Shoes: Fashion v’s Function

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Fashion v’s function: Why the difference between running shoes and casual shoes matters.

Lately here at Mullins podiatry we have seen the emergence of casual shoes being worn for the wrong purpose. Both children and adults have presented with conditions that can in part be attributed to the wearing of the wrong shoe for the wrong purpose.

If you pick your sports footwear based solely on it matching your latest active wear colour, sitting well with your jeans or looking good with shorts, you could be setting yourself up for stress fractures, knee problems and back pain.

Whilst it use to be easy to distinguish the difference between a street shoe and a purpose built running or cross training shoe, these days the differences to the average purchaser or recreational athlete can be less obvious.

Many shoe companies including Nike, Adidas, Sketchers, Asics and NB make both performance shoes and sports-styled street wear sneakers, and while the latter are great for getting out and about, they’re not suited for running, cross training or specific gym work. The difference in the mid-sole, the outer sole and the upper can lead to injury.

Essentially whilst the mid sole of a street shoe is fine for fashion or walking casually, it will not provide sufficient cushioning for the demands of running or sports. The lack of support and cushioning may lead to impact related stress to bones, joints and soft tissue.

Some examples of casual shoes and running shoes:

Fashion:                                                                              Function:

Adidas ZX Flux                                                                    Adidas Boost

Nike Roshe                                                                           Nike Pegausus

NB 574                                                                                   NB Zante

Asics made Onitsuka Tiger                                                Asics Kayano

The good news however is that if you find a shoe from the function column that suits your aesthetic demands and can be paired with your active wear look or chinos then you are less chance of causing injury.

If you need help choosing the right tool for the right job, are concerned your shoes are causing pain or aren’t sure what shoe you need, contact us at Mullins Podiatry at one of our 3 locations for a consultation. We will look at your foot type, your biomechanics/kinematics and review the purpose of your footwear.

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Children’s Feet

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Children’s feet differ from those of adults. At 6 months, a child’s foot is still mostly cartilage with the last bone forming around 3 years of age. By 18 years, most of the bones in the foot are fully formed.

In clinic, we are asked by numerous parents about the best ways to support their child’s growing foot, at the many different stages of development.

Development of Children’s Feet

Babies

Newborn feet only need protection in the cooler weather. Growing suit, socks or small soft natural fibre shoes can be used to keep tiny feet warm. Always make sure that these items are loose around your baby’s feet and make time for your baby to kick freely as this will assist in the development of the muscles in the legs and feet.

Toddler

From the time between 10 to 20 months of age, children usually begin to walk. Each toddler is unique; rolling, crawling, walking and running happens at different times for different children and it is important to allow each child to move through the developmental stages at their own pace. Use of certain equipment like Jolly Jumpers or Walkers has no proven evidence of helping toddlers to walk early, and may place unnecessary stress & pressure on feet that are not yet ready for taking weight.

When children first begin to walk, shoes should only be used when protection is needed from the outside ground. Barefoot or very soft shoes are best initially as they help the foot to develop and assist in the strengthening of foot muscles.

Childhood

A child’s foot grows in length and changes in shape with growth. Arch profile development is unique and arch height, or lack thereof does not always indicate that a child will have problems with their feet. Due to rapid growth in width and length, frequent changes in the size of shoes and socks may be necessary. It is important that you check your child’s foot in relation to their shoes size regularly; as a rule of thumb, checking every one to three months up to 3 years of age, every four months up to the age of 5 and every six months thereafter.

Footwear

Just like adults, shoes should above all protect your child’s feet. Ill-fitting or worn shoes can cause unnecessary and excessive pressure and stress on growing feet that can contribute to the development of pain and injury. Below is some advice about finding the right footwear for your child’s growing feet:

  • Always have both feet measured for length and width – too short or narrow can cause abnormal pressure, whilst too long or broad results in clawing of the toes and can lead to tripping.
  • The shoes should fit the natural shape of the foot, especially at the toes.
  • The toe of the shoes should allow toes to move freely and not be squashed from the top or the sides – allow 1cm growing room between the longest toes and the end of the shoes.
  • Shoes should fit comfortably around the heel and not be too loose or too tight.
  • Shoes should only bend at toe region – shoes that bend in the arch increase abnormal forces on the foot.
  • Shoes should be relatively light in weight – the heavier the shoe, the harder the growing feet and legs have to work.
  • Make sure the footwear matches the activity – if playing tennis, wear tennis shoes etc.

Having your child’s footwear fitted in store by a trained assistant can help ensure the correct size and shape to keep little feet running and jumping.

Common concerns for parents

Children’s feet are susceptible to many problems seen in adults, including ingrown toe nails, athlete’s foot/fungal infections and plantar warts. Other conditions seen within the developing foot and lower limb are unique to adolescents.

Below is a list of common foot and lower limb issues seen in children within our clinic:

  • Flat feet/rolled-in feet
  • Intoeing (Pigeon toed) / Out-toeing (Duck feet)
  • Toe walking
  • Heel Pain
  • Knee Pain
  • Forefoot Pain
  • In-grown toe nails
  • Unusual shaped/positioned toes
  • Bowlegged / Knock-Kneed
  • Limb Length Discrepancy
  • Growing Pains
  • Limping
  • Reduced strength/Low muscle tone

Professional Advice

Some conditions seen in children are a variation of normal development that resolve in time and often only requires reassurance whilst some can often impede activity and require a more targeted intervention.  A check-up with a Podiatrist is recommended if you notice:

  • uneven shoe wear
  • skin rashes, hard skin, lumps or bumps on your child’s feet
  • your child complaining of recurrent pain in the feet and/or lower legs which also increases with activity
  • your child constantly tripping or falling
  • Your child’s walk/run does not look symmetrical
  • Or you have any other concerns about your child’s feet

If you believe your child is in need of a check-up or is complaining about pain, Mullins Podiatry is ready to help. Please call today at one of our many locations.

 

5 ways to run faster

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If you have been training for a while and are progressing to running a few times a week, and can handle a run of 5-6km such as your local Park Run on a weekly basis, you may be looking at how you can run faster. These 5 tips from Mullins Podiatry will help you develop some speed in your running.

  1. FORM: ensure your form or technique is optimal for efficiency and to minimise risk of stress and inflammation as you start training faster. Basics of good form look at cadence (how often your feet hit the ground), posture, remaining strong and fluid when you need to be and foot strike (looking at where your foot hits the ground – this should be close to the midline of the body).
  2. VARIETY: you will not get faster doing the same thing 3 times a week – to run faster you need to mix up how you train. Broadly speaking you can separate running sessions into a long slow run, some hill work and some speed work. There are many variations of these sessions but essentially you need to be training different body systems to get faster.
  3. FOOD: you will not get faster if you fuel up more than you burn. Have a look at what food is coming in and at what time. People fail to realise that most sessions less than 90 minutes can be done in a depleted state (on an empty stomach).  A simple look at a food diary can reveal calories that are not needed or types of food that could be minimised.
  4. COMPANY: running with at least 1 other person will increase both honesty in pace and regularity, it will also ease the boredom runners often complain about. Rope in a friend with a similar goal or sign up to a running group, most groups have various levels from beginner right through to competitor.
  5. PLAN: without a plan it is easy to fall into a routine that does not produce improvements. Organising a realistic program with specific sessions and goals will help to take the thought process out of the equation, and working towards a specific goal will hold you accountable.

If you would like help with learning how to run, learning to run faster, or have any further questions please call Mullins Podiatry today.

Plantar Warts

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Plantar Warts (Verrucae Plantaris)

Nobody likes a wart and plantar warts can be a real problem, especially if they become painful and make normal activities, like walking, uncomfortable.

What is a Wart?

A wart is a small, contagious growth on the skin that develops when the skin is infected by the Human Papilloma virus (HPV). The infection occurs as a result of the skin coming in direct contact with the virus.  The virus causes an excess amount of keratin, a hard protein, to develop in the top layer of skin (epidermis). This extra keratin produces the rough, hard texture of a wart.

What is a Plantar Wart?

Plantar Warts are warts that develop on the bottom surface, the plantar surface, of the foot and are most commonly seen in young children, adolescents and the elderly.

There are three types of warts that commonly affect the foot:

–          A solitary wart is a single wart. It often increases in size and may eventually multiply, forming additional ‘satellite’ warts.

–          A periungual wart is one that develops under and around the toenails. These warts can affect the shape of the toenail

–          Mosaic warts are a cluster of several small warts growing closely together in one area. These warts are often more difficult to treat than solitary warts.

How does the virus spread?

HPV is passed on through close skin-to-skin contact but can also be transmitted indirectly from contaminated objects or surfaces, such as areas surrounding a swimming pool, towels, shoes or floors of communal changing areas. You are more likely to get infected if your skin is wet, soft or has been in contact with a rough surface. Warts are thought to be contagious for as long as they are present on your body.

How do I know if I have a Plantar Wart?

Plantar warts normally have an array of signs and symptoms, which include:

Thickened skin:
Often a plantar wart resembles a callus or corn because of its tough, thick tissue.
Pain:
A plantar wart will often be noticed when walking or standing, if it is in a particular prominent area, but are also known to be painful when squeezed.
Tiny black dots:
These often appear on the surface of a wart. The dots are actually dried blood contained in the capillaries that grow into and support the wart.
Skin striations:
Feet are covered, which are akin to fingerprints on the feet. Skin striae will go around a plantar wart; if the lesion is not a plantar wart, the striation continues across the top layer of skin.

What do I do if I have a Plantar Wart?

Most research states that a plantar wart can clear up without treatment, however it can take more than two years for the virus to disappear. There are numerous treatments available for warts, however, no single treatment is 100% effective. Here at Mullins Podiatry, we use a combination of sharp debridement of the viral tissue with potent Salicylic Acid and Cryotherapy. This will commence the process of reducing the viability of the surrounding tissue to become infected by the virus and introducing the virus to the body’s immune system.

If you think you have a plantar wart or have attempted Over-The-Counter products without any success, feel free to give the team at Mullins Podiatry a call today at one of our many locations.

Heel Pain

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Heel pain is one of those conditions that all Podiatrists see regularly in their clinics. Anyone can suffer from heel pain, but certain groups seem to be at increased risk, including:

–          Middle-aged men and women

–          Physically active people

–          People who are overweight or obese

–          People who are on their feet for long periods of time

–          Children aged between eight & 13 years (particularly boys)

–          Women who are pregnant

For some patients, their pain resolves relatively quickly whilst others can experience the debilitating effects of heel pain longer.

What is the cause of heel pain?

Heel pain can be a result of numerous causes with patients usually reporting pain either underneath or just behind their heel. Of the 26 bones in our feet, our heel is the largest and designed to provide a rigid support for the weight of our bodies; absorbing up to 1.25 times our body weight when walking, even more with higher-impact activities like jumping and running. Consequently, it is vulnerable to damage and ultimately pain.

Below are just a few of the conditions that many of our patients present with to our clinics:

Plantar Fasciitis

The plantar fascia is a band of connective tissue that travels along the sole from the heel to the ball of the foot. Plantar Fasciitis is a musculoskeletal condition causing pain under the heel or into the inner arch of the foot as a result of inflammation at the insertion point of the plantar fascia on the heel. The condition is due to mechanical over-stretching of the fibrous tissue in the arch. Most patients report pain with the initial few steps out of bed or after rest and returning towards the end of the day.

In many cases, plantar fasciitis is associated with a heel spur. During gait, abnormal mechanics can causes the insertion point of the plantar fascia to tear and bleed and, over time, these injuries calcify and form a bony growth.

Heel Spur

It’s estimated that 1 in 10 people have a heel spur and may not present with any symptoms. During gait, excessive or abnormal mechanics can place extra strain on the plantar fascia. Chronic inflammation may develop and, over time, lead to a bony growth or spur. A spur can only be seen on x-ray, but its presence is often flagged by a tender patch at the heel on the sole of the foot. Displacement and loss of the fatty tissue under the heel can lead to the spur being more prominent. The spur itself does not cause the pain, but the pain may be associated with inflammation in the area.

Stress Fracture

A stress fracture of the calcaneus is a hairline fracture of the big heel bone and is usually caused by overuse from abnormal mechanics. Common in long distance runners, ballet dancers and sports involving jumping, a stress fracture of the calcaneus is the second most common stress fracture location in your foot. Symptoms of a calcaneal stress fracture may be similar to that of a bruised heel and pain will come on gradually over time and be made worse with weight bearing activity like running and jumping.

Achilles Tendinopathy

Achilles tendinopathy is a condition characterised by tissue damage and pain in the Achilles region and it is most commonly brought about through physical activity or a sudden change in the level of activity. Repetitive activity, trauma or high loads cause excessive tension to occur in the tissues damaging the tendon and causing subsequent inflammation and degeneration. As a result of the degeneration, the tissues within the tendon function abnormally and lose strength, contributing to further localised inflammation to occur, and can increase the risk of rupture with continued activity. Patients usually report pain and tenderness in their heel along with heel stiffness after rest and swelling.

Regardless of whether your heel pain is something new or something you have learnt to cope with, seeing our Podiatrists can help you identify the cause and establish a treatment plan to enable you to return to the activities you love – heel pain free!!!

How do I start running?

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At Mullins Podiatry we are often asked by patients “how can I learn to run?” Whether it’s from the couch to a 5km goal, wanting to burn more calories, or getting bored with the gym, there are many different reasons as to why a person would like to start running.

If you have made a decision to get in shape and would like to add running to your fitness regime, or you haven’t run in a long time or you are looking at progressing from walking to running, the following guide from Mullins Podiatry may help.

Please note: It is important to get checked out by a doctor, particularly if you have any health risks such as heart or lung conditions, major diseases or are pregnant.

Step 1: Seek advice on the best pair of running shoes for you and your size / needs. This advice can be from a health professional such as a podiatrist or a specialist running store. Find someone with likeminded goals or a group to train with. Research shows that if you have someone to train with, not only are you more likely to succeed but you will have more fun in the process.

Step 2: Start small. Whilst you are enthusiastic to simply put some running shoes on and head out the door for half an hour or more of effortless running, the reality is that you will increase your chance of injury and decrease your chance of success if you try to do too much too soon.

I like a walk/run combination for the first few weeks. If going from the couch to running, I recommend patients start with a 6 minute cycle (4 minutes walking/ 2 minutes running) making sure that the 2 minutes of running is at conversational pace. Whilst the latest gadgets like GPS watches and heart rate monitors can help, at this stage all you need to do is hold a conversation during running/walking, relax and listen to your feet hitting the ground.

This 6 minute cycle can be done progressively for up to 4 cycles per session.

e.g 4 x 6 minute cycles = 24 minutes total per session. Aim for 3/4 sessions per week.

Step 3: Only gradually increase if the body is telling you to. If you are experiencing any pain or problems, consult a heath professional. If all is going well after the first week and you are recovering without any pain, you can progress this 6 minute cycle to a 3 minute walk/3 minute run combination.

The following week this can move to a 4 minute run/2 minute walk combination, and finally a 5 minute run /1 minute walk combination.

This gradual rule of roughly 10% increase in distance and intensity should hold, regardless of ability.

Step 4: Allowing for life getting in the way and motivation getting low, try to commit to 10 sessions in your first month of learning how to run.

Once this month is completed you are ready to progress to a more specific goal, take a look at your running form and start mixing in different types of training e.g hill work.

If you have any questions, comments or feedback please contact us at www.mullinspodiatry.com.au where we can help you start running today.

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Go run

What can I do about a painful ingrown nail?

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At Mullins Podiatry we have a range of options to treat and manage your ingrown nail. We first take a history and detailed examination to ascertain why the nail is ingrown.

It may be that

  • The nail has been cut incorrectly
  • The nail has been damaged
  • The nail shape causes it to break the skin
  • Genetic disposition
  • Footwear and lifestyle may be contributing to the way your nail may be growing

Our conservative approach is to cut and re-shape the nail to provide immediate relief and reduce chance of infection. We then educate you on the best way to avoid the recurrence of the nail growing into the skin.

If this conservative approach does not achieve long term relief or the recurrence is causing repeated discomfort or infection, a surgical procedure may be advised.

What is nail surgery?

Nail surgery refers to the technique of removing the nail and phenolising the matrix so the nail does not grow back.

This procedure is done under local anaesthesia in the clinic after a sterile field is constructed. After the ingrown nail is removed, the growth plate (matrix) is neutralised using the repeated application of phenol, a strong alkaline designed to stop the nail growing back.

Does it hurt?

The injection of LA will feel similar to any other injection. After the anaesthesia is applied, it is a pain free experience with most patients reporting little to no pain after the procedure and being able to walk freely.

Minor surgery such as Partial Nail Avulsion and Nail Wedge Excision provide approximately 95% success rate in permanently resolving ingrown toenails. The procedure allows a quick recovery with a return to normal activities on the same day and minimal post-operative discomfort.

Do I need follow-up care?

Patients are advised to attend a follow up dressing change in the days following the procedure and are required to be seen again one week later to assess the progress of the nail and the surrounding tissue. After the procedure, it is recommended you do not drive and whilst you are able to return to work or school, you may require an open toe shoe / sandal and will be required to keep the area clean and dr

What are the potential complications?

All nail procedures have been associated with a slight chance of recurrence. Infection whilst the wound is healing can also be an issue. We will advise you and manage these and any other complications that may occur.

How can we help?

Mullins Podiatry can manage and prevent ingrown toenails, alleviate pain, and help keep you on your feet and mobile. www.mullinspodiatry.com.au