Plantar fasciitis (pronounced: "PLAN-ter fash-ee-EYE-tis") is most commonly the cause of heel pain. The Plantar fascia is the ligament that connects your heel bone to your toes, and where the support for your arches come from. Plantar fasciitis refers to inflamed plantar fascia most frequently caused by overuse. Middle-aged people are generally the most affected by plantar fasciitis, though not exclusively. People who are on their feet for long periods of time, have high arches or flat feet, are obese, or have tight Achilles tendons are prone to experiencing this severe heel pain as well.
Plantar fasciitis characteristically comes about slowly. People with the condition describe the pain being most present during their first steps in the morning, after long periods of rest or when climbing stairs. Pain may also be brought on by bending the foot and toes up towards the shin and may be worsened by a tight Achilles tendon.
Different simple and non-invasive treatments include: basic stretching exercises, ice, tapping, rest, strapping, proper or custom shoes, and/or custom orthotics, in combination with prescription anti-inflammatory medication (as needed). If the condition is not getting better, other treatments such as ultrasound, laser, cortisone injection or shockwave therapy may be tried. Usually multiple treatments being used, typically several at once, will alleviate the pain of plantar fasciitis within a few months. Only in severe cases were the pain lasts for more than six months, would surgery or plantar fasciotomy be considered.
Most cases of plantar fasciitis are not serious and with several treatments (as listed above) can be alleviated. Check out our other blogs for ways to reduce strain on your feet, as well as the risk of plantar fasciitis.
Trust your foot with a foot specialist here at Waterloo Foot Clinic and call to book an appointment! If you have any problems, questions or concerns, please do not hesitate to contact us at (519) 884-3668 or firstname.lastname@example.org
Fungal Toenails (Onychomycosis)
Onychomycosis (on-ih-koh-my-KOH-sis), also known as “tinea unguium,” is a fungal infection of the nail. It can cause fingernails or toenails to thicken, discolor, and disfigure.
There are five subtypes of Onychomycosis:
1) Distal lateral subungual (DLSO or DSO) the most common form of Onychomycosis.
2) White superficial onychomycosis (WSO),
3) Proximal subungual onychomycosis (PSO), the least common form of Onychomycosis.
4) Total Dystrophic Onychomycosis
5) Candida onychomycosis, outbreak of fungi on the fingernails.
Signs and symptoms:
The first sign/symptom would be thickening and discolouration of the nail. The nail may change to a white, brown or even black colour. As the condition progresses, the nail may become brittle. In fact little pieces of the nail may fall off. As the fungus spreads, the nail will thicken more, and may cause the tissue around the nail to become inflamed resulting in pain.
With delayed treatment, the fungus will destruct the nail plate, nail bed (skin under the nail), and nail matrix (where the nail grows from). This causes the nail to look disfigured. The disfigurement may be permanent if enough damage has been done to the nail bed and nail matrix. Therefore, although the fungus may be erradicated, the nail may still look deformed.
There are many risk factors for fungal toenails. Fungus loves warm, dark, wet places. Therefore, communal bathing places (eg: swimming pools, showers in gyms, etc.) are common places people are exposed to fungus. In a child we often see the fungus present on the skin. However, as we age we are more susceptible to onychomycosis. Age is the most common risk factor; decreased blood circulation, longer exposure to fungus, increased thickness of the nail plate, and slower growth of the nail plate increase and individuals susceptibility.
Other risk factors include: heavy perspiration, exposure to moist environments, psoriasis, socks and shoes that hinder ventilation (eg: safety boots), previous fungal infection of the skin (athletes foot), nail injury/damage, diabetes, arterial insufficiency, and those with weakened immune systems.
Diagnosis of a fungal infection of the nail can often be made on presentation. If the practitioner can not determine the cause, the practitioner may send the nail away for laboratory testing. This testing involves microscopic examination and culture of a nail scrapping or clipping.
The easiest way to treat onychomycosis is to take preventative measures early on. However, this is not always the case. Therefore, regular reduction of the nail with an ongoing prescription of an antifungal is the next best option. If the infection is severe, surgery may be required to remove the nail, topical antifungal will be required and the nail may take approx. 1 year to grow back.
Oral Antifungals are often not used, as oral antifungals can be hard/destructive to the liver. If oral antifungals are used the patient must undergo liver enzyme testing to make sure there is not any damage to the liver. Due to this problem Oral antifungals are not very commonly prescribed.
Laser treatment is also an option. The laser heats the fungus under the nail causing it to be fungicidal (Fungal – death). This is an available option, however can be very expensive.
If you are experiencing this, please contact Waterloo Foot Clinic. Trust your foot with a foot specialist.
Healthy feet are extremely important to us and you as a parent. Healthy, strong feet allow your child to walk, run and play! If your child’s foot development is normal, it will prevent lower limb, and back pain in the future. Exams can help to show if your child’s bones are developing and growing correctly. An exam performed by a Chiropodist/Podiatrist may also assure that your child is walking right. If a problem does arise, this is the time that it is easiest to fix.
Your childs foot doesn't completely form til the age of 7 or 8 as there are many open Growth Plates in the childs developing lower limb(area where bone growth begins). If a Growth Plate is damaged, the bone may grow with a deformity. With proper care this can be reduced.
When to see a Foot Specialist:
If the injury is mild your child will probably not remember it for long. If, your child keeps complaining have the injury checked by a Chiropodist/Podiatrist. Call your foot specialist if you notice that the injury causes serious swelling, localized tenderness, limping, or ongoing night pains.
YOUR BABY'S Feet:
- Both size and shape rapidly change during the first year
- In fact, babys feet are FAT, FLAT and FLOPPY until the age of 3! – this is not a concern
- Many bones in the foot have yet to develop – too much added strain may affect your babys foot shape
- Allow your baby to kick and stretch his or her feet
- If you can, allow your baby to go barefoot in home (make sure there are no hazards)
- Make sure shoes and socks are not overly tight, as they may be squeezing the toes
Possible Foot Care:
- If you are concerned about your babys feet talk with a Chiropodist or Podiatrist – they will help determine if there is a problem
- It is common for your babys feet to turn in – this may worry you, HOWEVER, it is rarely a problem
- The shape of your childs foot will change as it grows
- Your Chiropodist or Podiatrist may suggest gentle stretching exercises to aid in proper development
YOUR TODDLERS Feet
- Your toddler will walk when he or she is ready – try not to force this issue. If there is significant delay you may talk to your Chiropodist/Podiatrist or GP
- Instead, monitor your childs Gait (how they walk) when they do start to walk
1) Do they walk on their toes?
2) Do they tend to sit while other kids play?
3) Feet FLAT, FAT and FLOPPY – not a concern this is normal up to the age of 3
- Many people are concerned that their childs feet tend to turn in. This may be referred to as IN-TOEING.Again, this is often not a concern – as most tend to out grow this problem. Don’t hesitate to contact someone should you have a concern
- PREVENT your child from sitting in a “W” pattern. (See picture above) Notice how the childs legs form the shape of a "W'.
WHEN FOOT CARE IS NEEDED:
- During the gait and biomechanical exam, we will identify any problems.
- We may prescribe orthotics to help with severe flat feet or even intoeing
- We may ask you to prevent your child from sitting in a “W” position
- If your childs foot or leg turns in a lot; shoes, splints or night braces may be prescribed.
- If you have any concerns don’t hesitate to come to the WATERLOO FOOT CLINIC.
Most of the time your feet take a beating without you even realizing it. Often, it's not until you feel pain that you begin to consider the health of your feet.
Did you know up to four times your body weight gets placed on the joints in your feet during every step?
With all that weight, it’s a good idea to give your feet a little extra attention. Here are a few tips to help take care of your feet and prevent foot conditions:
1. Be shoe smart.
Too many smart people often wear not-so-smart shoes. It's important to take a few things into consideration when you're buying a shoe. The first is to go shopping in the evening. Late in the day, your feet are tired and most relaxed/stretched. By doing your shopping in the evening, you'll be able to get the right fit for the whole day.
Next, be extra sure that you're buying the right size. If you shoe length or width is too small, it can cause a number of conditions like hammer toes, corns, ingrown toenails etc. With that said, overly large shoes can cause problems like calluses and blisters. As you can see, finding the right fit is very important. If you'd like more detail on selecting the right size shoe, check out our previous post.
Finally, pick a style of shoe that has the right support for you. A comfortable every day shoe that breathes well and doesn't trap your toes is a smart style choice. Most high heels do not provide support and can be extremely damaging to your foot's structure. Pick a round toe shoe so that each of your digits has enough room to be stretched out fully, with no cramping or pinching inwards.
2. Get daily foot exercise.
Each foot is made up of 26 bones and a collection of ligaments, tendons, nerves, and muscles. It's important to get your foot muscles the exercise they need to stay strong. Go out for a walk every day if you can. The length of the walk isn't as important as just getting out there and doing it. Keep your ligaments, tendons, and joints flexible and loose while strengthening the muscles in your feet!
3. Wash your feet thoroughly.
Make sure you give your feet an extra scrub every day. Your feet tend to be a hotspot for bacteria and fungus. No special foot washes or scrubbers are needed, just some good old-fashioned h2o and soap. If you are diabetic make sure your washing with the correct temperature water and soap that does not irritate your skin
For those of you who have dry and cracking skin, it's important to put on lotion. We recommend 2x/day. It doesn't have top be a specific brand, but try to get a colourless, non-scented lotion. REMEMBER: do not put lotion in between your toes!
5. Wear socks.
Wearing socks gives your feet an extra layer of protection. Calluses and blisters form much easier when you don't wear socks regularly. Additionally, if you are over-weight, are prone to varicose veins, or have bad circulation it is important to wear compression stockings. Compression stockings will assist with blood flow and alleviate added stress on your veins. Compression stockings are recommended for:
6. Avoid immediate skin contact in public areas.
Children, teenagers, and adults alike should all bring personal footwear when you're around a public pool, shower, change room, etc. These areas are common breeding grounds for bacteria, viruses, fungus and other pathogens. By bringing and wearing your own footwear, you will decrease direct contact and prevent spreading. Likewise, if you do have any foot condition it is important that you always wear shoes in public area's to avoid passing it along to others.
Please contact us at the Waterloo Foot Clinic if you have any questions about any material mentioned in this blog post or any of our other posts.
The Waterloo Foot Clinic Team