COMMON FOREFOOT PROBLEMS

• Do you suffer from forefoot pain and don't know why or what to do about it?
• Do you wonder why your toes are curling or why you have callouses?
  

This post is going to be a crash course in what forefoot problems you may be causing and what you can do about it. Whether you're athletic, on your feet alot at work, or just walking around the house, most people experience some form of pain in the front of the foot at some point in time. I'll try to go over as many causes of these problems as I can in one blog. If I don't get to them all and you think you may have something other than what's listed, feel free to give me a call to discuss it. Also, if there is a solution to any one of these ailments you didn't see, please e-mail me so that I can add it.

Athletic Forefoot Problems
Most athletic forefoot problems are gait related. You're putting an inordinate amount of pressure on your feet, and if that pressure isn't on just the right spots of your feet it'll probably cause injuries pretty quick.
Stress fractures: Generally a "prick" sensation when you put any weight on it. The little bones in the front of the foot and the narrow bones through the mid foot are very susceptible to stress fractures if misused.
Forefoot callouses: 1) If they're like a ridge on the toes, usually caused by wearing shoes with the wrong toe shape for your foot. The average person tends not to look at shoe shape when buying athletic shoes. Take out the shoe liner, put it on the floor, and stand on it. If any part of your foot overlaps the side of the liner, then it's the wrong shape for your foot. There are many shoe lasts (which is what creates the shape of the shoe). If you visit a professional shoe-fitting facility, they'll help you determine what lasts will work best for you. 2) If they're on the ball of your foot, then they're caused from excessive pressure. That usually means that you've been bearing too much weight on the front of your feet. The heel is meant to bear weight, not the toes. Do not run on the front of your feet unless you're in an actual race. The average person does themselves a great injustice by not heel striking properly during athletic activities. If you're in a sport like tennis that force more forefoot pressure, then you'll have to be careful to use a shoe built specifically for tennis AND putting a support inside of the shoe that helps to distribute pressure more evenly across the foot to prevent stress fractures and ankle sprains.

Other Forefoot Problems
Callouses
Cause: The combination of moisture and friction/pressure. So you're feet are trying to protect themselves against poor gait and bad shoes.
Medical solutions: none besides cutting them off periodically
Non-medical solutions: See a pedorthist at the Denver Foot Solutions about evaluating your footwear and gait. Depending on what cause is determined, the treatment will vary. An easy way to cut down on moisture and friction is switching from a cotton sock to a moisture-wick sock.

Numbness/Tingling/Burning
Cause: Usually nerves. If your heel is elevated higher than your forefoot, the likelihood is that you're pinching the nerves between your toes from being shoved into the end of the shoes. This also happens if your shoes are too narrow in the toe box, or if you've developed a slouchy posture. If left untreated can develop into a Morton's neuroma, which is a thickening of the nerve in the area of pinching.
Medical solutions: Cortisone shot
Non-medical solutions: Orthotics; wide/deep toe-box shoes; flat sole shoes or rocker sole shoes; Metatarsal pads/bars

Hammer Toe
Definition/cause: The interphalangeal joint of toe is bent upwards causing rubbing on the top of the joint from pressure of shoes. Cause is usually from the arch of your foot not operating properly. When the arch isn't working right, the tendons and muscles on the top of the foot try to compensate. They're not designed to take over the duties of the bottom of the foot, so they tighten up and pull back on the toes. This causes the joints to bend. If left untreated the joints begin to lose range of motion and become rigid. If you can catch them before they become rigid, it is more likely reversible than if you let them become rigid.
Medical solutions: surgery/pins
Non-medical solutions: If the hammer toe is still Flexible: Hammer toe splint, deep toe box shoes, Custom Bio mechanical Arch Support (CBAS), metatarsal pads/bars.
If the hammer toe is Rigid: Hammer toe crest, deep toe box shoes, Custom Bio mechanical Arch Support (CBAS), metatarsal pads/bars.

Claw Toe/Mallet Toe
Definition/cause: Toes are bent under to look like claws. Again, the cause is arch related. Cause is usually from the arch of your foot not operating properly. When the arch isn't working right, the tendons and muscles on the top of the foot try to compensate. They're not designed to take over the duties of the bottom of the foot, so they tighten up and pull back on the toes. This causes the joints to bend. If left untreated the joints begin to lose range of motion and become rigid. If you can catch them before they become rigid, it is more likely reversible than if you let them become rigid. Sometimes the cause is congenital in cases of Charcot Marie Tooth and other such rigid foot deformities.
Medical solutions: surgery/pins
Non-medical solutions: Custom Bio mechanical Arch Support (CBAS), Metatarsal pads/bars, Wide/deep toe box shoes

Morton’s Neuroma
Definition/cause: Tissue buildup around pinched nerve usually located between the 2nd & 3rd or 3rd & 4th bones in the ball of the foot, causing shooting pains and numbness. Some of the causes are from wearing shoes too narrow for your foot shape, wearing shoes that have an elevated heel, running on the balls of your feet, and having a slouched posture.
Medical solutions: cortisone shot
Non-medical solutions: Wide/deep toe box shoes; Rocker-sole shoes; Met pads/bars; Arch Supports

Metatarsalgia
Definition: General term for undiagnosed forefoot pain
Medical solutions: padding
Non-medical solutions: Wide/deep toe box shoes, Metatarsal bars/pads, Custom Bio mechanical Arch Supports, Rocker-sole shoes, socks with additional padding on the soles.

Dropped Metatarsal Head
Definition/cause: One or more metatarsal bone(S) of forefoot are dropped or set lower than the others. Sometimes structural, sometimes developed from excessive flexibility/pressure, and collapse of the arch.
Medical solutions: Reconstruction; excavation
Non-medical solutions: Excavation of shoes or orthotics, wide/deep toe box shoes, Rocker-sole shoes, Metatarsal pads/bars

Bunion / Tailor’s Bunion
Definition/cause: Big toe (bunion) or little toe (tailor's bunion) joint is enlarged or dislocated; usually develops osteo-arthritis, and heavy callousing around joint; may develop bone spurs if untreated. Cause can be either from poor foot bio mechanics, poorly fit shoes, or hereditary. And just because your parents had bunions doesn't make it hereditary. Chances are that you have the same feet as your parents, therefore just as predisposed to getting the same foot-neglect deformities. Hereditary bunions usually look much different than developed bunions.
Medical solutions: Fusion of joint; removal of bone
Non-medical solutions: Custom Bio mechanical Arch Supports (CBAS), wide/deep toe box shoes, shoes without any elevation in the heel or Rocker-sole shoes to take pressure off forefoot, stretch pockets in shoes for bunions, metatarsal bars/pads

Arthritis - Rheumatoid
Definition/cause: The body’s immune system attacks the joints, causing inflammation
Medical solutions: Inflammation management, pain management, possible surgery
Non-medical solutions: Nonrestrictive footwear with structure and shock absorption, Custom Bio mechanical Arch Support (CBAS) to take pressure off joints and balance bone structure, possibly try Rocker-sole shoes for shock absorption and increased circulation factor depending on pain level

Arthritis - Osteoarthritis
Definition/cause: The cartilage of the joints is worn away from overuse, stress, or misalignment.
Medical solutions: Pain management, possible surgery to fuse or replace joints
Non-medical solutions: Nonrestrictive footwear with structure and shock absorption, Custom Bio mechanical Arch Supports (CBAS) to take pressure off joints and balance bone structure, possibly try Rocker-sole shoes for shock absorption and increased circulation factor depending on pain level.

Gout
Definition/cause: Crystal-like Uric acid buildup in joints, usually the big toe causing pain when joint bends. It can be a form of arthritis or dietary related. You want to contact the doctor if your big toe is swollen, red, and tender to the touch to have gout diagnosed and treated as soon as possible.
Medical solutions: Dietary, Medications
Non-medical solutions: Limit range of motion in irritated joint, flat-sole shoe or negative-heel shoes, Consult a nutrition expert

The Custom Orthotics that the Denver Foot Solutions store fit are usually the best solution for the more common forefoot conditions:
Our custom orthotics help Denver residents to….
· Distribute weight evenly across the foot to reduce and eliminate pain
· Improve balance and stability
· Improve posture and align knees, hips, and back to remove pain
· Keep bunions and other foot conditions from getting worse
· Absorb shock from walking/running on hard surfaces
· Help with shin splints and other sports injuries
· Maximize athletic performance

*In some cases medical attention is imperative for both diagnosis and treatment. If there is a combination of discoloration and swelling, you should consult the doctor right away. Most of the other conditions are treatable by non-medical solutions without a diagnosis being necessary. Working with a Pedorthist who specializes in preventative foot care is my first recommendation for the more common foot ailments. The Pedorthist will send you to the doctor if there are signs of necessary medical care, or if the ailment is unresponsive to treatment.*

WHY DO MY FEET HURT?

Are you tired of having sore feet only four hours into your work day? Are your feet restricting your lifestyle? Do you feel like you've wasted an awful lot of money on shoes that hurt your feet?

Are you sick of shoe shopping only for your feet to be miserable… again?

You don’t have to be!

I’ve heard it all before, “I’m just getting older.” Hog-wash! Sore feet aren’t from age. They’re from abuse. The good news is that you don’t have to go another week with sore feet if you’re going to finish reading this article and listen closely. I’m going to tell you a few secrets.

Secret 1: Everyone’s feet are different. Feet are NOT generic. Shoes ARE generic.

What this means is that you probably just need a little bit more information about your feet so that you can find the right shoes for YOU, specifically. See a shoe-fitter at the Foot Solutions store. It’ll take maybe an hour or two of your day, and you’ll stop wasting money on shoes that hurt!

Secret 2: Shoes that are good for you are NOT always ugly. Sure, some are… but there are a lot of shoes that are very good for you that aren’t unattractive. You probably will not find super fashionista shoes that are “good” for you. But there are flip-flop alternatives and dress shoes that are designed to be pretty darn good for you. Remember, it’s about finding the right shoes for your specific feet, not your specific outfit! If you have to have a few basic-looking shoes in your closet for work, it’s not the end of the world.

Secret 3: Any shoe is ok to wear as long as you’re wearing them for the purpose they were designed for.

- Flip-flops: Pool/Water activities, Sand/Grass activities

- Crocs: Gardening… that’s it!!

- Dress shoes: 2-4 hours of light standing, special occasions

- Running shoes: Nike/Addidas/Avia/Reebok/Mizuno/etc – ONLY for soft-surface running (i.e. taking a jog on gravel or dirt or grass). Aetrex/Brooks/Saucony/New Balance 900 series and up – More of an all surface athletic shoe. Be careful about athletic shoes that you’re using them for the activity they were built for (i.e. don’t wear a running shoe for walking, or a running shoe for aerobics)

Secret 4: Only YOU really notice how ugly your feet/shoes are. Trust me, NO ONE cares about your feet/shoes the way that you think they do. Media has led us to believe that we must be super aware of our outfits. No one really cares, look around you! Besides, what’s more important? That your body is healthy and strong, or that you don’t “offend” someone you don’t even know by wearing ugly shoes? For real! You can’t be that shallow! I have gals who refuse to wear sandals because they have toe deformities, but the truth is that no one else really notices. All they’re doing is making themselves uncomfortable and insecure. Hold your head up high and don’t find self-esteem from what the media says you should look like.

To conclude, your feet do not have to hurt or ache. Come see someone who can help you figure out how to protect your feet and body from discomfort and the damages that occur from walking on hard, flat surfaces. They can help you learn how to find good shoes and explain why your feet hurt. Don’t wait until your feet are disfigured and injured to take care of them. If you can keep your feet looking nice AND operative correctly, then you’ll save yourself a lot of stress and pain AND money in the long run.

The Denver/Lowry Foot Solutions store is on Quebec street just North of Alameda and just South of 6^th street. It’s right next door to The Delectable Egg. We’ll see you there.

Chung Shi and Masai Barefoot Technology (MBT)

You’ve probably heard about them in an ad or from a friend. “They’re like magic. They’ll melt your cellulite and make your body feel really good.” Not all these claims are necessarily accurate, but the fact is that people LOVE Mbts and Chung Shis. I’d say their best advertising is through the people who wear them and have had results they’re happy with.
Now, let me explain some of the differences between the two, pros and cons, and some important key factors to consider before you buy them.

Q: What are the differences between MBT and Chung Shi biomechanically?
A: MBT began distribution in 1996. Chung Shi was developed later. Both began as medical equipment for physical therapists and pre/post surgical therapy. As research on the product progressed, more benefits were recognized.
Mbts slowly teach your body how to stand/walk appropriately. It takes time, but isn’t terribly aggressive or difficult to adjust to. They’re quite soft in the soles, which initially makes them feel like you’re walking on clouds.
Chung Shi shoes are an aggressive approach to gait correction. It forces the body to stand and walk correctly. They’re more rigid and stabile for more control and durability.
They’re both designed to counteract the detrimental effects of walking on hard flat surfaces your whole life. The body breaks down when forced to be on such harsh surfaces regularly. Not to mention the awful footwear that is standard in the US. This Biomechanical Technology was developed as a long-term preventative/corrective solution to muscle atrophy and poor gait. So far, being quite successful across the board.

Q: What are the main benefits of the Swiss Masai and Chung Shi?
A: These shoes are designed to over time, tone and shape the body, activate neglected muscles, improve posture and gait, help with shock absorption, and help with various discomforts and medical conditions both pre and post operation.

Q: Who cannot wear the MBT and Chung Shi?
A: It varies per person. If you have concerns about wearing these shoes with your condition, PLEASE ask your doctor or therapist. Tendonitis is usually a condition that has a pretty good bet of a negative response from these shoes, but there aren’t a lot of definites. There are no guarantees. Many people have amazing results medically/physically from these technologies, but even people with the same conditions can react differently to it.


Some Pros and Cons

MBT
Pros : Cons

Softer soles : Instability medially/laterally, which may mean you’ll need an arch support in addition to the shoe. Because of the softness and instability, they’re only to be used on hard flat surfaces.

Build muscles around the major joints so as to ward off cartilage wear and give the body a natural shock absorption : Some major injuries and/or surgeries can interfere with the ability to tolerate muscle use

Generally an easier break-in because of softer sole and more mild transition : The soles are more sensitive to water and chemicals causing them to break down more quickly BUT can be resoled.

Chung Shi
Pros : Cons

More stability in the sole which is designed to help control gait : More rigid and aggressive; can seem quite uncomfortable at first. BUT this sensation usually dissipates within minutes of walking in the shoe, as your muscles and feet get a little more used to the idea of the SHOE controlling your gait.

The rigid sole is very durable and isn’t sensitive to water like the MBT. They’re a multi-surface shoe : Cannot be resoled as of yet.

Build muscles around the major joints so as to ward off cartilage wear and give the body a natural shock absorption : Some major injuries and/or surgeries can interfere with the ability to tolerate muscle use.

Some things to be aware of before buying: Not everyone can wear these shoes. If you have a chronic medical condition, I’d recommend asking a medical professional before making your decision about these products.
They’re also a special fitting shoe. You need to be properly sized in the style of your choice as there isn’t consistency of fit between styles. Depending on the last and uppers, you may be several difference sizes.
Also make sure you are properly trained/informed on the dos and don’ts of MBT/Chung Shi use. There are things you may need to know for specific activities you wish to use them for.
**Most Importantly!! You may also need to wear arch supports in these shoes as with any other shoe. There is “more” control in the Chung Shi arch than the MBT, but that doesn’t mean that it’s ENOUGH. You need to be properly evaluated for poor alignment in your feet or you may end up with more irritation and discomfort than before you tried the shoes. Very important. A Pedorthist can evaluate your gait at the Denver, Colorado Foot Solutions store in the Lowry Town Center.

To sum up, You should be evaluated at your local Foot Solutions store to see if you are a good candidate for either the Swiss Masai Barefoot Technology or the Chung Shis. They’re both Great products that promote better health throughout the body.

Topic: SOCKS

You wouldn’t think it matters very much what type of sock you wear or what it’s made of. People usually think of sock as disposable clothing, therefore it doesn’t make sense to spend a lot of money on them, right? Especially when you can get them in packs of 6 for ten bucks.
Socks can serve many purposes, and can dramatically improve your comfort level when you have the right one per the activity/footwear.

MATERIALS –
Myth: Cotton socks are the best.
Truth: Not unless you’re allergic to microfiber and/or wool materials.

Cotton is only breathable when it’s exposed. If you’re enclosing it into a shoe, or trapping it between your foot and the ground/shoe sole, it is no longer breathable.
Cotton naturally absorbs moisture. The average foot puts out ½ pint of body oils in a day. Much more if you’re active.
The socks will absorb this moisture, and then what? It holds the moisture against your foot. The socks start losing their shape because they’re wet, and you keep having to pull at them as they’re sliding down your leg and bunching up in your shoe. Now you start to get blisters and corns, which are the result of the combination of moisture and pressure/friction. The other downfall to cotton is that, because of the moisture it holds, it starts to break your shoes down pretty fast.
Now you wouldn’t think that synthetics would be any better. Nylon blends and Rayon blends aren’t very good. Microfiber/Acrylic is the best material for socks, with marino wool coming in second. Microfiber and Wool grabs the moisture that your foot puts out and shoves it out towards the shoe. Get into a really good brand like Thorlo, Smartwool, Feetures, Aetrex. These socks will outlast all your other socks, plus they hold their shape without fail. They’ll cost you a little more money, but they’re worth every cent. You can find some of these brands at the Foot Solutions stores. The Denver location can order in whatever styles you desire in each brand.

ACTIVITY -
A lot of socks come in padding levels. Some are specifically designed to pad the spots on the feet that are affected by the activity that you’re doing. There are socks for Skiing, Hiking, Running, Walking, Golfing, Fishing, Snowboarding, Basketball, Tennis, Dress and many other activities. The brands I’m thinking of that have the most variety are Smartwool and Thorlo.

CONDITIONS -
There are even socks for medical conditions, like Diabetes. These socks are always microfiber blends, in order to keep the feet dry and blister free. They are also designed without seams, and usually with more built-in padding to protect the bottoms of the feet. The best Diabetic socks come in low-compression styles, or even ultra-low compression for the wider calf. Low compression socks are knit a lot more loosely, so that they don’t leave ridges in your feet or legs like most other socks do. It’s very important not to wear things that fit tightly when you are a Diabetic. That is, with the exception of your doctor stating otherwise.
Another condition or two that is affected by socks is Toe Fungus or Athletes foot. The moisture that you get from your feet every day feeds the bacteria and fungus growing under your nails and between your toes. You need the moisture control that wicking socks provide, and you should definitely not be in a synthetically made shoe either. All-leather uppers and/or mesh will allow the trapped moisture escape.

Synthetic socks will also help with temperature control with your feet if you have poor circulation and have cold feet all the time, or if you have sweaty stinky feet no matter what you do.

TIP -
A tip for fighting moisture in your shoes is to put some cedar balls/shoe trees in them when you take them off at night. Wear an entirely different pair of shoes the next day and let the cedar sit in your shoes for the whole day. By the following day, your shoes will be nice and dry, and the cedar balls/shoe trees will have absorbed a great deal of foot odors, moisture, and bacteria growing in your shoes (which is the natural result of normal wear). This, in addition to wearing Microfiber or Wool socks, will make a huge difference to the shoes preservation.

In a nut shell, materials that hold moisture are bad for the skin on your feet, your socks, and your shoes. Find the socks that most suite your lifestyle and enjoy your new sock-induced foot health.