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Are Those Aches in Your Legs Shin Splints?

Few lower leg injuries are as common as shin splints. In fact, between 30-70% of runners get injured each year, and about 35% of those injuries are attributed to shin splints.

Shin splints can be pesky injury as they can creep up fast, and often. Anyone that participates in high-impact sports like running, soccer, basketball, and the like are susceptible. Let’s get into shin splints 101 before outlining treatment and preventative measures.

What are shin splints?

Shin splints is a term generally used for any sort of lower limb pain associated with the tibia, the large bone in the front of your leg. Medial tibial stress syndrome is the proper term for the condition. It refers to stress on your shinbone and the connective tissues that attach muscles to your bones.

According to the Mayo Clinic, you might notice tenderness, soreness or pain along the inner side of your shinbone and mild swelling in your lower leg. At first, the pain might stop when you stop exercising.

Pain and severity varies. A stress reaction is irritation of the tibia while a stress fracture is a crack in the bone. If you ignore the early signs of shin splints, a reaction can turn into a fracture over time.

Causes of shin splints

There is rarely one single cause of shin splints. Rather, there may be a few factors that come into play including the following:

Overuse

No truer words have been said than “too much, too soon” to describe the onset of shin splints. Typically, runners experience shin splints when they ramp up either their intensity, or volume, too quickly. This is especially the case when coming back from injury as your body re-adjusts to the impact of running, and needs time to acclimate to the load running puts on the body.

Flat feet

People with flat feet may experience ongoing difficulties with shin splits. This is the case because those with flat feet have a collapsed arch during their normal gait. As such, your ankle rolls inward more so than it should, also known as overpronation – as your arch does not act as a governor.

Runners and walkers with flat feet may benefit from orthotics to artificially support their arch, and to prevent flat feet-induced injuries and conditions. Additionally, physical therapy including the taping of your arch may benefit you when struggling with flat feet and shin splints. See our blog post on Daily Feet Exercises for more information on exercises you can try to keep your feet strong and healthy.

Don’t worry, you’re not alone in this battle. About 30% of the population lives with flat feet.

Improper footwear

If you suffer from shin splints, the source could be your shoes. It may not even be your specific running footwear either. In fact, the shoes you wear when you’re not running could actually be the problem. Determining the right shoe for you, whether that’s an off-the-shelf running shoe, or the addition of orthotics comes down to a number of factors including weight, foot type, mileage, and much more. To learn more about proper running footwear, check out this handy resource, or visit us Feet First Clinic to speak with a professional.

Treatment

Although shin splints are common and can creep up quickly on you, fortunately, there are a number of treatment options that can have you feeling better quite quickly. Fortunately, shin splints can be managed and treated quite effectively.

Reduce load

First, reduce the activity which is causing the pain. Why? Shin splints is a repetitive injury and the condition is a stress reaction in the shin bone.

If that’s running, consider replacing that form of training with another, low-impact exercise like cycling, swimming, cross-country skiing, or using the elliptical. Depending on the severity of shin splints, you may still be able to run. And oftentimes, complete rest may not even be the best form of treatment. Rather, a reduction, and physical therapy while maintaining some forms of exercise, may be the best defense.

Icing

As shin splints are caused by the body not being able to repair itself fast enough, icing can help reduce inflammation caused by the repetitive nature of running. Additionally, icing the area can provide pain relief. Fill a paper cup with water and freeze it. Then apply it to your shin bone for 5-10 minutes.

You can also supplement icing with anti-inflammatory to reduce pain and inflammation.

Prevention

Proper footwear

Prevention begins with proper footwear. Depending on whether you overpronate or supinate, you’ll need to find a pair of shoes that’s right for your body. This can be said for both your running footwear, as well as personal footwear. If you find yourself wearing flat-soled feet often casually, consider replacing them with more supportive shoes that support your arch, and put less pressure on your lower limbs.

We also know that there is a breakdown of running mechanics when wearing worn-out shoes. Replacing your footwear every 500 kilometres or so is beneficial.

Foot exercises

One of the most common exercises is the toe curl. Place a towel on the ground, and while keeping your heel on the floor, bring the towel towards you with your toes. Pretend you’re using your feet like your hands to bring the towel closer to your body.

Another exercise is the heel drop. With one foot on a step or a ledge, and the other heel raised up, lower the heel and raise it again until it’s parallel to the ground. Keep your leg straight. Repeat 10-15 times per leg, and you should feel the muscles in your calf and ankle.

Finally, you can foam roll your calves, and gently massage along the tibia to break up some of the scar tissue. This can be done both before exercise, as returning from shin splints can often be easier when doing a proper warmup, or after exercise. In general, tight calves and Achilles tendons can exacerbate shin splints, so stretching them out can be a source of relief, both in the short-term and long-term.

Training plan

When it comes to runners, many of us always want to do more. But, sometimes our aerobic fitness is ahead of where our bodies are at. It’s important to listen to your body and recognize the early signs of shin splints: dull pain along the inside of your tibia and aches after runs. The worst thing you can do is nothing. Running through pain is never a good idea, and shin splints rarely go away on their own.

Instead, if you feel as though you want to ramp up the intensity or volume of your training, consider following the 10% rule. In essence, the 10% rule recommends increasing your weekly mileage by no more than 10% per week. So if you run 30 kilometres per week, aim to reduce your weekly mileage by no more than 3-4 kilometres. If you’re at 50 kilometres, ramp up your weekly mileage by about 5-6 kilometres.

Surface

Surface also matters. Harder surfaces like asphalt and concrete have a greater impact on your body while running on grass and trails softens the load. Opt for softer surfaces if you experience shin pain, and incorporate them within your routes as you return to running.

If you continue to experience shin splints, and are seeking professional help, don’t hesitate to reach out to us.

You do not need a referral to become a patient at our Toronto Foot Clinic.

Schedule an appointment by using the appointment request form below or contact the clinic at 416-769-FEET(3338).

Possible Reasons Why Your Knee Hurts

Did you know that your knees absorb about one-and-a-half times your body weight every step?

As the largest joint in our body, our knees are essential to the overall health of our bodies. Knees act as a hinge joint and permits flexion and extension. Additionally, the knee allows for slight rotation both internally, and externally. Knees allow us to perform horizontal movements, like running or walking, and vertically, like jumping.

Because of our reliance on knees, and its complexity, they’re often the source of many foot conditions, either directly or indirectly. As the gateway between our thighs and lower legs, all muscles run through, or adjacent to the knee, meaning prevention is absolutely necessary for overall leg health.

If you do experience pain, below are four reasons for why your knee hurts:

Common conditions

Your Knee Hurts Because…Patellofemoral pain syndrome

Patellofemoral pain syndrome, also known as runner’s knee, is the most common knee injury. Considering its nickname, it should come as no surprise that many runners and athletes experience patellofemoral pain syndrome.

Patellofemoral pain syndrome is a relatively broad term for any pain in the front of your knee. In particular, the following activities may trigger pain:

  • Walking up or downstairs
  • Kneeling or squatting
  • Sitting with a bent knee for long periods of time

There are a number of causes for patellofemoral pain syndrome including:

  • Overuse. Repetitive activity can cause irritation under the kneecap. Running for extended periods of time, or through pain, is one common cause, as are sports that involve a lot of jumping.
  • Muscle imbalances or weaknesses. Muscle imbalances can cause undue stress on your knees because of overcompensation. Additionally, weak hips can also cause your knees to taken additional loads off your body, which can increase the likelihood of injury.

Note that causes may also include acute injuries such as trauma or surgery.

Fortunately, treatment for runners knee can, for the most part, be done at home. Following the RICE method which includes rest, icing, compression, and elevation can be effective in keeping inflammation down and allowing your muscles to recover.

You can also try using a knee brace if you feel like your knee is not getting proper support.

In terms of prevention, there are a number of steps you can take:

  • Strength training. Keep your muscles that lead to your knees is crucial. Working on strong quadriceps and hip muscles keep your knees better aligned and balanced. Ensure you perform each strength exercise slowly, with an eye on form, as your knee will likely otherwise compensate, which can cause pain in and of itself.
  • Return from injury slowly. Now that you’ve rested, and iced, you’re ready to return to activity. But, your body may not be 100% ready to return to pre-injury form right away. Build up slowly, and make continuous checks of your knee to ensure you improve gradually. If you’re returning to running, follow the 10% rule which states that you should not increase your weekly mileage by more than 10% per week.
  • Find the right shoes. Research the type of shoes you need for your foot type. You may be better off with motion control or stability shoes, or neutral cushioned shoes might be best. If you have any doubt, visit the clinic for a full gait analysis and we’ll put you into proper footwear.
  • Warm-up. Perform dynamic stretches and light exercises before you exercise so your muscles are warmed up, and firing properly. Cold muscles can lead to poor form, and compensating in areas.

Your Knee Hurts Because…Patellar tendonitis

Patellar tendonitis is a common injury for why your knee hurts that affects the patellar, the ligament that connects your kneecap to the shin bone. The tendon allows the knee to straighten and is crucial in the overall health of your knee.

As with many knee injuries, patellar tendonitis is often seen among runners, and pain can worsen when using stairs, excessive use, and sitting for long periods of time. Approximately 25% of knee injuries are diagnosed as patellar tendinitis.

The following symptoms can be a sign of patellar tendonitis:

  • Pain under the kneecap
  • Inflammation and tenderness in the front of the knee
  • Difficulty walking or doing sports activities
  • Difficulty climbing or descending stairs
  • Pain when bending the knee

Common causes of patellar tendonitis include:

  • Trauma
  • Increased training
  • Weak quadriceps muscles

To treat tendonitis:

  • Rest. If you’re a runner, cross-train by swimming, cycling, or using the elliptical to reduce the load on the tendon
  • Ice
  • Seek medical advice

Like many knee injuries, preventative methods include:

  • Strength training
  • Stretching your quads and hamstrings to reduce the pressure on the knee, and the patellar tendon
  • Foam rolling

Your Knee Hurts Because…IT Band Syndrome

IT Band syndrome (short for Illiotibial band syndrome) is a common knee injury characterized by inflammation and friction of the IT band. The IT band runs along the outside of the tight from the pelvis to the tibia and is crucial as a stabilizer for the knee.

IT band syndrome arises out of overuse as the band crosses back and forth. This injury is particularly prominent in:

  • Long-distance running
  • Those who have increased hip internal rotation and knee adduction
  • Cycling
  • Weight-lifting

Although the IT band extends the entirety of the leg, pain is typically felt most common on the outside of the knee, and around 30 degrees of knee flexion.

IT band syndrome, although one of the most common running injuries, can be treated with physical therapy, as well as RICE (rest, ice, compression, and elevation).

Try the following preventative and treatment methods to keep IT band syndrome at bay:

  • Anti-inflammatories
  • RICE: Rest, ice, compression, and elevation
  • Foam rolling: self-massage your IT band by applying pressure to it with foam rolling. Read more in our complete foam rolling guide.
  • Stretching: focus on stretching your hips to help reduce tight muscles
  • Strength training: focus on the gluteus maximus and hip external rotators. You can target these areas by using a resistance band and performing some of these daily foot exercises.

Your Knee Hurts Because…Osteoarthritis

Knees are susceptible to osteoarthritis, a type of joint disease that results from cartilage breakdown between bones. Osteoarthritis is often known as wear-and-tear arthritis since it’s commonly associated with overuse.

You may be at higher risk of osteoarthritis if you fall into any of the following categories:

  • Age: many people 70+ have osteoarthritis
  • Sex: women are more likely than men to suffer from OA, especially in the knees.
  • Previous trauma: joint injury can change joint alignment and cause more overuse in certain areas
  • Weight: increased weight will increase the load on the joints, causing the earlier onset of osteoarthritis.
  • Biomechanics: deviations in the knee joints can cause excess wear on certain joint areas, for example, genu valgum (knees come inwards).

As osteoarthritis is a progressive disease, the effects will likely worsen over the years. But, that doesn’t mean you cannot delay the onset of pain.

Some common treatment options include:

  • Physical activity: light activity keeps joints and muscles lubricated. If impact sports aggravates your injury, try swimming or another form of non-weight-bearing activity.
  • Anti-inflammatories
  • Soft surfaces: running on grass or on the treadmill can lessen the load of sports

WebMD has a useful self-assessment tool that can offer a glimpse into why your knee may be hurting. Of course, use the tool only for reference, and do not take it as medical advice.

Protecting Your Body on the Hockey Rink

Hockey is the number one sport in Canada and this winter sport has been enjoyed around the world as well for over 100 years!

Not only is hockey extremely fun to play, but it’s also an excellent form of cardiovascular exercise and vigorously works your lower body. Playing hockey increases your heart rate, which improves your body’s ability to build muscle and burn calories.

Hockey is also beneficial for your mental health — getting vigorous amounts of exercise releases endorphins. This puts you in a better mood and gives you additional energy. Playing hockey can also keep your brain sharp; this is because it can help improve your problem solving and decision-making skills.

However, athletes should know that playing hockey comes with its fair share of risks. Hockey is one of the more aggressive sports —players can potentially experience concussions, lose teeth and break bones.

Hockey players are also prone to several foot and ankle related injuries. One of the most common hockey injuries is known as lace bite (also occasionally referred to as skate bite), which occurs when you tie your laces too tight.

Lace bite causes players to experience:

  • Ankle pain
  • Redness
  • Swelling

Some hockey players may experience less-common issues like sprained ankles, fractured bones or peroneal tendonitis (a chronic form of tendonitis caused by excessive overuse).

We know that a few potential injuries won’t stop hockey players from doing what they love; that’s why our team at Feet First Clinic has put together this list of safety tips.

For those that aren’t familiar with our work, Feet First Clinic is a foot clinic in Toronto that offers a diverse variety of foot and ankle-related services.

Aside from offering unique services, like shoe stretching and measuring, our team of foot specialists also offers an assortment of foot and ankle products, like custom-made orthotics. These products can help you deal with current injuries and prevent future incidences from occurring.

Are you looking for effective ways to keep your body safe while playing hockey? Feel free to continue reading!

Always Wear a Helmet

Practically every hockey league (both professional and recreational) require players to wear a helmet. This requirement, which was put in place in 1979, is essential for several reasons.

As mentioned earlier, hockey players are prone to head injuries, like concussions. Studies show that concussions account for approximately 2% to 14% of all hockey injuries. Additionally, concussions account for about 15% to 30% of all hockey-related head trauma.

Although concussions are occasionally unavoidable, wearing a high-quality helmet can drastically decrease your risk of experiencing head trauma.

So, why are modern helmets so effective? First of all, modern hockey helmets are made out of high-quality materials like vinyl nitrile and expanded polypropylene foam. These materials are made to disperse and absorb large amounts of impact.

Additionally, modern hockey helmets are form-fitting; they are designed to cup and protect the orbital protuberance (the back of your head).

Are you looking to protect more than just your head? Then you may want to consider buying a helmet with a visor and/or ear guards. These helmets are made to protect the remainder of your face from stray pucks, sticks and skates.

Wear Skates That Have the Right “Fit”

Having the right pair of skates is integral, especially if you want to perform at the best of your ability.

Are you new to the sport? Then you may not know that buying a pair of skates is quite different from picking out a pair of shoes.

Here are several key differences that you need to keep in mind:

Size

The first thing you need to consider is the size. While looking for new skates, you need to remember that hockey skates have a different sizing system than traditional walking shoes. You should generally look for hockey skates that are one to one and a half sizes smaller than your everyday footwear.

Are you buying skates for your child? Then you may want to get a pair that has a little bit of wiggle room. This way, if your child has a growth spurt, you won’t have to replace their skates instantly.

Tightness

While playing hockey, athletes want their ankles to feel stable and secure. Wearing loose-fitting skates strains your ankles and can increase the risk of sprained or broken bones.

Before hitting the ice, make sure that neither of your laces are untied. This will not only help you feel secure, but it will also lower the chances of you accidentally tripping.

For extra security, you may want to wear a pair of thick socks. This will help keep your feet warm and fill in any additional space in the skates.

Heel Movement

Can you lift or shift your heels in your current pair of skates?

When your skates fit properly, you shouldn’t be able to move your heels at all. Instead, they should feel snug and continuously in one position.

Wearing skates that don’t fit properly can cause your heels to shift in place. This can make your skin feel rough and potentially lead to painful blisters on the sides of your feet.

If you’ve noticed that your skates are impacting your heels, you should consider getting over the counter insoles like Superfeet.

Superfeet is an over-the-counter insole company that offers a wide range of products. Each product is made to benefit the wearer in specific situations.

For instance, hockey players can benefit from wearing a pair of Superfeet’s yellow insoles. Superfeet’s yellow insoles are designed to fit perfectly in hockey skates. These hockey skate insoles also feature a flexible heel cradle, which is designed to keep your heels in one place at all times.

Stay Hydrated

During the sweltering summer heat, athletes are constantly reminded to drink as much water as possible — however, if you’re playing sports in the winter, like hockey, you still need to drink a sufficient amount of fluids.

Drinking water is incredibly beneficial for athletes, as staying hydrated can:

  • Improve your joint and muscle health
  • Regulate your body temperature
  • Prevent and lessen the severity of muscle cramps

Failing to drink enough water can lead to dehydration; this happens when your body uses more fluids than it’s receiving. When this happens, your body slowly begins to shut down, and in some severe cases, dehydration can lead to short-term hospitalization.

It can be challenging to pinpoint exactly when you (or one of your teammates) are feeling dehydrated, as other common issues share many of the symptoms.

If you don’t know what to look for, then keep an eye out for the following signs:

  • Dizzy/light-headed feeling
  • Dry mouth
  • Upset stomach
  • Elevated heart rate

To be safe, you should aim to drink at least 8 oz of water before playing. During the game, you should try to consume anywhere from 7 oz to 10 oz. Finally, you should have no less than 8 oz of water after the game is finished. This may seem like a lot of fluid, but your body will appreciate it.

Wear Compression Stockings

These garments are designed to apply therapeutic pressure to your feet and ankles.

Wearing compression stockings can help improve the circulation in your lower body and decreases fluid retention. Fluid retention (also referred to as water retention and edema) generally stems from prolonged periods of sitting and/or standing. This condition causes extremities, likes your feet, to swell up and feel uncomfortable.

Additionally, compression stockings are a cost-effective tool for reducing and managing blood clots. After experiencing a blood clot, some patients are advised to wear compression stockings for as long as two years.

So, why are compression stockings so vital for hockey players? In short, compression stockings can improve your athletic performance. This is because compression stockings can:

  • Increase your endurance
  • Minimize muscle strain
  • Improve your balance and stability
  • Lower the risk of shins splits and other forms of soft tissue damage

Additionally, if you wear compression stockings while doing your daily feet exercises, you can drastically decrease your recovery time (for lower-body injuries) — this means you can spend less time on the couch and more time on the ice.

If you’re a female hockey player, you most likely want something that fits your body. That’s why many companies produce compression stockings for women as well as men. This makes them an accessible tool for both genders.

With all of this in mind, it’s clear why athletes should always wear a pair of compression stockings underneath their uniforms.

Whether you’re a professional hockey player or just want to have some fun with your friends, there’s no denying that hockey is an exhilarating sport. It’s social, competitive and is the ideal winter activity. However, hockey is also a dangerous sport, and if you’re not paying attention, you can easily injure yourself.

If you don’t want this to happen to you, then you should make sure that you always wear a helmet and have the right pair of skates. You should also drink lots of fluids and purchase a pair of compression stockings.

Morning Foot Exercises To Start Your Day Pain-Free

Waking up in the morning can be hard enough. Stiff and sore joints can make it even more difficult to get out of bed. Literally.

Although one might think that sore joints and muscles come only with ageing, that’s not necessarily the case. In fact, old age alone does not cause morning joint stiffness. Rather, morning stiffness is typically an indication of wore joints, muscle tightness, or inflammation from arthritis, according to Harvard Medical School.

Worn joints are not just for the elderly. Younger people can wear down their joints, specifically the intermediary cartilage, through normal wear and tear.

As Harvard Medical School points out, there are a few reasons why your joints feel sore in the morning:

  • As your joints get older, the spongy cushion of cartilage begins to dry out and stiffen;
  • The joint lining produces less synovial fluid, which lubricates the joint;
  • Weak muscles and stiff tendons tighten during sleep;
  • Osteoarthritis, which can be caused by wear and tear, and rheumatoid arthritis both can trigger morning stiffness;
  • Too much – or too little – exercise.

To combat the problem, and to ensure your aches and pains don’t last more than 10-15 minutes in the morning, you can incorporate foot exercises into your morning routine. This will help warm up your muscles and increase blood flow. Movement helps lubricate joints, so by starting your day off with some simple exercises and stretches, you can combat the late-day tightness and soreness.

Start slow. When you wake up, begin by wiggling your toes and working your way up your legs to activate the muscles. Then, you can incorporate the following morning foot exercises to start the day off right.

Towel stretch

While still in bed, sit up and with your legs straight out in front of you, bring your toes towards your body, and then away. Use a towel to keep your foot stretched while your toes are towards you, and use the towel as a source of resistance when pointing your toes away from your body. Hold for 20-30 seconds and repeat 3-5 times. Then, switch sides.

This activates the Achilles tendon, your hamstrings, as well as the plantar fascia.

Alternatively, you can skip using the towel and stretch your Achilles tendon and plantar fascia in the same way as you would with a towel.

Sitting stretch

While sitting on the edge of the bed, cross one leg over the other and stretch out your toes. Grasp them and stretch them upwards, and then down. You can do this for 20-30 seconds, and repeat 3-5 times before switching.

There is also additional benefit from increased flexibility in your toes through these stretches. Targeting your toes can be particularly beneficial for people with bone spurs and hallux rigidus who have little to no flexibility in their big toe.

Or, if you have trouble with your bunion, these five simple exercises may benefit you for the entire day let alone in the morning.

Rolling

Types of Foam Rolling

One great way to activate your feet in the morning is to use a foam roller or tennis ball.

Foam rolling involves using a foam roller as a method of release. By using your own body weight, the method is simple, effective, and low-cost. Foam rolling is a great injury prevention method and can leave your muscles feeling refreshed afterwards.

Specifically, foam rolling targets pain and discomfort that comes from the myofascial tissue—the tough, but thin membranes that cover and surround your muscles.

Foam rolling can be tricky at first, but you can get the hang of it pretty quickly. Using your body weight, position the foam roller about two-thirds to the bottom of your body, or to wherever on your legs you want to target. Then, roll slowly and gently back and forth and pause on particularly tight spots.

You can also roll with a tennis ball in a much easier way. While sitting on the edge of your bed, place a tennis ball (or lacrosse ball) under your foot and slowly roll the ball in various directions. Keep moderate pressure on the ball so you feel some massaging of your plantar, heel, and ball of your foot.

Read more about the techniques and 101 in our foam rolling 101 post.

Four-way ankle resistance band exercises

You can do this exercise sitting down, or standing up!

The sitting version involves wrapping one end of the resistance band around your foot, and holding the non-looped end with your hand. Pull to create some tension, and plant your heel into the ground. Then, move your foot outwards, inwards, away, and towards you while fighting the tension. Do this 5-10 times each way, and then move on to the other foot.

The standing version is more of a complete warm-up for many of the muscle groups in your legs. Wrap a resistance band around your knees and bend down into a quarter-squat. Then move side-to-side in a slow, smooth motion and repeat 5-10 times. Then, instead of moving side-to-side, move forward diagonally, and then to the side, and then backwards diagonally. You should be moving in an “X” shape. This morning foot exercise particularly activates your hips.

Remember, for all of these morning foot exercises, focus on slow, smooth movements as your body begins to wake up in the morning. The goal is to activate the muscles and to build strength through resistance. Never try to stretch through pain, or strengthen your way out of an injury.

If you have chronic aches and pains and want to see a Toronto foot specialist, book your appointment below or by calling us 416.769.3338(FEET).

What Is ‘Heel Whip’?

Have you ever completed a run and noticed dirt on the insides of your ankles? You may be experiencing heel whip.

Often times, you may not notice a few clips of your calf or ankle with your opposite foot as you run. It’s quite common and can begin after a period of exercise when your muscles fatigue. It’s not a widely-discussed topic, and it sounds more like a skateboard move than anything. But ask any runner and they likely know the feeling of heel whip.

Isolated, it’s not an issue. But, if it’s repetitive, whip may be a sign of a greater underlying problem.

Let’s get into what it actually is, why it happens, and what you can do to fix it.

What Is Heel Whip?

Heel whip is when your heel whips outwards (lateral), or inwards (medial) while you run. The most common form of heel whip is medial, which means your heel moves inwards and brushes your opposite leg. As a result, you may experience irritation, or even cuts, on the inner portion of your leg, whether it’s the ankle or calf. For the most part, heel whip is subtle and happens only a few times throughout the course of a run.

However, depending on the severity and repetitiveness, an excessive heel whip can be cause for concern. The treads of your shoes can also have an impact. If you’re wearing aggressive trail shoes with large rubber lugs, you may have more irritation.

Heel Whip
Aggressive lugs on your shoes can scrape your inner legs if you heel whip.

If you hear a runner say they kick their feet inward or outward when running, they’re referring to heel whip.

Based on a 2015 study to investigate the prevalence and characteristics of recreational runners with medial and lateral heel whips, half of the study’s participants were observed to heel whip. In that same study, there were twice as many medial (inward) heel whips as there were lateral, showing the prevalence of an inward whip.

Unfortunately, not all runners have access to a gait analysis, which is the best way to determine the severity of the issue. But, signs like scuffed calves and ankles are some clues to suggest you may be heel whipping.

Heel Whip
Inner legs scuffed with dirt from heel whip.

Video Gait Analysis

If you experience heel whip and want to have a professional analyze your gait, we offer 3D video in order to further analyze gait. Video gait analysis involves being recorded while walking or running on a treadmill. The video software allows us to slow and stop and zoom in on specific areas during your gait in order to educate you about your foot type and gait pattern. Following the biomechanical assessment and gait analysis, you may be recommended certain devices, shoes and/or exercises to assist with obtaining your optimal biomechanics.

Speaking about gait analysis, Dr. Andrew Miner appropriately told the National Post, “The runner who wins is the one whose form deteriorates the least.” This sentiment is particularly true for heel whip since it can occur during the latter stages of a run when the body is fatigued.

Because of its repeated nature, a minor issue in one’s form can manifest itself to become a significant problem over time. Thus, finding the root of the problem is essential, and video gait analysis may provide a glimpse.

Why Does It Happen?

Whip is not necessarily the issue, but rather the result of an underlying foot condition or muscle imbalance that should be addressed.

Heel whip does not necessarily result in injury. However, repeated movement with muscle imbalances may put you at greater risk if they go unaddressed.

Not running in proper shoes may also cause you to compensate which may lead to heel whip. Being properly fitted is a crucial step in choosing the right shoe as is determining the type of shoe you need.

In fact, any number of underlying issues could contribute to heel whip including:

  • Hallux limitus
  • Weak tib anterior and extensor toe muscles
  • Foot Baller’s ankle
  • Limited/impaired hip extension
  • Weak glutes (which minimizes hip extension range)
  • Sway back
  • Short quadriceps
  • Excessive flip flop use
  • Excessive pronation
  • Impaired foot tripod mechanics

How To Fix Heel Whip

With so many different possibilities of where the underlying condition may lie, it’s difficult to pinpoint the exact fix that will work for you.

Foam Roll

In general, mobility issues often stem from the hips. For example, if you sit at work for extended hours, hip tightness would be no surprise. This is where foam rolling can come in. Spend 10-15 minutes a few days a week foam rolling your lower body. You may not see immediate effects, but the habit of foam rolling will be one that pays off greatly in the long run.

For further reading, read our complete guide on foam rolling 101.

Strengthen

Another fix can be lower body strength via a resistance band. With a band wrapped around your ankles and your legs in a quarter squat position, walk side to side in what is known as lateral band walks. Perform 10-15 lateral walks, and repeat 2-3 times with a break in between. With the band in the same position, you can also do step-ups to target your glutes.

Read about a complete list of daily foot exercises.

Shoes

Getting fitted with the proper shoes – like footwear with a rocker sole for example – can also provide relief for heel whip. For more on the different types of shoes, and how to determine your foot type, check out the three primary types of running shoes.

For all of your shoe needs, we offer many leading brands at the clinic.

To better identify the cause of your foot pain or discomfort and get immediate care, visit us at our Toronto foot clinic. Book an appointment that works best with your schedule through our contact page.

You do not need a referral to become a patient at our foot clinic.

Corns: What Are They?

Callus or Corn?

 Hyperkeratosis is a thickening of the skin and can form on areas, usually over boney areas that are prone to repetitive pressure or friction. Callus, however, is a type of hyperkeratotic lesion that occurs over a larger area and is generally not painful. Callus is generally uniform in thickness and common areas include around the nail, the ball of the foot and the back of the heel.

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Corn is the common term for heloma durum, a well demarcated hyperkeratotic lesion that occurs in a localized spot with a central core that pushes deeper into the skin and can cause pain and inflammation.

The term corn is derived from the name of the epidermal outer layer, the stratum corneum.  The stratum corneum can be thickened with constant abnormal pressure causing either helomas (“corns”) or callus.

Corns, or helomas, as referred to by chiropodists and podiatrists, are well demarcated lesions with a central keratin core, which can appear more yellow or translucent in appearance.  They usually have surrounding callus.

Hard vs Soft Corns

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Hard corns or heloma durum are, as the name implies, hard hyperkeratotic lesions that are well circumscribed and have a central core.  They are usually found on the tops of toes or on the ball of the foot.
Soft corns are found between toes and with excess moisture, become a macerated lesion that can be painful.  They are most commonly between the 4th and 5th toes. They are caused when the toes are moving against each other, either through toe deformity or an ill-fitting shoe, or both.
Both types are not serious health concerns and can be conservatively managed through sharp reduction from your foot specialist as well as proper padding or insoles and properly fitted footwear. Other factors including smoking and moisture control can also be considered.

Will it go Away?

Corns, also known as Heloma durum, “go away” with physical treatment.  A foot specialist can remove corns via sharp blade.  However, true removal and prevention involves diagnosing the cause of corn development.

Why do I have it?

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The main cause of heloma durum, otherwise known as corns, is abnormal mechanical stresses, which can be intrinsic or extrinsic. Intrinsic risks include boney prominences, poor healing of old injuries, or faulty biomechanics including rigid joints and hammertoes.  Extrinsic causes include ill fitting footwear, improper footwear to the foot type (e.g. high heels), or high level of activity (e.g. stair climbing, martial arts.)

What are the Risks?

Risks include systemic disease like diabetes, rheumatoid arthritis, stroke, or neurovascular disorders like cerebral palsy or Charcot-marie-tooth disease. Family history of foot deformity like hammertoes or bunions can predispose a person to callus and corns. Smoking can also increase formation of corns as vascularity to the feet is decreased.

Corns can be dangerous if left untreated.  Specifically, heloma durum pushes against the dermis layer of skin and can create an ulcer if left untreated.  This is especially risky for persons with immune disorders or diabetes.

While corns are not cancerous, there may be some lesions that look like corns that can be or become malignant, and is best to contact your physician or book an appointment with us for an assessment.

Corns generally do not spread.  If you find corns are increasing in number it’s best to come in for an assessment, as they may be a different lesion that can mimic corns, like warts.

A question to ask is how long have you noticed the lesion?Corns are usually long standing and gradually developing.  Warts are usually new and generally on one foot.

Corns can have different types.  The common corn type, heloma durum, is treated with sharp reduction.  A blade is used to remove the core keratin plug.  Since this plug has no blood vessels or nerve endings, reduction should be little to no pain.

For more aggressive or painful corns, like neurovascular heloma, they may be treated with topical treatments  or with topical anesthetic before sharp reduction.

Can I Treat it at Home?

Due to the localized nature of corns, it is not recommended to self remove heloma durum. Foot specialists are highly trained to safely and evenly reduce callus and corns.

There are low acid concentrated solutions that are over the counter that can soften the keratin plug of corns. The topical is applied to the central core of the corn and when the core is soft enough, it can be easily removed.

Proper diagnosis of any foot lesions is vital to treatment.  Physicians or specialists will be better trained to evaluate any foot lesions.  Foot specialists can also provide treatment.

Shoes with deeper and wider toe boxes and soft insoles may reduce pressures that can develop corns.  Look for shoes with laces as they can prevent excess movement of the foot inside the shoe.

Dry skin may reduce elasticity to the skin which can increase corn and callus formation.

Any foot condition that cause abnormal mechanical stresses or foot deformity may increase risk of developing corns.  For example, hammertoe deformity may increase pressures at the ball of the foot and at the tip of the toe, which can lead to callus or corn formation.  Excess perspiration can cause corns that are between the toes to absorb more moisture leading to painful soft corns (heloma molle).

What Happens After?

Following corn removal, there may be a small depression where the keratin plug once was.  Treating the cause is most important to completely prevent reformation of corns. The area will look flat without pain for many months.

Corns may return if mechanical stresses exist, and thus can return dependent on intrinsic and extrinsic factors.

Treating the cause is the best way to prevent formation of corns.  A foot assessment is the recommended route to determine the cause of corns.  For example, if corns are caused by external pressures, the pressure source should be identified and removed.  If the cause is more intrinsic, e.g. foot deformity, then offloading devices can be made to prevent corn formation.

At-Home Diabetic Foot Care

What is Diabetes?

Diabetes is a chronic disease that occurs when the body is unable to either sufficiently produce or properly use insulin.  Insulin is a hormone secreted by the pancreas to help cells absorb sugar from the bloodstream and use it as an energy source.

When insulin is not adequately produced or properly used, it can result in elevated levels of blood sugar, called hyperglycemia.  Hyperglycemia can cause deterioration of the body’s blood vessels, nerves and organs, most commonly the kidneys, eyes, and heart.  Elevated blood sugars can leave a person more susceptible to slow healing wounds and infection, most commonly seen in the feet.

Type 1 diabetes is an autoimmune disease where the insulin producing cells of the pancreas are attacked, resulting in an insulin dependent body.  It is also known as juvenile diabetes and is usually diagnosed in persons under 40, most commonly children. People that are diagnosed with Type 1 diabetes require an external source of insulin daily.

Type 2 diabetes is an acquired disease where the body does not produce enough insulin or does not properly use the insulin produced.  It is most diagnosed in persons who are overweight or inactive physically, in individuals over 40 years old, but is now seen more in children and those under 40.

Type 2 diabetes can either be insulin or non insulin dependent based on the severity and chronicity of disease.

As of 2008-09, 2.4 million Canadians were living with diabetes.  It is estimated that 90-95% of Canadians diagnosed with diabetes have Type 2 diabetes and 5-10% have Type 1.

How Does Diabetes Develop?

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Healthy Diabetes Diet

Diabetes development can be multi-factorial.  There are many risk factors of type 2 diabetes, including inactive lifestyle, poor diet, family history, smoking, advanced age, or certain ethnicity.

Risk factors of Type 1 diabetes are currently not well understood, though there may be a genetic disposition or an environmental trigger that may initiate the autoimmune response.

Diabetes is normally diagnosed as either Type 1, or Type 2 and you cannot have both types of diabetes concurrently.

Hyperglycemia can be gradually increasing before onset of diabetes, and symptoms may go undetected.  Diagnosis is usually made with a plasma glucose test. Hyperglycemic symptoms include; frequent urination, increased thirst, unexplained weight loss. Other symptoms can include blurred vision, fatigue, and nausea.  Since these symptoms can be associated with other disorders or disease, diagnosis of diabetes may be delayed.  It is best to control modifiable risk factors that may lead to diabetes: staying physically active, eating a healthy diet and eliminating smoking.

Why is Taking Care of my Feet Important?

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At-home Diabetic Foot Care

Since diabetes can affect the blood vessels and nerves, the feet, situated the furthest from our nerve and vessel centre, are commonly affected in persons with long standing diabetes.

As other diabetes related complications can arise, the feet can become more affected and more difficult to manage.  Complications include deteriorating eyesight, and decreased flexibility.

Decreased nerve function can reduce sensation in the feet, meaning small cuts and callus that may normally cause pain in a person without diabetes will go undetected.  It is important to look at the feet regularly and immediately treat any developing callus or dryness to avoid foot wounds.

Decreased healing ability means infection may be a cause for concern in persons with diabetes.  The feet generally see more sharp instruments than other areas including nail clippers, and files or blades to remove callus and corns and therefore are at higher risk for small cuts.

Taking care of feet in persons with diabetes are very simple and should become habit.  The skin should be kept hydrated and elastic with use of cream and water consumption.  All nails should be trimmed and filed to avoid any sharp corners.  Avoid applying devices or items that are too hot or too cold directly to the skin.

Inspect the feet daily.  If the feet are difficult to see, a mirror can be used.  A friend or family member is the most helpful.  The person should be looking for any of the following: increased redness, swelling, blood, foreign objects, callus, corns, dry skin, or deformity (bunion, hammertoe).  If any signs are seen, visit a physician or book an appointment with one of our foot specialists.

A foot specialist is recommended for regular assessments every 6 months. If there are any concerns with the feet, regular foot care every month or 2 may be indicated.

Who Needs to Worry About Diabetes?

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As of 2008, over 200 000 Canadians are diagnosed with diabetes every year.  The increasing age of baby boomers and increased life span are contributing factors to the increase in diabetes diagnoses.  The people most likely to be affected by diabetes are those in certain ethnic groups (first nations, African, Caribbean, south Asian and Hispanic), age groups (over 40), and higher weight groups.

In 2017, approximately 2.3 million Canadians (7.3% aged 12 and over) have been diagnosed with diabetes.

What Problems does Diabetes Cause for my Feet?

Diabetes can affect the feet in so many different ways: the skin becomes drier, the muscles start to change where foot deformities can develop, and the nerves are affected where sensation is reduced.  Detection of problems can become difficult and due to decreased healing time and increased rates of infection; problems can progress rapidly.

Serious cases include undetected wounds, subsequent infection and possible amputation.  Undetected wounds can paint a picture of uncontrolled diabetes, where multiple vital systems can be affected (kidneys, vessels, nervous)

At every age group, mortality rates are two times those in persons with diabetes than those without.

So, What Products Can I Use?

For persons with diabetes, it is important to avoid products with acid as an ingredient.  Creams with mild acid solution can irritate the skin and cause small wounds.

Sharp objects such as nail clippers and foot files may be used in persons with controlled diabetes and with prior instruction from a professional.  Feel free to use a daily cream and emollient to hydrate the skin.

Be careful using product between the toes, as that area can accumulate too much moisture which can breakdown the skin.  Foot soaks can dehydrate the skin, please consult with your doctor or foot specialist before engaging in foot soaks.

Persons with diabetes may require shoes that are healthier for their sensitive feet. Shoes with soft foot beds that can reduce friction and increase shock absorption are ideal.  Avoid shoes that have rigid seams or stiff out-soles.

When wearing shoes, keep an eye out for any red marks on the skin, these are ones to discard or avoid as they can one day leave a wound or laceration.

Will it Get Worse?

Persons with diabetes may feel their feet are too hot or too cold and try to use hot or cold packs to alleviate the discomfort.  Due to decreased sensation, these hot/cold packs can cause hot or cold burns on the skin.

Be sure to protect the skin with a towel prior to using these types of warming/cooling packs, and test first on the hands as sensation is usually not as diminished in the hands. Never use hot water or hot packs – make sure the temperature is lukewarm.

If you have dry skin, make sure to moisturize; do not use harmful files or electric devices to remove callus or dry skin.  Contact your chiropodist as you may be prescribed a cream. Inspect the feet daily, checking for cuts, callus or redness and swelling.

Where Can I Get Help? Who Can I Ask?

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A licensed chiropodist is trained to treat feet, especially in those with diabetes.  They can prescribe special creams, and carefully and safely reduce nail problems and callus.  They can help reduce pressures by recommending orthopedic shoes or prescribing custom made orthotics.

They can improve mobility by offering specific exercises and stretches to keep you moving. And they are primary care practitioners who can monitor and inspect your feet for any new concerns.

Persons with diabetes should have a foot specialist examine their feet at least every 6 months.  If you have callus or nail problems, a visit to the chiropodist can be a more routine visit at around 2 months.  Regular examinations and visits can prevent foot complications that can occur with diabetes.  Consult your doctor who can refer a foot specialist in your area or call our clinic today!

5 Standing Stretches For Your Legs

Stretching is not just reserved for athletes and gym-goers.

The practice of keeping our muscles limber and flexible can benefit us all, especially when done consistently. But we all have busy schedules. So, to accommodate, we’ve rounded up standing stretches for your legs that you can do any time, anywhere.

According to Harvard Medical School, “stretching keeps the muscles flexible, strong, and healthy, and we need that flexibility to maintain a range of motion in the joints.” In fact, without it, Harvard Medical School notes, “the muscles shorten and become tight. Then, when you call on the muscles for activity, they are weak and unable to extend all the way. That puts you at risk for joint pain, strains, and muscle damage.”

For those who sit all day, the importance of stretching becomes even greater. And because so many jobs now are performed digitally, a large percent of the population spends much of their workday sitting down, in front of a computer. With these long hours in sedentary positions, our muscles can become used to one position, making them increasingly inelastic.

To fight back, one can incorporate standing stretches into their routines, whether it’s to begin the day or an addition to their gym routine.

Don’t overwhelm yourself by thinking you need to spend 30 minutes each day stretching. Even 10-20 minutes two or three times a week helps. The key is to stay consistent. Although you may not see immediate effects, the compound interest of the habit will result in significant gains over time.

A few things to consider before beginning a new stretch routine:

  • Don’t bounce. Hold a stretch evenly, as bouncing or rocking back and forth can cause injury as you may stretch the muscle beyond its physiological limit.
  • Consider a light warmup. Warm muscles are better than cold muscles. Even a short five-minute walk is enough to loosen the muscles.
  • Don’t stretch through pain. If you experience pain when stretching, stop. You’re likely damaging the muscle more than helping it.

Now, let’s get into five stretches that are designed to be done anywhere.

Standing Hamstring and Calf Stretch

This stretch targets two muscle groups at the same time. Stand about a foot away and place both of your hands on a wall. Your feet should be shoulder-width apart. Then, take a step back with one foot, keeping that leg straight. Push down with your heel so your entire foot maintains contact with the ground.

Maintain for 30-60 seconds and switch sides. Repeat 2-3 times.

You feel should feel a stretch in your calves; if not, lean forward slightly. By keeping your back leg straight, you should also feel a stretch through your hamstring.

Standing Hamstring Stretch (One Leg)

Standing Stretches For Your Legs

Another stretch to target your hamstrings. While standing up straight, lift one leg and rest it on a shoebox, or another item around the same height. While keeping both of your legs straight, reach up towards the ceiling, and begin to lean slightly forward. As you do, you should feel a stretch in your hamstring. Maintain for 30-60 seconds and repeat 2-3 times on both sides.

For this stretch, it’s important to keep your back straight and to avoid hunching over and putting undue stress on your neck.

Standing Stretches For Your Legs

Standing Pigeon

Cross your ankle over your opposite leg, just above the knee, and squat down. You can extend your arms out for balance, or be up against a wall for additional stability. Look straight ahead and avoid straining your neck. Hold for 30-60 seconds, and repeat 2-3 times with equal recovery time in between sets.

This stretch works your hips, glutes, and lower back.

For even more stretches, visit our blog on activities that will help you build up strong, healthy feet.

For more information on how to prevent foot injuries and foot conditions, book an appointment today at Feet First Clinic.

Important Facts You Need to Learn About Gout

Gout is an inflammatory disorder caused by high levels of uric acid in the blood. Uric acid crystallizes in the form of urate crystals in the joints of hands, feet and elbows. Gout affects roughly 3 million Canadians each year.

Illustration of foot with close up of build up of uric acid in joint of the big toe

Causes

Gout is caused by a combination of environmental and genetic issues. Most commonly, environmental triggers include diet with foods that have high levels of purines which then break down into uric acid. 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.

Gout was often called the “disease of kings” as only wealthy people would be afflicted due to their rich diet and excessive drinking. The most famous king to be afflicted with chronic gout was King Henry VIII. Genetic factors such as hyperuricemia can impact the frequency of gout attacks.

Hyperuricemia occurs when your body does not filter urate properly from the bloodstream, either from the kidneys or the gut. Another common issue is if your body doesn’t break down sugars properly, this can affect how urate is stored. The risk of gout increases with age, particularly in women. The role of estrogen helps to regulate urate in the body so after menopause, urate levels in women increases drastically. Certain medications may also lead to hyperuricemia, such as diuretics and cyclosporine.

Finally, conditions linked with hyperuricemia are high blood pressure, kidney disease, thyroid disease, diabetes and sleep apnea.

Symptoms

While your body is producing high levels of uric acid this stage is called Asymptomatic gout as there are no signs or symptoms. The next stage is Acute intermittent gout and it starts off with a painful swelling in the joint often in the middle of the night. Most people wake up with the feeling their joints or foot is on fire. Gout most commonly affects the joint of the big toe because urate crystals deposit at the furthest joint in your body – gravity also plays a role. However, gout can affect any joint, the ankle and elbow are also commonly affected joints. The pain and swelling of the joints is likely to be severe for the first 4-12 hours and then a lingering pain or discomfort can last for weeks. The affected joints are also noticeably different with a red, swollen, tender and warm appearance. As gout progresses and is left untreated, the range of motion of the joint is also limited due to the swelling and deposits of hard urate crystals lumps called Tophi which damage and affect the joint structure and the surrounding skin.

Gout vs. Rheumatoid Arthritis

Rheumatoid arthritis (RA) can have similar symptoms as gout but the causes are different. RA is an autoimmune inflammatory condition where your own body attacks healthy synovial cells inside your joints. This attack causes inflammation, pain and swelling and most often attacks the hands, wrists, ankles and knees.

Tests

Gout can be diagnosed clinically with the appearance of a red, hot and swollen joint but as well as the timeframe. Your family doctor will also check for urate crystals by running tests on the fluid from your joint, blood work and possibly order an x-ray.

Treatment

Depending on the stage of gout, your family doctor will prescribe medication to either help with the pain and swelling or to prevent further attacks. Medication to help relieve pain and swelling are NSAIDS, specifically Indomethacin, colchicine and possibly corticosteroids. These drugs are often prescribed for acute gout attacks.

For chronic gout, medications to help prevent further attacks are allopurinol and probenecid. Along with medication your family doctor will advise you to make some lifestyle changes such as reducing alcohol intake, losing weight and quitting smoking.

After a gout attack, it is advised to visit a chiropodist to assess the range of motion at the affected joint and see if your gait has been altered and affected.

At home Sprained Ankle & Foot Exercises

With the New Year many flock to the gyms or get their resolutions ready. Why not take 10 minutes out of your day to start taking care of your feet as well.

It has been proven that foot exercises help increase mobility, prevent injury, increase circulation and resolve many foot issues.

Here are some exercises you can do at home:

Heel raise and toe curls

Toe raises and curls

Start in a seated position barefoot, raise your legs on your toes and hold for 10 seconds. With your toes weight bearing, curl your toes as if you are gripping the floor and repeat 5-10 times, holding for 10 seconds.

Toe splay and crunch

Toe splay

In a seated position barefoot, balance your feet on your heels and spay your toes for 10 seconds and then grip, like creating a fist with your toes. Repeat 5-10 times on each foot.

Scrunching towel on floor with toes

Towel pick up

Barefoot again, throw a towel on the ground and start gripping and releasing the towel with your toes until it is bunched up underneath your feet. Next, use your toes to straighten the towel. Repeat 5-10 times.

sand-walking

Sand walking

Find a carpeted area in your house and walk around barefoot trying to grip the floor with every step and feel the surface throughout your whole foot. Be mindful of gripping the ground and pushing off with force at your big toe. If you don’t have any carpet around your house, then walk around barefoot but try to make as little sound as possible when walking. Silent walking allows your foot to grip the ground with full force and transfers energy through every step (same as sand walking).

Ankle rolling

Ankle rolling

This can be done at a desk, while watching tv or before bed. Raise your legs so your feet are not touching the ground and roll your ankles 10 times clockwise and 10 times counterclockwise. This exercise helps promote circulation and prevent limitation at the ankle ligaments and muscles of the foot.

Ankle spellingAnkle spelling

With your leg raised and your foot pointed, spell out your full name with one leg and then the next. The movement should be centred around your ankle. Again, this helps improve flexibility and circulation at the ankle.

Calf stretch by dropping and lifting heel on the edge of stairsCalf stretches

Stretching out your calves is a very important exercise as it helps loosen up your posterior compartment of your leg which is also attached to the bottom of your foot. These exercises include using a rubber band around the bottom of your foot and keeping your leg straight while pulling on the band. Another exercise is standing at the edge of stairs and dropping your heels.

Heel raisesHeel raises

While barefoot, stand flat on the ground and raise your heels so you are standing on the tips of your toes. Drop your heels and repeat this exercise 5-10 times and hold the last one for 10 seconds. You can work your way up to doing single heel raises – standing on one leg and raising your heels.

Alternate toe raisesToe raises

This is the ultimate toe-yoga move, often times called the Sun-salutation for your toes. With your bare feet firmly planted on the ground, raise just your big toe up (giving thumbs up) and keep your lesser toes firmly planted on the ground. Hold for 10 seconds. Then reverse, keeping your big toe firmly planted on the ground, and raise your lesser toes. Don’t worry if you can’t get this right away, sometimes it takes a little practice or even using your hands to help.