November 10, 2022
Your plantar plate plays a critical part in the anatomy and makeup of our feet. The plantar connects your feet with the joints in your toes.
Given the constant wear and tear of your feet, the joints and muscles can often become overworked or strained. The plantar plate is particularly susceptible to injury because of its location on the foot. This also makes it especially vulnerable to several other foot conditions. For example, having bunions or a hammer toe may increase the risk of a plantar plate tear.
But worry not. In this article, learn more about the plantar plate as a body part, plantar plate tear symptoms, causes, and treatment methods for the foot condition.
First, let's explore the physiology of the plantar plate itself.
What's your plantar plate?
The plantar plate is rigid fibrocartilage (a dense, whitish tissue with a distinct fibrous texture) which connects the phalanges to the metatarsal head. In other words, the plantar plate joins the toes (phalanx bones) with the forefoot (metatarsal bones). As the mediator, the plantar plate stabilizes the toes and prevents them from shifting side-to-side or overextending.
Next, let's look at the why of plantar plate tears.
Plantar plate tear: Causes
Overloading the metatarsophalangeal (MPJ) joint is the most common cause of plantar plate issues. Overloading the MPJ leads to strains and tears. The result? Pain and instability of the plantar plate.
In most cases, plantar plate damage occurs incrementally over time. However, you can acutely injure the plantar plate.
See below for a comprehensive list of plantar plate tear causes:
Bunions: Bunions - a deformity affecting the joint that connects the big toe to the foot - put pressure on the plantar plate by forcing the big toe to push against the 2nd toe.
Biomechanical abnormalities (metatarsal length): If your 2nd metatarsal is longer than your 1st (which it often is), you're at a greater risk of a plantar plate tear at that site. You're at a greater risk of this tear at the site because your 2nd metatarsal bears more weight than the "big" toe (1st metatarsal) when it's longer.
Biomechanical abnormalities (overpronation): When you overpronate, your foot bears much impact when running or walking. Typically, flat feet are a leading contributor to overpronation.
Cortisone injection: Cortisone shots can have the side effect of thinning and weakening the plantar plate ligament.
Specific activities/sports: Sports or movements that put excessive pressure on the toes and ball of the foot increase your chances of developing a plantar plate tear. Be cautious when dancing, running, jumping, or climbing stairs, especially if the balls of the foot are regularly sore or sensitive.
Hammertoes: A hammertoe deformity occurs when the toe's middle joint bends abnormally a toe deformity in which the middle joint in the toe bends abnormally.
In the next section, you'll learn how to recognize plantar plate tears.
Symptoms
Wonder what are the signs of a plantar plate tear? Well, look out for these symptoms commonly associated with plantar plate tears:
Toe alignment changes: The toe changing position, which occurs gradually as the tear increases, usually to the side or upwards
Pain: Discomfort usually stems from the ball of the foot, either as severe pain or a dull ache. If you find you're walking with very little cushioning under your toes, it may be because of a plantar plate tear.
Swelling: You may notice swelling underneath the ball of the foot extending between the start and end of one of the multiple toes.
Plantar plate tear: Diagnosis
You have a few options in terms of diagnosis:
Treat the pain yourself if it's not severe and the discomfort has just begun
X-rays
MRIs
Finally, in the last section, you'll learn more about how to treat plantar plate tears.
Plantar plate tear: Treatment
Pinpointing a plantar plate tear as the source of discomfort can be challenging. The foot is a complex network of muscles, tendons, and bones that are so intertwined that isolating the condition can be difficult. However, it's not a hopeless task.
Several DIY treatment methods exist for mild symptoms, as well as options for severe cases of plantar plate tears.
Visit a chiropodist
Our team of dedicated licensed chiropodists is committed to providing quality care and services for all your foot and ankle needs. They can diagnose, treat and help manage various foot conditions, from callus removal to ingrown toenails to bunions.
RICE (Rest, Icing, Compression, and Elevation)
The RICE method is a universal treatment for many foot conditions, including plantar plate tears. The RICE method, when combined, helps relieve pain, reduces inflammation, keeps swelling at bay, and allows for ample recovery for your muscles, tendons, and in this case, for your plantar plate.
Taping
Taping, the wrapping of a joint for added stability, can help hold your toes in position. Stabilizing the joint with tape can help correct any worsening abnormalities associated with plantar plate tears. It also prevents your toes from moving too far side-to-side, which can help encourage plantar healing and to avoid re-aggravation. A chiropodist can perform splinting, bracing, or taping for you.
Orthotics
Orthotics are a treatment method for the underlying causes of plantar plate tears. Custom foot orthotics are effective for bunions, hammertoes, and flat feet. You can also use shoe inserts with hardened plastic under particular toes for extra support.
NSAIDs
Anti-inflammatories like ibuprofen or Advil can combat pain associated with plantar plate tears.
Surgery
Surgery is a last resort option for plantar tears. There are two standard surgical procedures for plantar tears. The hat-trick procedure helps realign the metatarsal bone, while other surgeries are available for associated conditions like hammertoes, bunions, or other ancillary operations to balance the toe.
November 7, 2022
Feet come in different shapes and sizes, and some people go through life with wide feet.
You could simply be born with wide feet, or your feet may increase in width as you get older. Wide feet can also be caused by a foot deformity (like bunions and hammertoes) or a temporary condition like pregnancy.
Whatever the reason is behind your wide feet, shoe shopping can be an ordeal. Wide shoes are certainly available, but many people make the mistake of wearing ill-fitting shoes that heighten discomfort levels. In terms of managing wide feet, hunting for the proper footwear is key. Let's look at some tips you can use to find shoes for wide feet!
How to Find Shoes for Wide Feet
Don't trust the listed size
Look for wide and extra wide widths
Buy shoes with laces
Search for shoes with removable insoles
Check the toe room
Try shoe stretching services
Don't Trust the Listed Size
Sometimes, people with wide feet just go for one of the largest sizes and trust it will fit. This can be more common for people who tend to shop online.
But this isn't wise. Many shoe companies don't focus on the importance of wide shoes and simply list shoe options as narrow, wide, long, etc., with a standard numerical size (these refer to the length of the shoe, not the width).
But with wide feet, you need extra information to trust that the shoe will fit properly. Don't simply assume a basic "wide" description will be enough to comfortably accommodate your feet. Furthermore, you should always shop for shoes in person when you have larger feet.
Look for Wide and Extra Wide Widths
Try to find shoes that list width options. For example, a shoe may have a "B" width size as a "standard" option. But width options may also extend to "D - Wide, 2E - Extra Wide, and 4E - XX-Wide."
Pay attention to shoe manufacturers that list these options. And as we've mentioned before, don't try to go up a size and assume it will fit. Buying a larger will size will leave you stuck with a longer shoe, not a wider one.
Buy Shoes with Laces
Lots of different shoes come with laces, even heels. Opting for shoes with laces allows you to adjust according to your foot's width and loosen them up if needed. Lacing can also enhance the functionality of your footwear and can boost comfort levels after going for a long walk.
To maximize space, try using the eyelets that are closest to the ankle and leave the eyelets closest to the toes empty. You'll be able to tighten your laces without restricting the front of the shoe, where the foot is the widest.
Search for Shoes with Removable Insoles
While shoe shopping, try to find shoes where you can take out the footbed. Not only do removable insoles allow you more wiggle room, but having the option to replace them with custom orthotics or specialized insoles will give you added protection from foot pain.
Check the Toe Room
Assessing the toe room can indicate if you need to go up in width or both size and width. A good way to do this is to see if you have a finger's width of room between your toe and the end of the shoe. If you do, but the shoe still feels tight, you only need to go up in width.
Try Shoe Stretching Services
At Feet First Clinic, shoe stretching services are available by walk-in --- no appointment necessary. That said, it's important to note that this only works if your shoes are already close to the proper size and just feel a little tight. Shoe stretching also only works if you have a pair of shoes made of leather or natural material.
Foot clinic staff can expand the width of the shoe by one full-width size.
August 25, 2022
The term "shockwave therapy" can sound highly intimidating. It can conjure images of pain and torture, but fortunately, there is no need to worry! Shockwave therapy is a gentle and effective treatment method that can help reduce your pain and promote healing.
Keep reading to learn more about shockwave therapy and how it can benefit you!
What is Shockwave Therapy?
Shockwave therapy is a non-invasive treatment method that uses soundwave pulses. While the name may cause you to assume electrical impulses are at work, this therapy actually uses a very mild frequency of acoustic waves. These soundwaves penetrate through the skin at the site of an injury, which triggers your body to amp up its healing abilities. Very little (if any) pain is involved in the process.
Shockwave therapy was initially developed based on the same technology used to penetrate deep within the body to break down kidney and gallstones. The waves used in shockwave therapy are much lower in frequency, but their results have been just as amazing! Many people who undergo this therapy begin seeing results after just a few sessions.
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How Does Shockwave Therapy Work?
Also known as extracorporeal shock wave therapy (ESWT), this modality is becoming increasingly common in physiotherapy and foot clinics. Studies have shown that it is highly beneficial in helping many different conditions and injuries that deal specifically with tendons and ligaments. Shockwave therapy is best-suited for people with chronic, long-lasting conditions that don’t seem to respond to other treatment methods.
Shockwave therapy sends soundwave pulses through the skin to the injured area. It causes microtrauma to the tissue and prompts your body to speed up the healing process. This causes the body to send more blood and nutrients to the area which allows your body to heal itself naturally.
What to Expect During a Shockwave Session
Your chiropodist will take some time to assess your situation and determine if shockwave therapy is right for you. A gel-like substance will be applied to the affected area, and a small wand (similar to an ultrasound device) will be used to transmit the soundwaves to the affected area.
You will feel a slight pulsing sensation as the soundwaves are applied. Some people may experience very mild discomfort. If this occurs, inform your therapist and have them adjust the intensity of the shockwave machine. Each session will last approximately five to ten minutes, and most people require one weekly treatment for four to eight weeks.
Afterward, you will feel fine to go about your normal daily activities. You shouldn't have any lingering discomfort.
After your treatment, you should avoid taking anti-inflammatories or applying ice or heat to the area. Doing so will inhibit the body's healing response and may slow down your recovery time.
What Conditions can Shockwave Therapy Help?
Shockwave therapy is an excellent treatment method for any type of pain or injury affecting the connective tissue in the body, like tendons, ligaments or muscle tissue. Shockwave therapy can help if you suffer from any of the following conditions:
Plantar Fasciitis
Heel Spurs
Achilles Tendonitis
Shin Splints
Patellar Tendonitis
Tennis Elbow
Rotator Cuff Issues
Hip Bursitis
What are the Benefits of Shockwave Therapy?
If you are suffering from an injury that involves your tendons or ligaments, there are many benefits that shockwave therapy can provide:
It is non-invasive and causes minimal discomfort, both during the procedure and throughout the healing process.
Has very few side effects and a fast recovery time.
Can help relieve your pain after just one session.
Requires a short duration of therapy. Most people only need one shockwave therapy session per week for an average of four to six weeks.
Is relatively inexpensive when compared to other treatment methods.
Has an excellent recovery rate, especially in those who suffer from chronic pain and have not found relief from other methods.
Doesn’t require any sedation or medication.
Does Shockwave Therapy have any Side Effects?
This treatment method has few side effects; however, anyone suffering from circulatory problems or nerve or bone disorders should speak to their healthcare practitioner before accepting treatment. It should also be avoided by pregnant women.
Are you Considering Shockwave Therapy?
Shockwave therapy is an excellent option for anyone suffering from foot pain, plantar fasciitis, heel spurs, or other conditions affecting your connective tissues. It can provide many benefits, most notably its ability to help your body heal and significantly reduce your pain and discomfort.
April 12, 2021
Chances are you, or someone you know has lost a toenail at some point. Whether it was from sports or a falling object, detached toenails are quite common. Other than the obvious yuck factor, there are typically few ill effects.
But, that's not always the case. In this article, we explain the various reasons your toenails might fall off, how to treat a fully- or semi-detached toenail, and how long it actually takes for a toenail to grow back.
Toenails are thickened extensions of the top layer of our skin. Like our skin, toenails are made of keratin, a type of protective protein that is less prone to scratching or tearing than other cell types our body produces. Keratin is particularly tough.
As the cover to your nail bed, toenails are put under a great deal of stress. Everyday pressures include rubbing against your shoes, a stubbed toe, the presence of bacteria and fungi, and being your toe's protector against falling objects. These types of situations can damage the toenail, sometimes to the point of it falling off completely.
Not only does a nail expose the nail bed below, but it can also be painful, and difficult to ensure a toenail properly grows back in the place of the lost nail. Next, we break down why your toenails fall off in the first place, the rate of toenail growth, as well as some tips and tricks for healthy nail growth.
Why did my toenail fall off?
There are a variety of reasons why your toenail falls off. The most common cause is injury or trauma, but we break it all down below:
Injury
Trauma can cause the nail to pry away from the nail bed, like when it's hit or jammed.
Severe or repetitive toe stubbing/rubbing may cause a toenail to detach. This is also common in athletes who wear shoes that aren't roomy enough. Similarly, long-distance runners (marathoners and/or ultrarunners) and trail runners are particularly susceptible to black - and ultimately detached - toenails. In fact, you may come across athletes with multiple missing toenails.
Fungal nail infection, which occurs when fungi invade a fingernail or toenail and the skin underneath the nail. Symptoms include cracked, yellow, discoloured, streaked, thickened, or spotted nails.
Skin conditions, such as psoriasis.
Acetone nail polish removers or some soaps.
Chemotherapy or antimalarial medicines.
Severe illnesses.
What's a black toenail?
A black toenail is usually caused by direct trauma to the toenail. Trauma can include dropping an object on your foot, or repetitive trauma to the area like running long distances. Minor trauma, occurring over a longer period of time, can result in black/purple toenails as well. For instance, wearing ill-fitting shoes that put pressure on your big toe can damage your toenail.
The actual colour of the toenail is caused by the trauma beneath the toenail. As the area below the toenail is damaged and begins to bleed, the area darkens resulting in a black/purple toenail.
Toenails can turn black, but they can also become discoloured in other shades, which can be a symptom of a variety of foot conditions. The most common symptoms of a discoloured toenail include:
Yellow Toenail
Toenail fungus is the primary cause of yellow toenails. Additionally, thicker nails can cause a yellow colour as the disruption of light passage through the nail alters the look.
Green Toenail
Green nail syndrome (GNS) is a toenail infection caused by bacteria, not fungus. GNS is usually confined to a single toenail, but bacteria can be passed over from an adjacent toenail if it's damaged or affected.
Blue Toenail
In very rare cases, your toenail maybe blue. This is called a cellular blue nevus, which can become cancerous.
How long will it take for my toenail to grow back?
After a nail separates from the nail bed, it will not reattach, so don't try. In its place, a new nail will have to grow back. Toenail growth can be slow; toenails can take up to 18 months (1.5 years) to grow back.
Is there anything I can do to make my toenail grow back faster?
Absolutely. Although there's no single sure-fire way to encourage faster toenail growth, there are lots you can do to encourage a healthy toenail to grow back in the place of your lost partner. Here are some simple at-home remedies for ensuring your nail has the best chance at growing back:
Soak your foot in a combination of 1 tsp (5 g) of salt and 4 cups (1 L) of warm water for 20 minutes, 2 or 3 times each day, for the first 3 days after you lose your toenail. Cover with a fresh bandage.
Ensure the nail bed is kept dry and clean until the nail bed is firm and you see signs of the nail growing back.
Watch for signs of infection such as increased heat, redness, pain, tenderness, swelling, or pus.
Remove any artificial nail if it begins to separate from the nail bed. Leaving it on can tear the nail bed.
If you trim off the detached nail, you reduce the chance of nail catching and tearing. If part of your toenail has completely fallen off, don't remove the remaining nail. However, if there is still a piece of toenail attached, carefully trim it using toenail clippers.
Take biotin supplements. Biotin aids in the metabolism of protein-building amino acids that are essential for toenail growth.
Use nail hardeners. Nail softness makes nails more prone to breaking, which increases the need for nail regrowth.
Toenail trouble? We’ve got you covered!
We’re confident in our ability to help inform you and solve your concern with the least amount of discomfort possible. Call us to ask your question(s) and we’d be happy to point you in the right direction. Call us at 416-769-3338 or Click Above to Book Your Assessment Today!
March 1, 2021
Ask anyone their shoe size and they can likely fire it off in a moment's notice. How about the width of their feet? Wide feet and narrow feet are less talked about.
When finding proper footwear, it's not just the length that matters. The width of our feet is just as critical. Typically foot width falls into three categories: wide, regular, and narrow. Some footwear brands offer wide or narrow versions of their products. In other cases, they may have a specific nomenclature to denote wide or narrow products. 10W, for example, is a wide size 10.
It's no wonder that shoe size is a more common categorization of our feet. After all, our shoes are measured in a way that allows us to seamlessly pick and choose footwear. Unlike clothing - measured by XS, S, M, L, or XL, shoe size is measured numerically. Here in Canada, we share a system with the U.S., while the UK and Europe have their own measuring system that requires conversion calculations for equivalents.
The Brannock Device is the most popular tool for measurement. The device has both left and right heel cups and is rotated through 180 degrees to measure the second foot. This allows for a measurement in cm, which translates into a shoe size. (4-12 for women, and 6-16 for men, typically.)
Next, we get into how to measure your feet, and how to accommodate both narrow and wide feet.
How do I measure my feet?
The first option is to do it professionally. Here at Toronto’s leading foot clinic, we offer every customer a comprehensive footwear assessment free of charge to ensure that you invest in the healthiest footwear for your feet. Our footwear specialists and chiropodists will help match your foot shape, structure, and alignment to specific shoes and footwear features that answer your corrective, supportive, or accommodative needs.
The second way to measure your feet is to DIY.
Get a ruler, marker, and piece of paper.
Place the paper flat on the ground and stand on it. Make sure your foot is flat.
Make a mark behind your heel and another in front of your longest toe. If one of your feet is larger than the other, use the longer foot to measure your size.
Measure the distance between the two lines in inches or centimetres.
Using the measurement in cm (or inches), convert the foot length into the corresponding shoe size.
Women's Shoe Size Chart
US
EU
UK
FOOT LENGTH (approximate)
6
36-37
4
~8.75 in / 22.5 cm
6.5
37
4.5
~9 in / 23 cm
7
37-38
5
~9.25 in / 23.5 cm
7.5
38
5.5
~9.375 in / 23.8 cm
8
38-39
6
~9.5 in / 24 cm
8.5
39
6.5
~9.75 in / 24.6 cm
9
39-40
7
~9.875 in / 25 cm
9.5
40
7.5
~10 in / 25.4 cm
10
40-41
8
~10.2 in / 25.9 cm
10.5
41
8.5
~10.35 in / 26.2 cm
11
41-42
9
~10.5 in / 26.7 cm
Men's Shoe Size Chart
US
EU
UK
FOOT LENGTH (approximate)
7
40
6
~9.6 in / 24.4 cm
7.5
40-41
6.5
~9.75 in / 24.8 cm
8
41
7
~9.9 in / 25.2 cm
8.5
41-42
7.5
~10.125 in / 25.7 cm
9
42
8
~10.25 in ~26 cm
9.5
42-43
8.5
~10.4 in / 26.5 cm
10
43
9
~10.6 in / 26.8 cm
10.5
43-44
9.5
~10.75 in / 27.3 cm
11
44
10
~10.9 in / 27.8 cm
11.5
44-45
10.5
~11.125 in / 28.3 cm
12
45
11
~11.25 in / 28.6 cm
13
46
12
~11.6 in / 29.4 cm
How do I measure the width of my foot?
The width of your feet is the distance between the two widest parts of your foot. This is likely a single measurement in one area—at the base of your toes, called the ball width. This is the measurement between the big toe joint and the small toe joint.
To measure the width of your foot, follow these three steps:
Place a large piece of paper on an even surface.
Stand on the paper and trace an outline of your foot on the paper.
Measure the distance between the widest parts of your foot.
Do both feet. If one is wider than the other—which is totally normal—then account for the wider of your two feet.
Why do I have wide feet?
Remember, there's no one size fits all. Everyone has a unique foot size and shape, which can be attributed to a specific cause or be less known like genetics and ageing. A few causes of wide feet include:
Genetics. Some people are born with wide feet. Alternatively, people with flat feet (collapsed arches) are prone to having wide feet.
Age. As we age, our feet change. The ligaments and tendons loosen, and our feet tend to grow longer and wider as our arch collapses.
Foot deformities. Foot conditions like bunions, calluses, and hammertoes can affect the shape and anatomy of your foot. As a result, your foot may widen.
Improper footwear. Shoes make a difference. In fact, studies have shown 63-72% of people don't wear footwear that fits their foot properly. This no doubt can lead to foot deformities.
Pregnancy. During pregnancy, a hormone named relaxin causes ligaments and joints to loosen around the feet. Like in ageing, the loosing of the tendons causes your feet to widen. This is especially true during the second and third trimesters.
Swelling. Edema, a medical term for “swelling,” can cause your feet to widen. This can be a long-term condition or a short-term phenomenon depending on the cause.
How about if I have narrow feet?
Narrow feet are quite common. In fact, an early-2000s study found that roughly 33% of women have narrow feet, a figure that is likely underreported. People with narrow feet will find that they have extra room on both sides of the shoe. To accommodate for the fit, narrow shoes are typically 1/4 inch narrower than regular shoes, and 1/2 inch narrow than wide shoes.
Footwear that is too big or wide for your feet can cause issues like blisters, corns, black toenails, and calluses.
For people with narrow feet, like for brands that make footwear in AA (narrow) or AAAA (super slim). Looking for the proper footwear? Visit our clinic at 2481 Bloor St W, Toronto, ON M6S 1P8 for a full selection of leading orthopedic footwear.
Alternatively, look for shoe inserts that can help customize the fit of your shoe to your liking. This will help expand the selection of shoes you can wear, while also taking into account the width of your feet.
What if I have narrow feet and bunions?
If you have narrow feet, you’ll still need to accommodate for Bunions as shoes need to account for the width. Ironically, bunions can be partly attributed to slim-fitting shoes. Over time, ill-fitting footwear can cause your toe joints to shift, causing a bunion. Or, if you already have a bunion, constant aggravation from small shoes can exacerbate the condition.
Need your feet measured properly? Get a professional to do it!
Our team is trained to handle any and all your foot health concerns. From mild, to critical, we cover all sides of the foot needs spectrum. Call us to ask about actionable steps towards your solution today!
Call us at 416-769-3338 or Book Your Assessment Today!
February 22, 2021
With proper footwear and outdoor gear to keep you warm, a little snow (but maybe a little ice on some days) shouldn't keep you away from the hiking trails this winter! With restrictions on life at present, it is still possible to spend some time outside. Refuel your spirit with some time out in nature. The Greater Toronto area has some great trails that are worthy of exploration.
Evergreen Brickworks
Located in the Don Valley, it is one of the best markets I've been to over the years. I love the beautiful integration of the outdoors into the building's architecture, representing their mandate for sustainable living. The trail itself will take you about 20 minutes to get to the top with stunning views. It's a magical place, where under normal circumstances you can enjoy a nice warm drink and a little shop at the facilities afterward.
Humber River Recreational Trail
This 8.2 km paved trail is an ideal distance on a sunny afternoon. It's a good option for those who live northwest in the city. It is also approachable by transit, and there is free parking. Given its location, it can be a bit busy, so it is worth considering times that may be a little quieter.
High Park Area Trails
Partially paved and partially dirt, this can get a little mucky in the snow. However, if prepared with the proper footwear, and perhaps you have a four-legged friend up for an adventure, these trails will do the trick. With just over 5 kilometers available for exploration, and minimal elevation within the well-known park, it offers easy accessibility to all.
High Park is also conveniently close to the Feet First Clinic, located in Bloor West Village. This would be a great place to roam around after your appointment or try out your new boots!
Scarlett Mills Park
A 3.5 km trail with moderate elevation in terrain, this trail is great for a quick hike! It is also great for snowshoeing and biking. Located in Etobicoke, it's a great location for a little bit of a challenge in it's terrain, giving opportunity to try out different winter activities on this trail.
Beltline Trail
Not too far from the Brickworks trail mentioned above, the Beltline is an 8.9 km out and back trail. It's a mainly flat path, so the terrain isn't too treacherous for explorers of all levels. It's a great multi-activity trail for this reason too. A bit of a longer jaunt, if you are looking to keep warm, make sure you keep yourself heated up by layering or moving quickly! Don't forget to enjoy the scenic views of course.
Looking to be fully equipped for your winter hikes?
At Feet First we can assess your needs for proper foot health and make sure you have on footwear for safety and comfort! Call us today at 416.769.FEET (4338) and book your appointment or inquire about our boot inventory!
