Don't Let Your Feet Break Your Heart

Guest Post by Dr. Bruce Pinker

February is Women's Healthy Heart Month for a very good reason: According to the Centers for Disease Control and Prevention, heart disease is the leading cause of death for females in the United States. According to the American Heart Association, nearly 80 percent of cardiac events can be prevented through education and lifestyle change. Genetics plays a role, but diet and exercise are major factors that have been proven to help reduce heart disease in women, as well as in men.

As a board certified podiatrist and foot surgeon, I see many patients each day who suffer from foot pain that prevents them from running or walking. Without exercise, many run the risk of diminishing health. Regular exercise can promote cardiac health and overall wellness. Getting my patients back into pain-free activity is my number one goal.

Plantar fasciitis

One of the most common foot ailments is plantar fasciitis. An inflammatory condition affecting the bottom part of the foot, usually in the inferior heel region, it is often caused by overuse.  Due to excessive stress on the plantar fascia ligament, which spans from the heel to the toes, it stretches and snaps back, much like a rubber band. Regular stretching exercises can be performed to prevent it, coupled with the usage of supportive footwear, but this disorder sidelines millions of individuals every year.

Whether or not you are very active is not necessarily a factor, as it affects people of all different ages and activity levels. Prolonged standing or walking can lead to plantar fasciitis. In many cases, a heel spur accompanies this painful foot condition.

Various successful approaches can address plantar fasciitis, and most are conservative.  Physical therapy and orthopedic strappings are usually very beneficial, especially in cases diagnosed in early stages. Cortisone injections can be helpful, as well, and custom orthotics are usually instrumental in providing long-term relief. Custom orthotics can retrain the plantar fascia ligament, maintaining a proper arch that does not overstretch or contract.

In the more challenging cases, high energy shockwave therapy (ESWT) or surgery can be performed.  Approximately 90 percent of all cases of plantar fasciitis can be successfully treated conservatively, based on my experience. Upon the onset of inferior heel pain, it is best to roll your foot over a frozen 20 ounce water bottle several times. If this attempt is not successful in reducing pain, it is important to see a podiatrist for proper evaluation.

Bunion deformities and hammertoes

Bunion deformities are also a common foot concern. A bunion deformity, referred to as hallux abducto valgus, is a structural foot condition, often caused by improper biomechanics. Some may be born with a bunion deformity, but most are acquired, often subject to the footwear that is worn; narrow or pointy-toed shoes and high heels are known to lead to bunion deformities if worn frequently.

As the great toe points toward the second toe, and the first metatarsal points inward, excessive stress is placed upon the great toe joint. The stress leads to the growth of the typical "bump" right near the great toe as the ligaments stretch on the inside of the joint, and tighten on the outside. Tendons in the great toe region provide unbalanced forces that further the deformity.  As the "bump" enlarges, it presses against a nerve, leading to discomfort. While wearing shoes, the nerve can become sandwiched between the bones and the footwear, causing pain and difficulty walking.

Some bunion deformities, if mild, can be addressed conservatively, with physical therapy, orthopedic strappings, and oral anti-inflammatories or Tylenol.  However, most bunions need to be surgically corrected for long term relief. Several bunion procedures are available, most requiring three to four weeks of healing, in my experience. They are performed as an outpatient procedure, and the correction lasts for many years. It is best to avoid footwear that puts the feet under unnecessary stress. However, rest assured, most bunions can be addressed successfully, either conservatively, or surgically. Most bunion surgeries are covered by health insurance plans.

Often accompanying bunion deformities is the hammertoe. When a toe is contracted, it may point upwards at the first joint, and then downward at the second joint, thus illustrating a hammertoe. Improperly fitted footwear can cause hammertoe deformities. Pain usually develops on top of the toe, as it contacts the toe box of the shoe that is worn. The skin can thicken on top due to shoe irritation, and in some cases, can become a wound. The wound can get infected, leading to potential complications. The discomfort can be debilitating, so most hammertoes need to be corrected.

Some can be treated conservatively with toe covers or spacers, but definitive correction through surgery is usually necessary, also performed as an outpatient procedure.  These procedures are typically covered by health insurance plans, and recovery time is usually just two to three weeks.

Neuromas

Neuromas are inflammatory conditions of the nerves in between the toes. Commonly brought on by tight or narrow footwear that is worn repetitively, neuromas can also be addressed conservatively and surgically. Most patients elect for cortisone injections to start, usually performed in a series. If unsuccessful in providing relief, custom orthotics can also be utilized.  Surgery is reserved for the more challenging cases, and usually results are long-lasting. Recovery from neuroma surgery is usually two to three weeks, performed as an outpatient procedure, and often covered by health insurance plans.
                    
Your feet need to last a lifetime, so taking good care of them is vital. Realizing that exercise is important for promoting cardiac health, it is essential to address foot pain when it occurs. Keeping your feet healthy can be pivotal for improving your overall wellness and heart health.  Don't let your feet break your heart!

Dr. Pinker is a professional foot and ankle health and wellness speaker who delivers many original seminars annually, such as “Diabetes & Your Feet: The Winning Combination,” “Exercise Safe to Lose Weight,” and “Keep On Running.” He is a graduate of the New York College of Podiatric Medicine (NYCPM) in New York City. Dr. Pinker strongly believes the fusion of fashion and function is essential for footwear today, as the modern man and woman needs to look great and feel great. This is his motivation for his company: Dr. D-LuCS: Doctor Designed Luxury Custom Shoes.