoe for each sport. Probably a more important consideration is the condition of the shoe—don’t wear any sport or other shoes beyond their useful life.

Athletic footwear should be fitted to hold the foot in the position that’s most natural to the movement involved.

For example, a running shoe is built to accommodate impact, while a tennis shoe is made to give relatively more support and permit sudden stops and turns. For sports, “cross trainers” are fine for a general athletic shoe, such as for physical education classes. But if a child is involved more heavily in any single sport, he or she should have a shoe specifically designed for that sport.

Shoe Care

For longer service, keep shoes clean and in good repair. Avoid excessive wear on heels and soles. Give your shoes a chance to breathe—don’t wear the same pair two days in a row (you prolong the life of shoes by rotating their use). Never wear hand-me-down shoes (this is especially important for children).

Seal of Acceptance

The American Podiatric Medical Association awards its Seal of Acceptance to a wide variety of shoes (and shoe-related products), which have been deemed to enhance a consistently applied program of daily foot care and regular professional treatment.

The intent of such endorsements is to make a significant contribution to the foot health and foot health education of the public.

For a list of shoe companies holding the APMA Seal of Acceptance, visit the APMA’s online seal information.

Buying Tips

  • Have your feet measured while you’re standing.
  • always try on both shoes, and walk around the store.
  • Always buy for the larger foot; feet are seldom precisely the same size.
  • Don’t buy shoes that need a “break-in” period; shoes should be comfortable immediately.
  • Don’t rely on the size of your last pair of shoes. Your feet do get larger, and lasts (shoemakers’ sizing molds) also vary.
  • Shop for shoes later in the day; feet tend to swell during the day, and it’s best to be fitted while they are in that state.
  • Be sure that shoes fit well—front, back, and sides—to distribute weight. It sounds elementary, but be sure the widest part of your foot corresponds to the widest part of the shoe.
  • Select a shoe with a leather upper, stiff heel counter, appropriate cushioning, and flexibility at the ball of the foot.
  • Buy shoes that don’t pinch your toes, either at the tips, or across the toe box.
  • Try on shoes while you’re wearing the same type of socks or stockings you expect to wear with the shoes.
  • If you wear prescription orthotics—biomechanical inserts prescribed by a podiatric physician—you should take them along to shoe fittings.
Your podiatric physician/surgeon has been trained specifically and extensively in the diagnosis and treatment of all manner of foot conditions. This training encompasses all of the intricately related systems and structures of the foot and lower leg including neurological, circulatory, skin, and the musculoskeletal system, which includes bones, joints, ligaments, tendons, muscles, and nerves.

Hammertoes

What Is Hammertoe?
Hammertoe is a contracture (bending) of one or both joints of the second, third, fourth, or fifth (little) toes. This abnormal bending can put pressure on the toe when wearing shoes, causing problems to develop.

Hammertoes usually start out as mild deformities and get progressively worse over time. In the earlier stages, hammertoes are flexible and the symptoms can often be managed with noninvasive measures. But if left untreated, hammertoes can become more rigid and will not respond to non-surgical treatment.

Because of the progressive nature of hammertoes, they should receive early attention. Hammertoes never get better without some kind of intervention.

Causes
The most common cause of hammertoe is a muscle/tendon imbalance. This imbalance, which leads to a bending of the toe, results from mechanical (structural) changes in the foot that occur over time in some people.

Hammertoes may be aggravated by shoes that don’t fit properly. A hammertoe may result if a toe is too long and is forced into a cramped position when a tight shoe is worn.

Occasionally, hammertoe is the result of an earlier trauma to the toe. In some people, hammertoes are inherited.

Symptoms
Common symptoms of hammertoes include:

  • Pain or irritation of the affected toe when wearing shoes.
  • Corns and calluses (a buildup of skin) on the toe, between two toes, or on the ball of the foot. Corns are caused by constant friction against the shoe. They may be soft or hard, depending upon their location.
  • Inflammation, redness, or a burning sensation
  • Contracture of the toe
  • In more severe cases of hammertoe, open sores may form.

Diagnosis
Although hammertoes are readily apparent, to arrive at a diagnosis the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination, the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take x-rays to determine the degree of the deformities and assess any changes that may have occurred.

Hammertoes are progressive – they don’t go away by themselves and usually they will get worse over time. However, not all cases are alike – some hammertoes progress more rapidly than others. Once your foot and ankle surgeon has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.

Non-surgical Treatment
There is a variety of treatment options for hammertoe. The treatment your foot and ankle surgeon selects will depend upon the severity of your hammertoe and other factors.

A number of non-surgical measures can be undertaken:

  • Padding corns and calluses.Your foot and ankle surgeon can provide or prescribe pads designed to shield corns from irritation. If you want to try over-the-counter pads, avoid the medicated types. Medicated pads are generally not recommended because they may contain a small amount of acid that can be harmful. Consult your surgeon about this option.
  • Changes in shoewear.Avoid shoes with pointed toes, shoes that are too short, or shoes with high heels – conditions that can force your toe against the front of the shoe. Instead, choose comfortable shoes with a deep, roomy toe box and heels no higher than two inches.
  • Orthotic devices.A custom orthotic device placed in your shoe may help control the muscle/tendon imbalance.
  • Injection therapy.Corticosteroid injections are sometimes used to ease pain and inflammation caused by hammertoe.
  • Medications.Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
  • Splinting/strapping.Splints or small straps may be applied by the surgeon to realign the bent toe.

When Is Surgery Needed?
In some cases, usually when the hammertoe has become more rigid and painful, or when an open sore has developed, surgery is needed.

Often patients with hammertoe have bunions or other foot deformities corrected at the same time. In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity, the number of toes involved, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.