The Different Types of Compression Stockings and How to Wear Them

Written by Erica Halpern on May 11, 2023

Last updated June 7, 2024

It’s easy to forget that leg health is just as important as foot health. In fact, one of the most effective medical devices to target both foot and leg conditions is compression stockings. By gently squeezing your lower extremities, they help you manage aches and swelling and boost blood circulation. Many people can benefit from these special socks for relief for foot and leg problems, but worry about how they look or don’t know how to wear them. Today’s blog will discuss the different types of compression stocks and advise on how to wear them so you make the most of this amazing product!

Different Types of Compression Stockings

Compression gear looks just like standard versions of hosiery and stockings and blends in well with your outfits. Here are some of the most common types:

Pantyhose
Maternity stockings
Knee-high stockings
Thigh-high stockings
Open-toe stockings

How to Wear Compression Stockings

While appearing fashionable may be on your mind, Mayo Clinic notes that the most important thing is to wear compression stockings as your health care provider prescribes. This may mean wearing them all day or only in the morning or before bed (do not wear compression stockings when sleeping). Whether you have varicose veins, are pregnant, have edema (swelling), venous insufficiency, or deep vein thrombosis (DVT), the symptoms you struggle with can easily flare up if you neglect to wear them as intended. Improper use can also cause blood clotting or skin irritation.

Putting your compression stockings on and removing them is often the most challenging part of using them. You have to be gentle and take your time when putting them on. Otherwise, it can affect the elasticity and compression levels. Depending on the type, it’s also important to roll the stocking down to the heel, leaving the toe area open before you put them on. In addition, you need to smooth out wrinkles and ensure the stocking fully covers the part of the leg or foot that needs the most compression. Sigvaris, the brand we provide at Feet First Clinic, offers a detailed guide on how to put on your compression stockings and take them off.

Types of Compression Stockings

In addition to the above-noted conditions, compression stockings are recommended for people who stand at work for long periods or who travel on planes often. Your preferences, lifestyle, and specific condition can help your foot clinic choose the right type. Please also note that compression levels range from mild to firm, which are measured in mmHg; the higher the level of mmHg, the greater the benefit. The over-the-counter compression levels (like the ones you’d find at a drug store) range from 8-15 mmHg to 15-20 mmHg. Medical grade levels of compression start at 20-30 mmHg (the most common level of compression) and can go up to 40-50 mmHg. Your health care provider can help determine the level you need.

Pantyhose

Pantyhose compression hosiery is a good choice for women who work long hours, travel frequently, or have varicose veins or other circulatory issues above the knee. They start at the feet and go up to the waist, like standard pantyhose. They apply graduated pressure (like a gentle squeeze) along the leg, becoming less tight as they extend upwards. This stimulates blood flow back to the heart, thereby reducing pain and swelling. Compression pantyhose is available in various shades in sheer or opaque fabric, making them suitable as professional attire.

Maternity Stockings

Stockings for pregnancy-related symptoms are available in pantyhose, knee-high and thigh-high stockings. As hosiery, they can be opaque or sheer and include more wiggle room in the waist and hips to accommodate a growing belly. Pregnant women can also choose cotton and linen knee-high socks for pain and swelling in the lower legs (see below). Maternity stockings help prevent DVT and varicose veins often associated with pregnancy. Moreover, postpartum women may also be at risk of these vein issues and often experience prolonged circulation issues.

Knee-High and Thigh-High Stockings

Knee-high compression stockings provide compression and support to the calf muscles, ankle, and foot and usually resemble regular socks. Thigh-high stockings provide compression and support to the entire leg, from the ankle to the thigh and are generally opaque or sheer. Both come in a variety of materials for your individual needs.

Open-Toe Stockings

Open-toe stockings offer more ventilation than the standard closed-toe version, making them more appealing to wear in the warmer, humid months. They can also be helpful for individuals who have difficulty putting on traditional compression stockings or those who find them uncomfortable. Rest assured, open-toe compression stockings offer the same compression levels, just with the bonus of added breathability. You can also wear sandals with open-toe stockings as they’re more discrete.

Come to Feet First for a Compression Stocking Fitting!

Our chiropodists can guide you through everything there is to know about compression stockings. Take the leap towards healthy legs and feet today!

Call us at 416-769-3338 or Book Your Assessment!

About Author: Erica Halpern

Erica is the operations manager at Feet First Clinic. Since 2021, she has been writing, researching and editing website and social media content. She also oversees Feet First Clinic’s daily and strategic operations to ensure the best possible experience for our clients. Her goal is to ensure patients are equipped with the knowledge and solutions they need to help with their pain.

Learn more about Erica Halpern

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September 28, 2018

Compression Stockings: Everything You Need To Know

If you're one of the many people who is suffering from a Painful foot condition, you are likely interested in doing everything it takes to relieve symptoms. This includes the desire to research and purchase footwear accessories that come with countless foot health benefits, including compression stockings. While some folks may be doubtful that simply wearing magic socks will make any significant difference, we're here to tell you that Compression gear really works! While we primarily recommend these socks to treat venous and vascular disorders, runners and athletes may also be interested in using compression stockings for performance enhancement. In this article, we will cover everything you need to know about compression stockings. If you suffer from venous or vascular disorders and experience discomfort, numbness and swelling in your feet, we strongly suggest that you speak to your doctor about getting a prescription stating your diagnoses and mercury level (ie. 20-30 mmHg). Afterwards, you can stop by your local downtown Toronto foot clinic for a compression stocking fitting. Most health plans do in fact cover the cost of compression socks with an MD prescription, and the socks typically last six months if worn daily, so you have very little to lose by giving it a shot! In fact, if you suffer from any of the conditions listed below, compression socks could significantly change your life for the better. Compression Stockings Are Known To Help With The Following Conditions: Tired, aching legs Edema and swollen ankles Varicose veins Spider Veins Deep vein thrombosis Lymphedema Phlebitis Air travel – long flights Pregnancy Diabetic foot pain/ulcers Prolonged sitting or standing Compression Stockings: Making The Right Choice Now, if you're worried about wearing funny looking socks that will have your co-workers laughing at you, fear not. Once we've determined the fit that is best for you, you'll have the opportunity to choose from several styles, including: Ultra sheer socks, which are favoured by women and are similar to regular sheer stockings. They come with the added benefit of increased blood flow. For those who like a bit of subtle flare, compression socks are also offered in an argyle pattern. For your everyday office sock, a straightforward dress sock design with no special detailing is available. Additionally, we offer active wear socks that you can wear while playing sports, such as soccer, in the park or at the gym! Thus, you get all the benefits of compression socks without needing to feel self-conscious, no matter what you're up to. If you're all set up with compression stockings, but you're still experiencing pain that prevents you from walking or jogging, you might also choose to explore The benefits of custom orthotics. Custom orthotics can work wonders for arch support. Furthermore, getting the region beneath your knees set up with the proper gear for alignment and health is very affordable, relative to other treatments. It also often addresses many issues through the body, since the feet absorb the impact of every step you take. We Can Help! Are you in need of some compression stockings? Don't hesitate to ask our qualified foot specialists if they're right for you! Whether you’re experiencing a mild or severe foot condition, you can rest easy knowing we’re able and happy to solve all your foot care needs. Call us at 416-769-FEET (3338) or Book Your Assessment Today!

April 3, 2025

Why Poor Blood Flow Causes Toenail Problems

Healthy toenails need healthy circulation, but when blood flow is compromised, they can become brittle, discoloured, or grow slowly. Additional toenail conditions can also develop. Poor circulation and toenail problems are closely linked, especially for those with health problems like diabetes or peripheral artery disease. Understanding why poor blood flow affects toenails can help you take the right steps to protect your foot health and prevent complications. https://www.youtube.com/shorts/3JAUqiqJfus The Importance of Blood Circulation In order to understand the link between poor circulation and toenail issues, we have to start by understanding what blood flow is and what it does. The circulatory system, comprising the heart, blood vessels, and blood, serves as the body's transportation network. Its primary function is to deliver oxygen and essential nutrients to cells while removing waste products like carbon dioxide. The heart pumps oxygen-rich blood through arteries, which branch into smaller arterioles and capillaries, reaching every tissue and organ. This process ensures that each cell receives the necessary components for energy production, growth, and repair. Efficient blood circulation is vital for overall health. Oxygen transported by red blood cells is crucial for cellular respiration, the process by which cells generate energy. Nutrients absorbed from digested food are distributed via the bloodstream to support various bodily functions. Key nutrients delivered by the bloodstream include: Glucose: A simple sugar derived from carbohydrates in our diet, glucose serves as the primary energy source for cells, fueling various physiological processes. Amino Acids: These are the building blocks of proteins, obtained from the digestion of dietary proteins. Amino acids are crucial for tissue growth, repair, and the synthesis of enzymes and hormones. Fatty Acids and Lipids: Essential components of cell membranes and energy storage molecules, fatty acids and lipids are transported to cells for incorporation into cellular structures and for energy production. Vitamins and Minerals: These micronutrients support a range of cellular functions, including maintaining bone health and facilitating nerve transmission. Hormones: Although not nutrients in the traditional sense, hormones are vital signaling molecules transported by the circulatory system to regulate various physiological activities, such as metabolism, growth, and mood. Impaired circulation can slow down healing processes—even for seemingly innocent and minor problems like cuts and scrapes. Likewise, organs and tissues deprived of adequate circulation can suffer damage over time, increasing the risk of conditions such as peripheral artery disease, stroke, and heart attacks. Toenail Health and Circulation: The Connection The circulatory system delivers oxygen and essential nutrients to the nail beds, supporting the growth and maintenance of strong, clear nails. When blood flow is compromised, the nails may not receive adequate nourishment, leading to various issues such as brittleness, discoloration, and slowed growth. In some cases, poor circulation can cause nails to develop ridges, indicating underlying vascular problems. Reduced blood flow can also increase the risk of infections like toenail fungus (onychomycosis). A weakened circulatory system impairs the body's ability to combat pathogens, making the toenail environment more susceptible to fungal overgrowth. This often results in yellowed, thickened nails that you can’t treat without the help of a chiropodist or podiatrist. They must remove the infected portion of the nail so they can apply the correct medicine. Poor blood flow on its own may not cause a problem with your foot health, but it can contribute to the following toenail conditions: Slow or halted nail growth: Inadequate blood flow deprives the nail matrix of essential nutrients and oxygen, resulting in reduced or ceased toenail growth. This can be very frustrating if your toenail falls off or cracks and you’re waiting for it to grow back, leaving your feet vulnerable. Brittle and discolored nails: Insufficient circulation can cause nails to become brittle and change color, often appearing yellowed or darkened. Thickened nails: Poor blood flow may contribute to the thickening of toenails, often via toenail fungus, making them difficult to trim and maintain. Poor blood flow also affects the nail growth process, which can cause nail cells to pile on top of each other and lead to thicker toenails. Ingrown toenails: While not directly caused by poor circulation, individuals with compromised blood flow, such as those with diabetes, are at higher risk for complications from ingrown toenails, including infections and delayed healing. Diabetes, Toenail Health and Circulation Diabetes can lead to two significant complications affecting foot health: diabetic neuropathy and peripheral artery disease (PAD). Diabetic neuropathy results from prolonged high blood sugar levels damaging the nerves, particularly in the legs and feet, causing numbness, tingling, or a loss of sensation. This diminished sensitivity means that innocent injuries, such as cuts or blisters, may go unnoticed, increasing the risk of infections and complications like ulcers, or in severe cases, life threatening problems like gangrene, which require amputation. This is also the case for seemingly minor problems with the toenails. Simultaneously, PAD causes blood vessels to narrow and harden, reducing blood flow to the extremities. This impaired circulation hampers the delivery of oxygen and essential nutrients needed for healing, making the feet and toenails even more susceptible. Regular foot inspections and nail care with a chiropodist or podiatrist, maintaining proper hygiene, and promptly addressing any abnormalities are crucial steps for diabetics to prevent toenail-related complications stemming from poor blood flow. https://www.youtube.com/shorts/QFWBwM6mGqM?feature=share Foot and Nail Care for Poor Circulation Maintaining proper foot and nail care is essential for individuals experiencing poor circulation, as reduced blood flow can lead to various complications. Here are some recommended practices and treatments: https://youtu.be/5PCZuM5E6RU Regular Exercise: Maintaining good circulatory health through regular exercise, a balanced diet, and avoiding smoking is essential for ensuring that the body's systems function as well as possible. One of the best circulation maintenance tips for foot health is working the muscles in the lower extremities. Exercises like toe splays, toe flexes and raises, massage ball rolls, pen pick-ups and seated toe pulls can work wonders. Click here to learn the five best foot exercises to improve blood circulation. They’re particularly helpful in the winter, but are useful all year round. Regular Self Inspections: Conduct daily checks for cuts, sores, or changes in nail color and texture to detect issues early. Moisturizing: Keep feet hydrated to prevent cracks and fissures that can lead to infections. Learn how to moisturize properly here. OnyFix Nail Correction System: For those with ingrown or involuted toenails, the OnyFix system offers a non-invasive, pain-free solution. This innovative treatment involves applying a composite material to the nail, which helps guide it back to its natural shape as it grows, without the need for surgery. It's suitable for various nail shapes. Medical Pedicures: Unlike traditional cosmetic pedicures, medical pedicures are performed by trained foot care professionals, such as chiropodists or podiatrists, in a sterile environment in a foot clinic. They focus on health, addressing issues like nail trimming, callus reduction, and infection prevention. They are especially helpful for dealing with irregular shaped toenails caused by poor circulation - cutting and maintaining these on your own can be very difficult. For people with diabetes, who are at higher risk for foot complications due to poor circulation and neuropathy, medical pedicures are a common and recommended treatment. These specialized pedicures help prevent complications like infections or ulcers by ensuring meticulous foot care. Proper Footwear: Wear well-fitting shoes that provide adequate support and reduce pressure points to promote better circulation. Proper Nail Trimming: Trim nails straight across and avoid cutting them too short to prevent ingrown toenails. And if your toenails are too thick or difficult to cut on your own, book an appointment with a foot specialist.

March 27, 2025

How Tight Calves Affect Your Body

Tight calves and foot health go hand in hand (or should we say foot in foot?). Our body parts are intricately connected, meaning discomfort in one area can lead to issues elsewhere. Likewise, muscle strain and fatigue in the lower legs can wreak havoc on the feet and other body parts if ignored for too long. Let’s explore the symptoms and causes of tight calves, how tight calves affect the body and feet, and how a chiropodist or podiatrist can help you manage pain. Tight Calves: What Are They? "Tight calves" is a general term describing the sensation of stiffness, pain and tension in the muscles at the back of the lower leg, often leading to restricted movement that affects your daily life. This tightness can manifest as muscle pain and stiffness when walking, balance issues, and more. Tight calves and posture even have a connection! Anatomy of the Calf Muscles The calf comprises two primary muscles: Gastrocnemius: The primary or chief muscle in the calf. It’s located on the back of your leg, relatively close to the skin’s surface. This superficial muscle has two heads, medial and lateral. It helps flex the knee and foot, and also plays a crucial role in walking and posture. Soleus: Located beneath the gastrocnemius, this wide and flat muscle is deeper, and originates from the posterior tibia while connecting to the Achilles tendon above the heel. This group helps stabilize ankle during activities like walking and running. Understanding the structure and function of these may be helpful in determining the cause of calf muscle tension. What Causes Calf Pain? Pain in the lower part of the back of the legs does not always feel the same. It may some on suddenly, or nag at you all day by way of a mild, dull ache. The former is often the result of a sudden injury or sharp movement, whereas the latter can build over time, resulting from lifestyle choices like wearing unsupportive shoes or working out too hard. Here are some common causes of calf pain: Muscle Cramps. Sudden, involuntary contractions of the calf muscles, known as cramps, can cause significant tightness and discomfort. These cramps may result from factors such as dehydration, general muscle fatigue, or electrolyte imbalances. Overuse. Engaging in repetitive activities that involve a lot of running or jumping can overwork the calf muscles and make them feel tight. This is especially common when increasing training intensity or duration without allowing yourself to rest. Muscle Strain. Overstretching or tearing the calf muscles, often due to sudden movements or excessive force, can result in tightness, pain, and swelling. Non-supportive and Ill-fitting Footwear. Shoes lacking arch support, shock absorption, or cushioning force the muscles to work harder with every step. Without proper arch support, the foot may put excessive strain on the calf muscles as they attempt to stabilize the lower leg. A lack of shock absorption further increases the impact of the ground on the feet and legs. Similarly, insufficient cushioning fails to distribute pressure evenly, leading to increased stress on the calves, especially during prolonged standing or walking. Poor Ankle Mobility. Limited flexibility in the ankle joint can place additional strain on the calf muscles, contributing to tightness. Some causes include having a history of ankle injuries or arthritis. Pre-existing Gait Abnormalities and Foot Type. Overpronation (excessive inward foot rolling — common in flat feet) or underpronation (excessive outward foot rolling — common with high arches), can lead to calf muscle tightness due to altered mechanics and increased strain. Dehydration and Mineral Deficiencies. Lack of adequate fluids or essential minerals like potassium, magnesium, and calcium can lead to muscle cramps and tightness in the calves. Inactivity. Prolonged periods of inactivity or sedentary behavior can cause the calf muscles to become tight due to lack of regular movement and stretching. Venous Insufficiency. Conditions like deep vein thrombosis (DVT) or varicose veins can cause calf tightness, as well as general venous insufficiency. How Tight Calves Affect the Body and Feet We can feel the effects of tight calf muscles in more ways than one. Our feet can become weaker, more vulnerable and fatigued, sometimes leading to a foot condition we didn’t have before. Tight calves can also cause experience mysterious back and knee pain. Here are common additional problems can arise from strain in the lower legs. Joint Pain Tight calves can have a significant impact on the body's overall alignment, posture and movement, often leading to joint pain in the knees, back, and feet. When the calf muscles are tight, they restrict proper ankle dorsiflexion (a term for backward, upward bending). When ankle mobility is restricted, the body may lean forward slightly to maintain balance, causing strain on the lower back muscles and leading to chronic discomfort. This abnormality can put excessive strain on other joints, like in the knees. This perfect storm of joint problems and limited movement can contribute to conditions like osteoarthritis over time. Biomechanical Foot Conditions The feet often bear the brunt of tight calf muscles, as they have to absorb additional stress during movement. Calf pain can cause a disrupt our running or walking gait as we try to move through the pain. Further, since our calf muscles connect our knees to our ankles, when the calves become tight it puts strain on the ankle. This disrupts our foot mechanics and can cause painful, chronic overuse injuries like plantar fasciitis and Achilles tendonitis. In fact, tight calves is one of the leading contributing factors to Achilles tendonitis and plantar fasciitis. Increased Risk of Injury Aching, tense muscles are more susceptible to further strains and tears, in addition to also causing balance problems as you struggle with pain. All of this combined can be a recipe for disaster and lead to a slip or fall (especially in seniors) that may cause even more damage, like a broken bone. Tight calf muscles can also contribute to more mild conditions like shin splints (repetitive stress on the shin bone) and generally hinder athletic performance. Circulatory Problems The calf muscles assist in pumping blood back to the heart from the lower extremities. Tightness in these muscles can impede this process, resulting in swelling in the feet and ankles and, in severe cases, contributing to circulatory problems. How to Treat Tight Calves: Muscle Tightness and Foot Care https://www.youtube.com/shorts/sNdIAxZNOn8 A foot care professional can help with calf tightness and pain. With their guidance and your determination to improve your foot and leg health, you can live and move comfortably. Let’s explore some options. Compression Stockings Wearing medical-grade compression stockings can improve circulation in the lower legs, reducing muscle fatigue and tightness and giving your lower extremities a healthy, comforting and energizing boost. They work by applying gentle pressure to the legs, which helps prevent blood pooling and promotes better oxygen delivery to the muscles. Compression therapy is especially useful for individuals who spend long hours on their feet, live a sedentary lifestyle, spend prolonged periods sitting while travelling, pregnant women, or those with conditions like varicose veins. A physician can determine the right level of compression based on your specific needs. Custom Orthotics Custom orthotics can help address underlying biomechanical issues that contribute to tight calves. A chiropodist can assess foot structure to design orthotics that conform to your feet, and yours alone, providing tailored support and alignment for your unique needs. By correcting imbalances and reducing strain on the lower leg muscles, orthotics can help alleviate tightness and prevent further discomfort. These devices can be particularly beneficial for individuals with flat feet, high arches, or abnormal gait patterns that place excessive stress on the calves. Proper Footwear Shoes with adequate arch support, cushioning, and shock absorption that redistributes pressure away from the heel can help keep your feet comfortable, maintain proper lower limb alignment and reduce strain on the calf muscles. Chiropodists and podiatrists often advise against wearing unsupportive footwear like flip-flops or high heels for prolonged periods, as they can contribute to muscle tightness and discomfort in the calves and feet. Strengthening Exercises and Stretching Programs A structured exercise program focusing on calf flexibility and strength can significantly reduce tightness. Chiropodists can recommend targeted stretches that target the gastrocnemius and soleus muscles — helping improve range of motion in the lower leg and fighting off stiffness. Calf raises in particular (see demonstration below) can enhance muscle endurance and prevent recurring tightness. Incorporating these exercises into a daily routine can improve mobility and reduce the likelihood of calf-related discomfort. Some other good examples of stretches for calf muscles include the Soleus Stretch and Heel Stands. Click the links for Feet First Clinic demonstrations! https://www.youtube.com/shorts/ZVSfzY6so8w

March 13, 2025

Do Flat Feet Cause Bunions?

Flat feet are a condition in and of themselves. However, flat feet also have an impact on future foot health and can lead to other more painful foot conditions. But can flat feet really cause bunions? While it seems unlikely that a toe deformity can be linked to a flat arch, you'd be surprised how interconnected our lower extremities are, especially the feet! Today’s article will explore how flat feet cause bunions, what you can do to prevent them, and how a foot specialist like a Chiropodist or Podiatrist can provide treatment. What are Flat Feet? Flat feet, or pes planus, cause the entire sole or most of it to contact the ground when standing and walking. For some people, this condition can extend into adulthood from childhood (children have flat feet before the arch forms) when the arch fails to form.When you have normal arches, they provide an elastic, springy connection between the forefoot and the hindfoot, allowing forces incurred during weight-bearing to be distributed properly. When these arches don’t exist, this mechanism is disrupted, leading to pain and other complications. What are Bunions? https://www.youtube.com/shorts/sXF8lWHad0g Bunions, or hallux valgus, are bony protrusions that form on the inside edge of the first metatarsophalangeal (MTP) joint at the base of the big toe. They develop when pressure causes the big toe to deviate toward the second toe, resulting in a misalignment of the joint. Emerging research indicates that hypermobility in the midfoot (specifically the mid-tarsal joint between the navicular and the base of the first metatarsal) may be a key underlying factor in the development of bunions, and this hypermobility is often genetic. Common Bunion Causes and Risk Factors: Ill-Fitting Footwear: Wearing the wrong shoes for years is a major risk factor for most foot conditions, especially bunions. Wearing tight, narrow, or high-heeled shoes can exacerbate pressure on the big toe joint, contributing to bunion formation. Your toes need space to splay and rest comfortably! Gender and Age: Women, particularly those over 60, are more prone to developing bunions, generally due to decades spent making poor footwear choices, or possibly due to hormonal influences that affect the ligaments in the foot. Inflammatory Conditions: Diseases like rheumatoid arthritis can cause joint inflammation, which increases stress on the big toe and the risk of bunions. Foot Injuries: Trauma to the foot can alter its mechanics, leading to bunion development. https://www.youtube.com/shorts/KZiVzLyBUMo Flat Feet and Bunions: The Connection If you’re not proactive, the shape of your foot arch can have a big impact on our foot health over time. You may know that flat feet can lead to plantar fasciitis, and you may also know that high arches can lead to back pain, but our arch shape can affect us in countless ways. Let’s talk about the science behind why a flat foot can lead to a painful bunion. It all boils down to flat feet causing an abnormal gait (walking pattern), and the damage caused by walking with that abnormal pattern for a long period of time.The structural anomaly of flat feet and barely having an arch, or no arch at all, can significantly impact foot mechanics—particularly during walking. In a typical gait cycle, the foot pronates (rolls inward) to absorb shock and then supinates (rolls outward) to create a rigid lever for propulsion. Individuals with flat feet often experience overpronation, where the foot remains excessively rolled inward during the push-off phase. The altered biomechanics increases pressure on the first MTP joint, leading to instability and misalignment. Over time, this persistent stress can cause the big toe to deviate toward the second toe, resulting in a bunion. Moreover, flat feet can lead to muscle imbalances that exacerbate bunion formation. Weakness in the intrinsic foot muscles (a group of tiny muscles inside the foot) and the tibialis posterior muscle (a muscle in your lower leg) compromises arch support, worsening overpronation. This chain reaction places additional strain on the big toe joint, accelerating bunion development. Therefore, the combination of altered foot mechanics and muscle imbalances associated with flat feet plays a significant role in the development and progression of bunions. https://www.youtube.com/shorts/pdyv58z1D2Y Preventing Bunions With Flat Feet First and foremost, it’s all about the shoes! Selecting footwear that fits properly with a wide toe box and adequate arch support is crucial. A spacious toe box prevents crowding of the toes, reducing pressure on the big toe joint and minimizing the risk of bunion formation. Adequate arch support helps maintain proper foot alignment, distributing weight evenly and alleviating stress on MTP joint. Avoiding high heels and narrow shoes is essential, as they can exacerbate foot misalignment and increase the likelihood of developing bunions. Incorporating custom orthotics can provide even more arch support if you have flat feet. These orthotics help correct overpronation—which we know now is a common issue—by stabilizing the foot's movement during the gait cycle and keeping it in neutral alignment. By improving foot alignment, orthotics reduce undue pressure on the big toe joint, reducing your risk of bunion development. Lastly, Engaging in specific exercises can strengthen the muscles supporting the foot arch, enhancing stability and function. These exercises should aim to: Strengthen Foot Muscles: Targeting the intrinsic and extrinsic muscles of the foot to provide better support for the arch and improve overall foot stability. Improve Flexibility: Enhancing the range of motion in the toes, feet, and ankles to prevent stiffness and reduce strain on the MTP joint. Enhance Balance and Coordination: Developing proprioception to ensure proper foot placement and gait mechanics, thereby reducing the risk of misalignment. Regular practice of these exercises can improve foot biomechanics, reduce overpronation, and subsequently lower the risk of bunions. See below for an example of a great flat foot exercise. https://www.youtube.com/shorts/whJ3TZAOn00 Foot Clinic Bunion Care If you already struggle with bunions and foot pain, don’t worry; there are plenty of options available to you. Bunions cannot be reversed after they form, but they can be managed with guided care from a podiatrist or chiropodist. The goal is to avoid invasive surgical intervention while still preventing bunions from impacting your daily life as much as possible. Most of these bunion treatment options are available at our downtown Toronto foot clinic: Footwear Modification. Wearing shoes with a wide toe box and avoiding high heels can help reduce pressure on the bunion. Orthopedic shoes designed to accommodate bunions provide additional support and comfort. Anti-inflammatory Medication. Over-the-counter NSAIDs, such as ibuprofen, can help reduce inflammation and alleviate pain associated with bunions. Bunion Splints and Aligners. Devices like bunion splints and toe spacers can help realign the big toe and reduce discomfort. They can provide symptomatic relief, and you can try a more rigid device if your bunion is severe. Therapeutic Taping. Applying tape to the foot can help maintain proper alignment and reduce strain on the bunion, providing temporary relief from pain and inflammation. Shoe Stretching. Professional shoe stretching can create additional space in the shoe, reducing pressure on the bunion without altering the overall size of the footwear. Supportive Insoles or Custom Orthotics. Custom orthotics can provide support to the arches and correct faulty biomechanics. This can potentially slow the progression of bunions by reducing pressure on the first MTP joint. Bunion Exercises. Strengthening foot muscles through specific exercises can improve joint stability and decrease bunion-related pain. Try these 5 simple exercises for bunions. Shockwave Therapy: This non-invasive treatment can address tight muscles and soft tissue injuries associated with bunions. This can potentially reduce pain and improve function. Implementing these non-surgical interventions can significantly alleviate discomfort and slow the progression of bunions, enhancing overall foot health and quality of life. https://www.youtube.com/shorts/8g43ZWreZ1g

March 6, 2025

Palmoplantar Keratoderma: What is it?

Figuratively speaking, it’s a good thing to have “thick skin,” right? But if you have palmoplantar keratoderma, it’s a different story. This condition, sometimes shortened to PPK, refers to a group of foot skin disorders characterized by thick, rough, and yellowed skin on the hand palms and feet soles. These conditions can be either inherited or acquired. In today’s article, we’ll explore the symptoms, causes, and, most importantly, the treatment options available. This type of skin thickening may warrant a trip to a foot clinic and the expertise of a foot care professional, such as a Chiropodist or Podiatrist. However, successful treatment may depend on the underlying cause of the skin thickening. What is Palmoplantar Keratoderma? This condition combines two scientific terms: palmoplantar, which specifically refers to the skin on the soles of the feet and the palms of the hands, and keratoderma, a term for epidermis (skin) thickening. In less common cases, transgradient keratoderma can affect the top of the hands and feet. The feet are usually more severely affected than the hands. Palmoplantar keratoderma (PPK) causes thickened skin on the palms and soles due to an overproduction of keratin, the protein that forms the outer layer of the skin. Normally, keratin helps protect the skin from friction, pressure, and environmental damage. However, in PPK, something disrupts the balance of keratin production and shedding, leading to excessive buildup. This happens because of genetic mutations or external factors that affect how skin cells grow and mature. Inherited forms of PPK often involve mutations in genes that control keratin formation or the connections between skin cells. These mutations make the skin cells more resistant to breaking down, so they pile up instead of naturally shedding. Since the palms and soles experience the most pressure and friction in daily life, they are especially prone to this excessive keratin buildup. Over time, the thickened skin can cause pain or become hard and cracked, depending on the severity of the condition. Some types can also cause blisters to form. Types of Palmoplantar Keratoderma and Associated Symptoms https://www.youtube.com/shorts/-iNFLGednYY Genetic (hereditary) keratoderma is usually divided into three main categories: diffuse, affecting the entire hand palm and foot sole; focal, where thickening is limited to pressure points; and punctate, which appears as small, hard lesions. Some genetic PPKs - particularly diffuse - are syndromic, meaning they are associated with other health conditions and additional symptoms, ranging from hearing loss to nail abnormalities to internal organ damage. Acquired PPK, on the other hand, is always syndromic and develops later in life due to external factors such as infections, inflammatory diseases, or underlying systemic conditions like internal malignancies. Acquired forms may be easier to treat since you and your healthcare team can address the underlying cause. Acquired PPK is also more common than genetic, since there are more causes and risk factors associated with it. Most types of PPK cause varying degrees of thick skin, potential foot odor (as a result of sweat combined with thick skin) and yellow/discoloured skin. Genetic PPK Types and Symptoms Diffuse PPK This form presents with even thickened skin on the palms and soles, often with a red border at the edges. Symptoms typically appear in early childhood and may include excessive sweating (hyperhidrosis). The thickening is usually confined to the palms and soles, without extending to the tops of the hands or feet. Focal PPK This type is characterized by linear (striate) thickened areas on the palms and soles, often following the lines of skin tension. It is typically caused by mutations in genes encoding desmosomal proteins, which are crucial for cell adhesion. A specific type of focal PPK called Pachyonychia Congenita is a rare genetic disorder that can also cause thick toenails. Punctate PPK This form is characterized by multiple small, hard, corn-like lesions scattered on the palms and soles. It is associated with mutations in genes that play a role in skin cell function. Acquired PPK Types and Symptoms PPK from Infections (syphilis, etc) Rough, scaly and yellow thickening on the palms and soles. May come with a rash or other symptoms affecting the whole body. Clears up when the infection is treated. PPK from Inflammatory Skin Conditions (psoriasis, eczema) Thickened, inflamed skin with redness and scaling. Can extend beyond just the palms and soles. Often improves with medicated creams or treatments that calm the immune system. PPK Linked to Other Health Conditions (cancer, hormone disorders) Yellow thickening of the palms and soles that appears suddenly in adulthood. Can sometimes signal an underlying health issue, like cancer. Needs further medical evaluation to check for possible internal diseases. What is the Difference Between Palmoplantar Keratoderma and Calluses? PPK is not the only cause of skin thickening on the feet and hands. In fact, it is more rare than another common culprit: calluses. But how do you know which condition you have? Calluses are localized areas of thickened skin that develop as a protective response to repeated friction or pressure. Commonly found on individuals who are physically active or spend long hours wearing ill-fitting shoes, they are much less severe than PPK. PPK tends to be thicker and more noticeable, alarming and unsightly than calluses, often covering a larger, symmetrical area on the palms and soles. It can appear hard and more yellow, or red and flaky. In some PPK cases, you may observe a red band at the edges of the thickened skin. Calluses can have a more mild appearance (but not always; they can sometimes be thick and painful!), with some people not even realizing they have them. Does that mean that PPK is the same as having excessive calluses? Not exactly. Calluses are only caused by friction and pressure----whereas PPK always has a driving force behind it, whether it's a genetic mutation or the result of an illness. https://www.youtube.com/shorts/yBACD8bUim0 Palmoplantar Keratoderma Treatment: Can a Chiropodist or Podiatrist Help? While there is no outright cure for certain forms of PPK, Chiropodists and Podiatrists can help manage symptoms, reduce discomfort, and improve mobility. This typically involves regular debridement (carefully removing excess skin), possibly prescribing medicinal products, and offering footwear advice to minimize friction and pressure. The latter may also include prescribing custom orthotics to properly distribute pressure on the bottom of the feet, especially if the thickened skin is impacting daily life. Scheduling an initial assessment is a good start! Naturally, since PPK can be linked to an underlying condition, more comprehensive care may be needed. A Chiropodist or Podiatrist might become a part of a broader team of healthcare professionals that can help you, including a dermatologist, your family doctor or other specialists trained to tackle the root cause. You may need advanced treatments such as topical retinoids, corticosteroids, or even laser therapy in some cases. https://www.youtube.com/shorts/sBIdll7qylQ

February 27, 2025

The Connection Between High Arches and Back Pain

Dealing with high arches and back pain can be a challenging combination, as the two are more connected than they seem. Understanding how high arches contribute to back pain is key to finding effective treatments and preventing further issues. Whether you’re dealing with foot pain, back pain, or posture problems, addressing high arches can significantly improve overall comfort and protect the rest of your body—especially your back. What are High Arches? https://www.youtube.com/shorts/osC-UmBtgNk High arches (or cavus foot or pes cavus) is a condition where the foot has an abnormally pronounced arch (as opposed to a flat foot or a normal arch). Having high arches can be due to simple genetics, inheriting structural abnormalities in the foot from your parents. They can also be caused by several neuromuscular disorders, which are conditions (ranging from mild to severe) that cause dysfunction or muscle weakness and leave certain muscles inactive. High arches generally develop during or after childhood when the flat feet most children have start to take shape and the foot arch forms. In some cases, idiopathic pes cavus occurs without a known cause (like genetics or neuromuscular disorders), and is just a case of simple variations in bone and ligament structure. A pronounced foot arch is usually quite discrete, aesthetically, and isn’t a serious condition. However, high arches are a common cause of foot pain and discomfort. High arches put extra pressure on the heel and ball of the foot, affecting normal pressure distribution and making it harder to absorb shock properly. This can lead to heel pain (plantar fasciitis— which is also commonly linked to flat feet feet), arch pain, and more, as the muscles and ligaments supporting the foot work overtime to stabilize each step, leading to inflammation or strain. High arches often cause the foot to roll outward, a motion known as supination. This can place extra stress on the ankles and knees, further disrupting alignment and increasing the risk of injuries like sprains and shin splints. It’s important to schedule an assessment with a foot specialist, like a podiatrist or chiropodist, if having high arches affects your daily life. The Connection Between High Arches and Back Pain https://www.youtube.com/shorts/7m3SQ5dXaeg A pronounced arch can also lead to back pain. But how do high arches affect the back when the two areas seem relatively far apart? The answer lies in how the body stays balanced. Many foot problems, not just high arches, often cause back pain—along with knee, leg, and ankle discomfort—because the feet serve as the body's foundation (carrying your weight) and closest connection to the ground. When that foundation is misaligned and overworked, the entire body has to compensate, leading to strain in other areas. Simply put, everything is connected, and the feet play a crucial role in maintaining functionality throughout our body’s kinetic connection! When it comes to the back, pain and poor posture often coexist. As we know, when the arches are too high, they can throw off the body's natural alignment, affecting the way you stand and walk. Uneven weight distribution forces the lower body to compensate, which can lead to foot pain and posture issues over time. The strain on the feet may cause the ankles to supinate, shifting stress to the knees and hips. This misalignment can travel up the spine, making it harder to maintain proper posture and increasing the risk of chronic discomfort. Without proper shock absorption, the impact of each step travels up through the joints, leading to tension in the lower back and shoulders. Over time, these small imbalances can create lasting posture problems, making everyday movements more difficult. Treating High Arches and High Arch-Related Back Pain When you treat high arches, you’re also preventing any potential back pain that may occur further down the road. But if you already struggle with high-arch related back pain, you can still focus on treatment methods that simultaneously target both issues. Video Gait Analysis https://www.youtube.com/shorts/Rhuga6vLdc0 This is when a Chiropodist or Podiatrist assesses your walking patterns (also known as your gait) using video gait analysis equipment. It can give foot care professionals insight into the potential damage your high arches could cause, so they can recommend preventative treatments. Custom Orthotics and Insoles A Podiatrist or Chiropodist can prescribe custom orthotics that you can wear inside your shoes. They will provide much-needed arch support, distribute weight evenly, and reduce strain on the feet and spine. Another option is over-the-counter Superfeet insoles, with the Superfeet Green: All Purpose High Arch being a good choice to ask your foot specialist about. Supportive Footwear Look for shoes with good arch support, cushioning, and shock absorption to minimize impact on joints. People with high arches should wear shoes with flexible midsoles or rocker soles to improve movement and reduce strain. Cushioning running shoes with shock absorption help counteract supination, ensuring even pressure distribution and healthy biomechanics. Avoid high heels, rigid soles, and unsupportive flats, as they can increase discomfort. Read more about the link between footwear and back pain. Stretching and Strengthening Exercises https://www.youtube.com/shorts/-EeyHTdkrEs Targeting the feet, calves, and lower back can improve flexibility and stability, reducing pain. Some of the best include towel stretches (where you place a towel under your foot arch and pull towards you), seated toe pulls (pulling the top of your foot towards you - see above!), ankle circles and massage ball rolls (rolling your foot arch on a therapeutic massage ball). You can read more about them, including how to perform them, here. You can also try clamshells on an exercise mat with your ankles together (this will also help soothe hip pain. See below for a demonstration! https://www.youtube.com/shorts/ZODK0Q4zOws

February 6, 2025

Why High-Stack Running Shoes are So Popular

The HOKA trend is the rise in popularity of HOKA's high-stack running shoes, or running shoes with extra cushioning, extra height, a high heel stack and a rocker sole. They aren’t the first popular running shoes trend, and they certainly won’t be the last. Although people exclusively associate this type of trendy running footwear with HOKA, many other brands like ASICS and Saucony make footwear with the same high-stack shoe technology. Today, we’re diving into why these shoes offer more than just style—they come with real benefits. But they’re not for everyone, so we’ll also cover who should steer clear of this particular design. https://www.youtube.com/shorts/ySn158c143c What are High-Stack Running Shoes? High-stack running shoes, often called “super cushioned” or even “chunky,” by those who don’t know the terminology. They have transformed modern footwear design for many high-quality brands. Often attributed to HOKA for “starting the craze," these shoes feature thick midsoles packed with advanced cushioning foam technologies that enhance energy return, provide sufficient shock absorption, and improve comfort over long distances. Despite their benefits, high-stack shoes aren’t without controversy. Some runners prefer lower-profile shoes for better ground feel and stability, while others find high-stacks beneficial for injury prevention and endurance. Their chunky aesthetic has also sparked mixed opinions—some love the bold look and the added height without having to wear a true high heel while others see them as clunky. High-Stack Shoe Technology The defining feature of high-stack shoes is their thick midsole, which can measure over 40mm in some models. These midsoles use lightweight, resilient foams such as Pebax or EVA blends that provide exceptional cushioning while maintaining responsiveness. The goal is to reduce muscle fatigue by absorbing more impact, allowing runners to maintain performance with less strain on joints and soft tissues. Another key factor in their performance is the rocker geometry, rocker bottom shoe or rocker sole—curved soles designed to promote a smooth heel-to-toe transition. This feature helps conserve energy, particularly during long runs, by reducing the work done by the calves and ankles. ASICS Gel Nimbus 27 The Benefits of High Stack Shoes High-stack running shoes offer several benefits for foot health, especially for individuals dealing with arthritis, diabetes, and metatarsalgia. Here's a breakdown of their advantages: Enhanced Cushioning: High-stack running shoes feature extra cushioning, which absorbs shock and reduces impact on the feet during movement. This is particularly beneficial for people with conditions like arthritis, where joints are sensitive to pressure and movement. Pressure Redistribution: The additional cushioning and rocker sole work together to redistribute pressure across the foot. In the case of diabetes or metatarsalgia, this can help alleviate excess pressure on specific areas of the foot, such as the forefoot or metatarsal heads. For those with diabetes, reducing pressure can help prevent the skin damage that leads to ulceration, as it lowers the risk of tissue damage and enhances comfort. (However, people with diabetes and balance issues may wish to avoid rocker soles - more on that later). Joint Protection: The rocker sole limits the motion of foot joints. This helps manage conditions like osteoarthritis and hallux limitus (big toe arthritis). By restricting unnecessary movements, it prevents excessive strain on the joints, protecting them from further damage. This is especially useful for the big toe joint, where excessive motion can lead to increased pain and discomfort. It's also highly beneficial for people with high arches. People with high arches tend to experience joint rigidity (particularly hallux limitus) and lack of shock absorption. The rocker sole offsets the restricted mobility. Improved Biomechanics: The curved design of the rocker sole encourages a smoother, more efficient gait. The shape propels the foot forward with each step, facilitating a natural walking motion and reducing strain on the joints. This is particularly beneficial for those with ankle, midfoot, or big toe arthritis, as it helps maintain normal walking patterns without overloading the affected areas. Pain Reduction: Rocker soles are especially effective in reducing pain associated with conditions like hallux limitus and metatarsalgia. By minimizing motion at the big toe joint and redistributing pressure under the ball of the foot, these shoes can significantly reduce the discomfort felt during daily activities like walking or standing. https://www.youtube.com/shorts/qByZ0GRFoaQ When to Avoid High Stack Shoes Here are some individuals who might want to avoid them or consult a foot care professional, like a Chiropodist or a Podiatrist, before wearing them: People with Balance Issues The rocker sole on high-stack shoes can make them less stable for individuals who struggle with balance or proprioception (awareness of body position). Those at a high risk of falls, such as elderly individuals or those with severe neuropathy, may find that the rocker sole from stacked heels throws off their balance. People with Diabetes Complications from diabetic neuropathy can lead to balance issues. Therefore, while the cushioning of a stacked heel is great for addressing joint issues, the "rolling" effect of the rocker sole is not suitable for people with diabetes. Individuals with Ankle Instability The increased midsole height and curved design can reduce ground feel and make it easier to roll an ankle, especially on uneven surfaces. People prone to ankle sprains or with a history of ankle instability might be better suited to lower-profile shoes with more lateral stability, or stability shoes with posting in the midsole (like the ASICS Gel-Kayano), which is constructed to cradle the foot and control ankle movement. In shoes like the ASICS Gel-Kayano, even though there is a stacked heel, the foot actually sits below the sole to provide stability. https://www.youtube.com/shorts/osC-UmBtgNk

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