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Heel Spur: Causes and Prevention

A heel spur is a bony protrusion or growth from the underside of the heel bone. It forms over time due to repetitive muscular and ligament strain from activity such as walking, running, and jumping. It is a condition often associated with plantar fasciitis, which is the inflammation of the fibrous tissue that runs from the heel bone to the ball of the foot, causing heel pain. Contrary to popular belief, a heel spur itself does not cause pain at the heel; rather it is the soft tissue injury associated with it.

The heel spur is simply the reaction to the problem at hand, not the cause. These associated soft tissue injuries usually cause a sharp pain at the heel with the first steps in the morning or with the initial steps after rest. Some report the pain turns into a dull ache and comes back with increased activity throughout the day.

You can definitely increase your risk of developing a heel spur and associated heel or plantar arch pain by:

  • Wearing unsupported footwear
  • Not addressing fault foot mechanics and abnormal gait patterns
  • Increasing weight bearing activity, especially in sports that require you to run and jump
  • Being overweight

Heel Pain

Although a heel spur can only be removed by surgical means, the associated pain from various soft tissue injuries can be managed through conservative means such as rest, ice, proper footwear, custom foot orthotics, and daily stretching.

Look for shoes that have a cushioned sole with arch support rather than a shoe that is completely flat. A good shoe will also have good torsional stability, a firm heel counter, and a roomy toe box. In addition, for home shoes, opt for sandals or slippers with a cork foot bed and again, arch support is a priority.

Talk to your local Chiropodist for advice on custom foot orthotics. A custom insole will support your foot in all the right places and correct any harmful compensations or abnormal gait patterns. Furthermore, a heel pad may be added to provide additional cushioning or a horseshoe pad which will offload the heel spur/area of pain.

Finally stretching the muscles and tendons of the foot will reduce tension in these soft tissues as well as strengthen them.

Calf stretched against the wall and on a step are particularly helpful. Remember to hold your stretch for 15-30 seconds, repeating the exercise 10 times on each leg.

exercises
Calf Exercises

For more information on heel spurs and effective treatment options, book an appointment with one of our Licensed Chiropodists at Feet First Clinic.

We are open six days a week!

In Everything Give Thanks

Thanksgiving is just around the corner and that means spending time with family and friends. It also means spending a lot of time staying inside preparing, cooking and eating. It is important to be mindful about proper footwear at home especially during the holidays when we spend the most time walking around barefoot.

Recent studies find that it is not recommended to walk around barefoot at home when you have hardwood floors, laminate or ceramic floors. When we strike our heel, the pressures from the ground are absorbed by our heels by means of pronation. However, most people who are “heavy footed” lack proper shock absorption and with every heel strike those hard ground reactive forces are being transferred to the joints at an alarming force.

On the opposite end of the spectrum, people who walk with a “slap foot” have too much shock absorption and lack the ideal structure for proper pressure redistribution. If you are experiencing any heel pain, pain in the balls of the feet or your feet just feel tired – then you are definitely putting your feet at more risk by walking around barefoot. We often suggest wearing Birkenstocks as slippers for inside the house.

Birkenstocks have a cork footbed which is one of the best materials for shock absorption. The arch support also helps balance your foot and heel in the proper position for shock absorption. Also, straps around the ankle and the arch create a more stable platform for support. If you find Birkenstocks too hard or uncomfortable, a great alternative is Mephisto which have a softer footbed but equal support and shock absorption as Birkenstocks.

mephisto clog
Mephisto – Thea

If you find you are susceptible to corns or calluses or you have been struggling with a painful corn or callus, then it is necessary to be wearing shoes inside the house. Calluses occur due to pressures not being absorbed properly while corns occur usually within a callus due to excessive pinpoint pressure.

Excessive swelling can occur in the ankles and feet if you are standing for long hours. Along with the swelling, the veins can be overworked and eventually become twisted and bulge out as varicose veins. Compression stockings help promote circulation and prevent varicose veins and swelling.

compression stockings science

It is recommended to wear them while standing or sitting for long hours to make sure circulation is constantly flowing.

This year enjoy the Thanksgiving holidays with friends and family with pain free feet legs and feet.

Toronto Pumpkin Fest

If you’re looking for something exciting to do for the Thanksgiving weekend, plan a trip with your family down to a massive pumpkin patch at Downey’s Farm in Caledon, Ontario, just a 30-minute drive from Toronto.

Since Toronto Pumpkinfest is an outdoor event, there are several things you will want to prepare for beforehand.

The most important item to think about is footwear.

Fall weather can be unpredictable so be sure to check the weather the day of to prepare accordingly. Most outdoor events tend to be pretty muddy so wearing waterproof hiking shoes or boots is a safe choice. Be sure to check your shoes for any cracks or wear before the start of the season.

If you are looking for new footwear, brands such as Clarks, Portofino, Ara, Mephisto and Naot have a great selection of stylish and supportive footwear.

comfortable footwear
(From left to right) Clarks, Mephisto and Ara

Stay warm with proper fitting thermal socks or Merino wool socks which have moisture wicking properties to keep your feet dry. If you have tired or heavy legs that are prone to getting cold, consider ordering a pair of Sigvaris Merino Wool compression stockings.

merino wool compression

Compression stockings are graduated, which means they are tighter at the ankles and looser at the calves, which helps promote continuous circulation. If you are living with Raynauds or are prone to chilblains, Pyro Socks for Cold Feet by Infracare allow your feet to stay warm with their bio-material.

After spending all day outside, you can relax your feet at home, soak them with Gehwol foot bath and moisturize it with Gehwol Warming Balm.

Click the here for more details about Toronto Pumpkin Fest.

The Anatomy of Toe Deformities

The lesser digits in the foot are prone to deformity when there is an imbalance to the muscles, tendons, or ligaments surrounding the toe joints. These imbalances can occur due to faulty biomechanics, having excessively long toes, neuromuscular disease, systemic conditions (such as rheumatoid arthritis, diabetes), ill-fitting footwear choices, and genetics. Depending on where the bend in the toe occurs, the descriptive name for each deformity is given. Lesser toe deformities are commonly seen in a high arched foot or a foot with bunions. Continue reading to find out more about the different types of lesser digital deformities and how they can be prevented and treated.

Types of Toe Deformities:

Illustration of mallet toe, hammer toe, claw toe, and retracted toe

Mallet toe

A mallet toe has an abnormal bend in the joint of the toe that is closest to the toenail.

Hammer toe

A hammer toe has an abnormal bend in the middle joint of the toe. This term is commonly used as a general term to describe all lesser toe deformities.

Claw toe

A claw toe has an abnormal bend in both the middle joint and the last joint closest to the toenail of a toe.

Retracted toe

A retracted toe is very similar to a claw toe. In fact, it is a claw toe that is also pulled back or retracted so that the digit abnormally bent but also lifted from the ground.

Treatment and Prevention

All lesser toe deformities can either be flexible or rigid. The aim of treatment is to keep the joints in the toe flexible and prevent progression to a rigid deformity.

The following recommendations will help to do just that:

Wear properly fitting and supportive footwear

Wearing shoes that are the correct size is the simplest thing you can do to help your feet. If you do not know your foot size, use a standard foot measuring device to measure your foot before you purchase shoes. Always trying on shoes and walking around the store in them before purchasing will also help to determine if they fit properly. As a general rule, there should be about 1 cm distance between the longest digit and the end of the shoe. If you have digital deformities, look for shoes that are wide and deep enough at the toe box. Bring your shoes to Feet First Clinic if you want them stretched to accommodate bunions and hammer toes. Finally, avoid wearing unsupported shoes such as flip flops that encourage your toes to grip the shoe as you walk. Instead, opt for shoes that have arch support in the foot bed, a cushioned sole, and a minimal to low heel.

Address biomechanical issues

Faulty foot mechanics such as overpronation, which is the movement exhibited when your foot rolls towards your arches as you walk, can be a major culprit of hammer toes. In a pronated foot, the smaller muscles in the foot lose their function and the larger muscles gain mechanical advantage causing the toes to curl. The good news is that overpronation can be corrected and managed by custom foot orthotics -functional devices that are made to support, stabilize, and align the foot in its most anatomically efficient position.

Address painful corns and calluses

Lesser toe deformities can result in areas of increased pressures on the digits and consequently painful corns and/or calluses in these places. See your local chiropodist for debridement of these painful lesions and ask him or her about any over the counter toe supplies such as, hammer toe crests and silicone toe sleeves that may help.

Strengthen the muscles in the foot with these daily foot exercises.

As mentioned previously, toes bend abnormally due to muscular imbalance. This muscular imbalance can be caused by weak muscles in the foot and lower limb. Stretching and strengthening exercises will help to maintain flexibility in the digits and prevent less toe deformities.

Book an appointment with one of our Licensed Chiropodist at Feet First Clinic for your hammer toe concerns.

We are located at 2481 Bloor Street West and are open six days a week!

Gout: Symptoms, Prevention & Treatment

If you have a red, swollen, warm, painful big toe and it came about relatively suddenly perhaps in the middle of the night, you may have gout.

Gout is a form of inflammatory arthritis that is caused by high levels of uric acid in the blood. Elevated levels of uric acid lead to the formation of crystals which deposit into a joint resulting in the joint becoming red, hot, swollen, and painful. The initial attack of this condition is usually sudden, symptoms lasting for about a week. The most common joint it affects is at the joint that connects your big toe to the rest of the foot.

Gout is predominantly seen in men around the age of 60. People who have existing health problems such as high blood pressure, high cholesterol, diabetes, and heart disease are also more likely to get gout. In addition, dietary choices such as frequent consumption of red meats, shellfish, as well as alcoholic beverages can increase your risk.

If you think you may have gout, a Licensed Chiropodist will be able to manage your pain and ease the symptoms.

The main goals of therapy are to terminate a painful attack and prevent recurrences. In general, management of gout involves a prescription oral medication such as a nonsteroidal anti-inflammatory called, Indomethacin.

Then, to help decrease pain, a Chiropodist will aim to immobilize the joint temporarily. This can be done via pads and tape. Your footwear choices are also something to consider. Wearing shoes with increased toe-box depth, increased width and rigidity in the sole can help reduce pain.

If gout related pain becomes chronic, more permanent solutions such as a custom foot orthotic with a rigid extension to reduce mobility in the affected joint may be recommended.

Book an appointment with a Chiropodist at Feet First Clinic today for a full assessment and more information on how to manage gout attacks in the foot.

Rheumatoid & Psoriatic Arthritis

Other than osteoarthritis, most other forms of arthritis are described as “Inflammatory Arthritis” because in these cases, inflammation itself is the source of cartilage damage.

Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease, which means it occurs when the body’s immune system starts to mistakenly attack its own tissues. With rheumatoid arthritis, the immune system targets the lining of the joints, leading to chronic inflammation, cartilage damage, joint impairment and joint deformity. In addition, this disease is not only localized to the joint, but also has systemic implications, such as a low-grade fever, loss of appetite, fatigue, and anemia. In some cases, inflammation can even affect nearby organs like the nerves, eyes, skin, heart, and lungs.

Rheumatoid arthritis is characterized by flares and remissions of disease activity, including swelling, pain, and stiffness in multiple joints, usually presenting in a symmetrical fashion. For instance, when a joint in your left hand is swollen, the same joint in your right hand will also be swollen. The disease starts by affecting the smaller joints in the body such as those found in the hands, wrists, and feet, and will spread to larger joints as the disease progresses.

Psoriatic Arthritis

Psoriatic arthritis is an inflammatory arthritis associated with an inflammatory dermatological condition called, psoriasis. Psoriasis is characterized by red, silvery, scaly patches that are itchy and sometimes painful. Nails can also be involved and become thickened, discoloured, pitted, and crumbly, mimicking nails infected with fungus.

Psoriatic arthritis usually affects a joint or a few joints of the fingers and toes, resulting in a swollen, red digit. In some cases, the spine and knee may also be affected.

How Can a Chiropodist Help?

Rheumatoid and psoriatic arthritis can lead to joint disability and joint deformity. Therefore, wearing orthopedic footwear to accommodate the foot can help to manage pain and inflammation, thereby, slowing down the progression of the disease. In general, look for a wide set shoe with a wide and deep toebox and a cushioned insole. A biomechanical assessment and gait analysis will determine if there are any biomechanical faults that are exacerbating your symptoms. The best custom foot orthotic will control, stabilize, and support the foot, reducing stress on joints and evenly redistributing pressures.

 

If you have rheumatoid or psoriatic arthritis affecting the joints of your feet, stop living in pain and book an appointment with one of our Licensed Chiropodists at Feet First Clinic today. Chiropodists can help to restore and preserve function as well as maintain mobility in the joints of your feet, significantly improving the quality of your life.

Osteoarthritis: How it Affects Your Feet

Arthritis is a broad term that describes a disease characterized by inflammation (redness, swelling, and pain) in the joints of the body. As the disease progresses, chronic inflammation can lead to permanent damage to these joints, resulting in restricted mobility and loss of function. It is safe to say that arthritis can significantly diminish your quality of life.

There are many types of arthritis; however today, we will discuss the most common type: osteoarthritis.

Osteoarthritis

Osteoarthritis is a degenerative form of arthritis in which the cartilage between the joints in your body breaks down. This is usually caused by “wear and tear” or overuse of the joints accumulated over a long period of time. The most common areas affected are those exposed to the most stress or weight like the knees, hip, hands and spine.

Damaged cartilage within the joints makes movement painful and stiff. If you have osteoarthritis, you may experience a deep, aching pain in the affected joints, as well as morning stiffness and stiffness after resting. Moving your joints in its full range of motion and doing activity that engages the affected joints may be difficult and painful.

Although aging is inevitable, you can reduce your risk of developing osteoarthritis by maintaining a healthy weight, controlling your blood sugar, regularly participating in low-impact exercise, avoiding injury, and getting rest when needed.

How Does Osteoarthritis Affect the Feet?

In the foot, the most common joint to be affected is the 1st metatarsal phalangeal joint, which is the joint that connects your big toe to the rest of your foot.

If you’re experiencing arthritic pain, swelling, and restricted motion in the 1st toe, consider booking an appointment with a Licensed Chiropodist who can help by limiting painful movement and preventing further deformity. Your chiropodist may create a shaft pad for your shoe or tape the joint to limit range of motion.

A full biomechanical assessment and gait analysis will also determine an underlying biomechanical fault that may be exacerbating the progression of the disease. The best custom foot orthotic will control, stabilize, and support the foot, reducing stress and encouraging healthier joint alignments.

Book an appointment with a Licensed Chiropodist at Feet First Clinic today!

The Right Shoes Will Ease Your Back Troubles

Your feet are linked with your lower back through a kinetic chain. The chain starts with your feet, then continues to your ankles, your knees, your hips and then your spine. When one part of the chain is disrupted, it can have a ripple effect and agitate the other important links.

When you’re experiencing chronic lower back pain, and you’re unsure of the cause, you need to look down at your feet.

Check Your Feet for Clues

You should book an appointment at Feet First Clinic. It’s the best spot to get video gait analysis in Toronto. During the appointment, you will be filmed walking on a treadmill. The licensed chiropodist will view the footage in slow-motion and determine your gait pattern and foot type. An abnormal gait can lead to back pain because it disrupts the kinetic chain between the foot and the spine.

Your gait can be affected by a previous injury, a musculoskeletal condition or your foot pronation. Overpronation or flat feet can upset the natural gait and alignment. The term overpronation means that the arch of the foot moves downward and inward too much. On the other hand, foot supination is when the arch rolls outward too much, and it can also lead to chronic back pain.

In a single appointment, a  chiropodist can spot the clues that solve the mystery of your back troubles.

Change Your Shoes

The wrong footwear will negatively impact your gait and posture. For instance, flip-flops cause back pain because they have little structure and support, so you have to clench your toes to grip the sole and keep it steady as you move. The tension will affect your arches, heels, knees, hips and back.

Other shoes that can change your gait or give you poor posture:

  • Ballet flats
  • High heels
  • Mules
  • Toe shoes

If you want to give yourself the gift of good posture and alleviate your chronic back pain, you should get rid of your problematic shoes and restock your closet with orthopaedic shoes. Feet First Clinic has stylish options for every occasion, whether it’s dressing up for a night on the town or heading to the gym to jog on the treadmill.

Get Custom Orthotics

Corrective insoles can support your arch and keep your foot in the right spot when you stand, walk and run. It’s possible to get a cheap pair of inserts in the pharmacy aisle, but they will be made for the general public. There is no guarantee they will be the right fit for your feet.

For a guaranteed fit, you can have Feet First orthotics custom-made to match the exact size and shape your foot. You can visit a chiropodist today to undergo a biomechanical assessment — this will cover aspects like weight-bearing, range of motion and muscle tightness in your feet and connecting areas.

After the assessment, the chiropodist will take a plaster casting of your foot in the subtalar joint neutral position. Then, the casting is sent to an orthotics fabrication lab. Soon enough, you can slip your custom-made corrective inserts into your shoes and take them for a test-drive — or in this case, a test-walk.

When you’re dealing with soreness in your lower back, the surprising solution could be to take better care of your feet. By dealing with the bottom of the kinetic chain, you can relieve pain at the top.

How To Stay Cozy & Comfortable This Harvest Day

As the summer season comes to an end, celebrate the first official day of Autumn on September 21st at the Toronto Botanical Garden’s Harvest Day Celebration. This free family-friendly event is a great opportunity to spend time with family and friends outdoors in nature planting garlic, enjoying garden-themed stories, participating in arts and crafts, and planting vegetables for the Dorset Park Food Bank. It will surely be a day you and your kids will remember!

A day filled with activity and venture (ie being on your feet for a prolonged period), don’t forget to keep your foot health in check by following these simple recommendations:

Compression stockings

If you experience swollen, tired, achy legs and have varicose veins or spider veins on your lower extremity, you may want to talk to your doctor about compression stockings. Compression stockings or compression socks work to improve circulation by offering gradual compression up the limb and therefore, promoting blood flow back to your heart. They are especially effective for people who work sitting or standing for long periods of time throughout the day, as well as pregnant women, and frequent flyers.

Standing for a long period of time outdoors will make your legs and feet cold resulting to an uncomfortable experience. Keep your lower body region warm by wearing Sigvaris Merino Wool Compression Stockings. They have fashionable styles available for both men and women, made with the highest quality and extra fine Merino wool that is latex free, comes with a double-covered inlay that is thermoregulating for year-round giving comfort making it easy to wear.

merino wool compression

Wearing compression stockings on a day like September 21st at the Harvest Day Celebration will help to prevent swelling and heaviness in your legs and keep you happily on your feet much longer.

Proper footwear

Making the best footwear choices for your day to day life is important, and even more so when you plan to spend a little extra time on your feet. A trip to the Toronto Botanical Garden for the Harvest Day Celebration is one of those occasions where you would want to carefully consider your footwear choices and go with an option that will improve foot posture. A good shoe will have a sole that offers comfort, cushion, and stability. The shoe should be light weight and have some degree of flexibility. As a general test, try twisting the shoe at the sole and if it twists completely, it is too flexible. If you can also bend the shoe in half at the sole, it is also too flexible. A shoe with a good heel counter and heel depth as well as arch support are an added bonus.

Start off the autumn season by making healthier choices for your feet.

Drop by Feet First Clinic located at 2481 Bloor Street West today to see our selection of footwear and compression hosiery!

A Quick Guide For Addressing Cracked Heels

If you have hard, thickened, painful skin on the bottom of your heels, you may have what is called cracked heels.

Cracked heels, also known as heel fissures, is a common foot condition in which the skin on the bottom of the heels becomes excessively dry causing the skin to split and crack. Fissures are usually accompanied by thickened yellow or brown callus. These fissures can be painful and bleed and if persistent, can lead to infection.

To help avoid and manage cracked heels, follow the steps below:

Moisturize daily

This is probably the easiest thing you can do to help treat cracked heels. Applying moisturizer twice daily can really make a difference in your skin. Look for moisturizers that contain a handful percentage of urea. Urea helps to bring moisture into the skin as well as acts as a chemical exfoliant. For best results, apply right after washing your feet.

feet first clinic dermal therapy
  Dermal Therapy

Exfoliate

While in the shower or after a foot bath, use a pumice stone or file to gently exfoliate the heels of any dead skin cells and keep them smooth.

Feet First Clinic file and foot bath photo

Avoid harsh conditions

In general, avoid all harsh conditions such as excessively hot baths, exposure to very cold weather, or use of harsh soaps. Instead, opt for warm showers, wearing proper protective shoes and socks in the winter, and washing your feet using a gentle, scent free, moisturizing soap.

Visit your local Chiropodist

A Chiropodist is a primary health care provider who will be able to directly treat your heel fissures. This means, at your appointment, a Chiropodist will mechanically debride (removal of damaged tissue) or remove all calluses down to normal tissue to encourage closure of any cracks in the skin. If your cracked heels are accompanied with redness, swelling, pain, and you suspect infection, book an appointment with a Chiropodist for proper treatment.

Insoles

Whether over the counter or custom made, insoles with extra cushioning around the heels can also work to prevent cracked heels. In cases where you have an occupation which requires you to be on your feet all day or work on hard surfaces, insoles may be a great option to look into.

If you have a medical condition such as Diabetes associated with cracked heels, do not try to treat them yourself. Rather, book an appointment with a Registered Chiropodist at Feet First Clinic who will assess your feet and provide the necessary treatments. Careful debridement as well as the appropriate wound dressings may be required to encourage healing and prevent infection.

Call Feet First Clinic today!