Monday, May 18, 2009

Dr. Giacalone Ponders Summer Shoes

Well, even your podiatrist isn’t immune to wanting and wearing those adorable, not-so-good-for-you shoes! This weekend I purchased a very comfortable pair of Fit Flops and of course, true to my style, covered with sequence. But I realized during my searching for summer shoes that I have an unfair advantage over the average shopper. I know what is good for my feet, what is not and what I can get away with.

So which shoes are good for you? All shoes with a thick supportive sole, full top and back or large strap over the arch will keep you from toe gripping while you walk. This reduces foot fatigue and will keep things like heel pain and ball of foot pain from occurring. If you are flat footed, you’ll want something with good arch support and a stiffer sole. If you have a high arch, think arch support, but a little softer. You need the shock absorption. For summer shoes, the best option is a sandal that has a strap over the arch and behind the heel. And don’t forget tennis shoes for activities requiring a lot of walking.

So what should you avoid? Obviously the new 7 inch heels are out! And the ballet slippers need to be passed by as well. Any heel height over 2 inches causes increased pressure to the ball of the foot leading to things like metatarsalgia and neuromas. They also shorten the Achilles tendon which can result in Achilles tendonitis. The ballet slippers are glorified socks. And when was the last time you went shopping in your socks alone?

So what about flip flops? Well, these fall into the “what can I get away with” category. Most of the time, you will hear us say, “don’t wear them”. But we know you are going to and here’s the reason we don’t like them. The only way you can keep a flip flop on your foot is to grip your big toe and second toe together. This is not natural and causes the smaller muscles in your foot to work harder leading to foot fatigue, arch strain and overall foot pain. For those with flat feet, they also cause the large tendon on the inside of your ankle to work harder as well, leading to posterior tibial tendonitis and ankle pain. If you have bunions, wearing flip flops on a regular basis only emphasizes the forces that can make the deformity worse. The thing about flip flops and any other shoe that may not be good for you is to think minimalist. Wear them only once a week or special occasions. And if the shoe hurts as soon as you put it on, don’t try to break it in. It should be comfortable from the very beginning.

If you are not sure what foot type you have or what shoes are good for you, our Certified Pedorthist, Janet Dixon is available to help you. She is located at Healthy Steps DFW and is available for one on one assistance with appointment or walk in. But if you are having any foot pain, our physicians would be happy to evaluate your condition and help get you back to summer fun.

Tuesday, May 5, 2009

Is Yoga Bad For My Feet?

I have always been curious about yoga. I have tried every possible form of exercise in my quest to find the perfect one for me (alas, I am still searching; aren’t we all?). The one form that I avoided was yoga. My mother was the one who finally convinced me to give it a try. She swore it to be the perfect form of exercise and swore it was relaxing at the same time! An oxymoron, I know!!

I avoided yoga because yoga is performed barefoot and the poses, I imagined, could put a great deal of stress on them. I could only imagine! The curse of being a podiatrist!! Seriously though, my curiosity was such that I had to see for myself just how much twisting and torque was involved.

On my first class, I used the thick mats provided by my gym. It had to be better than the flimsy mats some of the other people were coming in with right? Needless to say, I need to work on my core because I was working really hard to keep my balance and could not concentrate to keep the stretch! And I can tell you for a fact that the thicker the mat, the harder the tendons and ligaments in your feet are working along with your balance to keep you in check. It is very easy to develop a tendonitis or a muscle strain doing the required poses on a thick mat. So yes, the flimsy thin mats are better! Invest in the yoga mat if you have had a tendon or ligament injury or are prone to getting one. People with “extreme” foot types, the flatter foot type or the super high arch type are more prone to these potential yoga-induced tendon/ligament injuries.

The next week I bought this yoga mat. It is “stickier” so your feet do not have to grip as much and much thinner so you have better control of your movements. Over all, much less strain and stress. This is a trade off. If you have joint problems, the thinner mat could aggravate your pain just by the fact that there is less to cushion an aching joint. On the flip side, it can also aggravate tendon and ligament injuries for the same reason.

Beyond the mat are the poses. There are some pretty severe hyper extensions and pressure points going on here! Those “downward dogs” and “half-moons” and don’t get me started on some of the other ones I am no where near perfecting! Not for the light-footed! I can see how easy it is to cause some serious over-use injuries.

The conclusion to my curiosity is that you do not enter a yoga class thinking it will be easy because it doesn’t involve rapid movements. It needs to be approached as one would any exercise. Build your way into it slowly if you do not have foot problems to see if your feet can tolerate what is required of them. Modify the position of your feet if what the teacher is doing to her feet just doesn’t feel right to yours. I do not recommend the “standing” or “inversion” yoga poses to those of you who are trying to recover from a foot injury even though it is “non-impact” simply because of the lack of support it places. That being said, as resistant as I was to try it, I must say that, though it is not my “nirvana” form of exercise, it is now not one I will easily give up either! I have found harmony with yoga and my feet after all!