"Toesie" has red paint on the area of the tonails that usually white.

Keeping ten happy little toes is connected to the care of your ten little toenails. How you trim them can make or break your foot comfort. And we all know how it goes with comfortable feet. If the feet are happy, the whole body is happy.

If they ‘ain’t’ happy — everything above them ‘ain’t’ happy. That unhappiness can spread to the folks around the unhappy feet.

Do trim your toenails and avoid leaving them uncared for. If you need help due to vision issues and potential risks due to diabetes or other conditions, you can seek assistance from a family member, a pedicurist or health organizations or businesses which frequently offer toenail clinics. Health organizations or businesses that would offer assistance include local health departments, hospice services or home health care services. They will be glad to tell you where they are holding toenail clinics.

Untrimmed toenails in winter when we wear closed shoes can press against the end and other surface areas in the shoe’s toe box, causing quiet misery. People who are on their feet a lot, such as wait staff know about the foot comfort secret of keeping toenails trimmed. Untrimmed toenails on smaller toes can grow in a curve that follows the toe shape enough to eventually touch and become embedded in the skin at the tip of the toe. Long toenails are a spot for moisture to accumulate along with bacteria leading to another set of misery.

Over trimming can get a foot into trouble as well. The toenails should never be over trimmed as the tissue and skin around the toe is tender and easy to cut when the clippers or scissors get to close to the ‘quick’ of the toenail. Some toenail growth does protect the tips of toes from rubbing or pressure due to shoe fit or a wrinkle in one’s sock.

I recommend trimming toenails to follow the shape of the of the toe, with some extension away from the quick — that is the white part that isn’t connected to your toe. “Toesie” has red ‘paint’ on the area of the toenails that is usually white.

Some recommend trimming straight, but that isn’t clear. We can easily see that creating a pointed toenail isn’t going to work. But following the shape of the toe in a straight manner makes much more sense than a ruler-straight-whack across the top. Too often this can lead to outside toenail tips growing sharp corners to snag socks and sheets. Those dry corners are vulnerable to breakage when we go barefoot or wear sandals. That break can be a big chip or a big rip that gets too close to the quick or the side cuticle, leaving a small, painful wound inviting bacteria and infection.

These toenail trimming suggestions may not fit everyone. Consult your podiatrist or health professional before making drastic changes in the trimming methods that have been working for you.

If you have questions about foot care, you can contact us at 317-660-2115 for a consultation appointment. Or you may use the online appointment request option available on the Hoosier Foot and Ankle website 24/7 for your convenience. We have five clinics available for your foot care needs in the Indianapolis area.

Other times, the pain is connected to things that you have influence over. Things like the shoes you’re wearing, or exercise or a small injury that will respond to R.I.C.E therapy.

The video below is a speed review of five things you can do to find relief from foot pain.

If the pain doesn’t go away shortly, please call your foot care professional. Hoosier Foot and Ankle has 5 clinics in the Indianapolis area. You can call 317-660-2115 to make an appointment or you can use the online appointment request option available 24/7 for your convenience.

Slippers or socks that rub spots on anyone’s feet is miserable and dangerous. But, for the diabetic on your gift list there are some little things that you can consider for healthier or safer footwear.

Slippers can be very comforting to bring warmth in situations of reduced circulation. You don’t have to sacrifice beauty for comfort — you can add some small, tightly attached decorations to a relatively plain, but well-shaped slipper. Begin your shopping with a search for room, but nothing that sticks out on the sides to contribute to tripping. Support for heels with a firm closure — this is a good place for velcro because laces can spoil everything. A deep toe box allows for clearance, movement and avoids those disastrous tight spots that rub sores. Fuzzy lining might be okay for slippers that are only warn as foot warmers for a short time, but that lining is often synthetic and can lead to excess perspiration. Damp slippers aren’t warm and matted lining is apt to lead to rubbing.

Look for footwear that has no internal seams that can make another place for rubbing.

If you are looking for socks to be worn with slippers or other shoes, think about Smartwool phd® socks (or other wool clothing featuring Merino wool). This product claims to help maintain an inner body temperature that helps reduce sweating and dryer skin. Wool is known as an efficient moisture control and frequently recommended as a clothing choice for next to the skin instead of something synthetic. Cotton is another reasonable natural fiber choice. Socks with knit seams instead of sewn help reduce spots that can rub sores on feet.

Remember that if a sore spot does show up, you should consult your foot care professional as soon as possible. We have five clinics in the Indianapolis area if you are located there. Anyone with foot issues can call 317-660-2115 for a consultation appointment. Or you can use the online appointment request option at our website.

We’re pleased with the VIP program where patients who refer others to Hoosier Foot and Ankle receive a special appointment opportunity that fits special spots with literally no wait time.

• Slippers are often something they won’t buy for themselves.
• The favorite old pair may be pretty well worn out and ready for replacement.
•  A spare pair can be extremely handy. Sometimes a different feel just fills the bill.
• A pair with tread and support may be just what is needed to get around the house and go get the mail.
• A pair of soft foot warmers are perfect for a pleasant snug nap.

There are a few things that you can apply to a favorite choice of slippers for Grandma or Grandpa. Safe options when choosing slippers for elderly people include:

• Support — mules (backless slippers) can increase risks of turned ankles or missed steps when the foot slips off the back of the shoe.
•  Tread — Too much tread can lead to stumbling, but no tread is a serious slipping risk.
• Comfort — Soft cuddly but tight vinyl slippers can be too warm and contribute to perspiration. Damp sweaty slippers are no fun. Leather or fabric tops will breathe and be comfortable for a longer time.

Perhaps the slipper will be worn outside by active seniors — getting the mail, slipping over to a neighbor’s for a cup of tea. If your grandma or grandpa are active and independent, you can expect they will be stepping outside without changing shoes. A choice with some tread, water resistance and adequate support in the counter area can help them enjoy your gift even more.

Handmade slippers are often appealing, but crocheted, knitted or sewn slippers are quite often slippery. If wearing them around the house will be a temptation, they make a ppor choice for an elderly person because of the contribution to falls. Handmade slippers are good foot warmers if the wearer is bedfast or chooses them for rest time. Not the safest choice for the active person.

If your gift has to be a surprise and you can’t ask Grandpa or Grandma about sizes or color preferences, you may have to recruit some family help and be observant on your own. Your elderly recipient will appreciate your efforts to choose a safe, comfortable and attractive gift.

At Hoosier Foot and Ankle, we don’t sell slippers, but we do offer quality foot care for you as well as for Grandma and Grandpa at five convenient clinics.  You can call 317-660-2115 for a foot care appointment or use our online appointment request option available 24/7 for your convenience.

The shoe is a make-over of the super light model introduced last year, Adizero f50, marketed as the lightest show on the market at 165 grams for a men’s size 8.5. The new shoe carries a chip inserted beneath the sole which transmits data on maximum speed, distance covered and the number of sprints to a computer or mobile device. The speed cell, “is able to measure speed and distance in all 360-degree movements.” according to an article in Bloomberg/Businessweek entitled Adidas Tries Soccer Shoes That Talk Back.

The article further quotes Thomas Effler, a Frankfurt analyst for WestLB, “The product (at $338) will be a little expensive for young people. However, parents are more willing to pay extra for clothing and shoes than for expensive electronic items. There’s a brand awareness among kids today and parents often pay for it.”

The shoes have been tested in an exhibition game in September 2011 by Lionel Messi, two-time FIFA World Player of the Year. Having the performance data may have more value for professional competitors while being interesting information for friends and peers to compare.

Recently I wrote about keeping your child safe on the soccer courts. The general makeup of soccer shoes can offer insufficient support to the foot, no matter what brand. Reviews of soccer shoes indicate the better shoes usually come in three types; cleats for firm ground which are a good all around choice, soft ground, which are used for wet fields, especially and hard ground which are aimed at artificial turf (the hg cleats are often called ‘turfs.’

If the shoes you’ve chosen for your child do not have built in heel cups, protect your kids’ feet by obtaining heel cups. Remember, you want to absorb shock when the heel hits the ground with all the pressure of a running step.

Good, well-fit shoes are the primary goal. Adding a set-up that collects performance data is gear that can be fun, but isn’t likely to be essential to soccer fun.

When injuries do occur or if heel pain is persistent, call 317-6600-2115 for an appointment at Hoosier Foot and Ankle to determine the cause of the problem. There may be something going on that is not related to the shoes. Or you may use the online appointment option available 24/7 for your convenience.

As the winter moves closer and we’re trying to function with less daylight for a few weeks, activity remains important. Planning can help us get the most out of our resources during lower temperatures and light.

No matter what activity level belongs to you, there are some good tips about choosing shoes, socks, warm-up techniques and more in this article written for Action.com by Dr. Christine Dobrowolski, DPM MS of Northcoast Footcare, entitled Winter Running: Helping your Feet Survive.

Activity of some sort will be good for your feet during the winter. When the weather is snowy and icy, then you may be limited to the gym, laps at the mall, or a route around the inside of your house. Choosing good fitting shoes or proper socks are part of a good plan for safe, comfortable activity.

If you have foot pain, particularly heel pain, call today for an appointment and exam before taking on a vigorous activity program. Or if you’ve suffered an injury while trying to remain active, you can call 317-660-2115 or feel free to use the online appointment request option available 24/7 for your convenience. At Hoosier Foot and Ankle, we’re committed to helping you find relief from foot pain and to help you avoid injuries or situations that can cause pain for your feet.

We have an article in the Resources pages of our Hoosier Foot and Ankle website that explains how calluses can get started and how they continue to deliver misery. Corns and Calluses

Proper fitting shoes can be one of the first lines of defense against corns and calluses. A little tender treatment of your feet with soaking, pumice and lotion will help you too. If a sore spot develops, you can get some relief from a donut shaped foam pad for a corn which sets up a little fortress around the tender spot while the hole avoids pressure on the corn. Solid, non-medicated corn pads or moleskin can help with a callus. Use gentle procedures when removing these to apply a fresh pad so that you don’t tear the skin and invite infection.

The highest relief comes from treatment at the podiatrist. Our office is set up to trim these painful spots safely. Pain relief is immediate when there is no thickness of skin to rub against the shoe.

Call 317-660-2115 today to make an appointment to get pain relief for your feet through the holiday season and longer. Or you are welcome to use the online appointment request option available 24/7 for your convenience. That is very handy when you get home in the evening and the corns or calluses have just reached the limit of tolerance for you. When the pain is ‘top-of-mind’, get online and request an appointment. We’ll get you set up.

Shoes: You are not defined by the way your shoes look – go for fit first. Remember that you look downward at your own feet, so maybe they look larger or not as pretty from your vantage point, but everyone else is more interested in you than your shoes. If they even look at your shoes, they have a different perspective and do not see large shoes. Shoes that fit your feet well will help you prevent the rubbed spots and blisters which can lead to infection and other issues of delayed healing that often goes with diabetes. Well-fitted shoes will help you feel like moving around to avoid problems with circulation as you maintain your exercise routines. You can get stylish shoes in designs and sizes that will not cause you foot problems.

You will benefit from more than one style of shoes. Have as many pairs of your favorite stylish shoes as you like. Then, some good walking shoes can be useful and appropriate for shopping and exercise. I suggest that you keep an open pair (casual, rugged sandals) that you can wear with cotton or other natural fiber socks which will help your feet stay warmer. The open shoes will permit freedom and air contact for your toes and heels while the socks still keep you warmer. You can wear your ‘granola’ shoes around the house evenings and weekends if your work style doesn’t encourage such casual footwear.

Socks: Lots of socks! I would recommend natural fiber socks because synthetic fibers can seem soft, but the threads can be irritating. They just don’t give. Clean dry socks are going to help you keep your feet warm while avoiding irritation from wet threads or avoid the excess moisture problems that can revive athletes foot and other fungal irritations. If your socks have gotten old and the threads are covered with little bumps that feel like gravel in your shoes, go get some new ones. They don’t have to be expensive, simply do what you need – keep your feet comfortable. Socks (and shoes) that are not too tight, but which permit your feet/toes to move will contribute to the warmth that you are seeking. They will work so well that you may not need the addition of heating pads that can get too hot or give you a chance to get tangled up in the cord, etc.

 Moisturizers: Lotions can be a great comfort to help exfoliate the rough skin of summer when feet were bare. You will see many warnings about lotion leading to extra moisture. Try using just a little less lotion. Taking a moment more to massage the lotion into your skin helps avoid that issue and provides circulation stimulation that has more benefits for the diabetic foot beyond soft skin. Pat your feet with a dry towel after a session with lotion to absorb any excess lotion.

Toenails: Your toenails might seem to sneak a lot of extra during the winter when you don’t look at them several times a day peeping out of sandal toes. When they get too long, they are going to cause pressure issues in your shoes. They can grow over the end of the toe curving back to dig into the toe’s tip. Make an appointment with yourself to give your toenails a good looking over at least once a week. Even better, get a pedicure or trade pedicures with someone else. While you’re checking to see if those nails need a trim, watch for spots that are quietly being rubbed red (and moving toward raw). Those spots are a hint to you to get different shoes or socks.

If you can take care of your own nails, make sure not to trim them too short. You don’t want to risk infection and irritation from even a tiny cut or snag from getting too close to the ‘quick’ on your toe. You may be able to use a file on your toenails regularly to keep them from ever getting long so long that they make you uncomfortable. If you must clip, work on toes that have been soaked in a shower or foot tub for a few minutes and are softer. Hard, dry nails can split and lead to the same infection problems.

Exercise: Moving around will help you keep your feet more comfortable because of the increased circulation. There will be blood flow, little or no tingling and more warmth from inside. “Inside warmth” is better than that achieved by socks, heating pads or drying hot water. Don’t let inclement weather keep you from moving around – you can lay out a path through your house to walk. It might not be ‘track and field’ activity, but it contributes to the exercise quota that you need.

In the event that you have a sore that doesn’t begin healing in a couple days, have tingling in your feet that doesn’t stop, have no feeling in your feet, call your doctor for an appointment. These things can be problems with diabetic feet. Neglecting them can lead to greater problems.

1. Proper Shoe Gear

Shoes are a very important initial treatment if you are experiencing foot pain. Here are some suggestions about shoes for aching feet:

• Get your foot measured by a qualified shoe fitter for both length and width, preferably at the end of the day.
• Wear the correct type of shoe for the type of activities you are doing. For everyday walking, consider a cross trainer or running shoe if possible. If you must wear dress shoes, visit a good shoe store for recommendations and make sure you try on several pairs.
• Alternate your shoes daily.
• Replace worn shoes.

1. Arch Support and Shock Absorption

Arch support and shock absorption can go a long way to decrease foot pain. However, this can be confusing due to the abundance of products available. Here are some tips to consider for an over-the-counter arch support:

• A support that is entirely soft acts as a cushion only and does not provide any support.
• Look for something costing in the range of $25 – 75; anything more is not worth the extra money and you would be better off with a custom made device from a professional.

• Look for an arch support that is multi-layer, with soft shock absorbing materials on the top and bottom with some type of supportive plastic material in the middle.

1. Stretching

Tightness of the Achilles tendon (heel cord) is a common cause or component of several foot conditions. Stretching of the Achilles tendon is very helpful, but must be done correctly:

• Start facing a wall with one leg in front of the other and the toes pointing straight ahead.
• Lean into the wall with both hands against it.
• Bend the front knee and keep the back knee straight.
• As you lean forward, you should feel a slight stretch in your calf; hold this for 10 seconds.
• Come back out of the stretch. This counts as one stretch.
• Perform this 10 times on the back leg.
• Switch legs and perform 10 times on the other leg.

1. RICE Therapy

RICE therapy is commonly used for acute conditions and simply stands for Rest, Ice, Compression and Elevation.

• Rest: You may need to discontinue any activities that aggravate your foot pain.
• Ice: 20 minutes three to four times a day. Should be avoided if you have poor circulation or are diabetic.
• Compression: Ace wrap or compression type of bandage. Should be avoided if you have poor circulation or are diabetic.
• Elevation: elevate the affected area, when possible, to heart level.

1. OTC Anti-inflammatory Medication

Consider taking an over-the-counter anti-inflammatory medication according to package instructions and precautions if you are able. If you have questions about this, please consult your physician.

Understanding these conditions and what you can do to help yourself can be the first step back towards a pain-free lifestyle.

1. Heel Pain – Watch out for that first step in the morning.

Heel pain is the most common foot disorder; it is a combination of plantar fasciitis with or without a heel spur. Plantar fasciitis is an inflammatory condition of the arch ligament that runs from the heel to the ball of the foot and helps to maintain the arch structure.

With continued strain, this can lead to the development of a heel spur. It is a common misconception that a heel spur requires surgery or is a more serious condition; this is inaccurate.

There is a direct correlation to body mass index (being overweight) and the occurrence of heel pain. Other causes of heel pain include: Foot structure, high activity level or a change of activity level, shoe gear, the type of surfaces you stand on, injury, and arthritic conditions.

Symptoms usually include a bruised feeling of the heel, which is often worse in the morning or after sitting. This is due to contracture of the plantar fascia while off the foot and a resultant stretch when first getting back on your foot.

You can be actively involved in your treatment with a few simple steps. The first goal is to get the inflammation under control, followed by long-term prevention of recurrence:

• Start with stretching, appropriate shoe gear, RICE therapy, over-the-counter arch support and anti-inflammatory medication – see the article on “Five Tips to Fixing Your Aching Feet.”
• If you do not see a resolution of symptoms, consult a professional.

1. Bunions – Why is my big toe crooked?

Bunions (Hallux Abducto Valgus) are a boney deformity of the big toe joint in which the great toe moves towards the second toe and a large bump develops on the joint. The joint subsequently does not move through a normal range of motion.

Bunions are most often related to foot structure and foot function. Shoes can play a factor in development of bunions, as can arthritis, injury, neuromuscular disorders, and congenital disorders.

Symptoms may include any of the following: Arthritis, pain and swelling, limitation of motion, redness, calluses or corns.

Treatment should be initiated with progression of the deformity or symptoms:

• Start by going to a wider shoe with good arch support.
• Consider an over-the-counter arch support.
• Take an anti-inflammatory medication per package instructions if you experience pain or swelling.
• If these measures do not alleviate your symptoms, consult a professional.

1. Hammer Toes – Why is my toe rubbing on my shoe?

Hammer toes are contractures of the toe, usually the middle joint on the toe, but may also involve the end joint of the toe or the joint where the toe attaches to the foot. They are the result of a tendon imbalance due to foot mechanics or structure. Other causes include shoes, neuromuscular disorders, congenital disorders, and injury.

Hammer toes are progressive and become more rigid with time, which can result in corn formation and pain. With progression, this can lead to redness, swelling and sores.

There are few treatment options for this condition, but here are a few things you can try on your own to help:

• First try to get a wider toe box shoe.
• If you have corns or skin irritations, consider non-medicated padding.
• Over-the-counter orthotics can help with the mechanical or structural deformities.
• If symptoms or deformities progress, seek professional care.

1. Morton’s Neuroma – Why are my toes burning and why does it feel like my sock is bunched up under my toes?

Morton’s neuroma is a pinched nerve that is typically located between the third and fourth toes.

The cause of this is unknown, but shoes are contributory, as are certain activities like running.

The symptoms can be varied, but normally they include burning, numbness, pain, and a full feeling in the ball of the foot. These symptoms are often made worse with dress shoes.

This is a difficult condition to treat on your own, but there are a few steps you can take:

• Start with a wider shoe and avoid dress shoes if possible; this helps stop the pinching effect of shoes.
• Try a cushioned over-the-counter arch support.
• Take an anti-inflammatory medication per package instructions.
• If symptoms do not resolve, consult professional care.

Call 317-660-2115 today to arrange for a consultation about your feet if any of these  or other foot disorders are giving you pain.  Or use the online appointment request option available 24/7 at Hoosier Foot and Ankle for your convenience.

References:

1. Apma.org (American Podiatric Medical Association)
2. Acfas.org (American College of Foot and Ankle Surgeons)