Foot Care Archives | Feet First Clinic

Are Foot Calluses a Problem?

Posted on July 6, 2020July 6, 2020 by Tim

Ask anyone and they’ve likely had Foot Calluses.

A callus is a common foot condition involving thickening of the skin. Prolonged rubbing causes calluses, in a similar manner as to how a Blister Forms. This is your body’s defence mechanism to prevent any additional damage to the area.

Runners, soccer players, and those who are barefoot may have calluses on the foot. Tennis players, gymnasts, weight lifters, and manual labourers may have calluses on their hands.

Calluses differ from corns since they’re less defined, and are often found in weight-bearing areas of the body including on your feet. Plus, calluses are often larger than corns, and evenly distributed whereas corns have a well-defined core.

Calluses can be yellow, white, or grey and can be accompanied by dry scaling skin and even fissures.

The question remains: are calluses good or bad?

The Good

Calluses are our body’s natural response to repetitive use to an area of the body.

For runners, calluses can be seen as a badge of honour. Like black toenails, they’re a sign that you’ve been training hard, and are a sort of right of passage.

Often, calluses reduce pain in an area. Think of calluses as a piece of cushion on your feet. For this reason, they’re often called nature’s shoes.

Someone with calluses on their feet can walk across rougher land and be without pain. Tennis players with calluses on their hands may not feel the same type of pain as a first-time user. In these cases, the cushion calluses allow people to go past their normal pain threshold since calluses act as a shield.

Calluses can also reduce sensitivity. If you’re a trail runner, a callus on your foot may be able to withstand a bit more load and pain than without a callus. And since calluses form in areas of friction, a callus in that spot is even more important, since you’re prone there.

In this sense, calluses can be good.

The Bad

Too much of one thing can be bad.

According to the American Podiatric Medical Association, painful corns and calluses affect about 5% of people in the United States every year, and many people never seek professional help.

When calluses build up significantly, they can become painful. Especially when calluses are big, they can end up rubbing with your shoe and sock, and even detach from the live skin underneath. Then, painful blisters can form on the open patch. That right there is when the pain starts.

If you find your calluses are highly centralized to one location, that may be an indication of biomechanical deficiency. Generally, calluses cover a larger area and are not localized to one area of the foot.

Seeing a podiatrist can also help determine another factor which may cause calluses: your gait pattern. Custom orthotics may help, and reduce pressure to specific parts of your feet. Plus, a proper shoe-fitting helps you choose the right pair of footwear for your needs.

A pumice stone’s sandpaper-like texture can reduce a callus, but it may not provide enough grit to treat painful calluses. Don’t use anything sharp, like a knife to try to cut the callus away. Consult a medical professional in this case and avoid DIY.

According to Harvard Health Publishing, follow these procedures to safely scrub away a callus:

Soak your feet in warm water first, to soften the callus
Dry your feet, then rub the pumice stone gently over the corn or callus
Afterwards, moisturize the area with skin lotion.

In fact, removing a portion of the callus can be done safely. Scrubbing away a portion of the callus can be aesthetically satisfying while maintaining the integrity of the callus. Plus, scrubbing down a callus regularly prevents it from getting too large. A callus that cracks, as a result of being enlarged, is prone to infection.

In this case, calluses may be bad.

Bottom Line

If a callus isn’t painful and isn’t growing in size, they’re fine as is. If they become painful, book an appointment with a podiatrist for next steps, and for proper removal to avoid infection.

Continue reading: How to Manage Foot Calluses.

4 Foot Problems For Runners

Posted on July 3, 2020 by Tim

Running is one of the most rewarding activities both for our mind and body.

That said, running comes with several risk factors in the form of injuries and foot issues. Some are rare, and some are experienced by almost every runner you come across. And, if you haven’t yet, now’s the time to do some reading to prevent yourself from the same fate by avoiding several runner’s foot problems

Consider these foot issues a part of the unofficial runner’s bucket list when it comes to experiences.

Shin Splints

Shin Splints are the common term for medial tibial stress syndrome.

This condition is characterized by pain along the inner part of the shin. Most commonly, shin splints are a result of too-much t00-soon. Your lower legs are not able to acclimatize to the load running puts on your body. For example, many new runners suffer shin splints when running for too long, too soon.

Typically, our aerobic capacity builds faster than our muscles and joints. So, it’s important to increase your weekly running by no more than 10%.

Another possible cause of shin splints is overpronation, which occurs when your ankle rolls too far inwards. The excessive inward rolling means your shins are bearing more of the impact than normal. If this is the case, consider purchasing motion control shoes that feature a thick medial post.

In terms of treatment, follow the RICE protocol – rest, ice, compression, and elevation. You’ll also want to reduce your mileage and the intensity of your workouts. When you’re ready to return, ramp up slowly, and avoid running on harder surfaces and opt for grass, and trail running.

Black Toenails

Running-induced black toenails are called Runner’s Toe. Repetitive trauma – the type associated with long-distance running – cause a blood blister to form under the toenail resulting in the blackened nail. Black toenails are among the most runner’s foot problems.

The medical term is known as a subungual hematoma, which means bleeding and bruising under the toenail. Sometimes, the blood blister can start out small, and remain small. In that case, the darkened part of the nail will begin to grow out and be removed with the routine nail clipping. The drying of the blood can cause your nail to separate, and loosen. So, your toenail may fall off altogether. Hence, the common runner experience of ‘losing a toenail.’

Fortunately, the whole experience isn’t particularly painful, and no intermittent treatment is necessary. If the toenail does, in fact, fall off, wash the area and wrap in a bandage. If you experience persistent pain, you should visit a healthcare professional.

In terms of prevention, find a shoe that fits right. Consider a Shoe Fitting to determine the exact size and type of shoe that’s best for you. If your toes are crowded and up against the edge of your shoe, there will be more friction and impact causing you toe to blister. Additionally, if you run on undulating terrains, like downhills, you may be more prone to black toenails.

Blisters

Getting blisters is a shoo-in for runners.

A Blister is a small fluid-filled bubble on the skin. Most blisters on your feet are friction blisters, which result from socks or shoes excessively rubbing against the skin of your feet. This excessive rubbing can be from ill-fitting shoes, wet shoes, or just overuse, like running a marathon.

The ‘bubble’ itself is a natural cushion that your body produces in order to create a protective barrier between the irritated area of skin and friction-causing object.

The most common question related to blisters is: should I pop the blister or let it be? It depends.

If the blister is small enough and poses no risk of opening and possibly causing an infection, leave it be. Cover it with a Band-aid, or even basic medical tape, which has proven to be one of the most effective tools in preventing blisters. Additionally, the medical tape is only mildly adhesive meaning it won’t tear the blister. Plus, it’s extremely inexpensive.

However, if it’s large, and has a greater risk of opening because of added friction, consider popping the blister. Use a pin or needle (sterile) and puncture the outer skin. Drain the fluid from the blister. Thoroughly rinse the area.

Chafing

Chafing is similar to blisters in that it’s caused by excessive rubbing.

For runners, chafing can occur anywhere where skin rubs against skin or clothing. One common hotspot is the groin area, both because of shorts, and because your thighs may rub together when running. In fact, the latter even has its own name: Chub Rub.

Chafing is more of a nuisance than a foot condition but still important to address. You’ll want to do a number of things in order to prevent chafing:

Use vaseline to provide a barrier on your skin.
Stay dry: moisture can increase irritation and lead to chafing.
Dress right: wear moisture-wicking clothes and do not re-use the same part of bottoms without washing.

If the area is very painful, swollen, bleeding, or crusted, your health care provider may recommend a Medicated Ointment.

If you’re a runner and are interested in avoiding potential concern, Call us at 416-769-3338 or book a visit today!

What is a Bunionette?

Posted on June 29, 2020June 29, 2020 by Tim

Bunions are among the most common sources of foot pain. Bunions are particularly prominent among women, especially those older than 60.

A Bunionette, on the other hand, is less common. When you think about it, a bunionette sounds like a bunion’s younger sibling. And it kind of is.

What Is A Bunionette?

While a bunion is a pronounced bump on the outer edge of the big toe, a bunionette is exactly the opposite. A bunionette is a bump on the outer edge of the little toe.

A bunionette is commonly known as a “tailor’s bunion.” Why? Because tailors used to sit cross-legged. All day. (Apparently, this was done to Tighten Back Muscles so they didn’t wear out as quickly.)

As a result, their feets’ outer edge always made contact with the ground. Over time, the rubbing created a bump on the outside of tailors’ little toes, and further aggravated the foot condition.

And that’s a brief history lesson on a bunionette’s backstory.

The bump may also be a bone spur – a bony outgrowth – caused by osteoarthritis in the fifth metatarsophalangeal joint. The metatarsophalangeal joint is the area between your metatarsal bone (the base of your toe) and your proximal bones (smaller bones close to the head of toe).

Pain associated with a bunionette occurs on the outside of the foot, and tight shoes may exacerbate the condition. Shoes with narrow toe boxes are particularly problematic for those with a bunionette. Narrow toe boxes increase friction against the bony protrusion.

People who have mild to medium cases of bunionettes may experience little to no pain. In these cases, one should take the proper precautions to keep the case mild, and not progress any worse. A mild case of a bunionette may be a small bump on the outer edge of the little toe. A severe case may be that your little toe is overlapping your fourth toe.

Since bunionettes are a progressive condition, they will only get worse over time. This means you cannot reverse what’s already been done.

But, don’t worry, there’s still plenty you can do. In fact, the worsening can be slowed significantly, and it’s absolutely possible to maintain a high quality of life without pain. However, because it’s a progressive condition, the only corrective measure to remove the bunion is surgery.

Causes

According to Harvard Medical, bunions and bunionettes can be heredity, due to arthritis, or misalignment of the foot.

The causes of a bunionette are classified as either intrinsic or extrinsic.

Extrinsic causes include:

External pressure on the forefoot
Tight shoes

Intrinsic causes include:

Genetics
Foot anatomy
Faulty mechanics

Foot function and foot mechanics can also contribute to the formation of Bunions and bunionettes. For instance, overpronation, which is the turning in of your foot towards your arches as you are walking, can lead to bunions and bunionettes.

Bunion vs. Bunionette: What’s The Difference?

Whereas a bunion is a result of a deformity and shift to the first metatarsal, a shift in the fifth metatarsal bone causes a bunionette.

The bump that you see is the metatarsal shifting in alignment as the toe begins to point inwards. As this happens, the base of the metatarsal bone shifts outwards causing the bump that is so often related to foot pain. Because the little toe is smaller than the big toe, a bunionette is considerably smaller than a bunion.

Treatment And Prevention

Bunion and bunionette treatment is similar. As such, properly-fitting shoes are an essential step. The team here at First Feet Clinic specializes in Shoe Fitting. No appointment is necessary to find a pair of shoes that fit the profile of your feet.

Additionally, stretching your shoe can provide benefits as it artificially provides additional toe room. This allows your bunionette more space in the shoe.

If foot anatomy and pronation appears to be the cause, investing in Custom Foot Orthotics can be beneficial in the long run. If you’re unsure of the root cause, see a foot specialist for a course of action. Additionally, foot specialists can perform a biomechanical assessment to determine whether orthotics are the right approach.

Anti-inflammatories can also help reduce swelling and pain. Furthermore, you can purchase bunionette Splints for relief and to reduce swelling.

As a final resort, and if physical therapy doesn’t work, surgery is an option. Like for a bunion, surgery corrects the joint and bone deformity. This restores the toe to its regular position. Recovery time can be between 6-12 weeks and it’s recommended you explore all other non-invasive options before considering surgery. Note that because the small toe generally absorbs less body weight than your big toe, bunionette surgery recovery time may be less than for a bunion.

Book an appointment with a chiropodist at Feet First Clinic for professional diagnosis and appropriate treatment plan.

Are Flat Feet A Problem?

Posted on June 26, 2020June 26, 2020 by Tim

About 30% of the population live with flat feet.

So there’s a high likelihood that either you or someone in your family have flat feet.

What Are Flat Feet?

Flat feet are as they sound: a collapsed arch with much of your sole in contact with the ground. This is relative to a regular arch, which is when about half of your arch is in contact with the ground.

Good news! Flat feet are usually a painless condition. Often, flat feet occur during childhood development, but they can also occur as you age. Flat foot often starts with a dysfunction of the ankle tendon known as posterior tibial tendon. This tendon is responsible for holding up your arch. Weakness or underdevelopment in the tendon means your arch can drop.

Injury to the ankle can also cause flat feet, partly because damage to the tendons won’t be able to support your arch.

How Can I Tell If I Have Flat Feet?

The easiest way to determine your foot type is with a wet test.

The wet test is a cheap and easy way to determine your foot type. The test only requires a piece of paper and wetting the bottom of your foot.

To perform the wet test:

Pour a thin layer of water into a shallow pan
Wet the sole of your foot
Step onto a blank piece of paper (or onto a wooded surface like your deck)
Step off and look down

Based on the shape of your foot on the paper, you can determine your foot type. If your arch is partially filled out, then you have a normal arch. An arch that’s fully filled out means you likely have flat feet and fallen arches. If your arch is barely visible, you likely have a high arch.

Is It A Problem?

In short: it depends. In most instances, it isn’t.

There are generally a few tendencies associated with flat feet.

People with fallen arches generally have more inward rotation than those with a regular arch.

Generally, this gait deficiency will overwork other muscles and tendons in the leg. Overcompensating in your lower leg can cause problems in your knees, ankles, and hips. Fallen arches can also cause pain in your arches and can lead to swelling. Overcompensation can also lead to underlying issues in the foot like bone spurs, osteoarthritis, and bony prominences.

Someone with flat feet may also experience posterior tibial tendonitis. This condition causes pain and swelling in the posterior tibial tendon. As the tendon supports the arch of the foot, and provides stability, leaving this condition untreated may lead to an increased risk of flat feet. Why? Since the resulting tendons become inflamed and damaged, they lose the ability to maintain your arch height.

In many cases, the body adapts to having flat feet and you may never experience pain at all.

One form of fallen arches is known as flexible flat feet. In these cases, you never develop symptoms and the fallen arch is related to the looseness of ligaments and is inherited. In this case, flat feet are not preventable.

How To Live Pain-Free With Fallen Arches

If you’re pain-free, no treatment is necessary.

However, just because you don’t have pain now doesn’t necessarily mean you won’t in the future. Given your body may compensate for fallen arches, the deficiencies in your stride may take years to develop. (On the other hand, the deficiencies may never develop into pain.)

If you do start to experience pain, there a number of measures you can take including:

Orthotics: custom foot orthotics are specifically designed for your feet. These devices work to correct faulty foot mechanics and redistribute pressures across the bottom of the foot.
Motion Control Footwear: to help with overpronation (when your foot rolls too far inward), motion control footwear has medial support built into the midsole to help limit the damage and wear to the inner portion of your shoe.
Lifestyle Changes: an exercise program and a plan to manage your weight can help reduce the pressure on your feet.
Stretching Exercises: stretching and lengthening the range of motion of your Achilles tendon can help.

In short, flat feet can pose some problems in certain cases. In many cases, they aren’t a problem, especially if you follow certain precautions like strengthening and orthotics.

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10 Common Foot Conditions And Injuries

Posted on June 22, 2020June 22, 2020 by Tim

Your legs are involved in every aspect of movement. They’re the foundation of your body, and act as shock absorbers. Our reliance on our legs cannot be overstated. It’s crucial we take proper leg and foot pain management to avoid common foot conditions.

Overwhelmingly, there are some common foot conditions that are more prevalent than others. These are either injuries or conditions that a large portion of the population experiences once, or repeatedly. To put you on the right track, we’ve rounded up 10 common foot conditions. Note that these are listed in no particular order.

1. Bunions

A bunion is perhaps the widest known foot condition. A bunion is an enlargement on the outside of the big toe. The enlargement can be a bony outgrowth, or a shift in your big toe. Often the base of the metatarsal shifts outwards (meaning your toe points inwards), and a bunion results because of the deformity.

You may develop bunions through any of the following reasons:

Your foot is shaped in a way that makes you more likely to have bunions
Your foot rolls overly inwards when you walk
Flat feet
Tight footwear

Fortunately, a physical therapy regimen, over-the-counter products, and proper footwear enables you to live with bunions without surgery.

2. Athlete’s Foot

Athlete’s foot is a contagious fungal skin infection that affects the skin on soles of feet and between toes. The fungi that causes athlete’s foot is commonly found in moist places, like shared showers and locker rooms.

Athlete’s foot typically presents as a translucent white moist skin between the toes on one or both feet. To treat the condition, you can use over-the-counter products including medicated creams, ointments, sprays, and powders.

3. Ingrown Toenails

An Ingrown Toenail occurs when the nail begins to grow into the skin. In many cases, you can treat ingrown toenails yourself. In severe cases, you should consult a doctor.

Typically, wearing tight shoes, cutting your nails too short, or not across, and injuring your toenail can cause an ingrown toenail. Home remedies include soaking your feet in warm water, wearing proper footwear, taking anti-inflammatories, and placing dental floss under the edge of the toenail.

If the ingrown toenail is serious, surgery is performed.

The surgery consists of numbing the toe with a local anaesthetic, then removing the portion of the toenail that is growing into the skin, and finally, applying a chemical to the nail root to prevent regrowth.

4. Black Toenails

Black toenails may be rare to the majority of the population, but are common among runners. The repeated nature of running puts your toenails at risk due to impact and friction. Typically, black toenails result from a blister underneath the toenail. The most common cause is tight footwear, and from undulating terrain as downhill running adds pressure on your toes.

You might also get a black toenail because of trauma to the toe. Occasionally, a black toenail will fall off.

Here’s everything you need to know about black toenails including treatment and prevention.

5. Plantar Fasciitis

Plantar fasciitis can be a real pain…in the heel.

This foot condition involves inflammation of a thick band of tissue that connects your heel with your toes – the plantar fascia. Plantar fasciitis can cause sharp pain in the heel, especially in the morning.

Runners are especially prone to plantar fasciitis because of the repeated stress to the plantar fascia. Common treatment and preventative measures include self-massage with a golf ball, anti-inflammatories, and if necessary, custom orthotics.

6. Nail Fungus

The toes are particularly susceptible to nail fungus because fungi thrive in dark, moist places. Since many of us wear shoes for hours every day, one can understand how nail fungus comes about.

Common symptoms of nail fungus include yellowing and thickening of the toenail, brittleness, and sometimes an unpleasant odour. For early or mild cases of nail fungus, you can use a topical antifungal cream.

To prevent nail fungus, wash and dry your feet regularly, don’t share nail clippers, avoid being barefoot in public facilities, and keep your toenails short, but not too short.

7. Bone Spurs

Bone spurs are bony outgrowths, typically in areas prone to osteoarthritis. The most common forms of bone spurs in the foot include heel spurs, and a bone spur on top of the first metatarsophalangeal joint (MTJ). The latter is a common spot. Stiffness and arthritis in the big toe leads to a condition known as hallux rigidus.

Bone spurs inherently reduce flexibility and can be quite painful. With treatment including proper footwear, people can live normally with bone spurs without needing surgery. You should note that bone spurs are progressive meaning there’s no reversal of impact and damage done.

8. Corns

Corns are like calluses, except that corns can be painful. A corn is an area of hardened skin that develops on areas of the feet that sustain too much compression.

A corn has a few hot spots: between your toes, the outer edge of your little toe, and on top of the toes.

Corns are removable. One of our Toronto foot clinic specialists or chiropodists can safely remove the build-up of tissue and assess whether Orthopedic Shoes or Custom Orthotics may be indicated to prevent their recurrence.

9. Blisters

Blisters are more of an annoyance than anything. This minor foot condition occurs when the skin is aggravated. Because of this friction, a small fluid-filled bubble on the skin forms.

Fortunately, most blisters heal on their own. To ensure there are no complications, you can cover the blister with an adhesive bandage or blister pad, both of which are available at our Toronto foot clinic. Common tricks to avoid blisters include using baby powder for sweaty feet, proper moisture-wicking socks, and wearing shoes that fit.

10. Gout

Gout affects roughly 3 million Canadians each year.

This condition is a form of arthritis that can develop rapidly. The painful condition involves swelling and tenderness of joints. Gout is most common at the base of the big toe.

According to the Mayo Clinic, “gout occurs when urate crystals accumulate in your joint, causing the inflammation and intense pain of a gout attack. Urate crystals can form when you have high levels of uric acid in your blood.” Foods that can lead to high levels of urate are red meats, seafood, refined or processed carbohydrates, sugary drinks and alcohol such as beer and hard liquor.

And there you have it: 10 common foot conditions.

This list is by no means an exhaustive list. There are tens, if not hundreds, of different common foot conditions you might develop over the course of your life. To address your foot issues early, see a foot specialist.

If you’re in Toronto, Book An Appointment with a specialist today, or visit the store for everyday items like compression socks, footwear, and for a custom shoe fitting.

Foot Myths, Debunked And Explained

Posted on June 19, 2020June 19, 2020 by Tim

Our legs are a complex and intricate system of bones, joints, and muscles. Everything is interconnected in some way.

Muscles and joints rely on each other to perform properly, and to provide the necessary foundation for our body. Our habits, genetics, and environment all affect our feet. With so many different possibilities for foot conditions to arise, it’s important to remember that correlation is not causation.

Just because we do one thing, does not necessarily mean it causes another. To help clear the air over a sample of common foot myths, we decided to debunk a few of them below.

1. Flat feet are bad

About 30% of the population lives with flat feet.

Flat feet are defined as a postural deformity in which the arches of the foot collapse. As a result, the entire foot makes contact with the ground. The foot is characterized by a very low arch, and can other foot conditions because of the leg’s compensation.

Flat feet can develop in one foot, or both, depending on your body’s development.

According to Harvard Medical School, even in adulthood, 15% to 25% of people have flexible flatfeet. Most of these people never develop symptoms. For those with what’s called rigid flat feet, several measures can be taken to reduce pain and live comfortably with flat feet. These include:

Custom orthotics that artificially raise the arch and provide support
Strengthen and stretch your calf as this reduces the pressure and load on your arches
Supplement some high-impact exercise with low-impact activities like swimming, cycling, or spinning
Anti-inflammatories
Wearing slippers or supportive footwear inside instead of walking around barefoot

2. Wearing heels causes all of women’s foot problems

Additionally, a common misconception is that high heels cause bunions. This isn’t true. Heels aggravate bunions but are likely not the cause.

However, excessive heel usage can result in a few common foot conditions: Corns, Hammertoe and Calluses. Additionally, you’re at a greater risk of osteoarthritis since you may lose fat under your foot.

According to WebMD, you can prevent certain foot conditions while continuing to wear heels. Some of these preventative measures include:

Get the well-fitted high heel
Use silicone metatarsal pads for under your feet
Wear a thicker heel for stability
Pay attention to the “slope” or “pitch” of the heel
Wear open-toe high heels to relieve pressure on corns and calluses

3. A bunion is just a bump

A bunion may look like just a bump. However, that’s another in the list of foot myths. If only it were that simple…

Depending on the cause, your habits may worsen the condition. Maybe you wear shoes with a narrow toebox. Without correction, bunions can get a lot worse over time, turning just a bump into severe pain.

A Bunion, or hallux valgus, is a bony protrusion that forms at the site of the large joint that connects your big toe to your foot. As you can expect, without addressing the cause of bunions, the toe angle’s alignment can sharpen, causing a larger bump.

It should be noted that bunions can be hereditary, in which case you might be doing everything right. In this instance, continue to practice proper foot habits like:

Footwear modification, i.e., avoiding tight shoes with a narrow or stiff toe box.
Anti-inflammatory medications
Bunion splints
Bunion aligner
Therapeutic taping
Supportive insoles or custom orthotics

You should consult a foot specialist to see whether or not action needs to be taken.

4. Foot pain is the result of getting old

Foot conditions like osteoarthritis are common in older people. Osteoarthritis is a generative joint disease characterized by both a breakdown of cartilage and a build-up of osteophytes.

However, young people are not immune to the foot conditions of the elderly. If you train at a high level and participate in high-impact sports, you may experience osteoarthritis earlier in your life, even in your 20s. Common areas for osteoarthritis include the big toe joint, knees, and hips.

Because osteoarthritis is a degenerative disease, the damage that’s been done is irreversible. The damage to the cartilage between your joints has been done. If this is, in fact, the case, physical therapy is the best course of action. Common treatments include functional improvements – like stretching for a range of motion – and managing symptoms like with rest and ibuprofen.

5. Surgery will fix foot problems

Surgery can help fix certain foot conditions, but non-invasive options may work equally well, if not be more effective.

There are several factors to consider when deciding on foot surgery:

Necessity
Success rate
Cost
Recovery time
Long-term effectiveness

Certain progressive conditions like hallux rigidus, bunions, and a ruptured Achilles may require surgery to correct the inherent problem. However, physical therapy can also improve quality of life. Proper orthotics, avoiding high-impact exercise, proper footwear, and strengthening can help limit pain associated with certain foot conditions.

However, surgery removes the bone portion of the injury. For those with Hallux Rigidus, the Bone Spur contributes to the toe’s stiffness. The range of motion won’t improve without surgery. Although, the worsening of the condition can be slowed with physical therapy as mentioned above.

For those with a Bunion, you’ll want to explore All Non-Invasive Measures before deciding on surgery. If you have explored all options, surgery may be an option. Typically, those who experience significant pain, have severe toe deformities, and have chronic inflammation are the likely candidates for surgery. Bunion surgery (of which there are a few) can include several correct measures:

Realigning the metatarsophalangeal (MTP) joint at the base of the big toe.
Pain relief.
Correcting the deformity of the bones, especially if your big toe is drifting inwards towards your second metatarsal.

If you’re unsure about foot conditions, toenail conditions, or skin conditions, contact us at Feet First Clinic to set up an appointment. You can do that below, or by Contacting Us Here!

Everyday Toe Conditions

Posted on June 15, 2020 by Tim

It’s all in the toes.

Our toes bear the weight of the body with every step and are the foundation for our movement. The big toe specifically is the final point of contact before each step. In fact, the big toe carries the most weight of all the toes, bearing about 40% of the load.

As a result, many foot injuries and toe conditions stem from, or affect, the big toe.

Maintaining good toe health is crucial for the longevity and long-term health of your feet. There are a number of different foot conditions that can result from toe neglect. Stiff toes, for example, can lead to hallux limitus or hallux rigidus.

Below you’ll find a list of common toe conditions.

Claw Toe

A Claw Toe has an abnormal bend in both the middle joint and the joint closest to the tip of the toe.

Symptoms of claw toe include an upward extension from the joints at the ball of the foot and downward flexion at the middle joints toward the sole of your shoe. Claw toe comes in the shape of a bridge or a hump.

Early on, claw toe resembles a flexible hammertoe (see more below). However, over time, claw toes can stiffen. It’s important to address claw toe early to reverse the deformity. One such treatment is a splint or tape to hold your toes in the correct position.

Finding shoes that fit correctly is also a key preventative measure. You’ll notice through this article that many toe conditions can be prevented by wearing Proper Footwear. Additionally, you can use your hands to stretch and straighten your toes, and perform exercises including picking up marbles or a towel to strengthen local ligaments and tendons.

Subungual Hematoma

A subungual hematoma is a medical term for a Black Toenail.

A black toenail occurs when the skin below the nail is damaged. Long-distance runners are particularly susceptible to black toenails because of the friction to the top of the foot, as well as the duration of the activity.

Immediately after injuring your toe, you should follow the RICE protocol to reduce the pain and swelling: Rest, Ice, Compress and Elevation. Rest means you should stop doing any physical activity. Wrap a clean bandage around the toe to stem the blood. Put a bag of ice or a cold compress on the covered injury. Then lie down and elevate your foot by resting it on a pillow.

Turf Toe

Turf toe is a sprain of the big toe joint resulting from injury during sports activities.

This acute injury typically occurs from jamming the toe. Turf toe includes pain, swelling and limited joint movement. Following the RICE protocol – rest, ice, compression, and elevation – is beneficial. Additionally, wear stiff footwear to keep the toe at a neutral angle and isolated while walking.

The biggest concern here is either not addressing the injury, or rushing back to activity too quickly. Without the proper treatment, turf toe can turn into hallux limitus.

Hallux Rigidus

Translated to a stiff big toe, hallux rigidus is a progressive condition that stems from osteoarthritis in the big toe. It causes pain and stiffness in the joint and over time, the toe loses flexibility.

As the cartilage at the first metatarsophalangeal joint (MTP) breaks down, the metatarsal bones and the proximal bones rub together. This friction, as well as the body’s response to fill the void left by osteoarthritis results in the formation of a bone spur.

In this case, it’s important to recognize the early signs of hallux rigidus, including at its previous stage hallux limits. Work on improving the range of motion in the toes and invest in custom-made orthotics or footwear with a rocker to reduce the pressure and bend of the big toe.

Hammertoe

Hammertoe is a progressive toe condition that worsens if left untreated. In short, hammertoe is a toe deformity of one or both joints of the second, third, fourth or fifth (little) toes. You’ll see one of the toes shift and cross over another toe.

Hammertoe occurs when you wear ill-fitting shoes. Specifically, footwear that is far too small for your feet. The lack of space deforms your toes and can cause a shift in the tendons and ligaments. Fortunately, addressing the cause quickly can be extremely effective.

Treatment includes:

Corn pads
Stretching and strengthening your toe and toe and foot muscles
Roomier footwear
Custom orthotics that help reposition and take the pressure off of your toes
Surgery

Left untreated, hammertoe can worsen and require surgery. If your toes appear bent or you are experiencing toe mobility, visit one of our licensed chiropodists (foot specialists) as soon as it’s safe to do so.

Drop-in shoe fitting for hammertoe is also offered.

Gout

Gout is a common and complex form of arthritis that often begins in the big toe.

It’s often known as the “disease of kings” or “rich man’s disease” because it’s prevalent in older men, as well as those who eat meat or seafood, drink beer, or are overweight.

It’s characterized by sudden, severe attacks of pain, swelling, redness and tenderness in the joints. Gout looks like a swollen bunion on the outside of the big toe.

To help prevent gout, you can follow these preventative measures:

Drink plenty of fluids
Limit or avoid alcohol
Get your protein from low-fat dairy products
Limit your intake of meat, fish and poultry
Maintain desirable body weight

Remember, our bodies begin at our feet. Take proper care through the various methods mentioned in this article to prevent toe conditions from occurring.

Is Foot Surgery Worth It?

Posted on June 12, 2020June 12, 2020 by Tim

If you experience foot pain for some time or have a trauma injury, surgery has likely come to mind.

Surgery is a treatment of injuries or disorders of the body by incision or manipulation. Surgery is quite common for foot injuries and is done as a restorative measure.

Because of its invasive nature, considering the positives and negatives of surgery is important. You should not only weigh the direct impact of surgery but also the long-term effects.

There are several factors to consider when deciding on foot surgery:

Necessity
Success rate
Cost
Recovery time
Long-term effectiveness

With these in mind, you should take into account the positives and negatives of both. Does the recovery time justify getting surgery, for example? How about the long-term effectiveness of the surgery?

Below, we get into the case for, and against, foot surgery.

When is Foot Surgery Necessary?

Some foot conditions require surgery. You should explore all non-surgical options and physical therapy before foot surgery.

Certain foot conditions are progressive, and will not get better without surgery. In these instances, one can consider surgery as a measure to better their quality of life. A few examples of progressive foot conditions include hallux rigidus, bunions, a rupture in your Achilles tendon. Conditions that get progressively worse over time (though slowed with proper measures) may require surgery.

However, that doesn’t mean you can’t live comfortably with the condition. Investing in proper shoes, doing physical therapy, and avoiding certain activities may relieve pain.

In the instance of hallux rigidus, you can maintain a high quality of life through physical therapy, proper orthotics, avoiding high-impact exercise, and working on flexibility. However, since the osteoarthritis that breaks down the cartilage won’t be able to recover, the resulting bone spur will likely grow over time, further limiting the range of motion.

Some people opt for a cheilectomy, which is an incision along the top of the toe to shave down a Bone Spur. In other cases, people opt for a fusion, which connects the first metatarsal with the phalanx. The connecting of the two bones fuses the area of the first metatarsophalangeal joint (MTP joints).

For those with a bunion, you’ll want to explore all non-invasive measures before deciding on surgery. If you have explored all options, surgery may be an option. Typically, those who experience significant pain, have severe toe deformities, and have chronic inflammation are the likely candidates for surgery. Bunion surgery (of which there are a few) can include several correct measures:

Realigning the metatarsophalangeal (MTP) joint at the base of the big toe.
Pain relief.
Correcting the deformity of the bones, especially if your big toe is drifting inwards towards your second metatarsal.

Finally, in the case of an Achilles tendon rupture, surgery may be needed. A rupture of the Achilles is a partial or entire tear of a tendon when stretched beyond its capacity. You may hear a pop when a rupture occurs. Surgery on the Achilles tendon involves making an incision in the back of the leg and stitching together the affected tendons. Foot surgery in this instance should only be explored after non-surgical options have been explored including icing, rest, using a walking boot or crutches, and taking anti-inflammatories.

When is Foot Surgery Not Necessary?

Generally, you can treat foot conditions without operational procedures. The body is incredibly resilient when it comes to injuries, and many foot conditions can be treated with a proper plan.

Surgery is usually seen as a last resort because there is significant rest needed afterwards, the occasional complication, and sometimes nerve damage. Surgery can also be expensive if it’s not covered under provincial or private insurance. Finally, surgery might the obvious problem, but may not solve the underlying issue. This means that the foot condition may return in the future.

For the examples mentioned above – hallux rigidus, bunions, and an Achilles tendon rupture – all have recommended treatment options that don’t involve surgery. Working with a foot professional to determine the underlying cause, like a muscle imbalance, for example, can help treat the resulting condition, and can be better for your body in the long run.

Surgery also can take weeks, if not months to recover from. Make sure to incorporate several weeks of recovery into the discussion when considering foot surgery. Recovery time may otherwise be used to build a habit of incorporating physical therapy into your routine. Consider the opportunity cost of the severity of the surgery as well as the recovery time.

For most foot conditions, there are a number of treatment options you should consider including:

Rest
Icing/compression
Strength-training
Custom orthotics
Proper footwear
Physiotherapy
Over-the-counter footwear products like Bunion Socks

Any number of these treatment options may be able to provide the relief you need. Remember, you might not see results right away. In some cases, incorporating these treatments may take weeks, if not months, to result in meaningful change. However, those habits will continue to benefit you for the rest of your life.

There’s no hard and fast rule for in cases for and against surgery. Always consult a medical professional when deciding upon the best course of action, and see if foot surgery is recommended. For chronic foot pain, and conditions, schedule an appointment by using the appointment request form below or contact the clinic at 416-769-FEET(3338).

Hallux Rigidus or Bunions: What’s The Difference?

Posted on March 30, 2020June 8, 2020 by Tim

If you have a lump on your big toe, you may be wondering whether it’s a Bunion or Hallux Rigidus. Both foot conditions affect the big toe and are bony outgrowths that are progressive conditions that get worse over time if not properly treated. The two conditions are also characterized by bumps on the big toe and can prove to be painful when wearing improper footwear.

Although hallux rigidus and Bunions affect the same joints, the two are quite different and require different treatment. And because our toes are the foundation of our legs, and bodies, proper treatment is essential. For one, you will prolong the joint. And second, proper treatment helps prevent other conditions that can result from compensation.

The most common distinction is where the bony outgrowth can be seen. Hallux rigidus is characterized by a bump on the top of the toe. A Bunion is an outgrowth along the edge of the big toe.

What is Hallux Rigidus?

Overview

Hallux rigidus gets its name from hallux, or big toe, and rigidus, which translates to stiff. In the simplest terms, hallux rigidus is a stiff big toe.

Hallux rigidus develops as a result of Osteoarthritis. As the metatarsophalangeal (MTP) joint breaks down over time, often due to repetitive use, the body responds by creating bone growth as a defence mechanism. As the area becomes increasingly crowded with bony outgrowth, one loses flexibility in their big toe, and the condition worsens as the first long bone (metatarsal) in the forefoot begins to rub against the first bone of the big toe. The bony outgrowth is known as osteophyte. In other words, a bone spur.

This area is particularly prone to Osteoarthritis and foot conditions because of the amount of weight the joint bears. As Harvard Medical School puts it, “every time you take a step, the MTP joint bends, allowing the foot to roll forward and push off. During this phase of the walking cycle, the joint supports 50% of the body’s weight.” Yes, 50%.

As the joint stiffens, and your toes lose flexibility, walking, and any other form of weight-bearing exercise for that matter becomes increasingly difficult.

Causes

This condition typically takes many years to develop. In its early stages, you may simply experience a tight big toe, or occasional pain when exercising. Alternatively, hallux rigidus can also develop after trauma to the joint. For example, stubbing your toe repeatedly, and not treating the injury, will contribute to joint decay over time. In fact, many professional athletes experience some form of hallux rigidus, either as a direct result of turf toe or because of years of intensive activity.

NBA legend Shaquille O’Neal is one such example, though he suffered from bone spurs in his little toes. Ballet dancers, thanks for the fact that they are routinely on their tiptoes, are also particularly prone to hallux rigidus.

Finally, hereditary defects and faulty foot mechanics can place additional stress on the joint, triggering arthritis.

Not all toe stiffness is the same. Minor joint stiffness is hallux limitus. Those with the condition have more flexibility and range of motion than those with rigidus, and bone spurs may also be absent. However, without the proper treatment, or ignoring it all together, the condition can quickly worsen. Unlike other injuries that you can injure, hallux rigidus is a progressive, and permanent condition.

Treatment

However, those with hallux rigidus can offset the limits of their big toe in ways to enhance their daily lives. Physical therapy, proper Orthotics, avoiding aggravating exercise, and strengthening the surrounding muscles that relieve pressure on the joint can all improve quality of life. More invasive options include surgery, including fusing the two bones, and a Cheilectomy, which is a surgical procedure to remove excess bone from the joint of your big toe.

You can read more about hallux rigidus and Bone Spurs here.

What is a Bunion?

Overview

Bunions, like hallux rigidus, affect the metatarsophalangeal (MTP) joint, which are the links between your foot and toes.

To make things confusing, the condition is actually known as Hallux Valgus. (Another ‘hallux’ term.)

Bunions occur when the first metatarsal bone of the foot turns outward and the big toe points inward, according to Harvard Health. Unlike hallux rigidus, hallux valgus is the result of your bones shifting, with the resulting protrusion going outwards, and not upwards like with hallux rigidus’s osteophyte.

Hallux valgus, bunion in woman foot on white background — Hallux valgus, or a bunion, with a bump on the left big toe.

There are Several Phases of bunions. To start, a small bump may appear on the outer edge of the foot. Over time, and if the bunion gets worse, the bump will grow, and the big toe will increasingly point inwards, sometimes crossing over your other toes.

Causes

Often, Bunions are the result of narrow-fitting shoes, which can force the big toe inward, scrunching all five toes together. High heels are one example. (In fact, bunions are 10 times more common in women than in men.)

Ill-fitting shoes are however just one of many causes. Genetics can also pass on bunions through generations. Additionally, your foot type can be a factor.

Treatment

Treatment and preventative measures include finding the Right Shoe, to reduce risks of Bunions from forming in the first place. However, like hallux rigidus, Bunions are a progressive foot condition. Surgery is necessary to actually remove a bunion. But, physical therapy and over-the-counter products can certainly reduce the need for surgery as generally non-invasive options are best.

Conservative Bunion management includes Custom Foot Orthotics, splints, bunions guards, toe separators, and Foot Exercises. For additional treatment options, read our blog on Effective Ways of Treating Bunion Pain.

Are you confused about whether you have hallux rigidus or a Bunion?

Book an appointment with a chiropodist at Feet First Clinic today for a professional diagnosis and appropriate treatment plan.

The ‘What’ And ‘How’ Of Foot Conditions

Posted on March 23, 2020March 9, 2020 by Tim

We’re on our feet every day, if not for hours a day. Our daily habits shape how our body functions, and vice versa. Because of how interconnected our body is, small abnormalities and foot conditions can manifest into something much greater. All a small problem needs is time.

From what we wear to the anatomy of our body, there are many factors that contribute to potential injuries or foot conditions. Below we outline a possible scenario, like a daily habit, and what might come from it. Then, we outline fixes for various foot conditions might be.

The what: Ill-fitting shoes

May cause: Bunions, black toenails, blisters

The fix:

Proper shoe-fitting session: we offer shoe fitting here at the clinic. Come visit us – no appointment required – to be properly fitted into a pair of shoes best suited for your feet.
Taping: if you experience blisters on a regular basis, consider using basic medical tape to provide protection, and to reduce friction that causes blisters.

The what: Flat feet

May cause: Plantar fasciitis

The fix:

Arch support: orthotics can help reduce the symptoms of flat feet as they act as a support under your arch.
Stretching exercises: stretch your Achilles tendon as that area often takes the brunt of the impact when walking and running with flat feet. This is because of your arch’s lower profile, and overpronation.
Supportive shoes: Since your arch collapses as a result of flat feet, you will likely overpronate. As such, supportive shoes can help correct your gait imbalance, and provide a solid foundation under your arch to keep your foot stable.
Physical therapy: the goal with physical therapy is to help reduce the muscle imbalances that naturally occur as a result of compensating with flat feet. Important exercises include strengthening the muscles along your arch, and your Achilles tendon. Read more about various exercises for flat feet in our daily foot exercises post.
Rest: According to the Mayo Clinic, “avoid activities that aggravate your condition. Participate in low-impact activities — such as walking, biking or swimming — rather than jumping and running activities.”

The what: Overpronation

May cause: Morton’s neuroma

The fix:

Custom orthotics: as pronation lower the transverse arch of the foot, orthotics can help with stability and limiting the effects of overpronating.
Stability shoes: those who overpronate may benefit from stability shoes, which have a stiff medial post. This reduces the amount of overpronation as your foot no longer rolls inwards as much. Additionally, the support that is along the medial shoe of such a shoe can absorb some of the impact.

The what: Overtraining

May cause: Osteoarthritis, bone spurs, Achilles tendonitis, plantar fasciitis

The fix:

Overtraining is a surefire way to injure yourself, and to quicken the onset of progressive foot conditions like osteoarthritis.
Rest: no good comes from continuing to train through pain. Rest if you feel like muscle soreness is gets worse.
Stretching: maintaining flexibility in your lower limbs is key to staying healthy.
Increase load slowly: the human body can withstand an incredible amount of impact, but only if you train it to. Slowly ramp up the intensity of whatever exercise you’re doing to ensure you don’t do too much too soon. Sometimes, your aerobic fitness improves faster than your body’s adaption to an increase in training, so make sure to recognize the early warning signs like chronic pain, and delayed onset muscle soreness (DOMS) for a few days.

The what: Tight calves/Achilles

May cause: Metatarsalgia

The fix:

Tight calves can increase the weight applied onto the front of the foot, which can lead to metatarsalgia.
Stretching: loosen your Achilles tendon, and calf muscles as with tight muscles, your foot will compensate by bearing more load in the balls of your feet.
Orthotics: you can reduce forefoot pressures and improve biomechanical function to prevent further pain by investing in a pair of custom orthotics. Visit the clinic for an assessment and to be fitted with custom orthotics. Most extended health insurance plans cover the cost of orthotics in part or in a whole.

The what: Wearing high heels

May cause: Heel spurs/Haglund’s deformity, bunions

The fix:

Reduce usage: high heels don’t necessarily cause bunions, but they do exacerbate the problem because the front of your foot bears more weight. Swap out high heels for more comfortable shoes, or, if your workplace is formal attire, try to reduce the amount of hours spent in them.
Orthotics: custom foot orthotics can reduce excessively high pressures at the forefoot, which can, in turn, aggravate and accelerate bunion formation
Haglund’s deformity on the heel is known as ‘pump bump’ because of its association with wearing high heels. Haglund’s deformity an abnormality of the foot bone and soft tissues characterized by a bony protrusion. Additionally, this condition develops when there is too much pressure on the heel, in part because of tight-fitting shoes. To Haglund’s deformity:
- Replace heels with open-heel shoes
- Ice the bump
- Soft tissue massage
- Orthotics
- Heel pads

As you can tell, small changes to your habits can make a significant difference in the long-term health of your feet. Habits in moderation, like wearing high heels, can lessen the impact on your legs versus say, wearing them each and every day.

If you continue to experience pain, and are looking to get to the root of the problem, feel free to visit the clinic. You do not need a referral to become a patient at our foot clinic. Schedule an appointment by using the Appointment Request form below or contact the clinic at 416-769-FEET(3338).