March 23, 2023
Diabetes is a serious illness that affects people from all over the world. Type 1 or type 2 diabetes can lead to several complications, like heart disease, kidney problems, vision issues, oral health deterioration, and more. But one of the most common problems diabetes patients face is diabetic foot pain and other foot problems that can transform into serious complications when left unchecked.
Today's blog will discuss the following:
The causes of diabetic foot pain
Diabetes-related foot complications
Diabetic foot pain treatment at a foot clinic
Self-care tips and at-home diabetic foot care
Photo by Artem Podrez from Pexels
What Causes Diabetic Foot Pain?
The main culprit behind type 1 and type 2 diabetes-related foot pain is diabetic neuropathy. Diabetes patients struggle with four types of neuropathy, all of which cause nerve damage:
Peripheral Neuropathy: This is the most relevant categorization of neuropathy when discussing foot pain causes. It affects the lower extremities (feet and legs), arms and hands. It occurs when high blood sugar and triglyceride levels damage the nerves and tiny blood vessels in the circulatory system, causing poor blood flow. Symptoms include shooting foot pain, "pins and needles," numbness, weakness and burning sensations.
Autonomic Neuropathy: This is similar to peripheral, except the nerve damage affects the body's organs rather than the limbs.
Proximal Neuropathy: A rare type of nerve damage that causes severe hip, buttock, or thigh pain.
Focal Neuropathies: Rare singular/local (hence "focal") nerve damage, typically in the hand, head, torso, or leg.
Diabetes-Related Foot Complications
Whether it's numbness or pain, it is extremely important to pay attention to the warning signs your feet give when you have diabetes.
Moreover, your feet often fail to signal problems to your brain due to neuropathy. This means you also need to consistently inspect your feet and visit a foot specialist for an extra set of eyes and expertise (more on that later!)
If you don't, debilitating complications with varying degrees of pain and discomfort may creep up. These include:
Skin changes like dry skin and cracked heels. This occurs due to nerve damage preventing your body's natural oil and moisture production.
If you cannot feel cold, heat and other sensations on your feet, you may be unaware of a foot injury. This can lead to a worsening injury or infection if the skin is broken and you haven't noticed.
Calluses are common in people with diabetes, and the more they thicken, the more likely they are to become an ulcer (open sores or lesions that will not heal).
Peripheral artery disease (plaque buildup in the arteries) can arise in diabetic patients. Like neuropathy, it reduces blood flow, so you don't notice ulcers, infections and injuries. Aggressive infections and ulcers without treatment can lead to gangrene or amputations.
Edema (swelling): This is caused by nerve damage and the subsequent fluid buildup in the body's lower extremities. Swelling can cause pain and mobility problems.
Diabetic Foot Pain Treatment at a Foot Clinic
Since diabetes impacts our feet, patients should find a chiropodist and schedule regular appointments. The general recommendation is no less than once yearly but more frequently if nerve damage is present.
Not only can foot specialists help with pain management, but consistent foot inspections are critical for spotting the beginning stages of a complication.
Some of the main ways chiropodists help with diabetic foot pain include:
Skin health assessments and maintenance
Foot assessments
Custom orthotics
Footwear recommendations
Skin Health Assessments and Maintenance
This is one of the most important jobs a chiropodist will do. They can notice signs of ulcer development, infections and other skin abnormalities. Chiropodists also perform regular diabetic foot care on diabetes patients, so they don't develop ingrown toenails or fungal infections.
Foot Assessments
Your chiropodist will check your vascular (circulation) health via regular inspections. They will also check your foot temperature, look for swelling, and check the colour of your feet. They can also ask what type of foot sensations you're feeling, like tingling, shooting pain or burning and proceed from there. This is included with Feet First Clinic's diabetic foot care services.
Custom Orthotics
Orthotics make walking much easier, as they distribute body weight evenly across the foot while reducing pressure and friction and relieving the foot's pressure points. They also help regulate your motion and correct any abnormal gait patterns you develop while struggling with foot pain. Chiropodists can provide orthotics via a thorough a biomechanical assessment.
Footwear Recommendations
Footwear modifications can help reduce diabetic foot pain, and the special shapes and designs of orthpaedic footwear can accommodate neuropathy symptoms more successfully than standard footwear. Diabetic patients often need deep shoes to support orthotics and to manage the discomfort and pain they experience when dealing with swelling. Diabetes patients also need footwear with little to no seams in order to reduce pressure points and friction against the foot. Companies such as APEX and Anodyne make shoes especially for diabetes patients.
Self-Care Tips and At-Home Diabetic Foot Care
Orthopedic slippers can help manage foot pain and allow you to move around your home more freely.
Soak your feet in a warm foot bath to ease stress and soothe aches and pains.
Try your best to regulate blood sugar levels to help fight nerve damage.
Inspect your feet and keep them clean. Note: do not try to get rid of calluses and other skin abnormalities on your own. Schedule an appointment with your chiropodist if you notice callus buildup or skin problems.
Keep on top of diabetes routines not directly related to your feet. This includes proper medication management and regularly checking your blood pressure at the local pharmacy and doctor's office.
Light exercises and stretches can be beneficial for diabetic foot pain. For example, rolling your feet on a ball (or water bottle) or scrunching your toes to pick up a towel can strengthen your feet. And those are just two examples! Most foot stretches are easy to perform and relieve pain in different ways. Low-impact activities like swimming and walking can also be beneficial.
February 6, 2023
Age is just a number, but age starts to catch up with us at a certain point. As much as we want aging to slow, getting older comes with its fair share of aches and pains.
Few people age the same; it is a complex process. Environment, genetics, exercise, and many other factors mould who we become as we enter our elderly years. This also applies our feet. As we age, our feet become more susceptible to various conditions such as arthritis, plantar fasciitis, bunions, foot injuries and chronic pain.
Our latest blog is all about common foot conditions in the elderly and how to treat them.
What happens to our feet as we age?
Did you know that when you turn 70, you'll be 25,550 days old? That helps put the body's remarkable ability to withstand constant wear and tear into perspective.
Beyond just a number, there are also physiological changes that occur as we age. Your feet may get bigger. Your feet may widen. Muscles, tendons, and ligaments also wear down, putting you at greater risk of certain foot conditions.
You may notice you experience foot pain and other problems more often. Any number of the following may happen:
Weakness
Frailty
Exhaustion
Gait alteration
Balance difficulties
Increased swaying while walking
Decreased walking
Walking speed
As we age, it's essential to check how you feel regularly. A bonus would be to have your feet checked regularly. Our team of expert foot specialists can help you manage acute and chronic conditions that affect the toes, feet, and ankles.
Most common foot conditions in the elderly
Foot conditions amongst the elderly may include bone injuries, toenail damage, foot deformities, and muscle and tendon damage. It's important to note that most of these conditions are not specific to the elderly, but age contributes to increased risk.
Below we break down the following common foot conditions in the elderly and how to treat them:
Bunions
Osteoarthritis
Fat Pad Atrophy
Thickened or Discoloured Toenails
Gout
Plantar Fasciitis
Stress Fractures
1. Bunions
What are bunions?
A bunion is a deformity of the first metatarsophalangeal joint ("MTP" joint for short). The first MTP is the joint of the big toe. (Essentially, the big toe's "knuckle.) Damage to this joint can cause bone misalignment over time. Eventually, the bone shifts and protrudes at the base of the big toe. Bunions affect approximately one quarter to one third of adults, and women experience the foot condition more often than men.
As we age, bunions worsen. Although there is no "cure" for a progressive foot deformity, you can lessen the effects and pain associated with bunions through several habitual changes.
How can I treat bunions?
You can choose either invasive treatment or non-invasive bunion treatment. In most cases, you can manage bunions with non-invasive treatments, though surgery is the only way to remove the bump altogether.
Footwear modification: Avoid tight shoes that squeeze the toes and ditch your high heels. You may also find that orthopedic shoes that stretch or come in wide widths effectively accommodate your bunion in your footwear. Shoe stretching is also an effective method for changing the structure of your current footwear.
Anti-inflammatories: Specific medication like NSAIDs or ibuprofen reduces joint inflammation and relieves pain.
Splints/aligners: Medical-grade bunion splints and bunion aligners help stabilize the joint. You can choose from medical-grade plastics or a toe sleeve based on your preferred rigidity.
Taping: A specialist tapes the joint to keep the big toe in place, prevent further misalignment, and manage pain and inflammation.
Supportive insoles or custom orthotics: Supporting your arches and correcting poor biomechanics can reduce pressure and strain on the first MTP joint.
Bunion exercises: Basic exercises to strengthen foot muscles can better support and stabilize the joint, thus decreasing pain over time.
The treatments you see above are all available at Feet First Clinic.
2. Osteoarthritis
What is osteoarthritis?
Osteoarthritis is not only the most common variant of arthritis; it is also one of the most common foot conditions in the elderly. Osteoarthritis is the "wear-and-tear" arthritis that causes degeneration of the cartilage in our joints. Reduced cartilage in our joints causes pain and can lead to other foot conditions like bone spurs. Your toes are most susceptible to osteoarthritis.
Age plays a significant role in developing osteoarthritis. Wear and tear of our joints accumulate over time. Also, post-menopausal women risk developing osteoarthritis through osteoporosis (low bone density).
How can I treat osteoarthritis?
Osteoarthritis is a degenerative condition, meaning what's done cannot reverse. The cartilage in your joints doesn't re-grow, so treatment aims to slow the effects of osteoarthritis and reduce pain. Effective treatment includes a combination of the following:
Active rehabilitation: Physiotherapy, massage, and exercise all help reduce the effects of osteoarthritis by promoting solid muscles. Stronger and more balanced muscles and feet reduce the strain on affected areas where you may have osteoarthritis.
Medication: Anti-inflammatories can help control inflammation.
Proper footwear: Specialized shoes can accommodate deformities of osteoarthritis (like bunions or hallux rigidus). The right shoes or boots can support your feet, provide balance, and offer cushion.
Custom orthotics: Orthotics can be customized to add or reduce your reliance on certain parts of your feet. Controlling the impact on affected joints can help prevent further joint damage by distributing the impact and weight elsewhere.
Limit awkward movements: If you find your joints are sore after a particular activity, consider reducing, modifying, or stopping the activity. For instance, if lunges hurt your foot, consider finding a replacement exercise.
Surgery: If the joint is damaged extensively, a doctor may recommend surgery. Surgery and removing part of a bony outgrowth can be effective if the sheer volume of bone buildup is the culprit.
If you experience osteoarthritis and are looking for orthotics, a gait analysis, or proper footwear, visit Feet First Clinic for solutions.
3. Fat pad atrophy
What is fat pad atrophy?
The heel fat pad is a cushion to absorb shock and distribute plantar force on impact. As we age, the heel fat pad gets atrophies and gets thinner. This can put you at a greater risk of heel injuries and other foot conditions. The increased pressure on the heel can cause you to overcompensate with other parts of your body, and weight distribution becomes unevenly distributed.
How can I treat fat pad atrophy?
You should reduce the pressure on your heel if you suffer from fat pad atrophy. Custom orthotics are effective as the personalized insoles provide padding and support and help distribute weight across the complex network of foot muscles. Be sure to also wear shoes with lots of padding and cushioning, like the ASICS Gel-Nimbus.
4. Thickened or Discoloured Toenails
What are thick or discoloured toenails?
Thick toenails and discoloured toenails are a byproduct of aging and are one of the most common foot conditions in the elderly.
As we get older, toenail growth declines. As such, nail cells begin to accumulate at a faster rate than nail growth. The accumulation of onychocytes (nail cells) causes thickened toenails. Alternatively, reduced circulation or acute trauma can cause thickened toenails.
Discoloured toenails, on the other hand, indicate damage to the nail or nail bed. Acute trauma to the nail causes discolouration, but so does reduced circulation. At an older age, we're at a greater risk of diabetes and peripheral vascular disease. Both diabetes and peripheral vascular disease cause reduced circulation in our feet and discoloured toenails.
How can I treat thick or discoloured toenails?
Toenail treatment for thickening and discolouration varies. To properly diagnose your feet and nails, book an appointment with a specialist at Feet First Clinic. Our nail care services involve proper trimming and filing of the toenails, addressing any pain or discomfort, and educating patients on proper hygiene and care.
For more information, visit our nail care and treatment page.
5. Gout
What is gout?
Gout is a form of inflammatory arthritis targeting the foot's joints. You may experience intermittent bouts of severe pain, including inflammation and hypersensitivity. During these episodes, any kind of activity becomes challenging, leaving you less mobile.
The prevalence of gout increases in older people. Elderly people are susceptible to gout for a few reasons: Renal function declines with age, there can be dietary changes, you may experience sudden weight gain, and certain medications for age-related conditions have indirect side effects that may lead to gout (i.e.: water pills, blood pressure medication).
How can I treat gout?
Before any treatment, the first step is to see a family doctor and a rheumatologist. Once diagnosed, you may be prescribed the following treatments, all of which aim to prevent future attacks, reduce pain, and improve quality of life:
Change your diet: Ditch food containing excessive purines. Avoid foods like red meat, certain types of seafood like sardines and mussels, alcohol, high fructose beverages, and yeast. Diet also impacts your weight. Maintaining a healthy and consistent diet can help reduce sudden weight gain and keep inflammation at bay.
NSAIDs: Non-steroidal anti-inflammatory drugs reduce joint inflammation. Alternatively, corticosteroids are an option if one doesn't react to NSAIDs.
Stay or become active: Light-strengthening exercises, relaxing physical activity, and physiotherapy can improve quality of life and mobility in people with gout. Keeping your muscles strong also makes them less susceptible to inflammation build-up, which can trigger gout attacks.
Supportive footwear: Proper footwear can help you deal with any pain associated with gout as it reduces the impact on the joints.
6. Plantar fasciitis
What is plantar fasciitis?
Plantar fasciitis is a condition of the heel. The band of tissue on the underside of the foot gets inflamed and causes pain. Often, plantar fasciitis develops gradually over time. Changes in our body as we age can make this condition more common in the elderly.
How can I treat plantar fasciitis?
With proper care and treatment, most cases of plantar fasciitis heal with time. A foot specialist can guide you through the healing process and provide options for preventing it from recurring in the future.
There are several treatment methods available for plantar fasciitis.
Rest: Take a break, and let your heel recover by staying off your feet.
Supportive footwear: Wearing supportive footwear with strong arch support and a good heel counter is essential for managing and even preventing plantar fasciitis. Stability shoes are particularly helpful. Check out this article for our top recommended shoes for plantar fasciitis.
Rolling: Gently massage your heel using a tennis ball or frozen water bottle under the foot. Rolling helps massage and relieve the plantar fascia and encourages faster recovery.
Add stretching and strengthening exercises to your routine.
Shockwave therapy: Shockwave therapy delivers sound wave pulses to the injured fascia. This triggers your body's the healing process, making for a natural recovery. Shockwave therapy is extremely effective for cases of plantar fasciitis persisting more than 6 months.
Taping: Taping the heel engages other muscles and tendons of the foot, reducing the load on the plantar fascia.
Wear a splint: A splint helps keep your foot stable while you sleep.
Supportive Insoles or Custom Orthotics: A good supportive insole, like Superfeet Green, is tried, tested and true for helping with plantar fasciitis. If that doesn't work, or if there are biomechanical factors contributing to your plantar fasciitis, you can look into custom orthotics.
7. Stress fractures
What are stress fractures?
Stress fractures are micro-breaks of bones are another common foot condition in the elderly. When we age, bone growth slows, losing more bone than we generate. Our bone density also reduces. If your bone density drops too much, you develop osteoporosis. Weaker bones put the elderly at greater risk of stress fractures, whether acute, like when you fall or by too much repetition, like walking.
How can I treat a stress fracture?
The RICE method is critical to treating a stress fracture. Rest, ice, compression, and elevation. Untreated stress fractures can lead to bone shift, permanently altering the foot's biomechanics.
January 5, 2023
What comes to mind when we think of the best "medical shoes?" Would they be shoes for doctors? Or shoes someone wears to overcome an injury? While both may technically be true, a medical shoe is simply a shoe that supports and accommodates the structure of your foot, which is a means of treating foot ailments. In other words, they go above and beyond what standard footwear can provide.
The best medical shoes are more widely available than some people may think. Countless shoe brands focus on constructing the best shoe for your foot health. But it can be tough to know what shoe you need to address your unique foot concerns.
Let's assess the best medical shoes of 2023 to better understand what footwear you may be missing out on!
Best Medical Shoes 2023
Saucony Integrity Walker
ASICS Gel-Nimbus
APEX Lace Walker
Anodyne Sport Double Depth
ASICS Gel-Keyano
Saucony Integrity Walker
The reasons the Saucony Integrity Walker shines amongst footwear choices are twofold. This shoe can help with foot pain relief for everyday Torontonians, but it's also a great choice for nurses, doctors, and working students who spend Mondays to Fridays (and sometimes the weekends!) standing all day.
Part of what makes this one of the best medical shoes is its ability to accommodate wide feet, and you can select options based on your foot width. You can choose from wide, extra wide, regular or narrow to ensure the perfect fit. This neutral walker also offers responsive cushioning for people who need to walk or stand for long days. Furthermore, the PWRRUN midsole gives the shoe a light and bouncy feel, as opposed to a clunkier shoe which can weigh you down.
Lastly, this shoe has the stamp of approval from The American Podiatric Medical Association. Not all shoes come with the honour of being recognized as a highly beneficial product for maintaining foot health - so that's a plus!
Saucony Integrity Walker
ASICS Gel-Nimbus
The Gel-Nimbus is a great medical shoe for neutral walkers or those with high arches who slightly underpronate. If you have a higher arch, this shoe can prevent and help you manage ankle strain, shin splints and plantar fasciitis.
The newest version of the Nimbus is about 10% lighter than its predecessor, which keeps your steps light and springy. In terms of being a top-notch medical shoe, its advanced impact protection stands out and helps you land your steps without triggering muscle strain. This is thanks to ASICS' highly developed rearfoot and forefoot GEL® technology.
Lastly, the FLYTEFOAM™ and FF BLAST+™ cushioning work together to protect your joints by creating a softer landing, more responsive toe-off, and lightweight impact absorption. After all, cushioning is more than just "padding"; Insufficient cushioning can make your feet too tired to continue throughout the day.
ASICS Gel Nimbus
APEX Lace Walker
The APEX Lace Walker is an orthopedic shoe and a godsend for anyone with flat feet.
This type of foot structure can cause you to overpronate while walking. Likewise, neglecting to buy the proper footwear for flat feet can put you at risk of developing bunions, bone spurs, and arthritis.
The external heel counter in the APEX walker extends around the heel to the foot's arch. Then it works with the internal heel counter to provide excellent motion control and promote neutral steps. This gives people with flat feet a higher chance of successful and comfortable walking.
If that isn't enough to make it one of the best medical shoes, doctors recommend the APEX Lace Walker for anyone who needs stability control and extra comfort.
Apex Lace Walker
Anodyne Sport Double Depth
Anodyne makes shoes for people with diabetes, propelling them to superstar status in our discussion of the best medical shoes. Furthermore, this company's careful construction and focus on health makes Anodyne shoes an appropriate choice for those with other foot problems, not just diabetes.
The Anodyne Sport Double Depth shoe comes with width options, but where it truly shines is in its depth. This gives even more room to accommodate those with debilitating foot conditions than other Anodyne options.
Hailed as perfect for those with "difficult" feet, anyone with extremely swollen feet or who need to insert their custom orthotics into their shoes can use them. Furthermore, those with bunions and hammertoes should consider investing in the Anodyne Sport Double Depth, as those conditions are known for requiring extra depth in the toe box.
Anodyne Double Depth Shoe
ASICS Gel-Kayano
While the Gel-Nimbus is designed for those with high arches who underpronate, the Gel-Keyano is great for people with low arches who overpronate.
This shoe helps with rearfoot support by offering a low-profile external heel counter. The LITETRUSS™ stability feature in the midsole keeps your feet from rolling too far inward, which is the typical experience of overpronators. This is highly beneficial as overpronators are more at risk of putting strain on their muscles, tendons and ligaments, which makes them more injury-prone.
Other features include the Rearfoot GEL® technology cushioning, which gives your shoes much needed shock absorption, and the OrthoLite™ X-55 sockliner takes comfort to new levels.
ASICS Gel Keyano
January 3, 2023
The top of your foot is one of the most common areas to experience everyday foot pain. The muscles and tendons within the top side of your foot play a critical part in how you move. The top of the foot can be easily overworked and damaged, leading to various foot conditions.
Some symptoms and top-of-foot conditions are short-lived. Other top-of-foot symptoms can signal an underlying condition elsewhere in your foot or leg.
This article teaches about five potential causes (and solutions) for top-of-foot pain.
Cause 1: Foot Sprain
A foot sprain occurs when the ligaments in your foot stretch beyond their limit and become damaged. Foot sprains can vary in location. An ankle sprain is likely to be more of a forefoot sprain. A midfoot sprain is more likely to affect the front half of your foot.
Cause: Acute trauma causes foot sprain. Acute trauma refers to a one-time impact of an incident where you put your foot in an awkward or uncomfortable position. Your tendons are stretched beyond their limit and lose some elasticity. Your tendons may develop micro tears or more serious strains. More severe forms of acute trauma can result in a stress fracture or a hairline break of the bone.
Solution: Foot sprains require rest and recovery to heal. Rest allows your tendons to repair themselves and regain their elasticity. Ice and elevating your legs above your body can help promote healing and may quicken the recovery process. If the injury persists, or you have difficulty moving, you should visit your family doctor.
Taping can also act as an additional support system. A chiropodist can skillfully tape your feet. Taping works by providing additional support and "locking" your feet to avoid re-aggravating the injury.
Cause 2: Tendonitis
Inflammation of the tendons in the foot can cause top-of-foot pain. Damage to the tendons is known as tendonitis.
Cause: Extensor tendonitis can cause pain in the top of the foot. The extensor tendons are the tendons that run along the topside of your foot. The tendons help you straighten your feet and lift your toes. The extensor tendons play a critical role when running or walking. Chronic damage through overuse injuries can cause extensor tendonitis. Too much walking or running, or even too much of a weight-intensive activity too soon after any injury can cause extensor tendonitis.
Solution: The best course of action for tendonitis is rest. Specifically, you want to avoid the source activity that causes aggravation. If the pain is intense, you can also take over-the-counter medications and visit your family doctor. They may refer you to a massage or physiotherapist. If the tendonitis persists or is disrupting your mobility, you should visit your family doctor.
Cause 3: Athlete's Foot
Athlete's foot is a contagious fungal skin infection that affects the skin on the feet. Although athlete's foot, medically known as tinea pedis, sounds like it only affects sporty folks, it can affect anyone. Although not life-threatening, it's contagious and can be painful if left untreated.
Cause: A fungus called dermatophytes causes athlete's foot. The fungus inhabits, grows, and survives off the outer layer of the skin. By extension, the fungus can also spread to other parts of the body and people, either directly or indirectly.
You can catch athlete's foot anywhere where fungus thrives. Fungi love warm, moist environments, such as communal showers, locker rooms and the decks around public swimming pools.
Solution: Over-the-counter topical antifungals are the most common remedy for mild cases of athlete's foot in the early stages. However, fungal infections are notoriously persistent and stubborn. If your Athlete's foot persists, you should see a chiropodist, who can treat the skin on your feet and prescribe prescription anti-fungal creams. Our Toronto foot clinic also sells foot deodorants, including an antifungal foot spray, which are great for prevention and supplementing your athlete's foot treatment.
While treating your athlete's foot infection, it's essential to do the following:
Clean your socks and linens with bleach or hot water. The fungus can spread from your feet to these surfaces and re-infect you if not cleaned between uses.
Clean any surfaces that your bare feet come into contact with
Wash your feet once or more a day
Ensure your feet are thoroughly dry after bathing or washing.
Wear flip-flops or shoes in any place where you think you could catch athlete's foot
Cause 4: Bone bruise
Damage to the bone itself can be painful and cause top-of-foot pain. There are varying degrees of bone damage, ranging from bruises to fractures.
Cause: A bone bruise is an acute injury, less severe than a fracture. Bone bruises typically stem from a one-time event that causes damage to the foot. Dropping an object, rolling your ankle, or stubbing your foot on an object can cause damage to the bone itself. You may notice bruising (reddish/blueish) on the skin. When in doubt, an X-ray can determine the severity of a bone bruise.
Solution: Treatment for a bone bruise includes the following:
Rest
Icing
Elevating your leg so it's above your heart (to promote blood flow and reduce swelling)
Taking anti-inflammatories or over-the-counter medications if the pain is intense
Cause 5: Peroneal nerve injury
Nerve damage can cause top-of-foot pain. The general term for nerve damage is known as peripheral neuropathy. When nerves are damaged, signals between your muscles and brain are disrupted, causing numbness, pain, and complete loss of sensation.
Cause: Injury to the peroneal nerve, known as peroneal nerve dysfunction, can cause top-of-foot pain. The peroneal nerve is outside our lower leg and just below the knee.
For example, you may experience temporary numbness in your feet from peroneal nerve compression. Have your legs crossed, and your feet and toes go numb? Peroneal nerve compression causes the numbing and tingling sensation.
There are several symptoms of peroneal nerve dysfunction. Signs can include:
Foot drop
Pain, weakness, or numbness on the top of the foot
Inability to move the toes up and down
Reduced mobility in the foot
Abnormal knee lift to compensate for reduced motor function
Solution: You should visit your family doctor at the first sign of any nerve-related symptoms. They will conduct the necessary diagnostic investigations and refer you to the appropriate doctors. There are both surgical and nonsurgical treatments for peroneal nerve injury.
Non-invasive treatments include orthotics, which can correct your gait and better distribute pressure within your feet. Additionally, physical therapy and foot-strengthening exercises to fortify the muscles in your feet can help improve mobility. If you have foot drop, an ankle-foot orthotic may be recommended.
You may require surgical treatment for more severe cases, including decompression surgery or nerve repair.
Other causes of top-of-foot pain
Tarsal tunnel syndrome: Tarsal tunnel syndrome occurs when the nerve inside one of the tunnels within your ankle compresses. Specifically, the posterior tibial nerve (within the tarsal tunnel) is compressed from injury, flat feet, or fallen arches.
Bone spurs: Hallux rigidus, or arthritis of the big toe joint can cause bone spurs, which can lead to pain on the top of the foot. The bony outgrowths can put pressure on your foot or toe when wearing shoes and cause pain when lifting your toes due to the deteriorated joint.
Ganglions: Ganglion cysts are fluid-filled bumps on the tendons or joints in the feet. The cyst itself doesn't cause pain, but if large enough, it can add pressure to the nerves in the same vicinity.
December 22, 2022
Holiday travel can be an exhausting and inconvenient experience, no matter how excited you are. There is often little time to rest. Standing, walking, and waiting for hours at the airport can also do a number on your feet. Moreover, the Canadian winter weather can surprise you and leave you without the right footwear. That's why bringing the right travel shoes for your plans is critical.
Now, you don't have to jam-pack your luggage with five pairs of travel shoes. That is just another inconvenience, especially for those who want to avoid checking bags at the airport. But you should assess your winter activities and double-check the weather forecast before selecting a couple of shoe types for your travel bag. And if you invest in some of the shoes in today's blog, your feet will thank you!
The Best Travel Shoes 2022
The all-purpose boot
The snow boot
The running and walking shoe
The dressy shoe
The hiker
All-Purpose Boot: Portofino ID1673 or Portofino MS-105
Everyone needs an all-purpose boot to get from point A to point B, especially during the holidays when your travel time includes a dusting of snow. The depth of snow can soak your feet and make the sidewalks slippery, putting you at risk of a fall.
While searching for winter boot travel shoes, you should opt for a brand that offers not only foot support, but also insulation, a solid grip, and waterproofing features.
That's where Portofino comes into the picture! They make orthopeadic boots, a feature rarely found in winter footwear that can help with countless foot conditions. Their unisex black boot (ID 1673 on their website) is perfect for a mild snowfall and is lined with genuine sherpa wool that keeps you cozy and warm. They're also waterproof, and the rubber outsole allows for a slip-free walk during the holidays. Moreover, you can remove the footbed if you need to insert custom orthotics or insoles to walk without foot pain.
The MS-105 boot from Portofino is another solid all-purpose option, with the main difference being the outside is made with suede, and there are just laces and no zippers.
Portofino ID 1673
The Snow Boot: Sorel Tivoli Parc Boot
Snow boots differ from all-purpose winter boots, so you may need to alter your travel shoes depending on where you're heading for the holidays.
Essentially, a snow boot should take the insulation and waterproofing features of an everyday boot to the next level. And a boot that can handle deep snow is crucial for any Canadian. Furthermore, some provinces encounter much heavier snow than others. So if you're travelling from the west coast to the east, you should prepare for inconvenient weather. A supportive, warm and protective snow boot is also great for doing some last-minute Christmas shopping on a particularly cold day.
Sorel is known for its winter footwear, and the Tivoli Parc Boot, with its 200g insulation, is great for cold temperatures that dip as low as -40. The shearling collar and microfleece lining also work together to warm your feet. The moulded rubber outsole keeps you safe from sudden slips, and this boot also features a removable footbed for custom insole accommodation. And lastly, the entirety of the boot's upper (sans the laces) is waterproof, so you can walk easily and confidently, knowing the elements won't slow you down.
Mephisto Tivoli Parc Boot
The Running and Walking Shoe: ASICS Gel-Cumulus GTX or GT-2000 GTX
Did you know that you can still go for runs during the wintertime?
That means you can take your fitness goals with you during the holiday season if you bring the right travel shoes. You should assess your comfort level and conditions, but wet sidewalks and trails with compacted, dense snow are usually no trouble!
You should look no further than ASICS for a smooth December running session. If you need a stability or a neutral shoe, you can opt for the Gel-Cumulus for GT-2000 GTX. The GT-2000 GTX is designed for overpronation (low arches and flat feet), and the Gel-Cumulus GTX is designed for neutral gaits and underpronation (high arches). If you aren't sure what type you need, you can read more about shoe stability here!
Both shoes are lined with GORE-TEX fabric to keep your feet dry, letting you stay active as long as you'd like. Other notable features include the engineered mesh upper, lightweight cushioning and reflective accents that keep you visible when it's dark outside. ASICS is also always upgrading and fine-tuning its GEL technology, which makes you feel like you're walking (or running) on a cloud.
The GT-2000 GTX is similar to the Cumulus but includes LITETRUSS™ technology to improve medial support for stability.
ASICS Gel-Cumulus GTX
The Dressy Shoe: Ara Maggie
Sometimes, travel shoes need to be stylish. And while Ara's highly-cushioned waterproof pump may not be the best for snowfall, it's a solid choice for a short journey to a holiday party.
Like your ASICS running shoes, the Maggie is made with GORE-TEX membrane, which guarantees dry feet. It also comes with a removable footbed for easy insole insertion. Ara's Maggie is also made with a stretchy fabric, so it's easy to wear with thick fleece tights or leggings.
Ara Maggie
The Hiker: Mephisto Allrounder Nigata-Tex
Winter hikes are underrated, and snow lovers should bring hiking boots for the holidays!
Mephisto's Nigata-Tex is great for trudging along the winter trails. That's likely why they claim this boot is great for "rising to everyday challenges." More specifically, it combines the lightweight feel of an ankle boot with the protection and innovation of your winter boots.
The ALLRO-TEX technology ensures breathability, which keeps your feet healthy during strenuous activity. The shock absorber in the outsole protects your feet by reducing the harsh impact often felt on hiking trips. Most importantly, they have one of the best grips out of all the shoes in today's blog. This is especially crucial for the unpredictable nature of trails.
Mephisto Nigata Tex
December 8, 2022
Have you ever felt a prickling, tingling, or pins and needles sensation in your feet? You may be experiencing numbness in your toes. At times, it may even feel like your foot has fallen asleep, which occurs after keeping your foot in the same position for an extended duration.
What's happening in your foot and toes when they go numb? The underlying sensation is likely a result of peripheral neuropathy. Peripheral neuropathy is a catch-all term for more than 100 types of peripheral neuropathy. It refers to damage to the nervous system, which hinders the network of nerves that relays information to your brain.
There are various reasons why you experience numbness in your feet or your toes. Possible causes may include poor blood circulation or a byproduct of diabetes. The sensation may be numb; in other cases, you may not feel anything since your feet or toes lack feeling.
In this article, we outline five potential causes for why your feet or toes may go numb.
Frostbite/Frostnip
It's no secret that Canada experiences cold winters. Low temperatures and high humidity can make keeping your feet warm and dry difficult. That's why frostnip, and its successor, frostbite, are possible during Canada's winter months.
There are various degrees of skin and tissue damage due to cold. They are:
Frostnip is a mild cold exposure injury that doesn't cause permanent skin damage. A slight numbing sensation may occur during the frostnip stage and minor (but temporary) nerve damage. Frostnip should subside naturally by escaping the cold and returning to warmer temperatures.
Superficial frostbite is the second stage of cold damage to your toes. Your skin may feel warm, and you likely experience a more intense numbing or tingling sensation.
Deep frostbite is the third stage and most severe form of cold damage. You may experience total numbness and loss of sensation in your toes. The toe muscles and joints may no longer work, and you're at risk of permanently damaging the skin and nerves in your toes. Blisters form 24-48 hours after exposure. Afterwards, the area may turn black and harden as the tissue dies.
It's critical to recognize signs early. If you're outside for extended periods and feel your feet and toes are cold, it's time to head inside. Once you reach the numbing and tingling sensation, the damage begins to occur and will only worsen if not addressed. With minor forms of frostnip, the feeling will return to your feet and toes with no long-term effects. With frostbite, you risk permanent and irreversible damage.
Diabetes
Diabetes is a severe condition characterized by high blood sugar levels that can lead to blood flow and nerve issues. 3.4 million Canadians, or roughly 8.1% of the population, live with diabetes as of 2017–2018.
Regarding the foot, diabetes can complicate the nerves and blood vessels in two ways:
Diabetic neuropathy, a common long-term complication of Type-2 diabetes, causes nerve damage, leading to loss of sensation in the legs, feet and toes. A lack or loss of feeling in your feet and toes is dangerous as it can mask injuries, cuts, or other conditions.
In peripheral vascular disease, sugar accumulates in the bloodstream and can cause poor blood circulation. Blood vessels can narrow, block, and spasm due to PVD.
The best action for diabetes is to monitor your symptoms consistently. Further, a foot specialist can check for adequate circulation, signs of neuropathy, and risk for foot ulcers.
Rheumatoid arthritis
Both rheumatoid arthritis and rheumatoid vasculitis can cause numbing and tingling in your feet and toes. RA, an autoimmune disease where your immune system mistakenly attacks healthy cells in your body, can affect the nerves in your feet through inflammation and swelling.
Similarly, rheumatoid vasculitis targets the blood vessels in the feet, inhibiting their ability to transport blood. Reduced circulation can cause your feet and toes to be numb, creating a tingling sensation. Typically, one develops rheumatoid vasculitis after having RA for some time.
Tarsal tunnel syndrome
Tarsal tunnel syndrome is an ankle nerve condition that has downstream effects on the feet and toes. Analogous to carpal tunnel syndrome in our hands, tarsal tunnel syndrome occurs when a nerve becomes compressed—specifically, the posterior tibial nerve inside the ankle.
The tarsal tunnel itself is a narrow space next to the ankle bones. It's covered with thick ligaments and contains veins, arteries, tendons, and nerves (including the tibial nerve). When the tunnel becomes compressed, so does everything inside. Compression reduces blood circulation and puts pressure on the nerves that connect your feet and toes with the rest of your body.
The exact cause of tarsal tunnel syndrome can be tricky. In many cases, it's a variety of factors, including:
Flat feet
Bone spurs and cysts in the ankle
Varicose veins
Inflammation
Osteoarthritis
Tight shoes
Acute ankle injuries
Tarsal tunnel syndrome symptoms include sharp, shooting pain, pins and needles, or a burning sensation on the inside of your foot, close to where your foot meets your ankle. The numbness may radiate to the toes as well.
Morton's neuroma
You may suffer from Morton's neuroma if you've ever felt a sensation akin to having a pebble stuck in your shoe. This type of neuroma targets the base of the third and fourth toes. When the muscles and tendons become inflamed, the nerve becomes increasingly compressed, inhibiting its function.
You may develop Morton's neuroma with poor biomechanics - namely, overpronation (when your foot rolls too far inwards when walking or running). Biomechanical abnormalities unevenly distribute weight in your feet, adding too much (and too little stress) to certain parts of the foot. Over time, overpronation adds stress to the ball of the foot, causing it to thicken and become inflamed. As such, the foot's nerves can become compressed.
High heels (which promote poor biomechanics) are also a common contributing factor to Morton's neuroma.
The best course of action to treat Morton's neuroma is for a foot specialist to fit you with proper footwear or custom foot orthotics. Fixing your footwear and correcting your biomechanics will help distribute weight and stress in your feet more evenly.
Other causes of numb feet or toes
You may experience numb feet or toes for reasons other than those outlined above. For instance, your feet may fall asleep when you are asleep, and as a result, your feet may feel numb upon waking up. Being sedentary and keeping your feet and toes in the same position for extended periods may also create a numbing or tingling sensation.
Other, more uncommon causes may include:
Charcot-Marie-Tooth disease is a group of conditions that can cause nerve damage. It's genetic, and the mutations in the genes affect the nerves in your feet and the protective coating of your nerves, which can inhibit signals between your feet and brain.
Guillain-Barré syndrome is a rare disorder where your immune system attacks your body's nerves. You may experience weakness, tingling, and numbness when it affects your feet.
Vasculitis describes inflammation of blood vessels. Most types of vasculitis are rare. Vasculitis can cause a numb sensation in the feet due to a thickening blood vessel wall. As such, the thickening of the vessels can restrict blood flow to the limbs.
When in doubt, if you ever feel numb or have a tingling sensation in your feet for abnormal or irregular reasons, contact a professional for a proper diagnosis.
