Podiatry Blog

Pose running is a method of running that advocate the use of a shorter stride length, a forefoot rather than a midfoot strike and a lean forward at the ankle joint rather than the waste. It is claimed by those promoting Pose running that this is a more efficient way to run and that there are less injuries. There is no evidence that there are less injuries in those using the Pose technique and the evidence is that Pose running is more metabolic costly than other forms of running. There are a lot of runners who have changed to Pose running that are doing fine, however, there are also a lot who are not doing fine.

Cracked heels are common problem seen in podiatric practice. They occur when the fat pad under the heel expands out sideways from under the heel bone and the skin is not supple enough to accommodate it, so the skin cracks. The main risk factors for cracked heels are a dry and callused skin around the heel; being overweight; and wearing open heels shoes (which allow the fat pad to expand). When a crack occurs, it pulls on the good skin below it and is painful and bleeds.

The treatment of cracked heels is to reduce the risk factors that caused it in the first place. The dry callused skin needs to be removed by debridement’s and regular maintenance. Emollients need to be used to keep the skin supple. Wearing closed in shoes helps keep the fat pad under the heel and prevents it expanding out sideways. A heel cup can also be used.  In the short term, strapping can be used to treat cracked heels to allow the wound to heal, but will happen again unless the risk factors are addressed.

Toe walking is mostly of concern due to the potential underlying neurological or behavioral problem that may be the cause of it. If there I no underlying pathology and the ankle has a normal range of motion, then most cases of toe walking are of no concern and are classified a habitual or idiopathic. Almost all children in that category grow out of the toe walking and have no problems. In those case the toe walking should still be monitored in the case that the underlying pathology manifests itself.

Poor circulation due to peripheral vascular disease is a common problem in podiatry clinical practice and complicates a lot of conditions such as the diabetic foot and infections. Minor surgical procedures are more difficult to heal due to the problem and minor wounds can be more serious in the presence of poor circulation. The biggest issue with peripheral vascular disease is that it does not get the public health attention as other conditions, such as diabetes that put the foot at risk for damage.

Top of foot pain often presents as a diagnostic challenge, but most recently the Dorsal Interossoeus Compression Syndrome has been described as a entity and all of a sudden, it has become quite a common problem. Top of foot pain due to this occurs when there is greater dorsiflexion of the forefoot of the rearfoot and this results in some dorsal jamming of the midfoot joints producing the symptoms. Often in the past this may have been dismissed as “arthritis”. The treatment for top of foot pain caused by this is the use of foot orthotics to plantarflex the forefoot on the rearfoot, so that the dorsal jamming does not occur. Low dye strapping has also been suggested to be very effective at also doing this provided that the tape actually plantarflexes the forefoot on the rearfoot. Barefoot running is also a common cause of this and ‘top of foot pain’ is widely discussed on barefoot running websites. The common recommendation on these websites is to change running form in such a way to lesson that dorsal jamming in the midfoot.

There is no best running shoe. There never will be a best running shoe. All runners have different styles and foot types and different characteristics. The secret to proper running shoes prescribing is matching up those characteristics to the different design features of the running shoes. It really is a very complex task to get the match up right. There is a potential from increased risk from injury if the match is wrong. There is also a potential for a decreased risk of injury and increased performance if the match is wrong. To further complicate things is that the running shoe companies are constantly changing things, so it can be a difficult task to keep on top of the running shoes changes that are constantly happen. From a podiatry perspective it is very helpful to develop a relationship with a local specialty running shoes store to help out.

Growing pains in children can be distressing for the parent and child, but there are no long lasting consequences. Classical growing pains in children occur in in the upper part of the calf muscles or back of the knee. Typically it causes night-time foot pain. They do not occur in the knee joint and they do not occur in the bone. They usually wake the child from sleep. The child can normally be got back to sleep with reassurance and gentle rubbing of the area. The reason growing pains in children is important is that the pain on very rare occasions can be due to something very serious, so they do need to be carefully evaluated. Sometimes stretching before bed time can be helpful. If they are keeping the child from sleeping, then anti-inflammatory drugs can help some. The cause of growing pains in children is not known, but is likely to be biochemical and maybe related to muscular fatigue. Despite it being very common not a lot is clearly known about growing pains in children.

The Pinpoint laser for toenail fungus reviews on the web are mixed. On the one hand, there are the positive reviews  from those who make money by owning or selling the laser. On the other had other are objecting to the high price for treatment and the lack of research comparing this method of treating the toenail onychomycosis with the more traditional methods. The FDA has approved the PinTointe machine as safe for use, Approval does not mean that it is better than other clinical methods of treating onychomycosis. All pinpoint laser for toenail fungus reviews needed to be interpreted in the context of this lack of scientific research that is published for peer review.