7 easy tips to find the perfect shoe fit

When purchasing a pair shoe one of the most difficult task is deciding whether the shoe fits properly. It is not only key to preventing future foot problems, but can also help with recurring foot pain. A common source of foot pain is due to improper fitting shoe. Following a few basic guidelines a person can ensure properly fitting shoe for the average foot.

 

Guidelines:

1. Shop for shoes at the end of the day. Feet swell and are a different size at the end of the day. The way a person’s shoe fits in the morning may differ later in the day.
2. Try on the shoe in the store and have your foot measured. Shoes should be comfortable in the store before purchase. An uncomfortable shoe in the store will be one outside the store. People do not grow into shoes. Before a shoe size is decided, each foot should be measured with the person in the standing position. Shoe sizes have various between brand and size selection should be based on foot measurement. Foot sizes tends to change with age and important to asses before each purchase.
3. Make sure there is a “3/8 to1/2” inch from the longest toe to the end of the shoe and 1/8 inch from the back of the heel counter and the heel. Shoes that are too big or too small can increase pressures on the foot and lead to corns and calluses
4. Buy shoes that match the natural shape of your foot. The shoe should allow adequate room for the arch and different contours of a person’s foot. 
5. Make sure there is adequate room in the shoe’s toe box or ball of your foot. Your toes play a large part in proper foot function and need adequate room to perform their task.
6. Buy the right shoe for the right job. All shoes are not made to perform the same task. Make sure to purchase a walking shoe for walking and a basketball shoe for playing basketball. Shoe manufactures design shoes for specific uses, to use a shoes outside their design can lead to injury.
7. Take your shoe for a test drive in the store. It is important to try on both shoes and take them for a test drive.  A properly fitting shoe should feel good when walking around in them. The test drive should be the deciding factor for shoe purchase. 

What is a bunion?

Bunions or referred to by physicians hallux abducto valgus (HAV) is a common foot deformity. Patients with this condition complain of pain around their big toe when wearing certain shoes, especially snug fitting shoes, or during physical activities, such as walking or running.  Mild bunion deformities can be treated with conservative care such as pads or foot orthotics, however more severe deformities or bunions that do not respond to conservative care are treated surgically.  There are different causes to why bunions occur, many of which are unproven. Nonetheless, they are functionally debilitating and cosmetically deforming to most people. 

How a bunion looks:

The classic bunion deformity presents with a bump on the side of the big toe with the big toe positioned closer to the second toe. The bump on the side of the toe is an overgrowth of bone and inflamed tissue. People with bunions have pain on the side of their big toe. Some will have pain on the bottom of their foot also. However, most pain is associated with the big toe due to snug fitting shoe gear. Shoes with narrow toe boxes or shoes made out of stiff material such as leather will often irritate the site of the deformity. Shoe gear of this type often leads to constant rubbing and irritation that causes the bump on the side of the toe to become painful, swollen, and inflamed.  Usually, pain in the first toe as a whole is due to improper positioning of the big toe, causing poor foot biomechanics and ultimately resulting pain the first toe.

Exact cause:

The exact causes of bunion deformities are unknown. Some of the many etiologies of bunion foot deformities are: genetic disorders, history of shoe gear with a tight toe box, neuromuscular diseases, family history, and biomechanical foot problems. The two most common accepted causes by most physicians are history of shoe gear with a tight toe box and improper foot biomechanics. Shoes gear is thought to be the cause of bunion, because HAV deformities are most common in women. In addition, bunion foot deformities are not common in barefoot population and in historical time periods before snug fitting shoes. Improper foot biomechanics is the universal cause accepted by most doctors, because surgical repair of bunion deformities often requires the restoration of proper foot biomechanical to reduce the bunion deformity.

Treatment:

Early conservative care of bunions are often symptomatic treatment. Functional foot orthotics can be helpful in early conditions improving the biomechanics of the foot. Pads and other cushion devices are also helpful to prevent the toe from shoe irritation. However for moderate to severe bunions, surgery is the most often the only corrective process of repairing a bunion deformity. These deformities actually cause a remodeling of the joint leading to changes in the function of the joint. The surgical process of correcting a bone is breaking and repositioning the bone and correcting the muscle imbalance in the foot. 

Bunions are cosmetically and can be functionally debilitating foot deformities. HAV are not only common, but are very treatable. If you are suffering from a bunion see a podiatrist.

The Best Treatment of Nerve Pain in Diabetic Patients

Diabetic neuropathy is a common complication experienced by most diabetics. It is a painful pins and needles sensation with a feeling of numbness. Diabetic neuropathy is a detrimental complication of diabetes, which is not easily treated. Patients with neuropathy are left with a loss of peripheral awareness causing ulcers and other complications that may lead to limb loss. Microangiopathy is the cause of diabetic neuropathy, which is due to excess blood sugar and high blood pressure.

 

Patient controlled blood pressure and sugar are the only real treatment of diabetic neuropathy; however, doctors most often treat the symptoms of diabetic neuropathy through topical and oral medications. Low average fasting blood sugars below 125mg/dl and low H1AC below 6% are the only proven treatment to stop and control diabetic neuropathy. Most other treatments are just band-aids to the problem. 

Capsaicin is a topical medication commonly prescribed to treat diabetic neuropathy. Capsaicin is derived from the active ingredient in chill power and works by interfering with pain impulses to the brain. It can be purchased over the counter, but a stronger dosage can be prescribed. Capsaicin is not effective in diabetics with blood sugars levels higher than 200 mg/dl. Other topical NSAID such as Voltaren gel and other topical anesthetics are used for diabetic neuropathy, however none of them treat the underlying cause just the symptoms.

 

Neurotin and Lyrica are common oral medications prescribed by doctors to treat diabetic neuropathy. There medications are GABA analogue that are used to treat epilsely but also used for diabetic neuropathy. These oral medication block pain impulse centrally. Neurotin and Lyrica oral are effective method of treating the symptoms of neuropathy but not the cause.

 

If you are experience numbness, tingling, and pain in your feet see a podiatrist.

The Pain of Peripheral Neuropathy

Peripheral neuropathy is a painful disorder that is a nerve condition and can result in pain, loss of sensation, and potentially an inability to control muscles. Peripheral neuropathy may be  present in the arms, hands, legs and feet, but neuropathy normally starts first in the feet. 

Even though the underlying causes of peripheral neuropathy are diverse, the overall symptoms and actions of the disorder are similar. Peripheral neuropathy is defined as a polyneuropathy. It is a disorder that occurs when many of the peripheral nerves malfunction at the same time ultimately resulting in loss of sensation and self-awareness.

Symptoms of peripheral neuropathy are:

• Tingling 

• Numbness 

• Loss of sensation in arms and legs

• Burning sensation 

• Pain 

• Sense of ants walking on arms and legs

Diabetes, alcoholism, nutrition deficiencies, trauma, AIDs, infections diseases and syndromes such as Rheumatoid arthritis and Guillain Barre can all cause neuropathy. Diabetic neuropathy is most common and chronic form of peripheral neuropathy resulting from poor control of blood sugar. Guillain-Barre syndrome is less common cause of peripheral neuropathy, but can be one of the more serious causes because it is an autoimmune disease that can lead to paralysis. 

Peripheral neuropathy is a determinate disease. Individuals with neuropathy lose their self-awareness. They are unable to sense temperature and pain. Commonly diabetics develop sores and ulcers from prolong pressure and suffer burn and other injuries from lack of body awareness. If you think you suffer from a peripheral neuropathy you should see your doctor. 

Finding the Right Back-to-School Shoes

Preparing for a new school year means back-to-school shopping for the usual supplies, clothes and shoes. Shoes should be one of the most important items on any back-to-school shopping list. While many youngsters many want to find the latest and greatest or coolest shoes, parents should consider some important factors on shopping for the right shoes. The American Podiatric Medical Association put together these tips on shoe shopping. 

1. Children’s feet change with age. Shoe and sock sizes may change every few months as a child’s feet grow.
2. Shoes that don’t fit properly can aggravate the feet. Always measure a child’s feet before buying shoes, and watch for signs of irritation.
3. Never hand down footwear. Just because a shoe size fits one child comfortably doesn’t mean it will fit another the same way. Also, sharing shoes can spread fungi like athlete’s foot and nail fungus.
4. Examine the heels. Children may wear through the heels of shoes quicker than outgrowing shoes themselves. Uneven heel wear can indicate a foot problem that should be checked by a podiatrist.
5. Take your child shoe shopping. Every shoe fits differently. Letting a child have a say in the shoe buying process promotes healthy foot habits down the road.
6. Always buy for the larger foot. Feet are seldom precisely the same size.
7. Buy shoes that do not need a “break-in” period. Shoes should be comfortable immediately. Also make sure to have your child try on shoes with socks or tights, if that’s how they’ll be worn.

Not only is finding the right shoe size important, the overall structure of a shoe is critical. A good shoe should have a stiff heel that cannot be easily squeezed or bent. The toe box of the shoe should bend flexibly when your child walks. And the shoe should have a solid midsole that should never twist in the middle. 


Properly fitting and structured shoes can help children avoid years of pain and future ailments. Click here for a list of children’s shoes that have been awarded APMA’s Seal of Acceptance. 

Dry Skin In feet

While dry skin is viewed as mostly bothersome and unattractive, chronic dry skin can lead to fissures and painful infections. Dry skin is caused by a variety of factors However, simple changes in lifestyle can solve most dry skin problems. 

Reason behind dry skin:

The water content in the epidermal layer, natural oils, and fatty substance are the major factors that determine dry skin or xerosis. The epidermal layer holds large amounts of water, which is key to keeping moisture in the skin. The skin also has a thin layer of natural oils and fatty substances that aid in skin hydration and protection from external drying forces. The absences of these factors lead to the common problems and symptoms of dry skin: scaling, redness, itchiness, and chapping.

Most common causes of dry skin:

1. Genetics: Some people are genetically predisposed to dry skin for some reason or another.
2. Soaps: The use of harsh soaps tends to strip away the protective oily fatty layer causing dry skin. Such as antibacterial and deodorant soaps.
3. Frequent, long, hot showers: Extend exposure to hot water strips the skin's protective layer and showers do not give skin an opportunity to re-hydrate.
4. Improper application of moisturizers: Moisturizers need to be applied when the skin is damp and not completely dry.
5. Medication and Drugs: Diuretics for high blood pressure and antihistamines for allergies can cause dry skin
6. Underlining medical conditions: Eczema, psoriasis, fungal infections, diabetes, hypothyroidism, and malnutrition can all lead to dry skin.  

Treatment:

Treatment of most dry skin is relatively simple. Small changes in a person’s daily habits and routines is all that is required to conquer dry skin.

• Do not shower excessively and take short showers in lukewarm water
• Occasionally take a bath in lukewarm water no longer than five minutes to re-hydrate the skin Use mild and fragrance free soaps
•  Use thick and greasy moisturizers. Stay away from oil based moisturizers and apply moisturizer when skin is still damp.

Dry skin can be prevented and is often easy to treat. However, people with chronic dry skin should consult a doctor.

Fungal nail infection

Many people suffer from discolored and distorted toenails. While all too common, there are many causes behind the changes to toenails; fungal or chronic bacteria infections, eczema, psoriasis, and even trauma to the toenail cause distortion of the nail.

Fungal infections are the most common cause of yellowed, thickened and/or deformed toenails and can affect one to all toenails, but cannot spread in the body via the blood stream. Fungal nail infections are slow developing infections that normally go unnoticed, but over time the infection can cause the nail to become distorted, thickened, and brittle in appearance. 

Fungal infections are the result of walking barefoot in public areas and showers with a moist environment that allows fungus to thrive. Sweaty and moist shoes that do not dry out can cause a person to contract an infection. Dermatophytes, the same organisms responsible for athlete’s foot, are can also infect toenails and skin. However, people with diabetes and immunocompromised individuals are more likely to contract these types of infections. 

Fungal infections are easy to diagnose, but can be difficult to treat. Early detection is key to lessening the length of treatment and can increase the chances of having a normal looking nail. Acute infections can be treated with over the counter medication; however, chronic infections can almost always be treated with prescription medications. Laser treatment is also an option in both types of infections. But, chronic infections normally allow little chance for a normal looking nail again even after clearing infection. If you noticed changes in your nail appearance see a podiatrist.

Tips on preventing fungal nail infections:

1.    Change socks frequently if your feet sweat a lot

2.    Bleach socks when washing

3.    Be cautious when walking barefoot, especially in public setting