Fractures occurring in the base area of the 5th metatarsal are a difficult burden for athletes.  The area lacks a healthy blood supply and a tendon attaches at its base. The tendon, if not immobilized in a cast of boot, will keep pulling on the fracture fragment. This repetitive pulling keeps the fracture from healing well. Conservative treatment for competitive athletes, and NOT the average joe, have been found through research to be inadequate.

This fracture can take close to 8 weeks to heal and has a higher rate of fracturing again, especially with early activities.  Surgical intervention, therefore is the way to go.  One recent podiatric journal stated that on average the athletes they operated on took a mean of 9 weeks to return to activities – some were even close to 14 weeks of recovery!  The only benefit of having the fracture surgically fixed is to hopefully heal the fracture sooner and prevent a recurring fracture. In a nut shell, it is a tough injury and a tough recovery regardless of if you do surgery or not!

More on common injuries to athletes here.

Your new boot should be comfortable when trying it on in the store. Do not settle for a cute boot and say “I will break it in”. The best material for a boot is a natural material such as leather, which will keep your feet dry and comfortable during these winter months. Another good tip when looking for a boot is to make sure it has good traction; you do not want to be slipping when walking to your car or shoveling that drive way. The most common winter injuries are ankle sprains and fractures as a result to a slip, usually on ice, in addition to winter sport injuries.

One last tip: Check for spiders in the winter boots that you may have had packed away all summer.

What is it?

Causes:
Charcot foot usually develops as a result of neuropathy because patients have decreased or no sensation for pain, temperature or trauma. These patients continue to walk on the injury without knowledge and make it worse. Patients with neuropathy are therefore at risk for developing Carcot foot.

Symptoms:

• Warmth to the touch (affected foot feels warmer than the other)
• Redness in the foot
• Swelling in the area
• Pain or soreness

Diagnosis:
To arrive at a diagnosis the podiatrist will discuss history, examine the foot, take x-rays or possibly order further imaging studies. X-rays will be taken periodically during treatment to assess progress.

Treatment:
Non-surgical treatment may consist of:

• Immobilization: The foot and ankle are fragile in the early stages of Charcot foot and must be stabilized in order to allow the weakened bones and joints heal properly. Complete non-weight bearing is necessary to prevent further collapse.
• Custom Shoes and Bracing: Bracing may be required if the deformity is significant. Shoes with special inserts may be used to help prevent recurrence of Charcot, development of ulcers as well as to enable the patient to return to daily activities.
• Activity Modification: A patient who develops Charcot in one foot is more likely to develop in in the other foot, so activity modification may be necessary to prevent injury and protect both feet.
• Surgery: Surgery maybe necessary in some cases, your podiatrist will determine the proper timing and procedure in each individual case.

Preventative Care:
You can play a vital role in preventing Charcot foot:

• Keep blood sugar levels under control to reduce the progression of nerve damage.
• See your podiatrist regularly for check ups.
• Check both feet every day
• Try to avoid injury such as bumping the foot or over exercising to strain the foot.
• Follow your podiatrist’s instructions for long-term treatment and prevention.

  
  
  Normal Lateral Foot X-Ray
  
  
  
   
  Charcot Foot X-Ray
  
  

Symptoms of turf toe are usually sudden as a result of injury (you may hear or feel a pop), but can also happen over time. Pain around the MPJ joint is a common symptom; sometimes swelling and stiffness can occur at this location as well. Turf toe is diagnosed with a thorough history, physical exam and x-rays.

Unfortunately for our athletic patients, treatment for turf toe often requires rest for at least a month. Bracing the MPJ joint isn’t easy, but limiting dorsiflexion (upward bending) of the toe can be done with taping the toe and wearing shoes with a rigid sole. A walking boot or cast may be used to immobilize the foot and toe. Physical therapy may be prescribed and NSAIDS can be used to decrease pain and inflammation. If left untreated, turf toe can become a chronic problem that is slow to heal, so don’t ignore it!

Did you know that keeping your sugar in tight-control can help prevent foot pain or nerve damage?

” In all, participants who had begun with tight blood-sugar control and stuck with it were 51 percent less likely to report symptoms of neuropathy, and 43 percent less likely to show signs of it, than those who had started out with regular blood-sugar control and then gone to tight control. There were also differences between the two groups in the incidence of open sores requiring medical or surgical treatment, and in incidence of amputation.”

Even though this study was only done with type 1 diabetes, the most commonly seen diabetes today is type 2. The results did show implications for those with type 2 diabetes; “It suggests that good glucose control clearly protects patients over the long term” says senior author Dr. Eva Feldman.

Read more by going to this link

With these cold days creeping up fast, flip flops and sandals are no longer a good option to let your feet air out that bad smell. First, we need to discuss how that “bad smell” even exists. Bacteria love moist/warm feet, socks, dead skin, and shoes. The bacteria found in these places are the cause of your unfortunate embarrassing foot odor.

Luckily for you, we have some healthy remedies to help prevent this foot odor as well as some home remedies to treat foot odor. We will start with the healthy habits first.

• Wash your feet often and try to use a pumice stone to get rid of the dead skin.
• Wear shoes made of natural materials, such as leather, which tend to breathe better than those man-made shoes which don’t let heat escape.
• Wear socks that allow your feet to breathe too. You should change your socks at least once during the day to prevent sweat to build up and NEVER wear the same pair two days in a row.
• Avoid shoes that are lined with solid rubber or synthetic materials.
• Wash your shoes, if possible. Most shoes, such as sneakers, can be washed right in the washing machine. However, let them air-dry instead of putting them in the dryer. (Better for your shoes and better for your bill!)
• It is best to alternate shoes everyday. You do not need to have five pairs of shoes but try to have two good pairs and alternate them. While doing this, air your shoes out in between wearing them by loosening up the laces and pulling up on the tongue.
• Believe it or not but what you eat can determine the smell too. Try to avoid foods with strong-flavoring such as garlic, onions, scallions, and peppers because the aroma can pass through your bloodstream and concentrate in your sweat.
• Getting stressed or anxious with the holidays coming fast? This will cause an increase in production of sweat, which gives the odor-causing bacteria more to feed on.

Now that we have talked about some healthy habits to help prevent that smell, let’s talk about some home remedies to stop your foot odor. Don’t try all of these at once, pick one or two that you can do daily (or at least 3-4x a week) and stick with it. If it doesn’t work – move on to another method!

• Pour two to three teaspoons of liquid chlorophyll (Chlorophyll helps sweeten your feet) into a bucket filled with a gallon of warm water, and soak your feet for 15 minutes. Make sure to dry your feet completely after soaking.
• Soak your feet in one third cup of apple cider vinegar, added to a small pan of warm water, several times a week.
• Make a pot of black tea and pour it into a dishpan. Soak your feet for ten minutes once the tea has cooled down a little. Tea contains tannic acid, which helps eliminate foot odor.
• Apply tea tree oil on your feet, toes, and nails thoroughly after showering to kill the fungus and give your feet a nice smell.
• Sprinkle some baking soda inside your shoes to absorb the moisture and the odor.
• Zinc, a vitamin, makes the skin more resistant to odor-causing bacteria and may reduce or eliminate the odor within a week or two. You can take 15 to 30 mg of Zinc per day either alone or in a multi-vitamin. DO NOT take more than 30 mg of zinc since high levels can interfere with the absorption of copper and can damage the immune system. Talking to your primary care physician is recommended before taking anything.
• Spray or sponge on colloidal silver on your feet and let them air dry. The colloidal silver can be very effective at eliminating odor-causing bacteria.
• A lot of people know of ginger as helping with nausea, but it can also help with foot odor. Mash a one or two inch piece of ginger into a pulp, put it into a handkerchief or piece of gauze, and soak it in hot water for a few minutes. Rub the ginger liquid onto each foot each night after taking a shower.
• Juice about two dozen radishes, add 1/4 teaspoon of glycerin, and put it in a squirt bottle or a spray-top bottle. Spray the feet and let them air dry to help decrease some of the foot odor.

Walking barefoot is how children build their muscles and ligaments in their feet. By walking without shoes they are able to feel the ground and their surroundings without having to look down, which can cause them to fall. With their heads looking up, they are able to view the things around them, develop a better posture and increase their strength.

Shoes are good for taking your baby outside this winter, but when you are indoors and warm, let them run around barefoot to help prevent any deformities that shoes at such a young age can attribute to. Who wouldn’t want to see their precious naked feet anyways?

Read more on this here.

If we look back in history, humans used to hunt by running after animals such as zebras or wildebeests until they collapsed. We were able to outrun them, because these types of animals cannot pant as they run, causing them to pass out in exhaustion. Humans have the capability to run farther and longer than their prey counterparts; however, we hear a lot of people complaining about back pain and foot pain saying they cannot run because of this. The researchers have found a reason for our evolved pain as well. In today’s society, a lot of jobs require us to sit for long periods of time; even while relaxing at home, most of us are sitting. This causes our backs to hurt because we were not meant to sit in chairs all day with no exercise, we were meant to be on our feet, running and walking! As far as foot pain, it can be caused by wearing certain types of shoes. They found that runners who wear regular running shoes, land hard on their heels creating a lot of shock which travels all the way up to our heads with each stride. They also found that those runners that run barefoot or with the new minimal shoes,  tend to run on the balls of their feet, creating minimal or no pain to their feet and no shock wave running to the brain.

If everyone started to run more in their lives, maybe we can lessen the amount of pain we receive and let our bodies be used how they were meant to be. The next time it is nice out again, try going for a light jog or run and see if it makes any difference in how your body feels. One day might not make a major change in your life, but if you try for a week or more, there is a great chance that your back pain might improve, if not go away.

Read the conversation with Dr. Lieberman in the New York Times or at this link.