I hope you enjoy reading this helpful foot-care info!

Common Foot Problems to Watch for in Your Feet

By Michael Nirenberg, DPM

Eighty percent of people, at some point in their lives, have a foot problem that requires medical care. However, many people let their problems persist and worsen untreated. Here is a list of the most common foot problems I see in my practice that you can watch for to ensure the health of your feet.

Heel Pain

Heels get a bad rap. The dictionary defines a heel as a dishonorable person, and the term “Achilles’ heel” refers to a fatal weakness. The reality is our heels are quite strong, though no other part of our foot malfunctions more. Heel pain is the number one reason people come see me.

Heel pain can be very complicated and may have a variety of causes, including a stress fracture, pinched nerve, bone cyst, or tumor. Most patients with heel pain believe they have a heel spur. This may be part of the problem, but the most common cause of heel pain-whether or not a heel spur is also present-is inflammation of the largest ligament in our foot, the plantar fascia. In doctor-speak this problem is called plantar fasciitis.

Treatments for plantar fasciitis range from custom-made arch supports (called orthotics), to simple stretching exercises, to the revolutionary, high-tech shockwave treatment.

Nerve Problems

Burning, numbness, tingling, or shooting pain in our feet or ankles often means something is wrong with a nerve. Nerve problems are common in our feet, so if you have one don’t get nervous. Most of the time, the treatment is relatively simple.

The main nerve problems I see are:

• Morton’s Neuroma

Not to be confused with Morton’s Steakhouse-which may cause a full stomach-Morton’s neuroma causes cramping, tingling (a feeling of pins and needles), burning, or shooting pain in the toes or ball of your foot. A neuroma is a painful growth on a nerve that forms when the nerve becomes irritated. Treatment for neuromas consists of using a special arch support, called an orthotic, and sometimes injections are needed. Surgery is rarely necessary.

• Tarsal Tunnel Syndrome

Almost everyone has heard of carpal tunnel syndrome in our hands, but few people realize the same problem occurs in our feet. Tarsal tunnel syndrome may cause burning, tingling, shooting pain, or a cramping sensation in our foot. The good news is that there is a light at the end of this tunnel. Tarsal tunnel syndrome is often easily treated with orthotics, injections or a short, outpatient procedure.

• Neuropathy

Neuropathy literally means a “disease of the nerves,” and it affects millions of people each year. Persons with neuropathy often experience loss of sensation, burning, tingling, or shooting pain. The number one body part affected by neuropathy is the feet. Persons with diabetes are those most afflicted with neuropathy, but it also occurs in people with thyroid problems, vitamin deficiencies, alcoholism, and some types of arthritis. Neuropathy has many treatment options and some people might opt for a new, somewhat controversial, procedure that involves surgically freeing up the nerves to restore normal sensation to their feet.

Arthritis of the Foot and Ankle

Degenerative joint disease, osteoarthritis, or just plain old “Arthur” is a deterioration of the joints between our bones. When Arthur visits people’s feet or ankles, many believe they just have to live with it. This is far from the truth. The reality is podiatrists have many techniques to alleviate arthritis, including a high-tech, tiny arthroscopic camera that can remove arthritis from sore ankles.

Nail Problems

I am not talking about rusty nails on your garage floor, but ingrown toenails and fungal toenails. Ingrown toenails occur when the edge of the nail grows deep into the flesh of the toe. These are painful and can become infected. Fortunately, a brief, in-office technique can alleviate ingrown toenails, often permanently.

Fungal toenails are another story, and usually require a long course of medication.

Bunions

These are protrusions of bone or bumps that form on the inside of the foot at the joint at the base of the big toe. If you wear ill-fitting shoes, don’t blame them for bunions. Blame your parents.

Bunions are inherited. However, poor footwear can contribute the formation of a bunion.

Numerous conservative treatments, such as trying wider shoes or foot soaks, can alleviate painful bunions, though getting rid of them requires a short, outpatient surgical procedure.

Other Big Toe Problems

• Hallux Rigidus

With hallux rigidus the big toe may look normal; however the inside of the joint at the base of the big toe is deteriorated and painful. Sometimes the big toe won’t bend. Like bunions, simple treatments can lessen the pain, but in on some cases surgery is necessary.

• Gout

Known as the “rich man’s disease,” gout doesn’t just affect the rich. Gout is a type of arthritis that most often occurs in the joint at the base of the great toe, causing redness, swelling, and pain. Some patients say the pain was so severe they couldn’t stand the bed sheet resting on their toe. Other patients describe less intense symptoms.

Gout occurs when too much uric acid is present in our body. Uric acid is a natural chemical that our bodies manufacture, and we ingest in certain foods, like pork, beer, or liver. Treatment consists of altering the patient’s diet to limit the amount of uric acid they ingest, and if that isn’t enough, medication is prescribed.

• Corns and Callouses

Corns have nothing to do with plants that grow ears. Painful corns (and callouses) are a build-up of hard, dead skin that often occurs due to an abnormal bony prominence or a bone out of position.

Corns occur on toes and callouses are found on the bottom of the foot. Contracted toes (hammertoes) cause corns to form, and callouses form when a bone or bones are out of position. Treatment of a corn or callous depends on what is wrong with the bone underneath them.

Final Thoughts on Common Foot Problems

These are the top foot and ankle offenders, but the list of problems I see in my practice is endless. If you have foot or ankle pain or another problem, the best thing you can do is have it checked by a podiatrist.

To learn about our amazing feet and ankles, visit Dr. Nirenberg’s blog America’s Podiatrist.

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Dr. Michael Nirenberg – America’s Podiatrist^SM — is passionate about helping America’s 600 million feet. He has treated over 10,000 feet, been featured on the radio, magazines, newspapers and on TV (including the History Channel and Fox News).  He is a podiatric physician, surgeon, and forensic podiatrist.  His practice Friendly Foot Care is located in Crown Point, Indiana.  To get more great insights on foot care and all things feet, visit Dr. Nirenberg’s blog.

One of Christopher McDougall’s comments in this video clip is that he was searching for anything that might help him reduce injuries and keep on running.  With a closet full of shoes that  just wasn’t helping him avoid the heel pain, Achilles pain, and arch pain he was challenged with, the medical advice he received was stop running.  Good advice, but not ever what somebody wants to hear if it involves giving up something that we love to do that’s supposed to be good for us.

For Christopher McDougall author of Born to Run, he realized that, “Shoes are the Devil,”  and learning barefoot running techniques has helped keep him on the road and injury-free.

Watch the interview on this CNN video clip.  Barefoot ultrarunner Christopher McDougall explains his inspiration for barefoot running, injury prevention, and the benefits of running without shoes.

So our feet DO tell us what they need, but we’ve stopped listening! And like many other parts of the body, we tend to ignore the problems, signs, and signals and hope that whatever is bothering us will just “go away.”

Not everyone has the drive or desire to run ultra marathons barefoot to retrain the feet for better health.  But there are many other great exercises and activities that can be done without shoes to help improve both foot fitness and whole body health.

Here Are Just a Few:

• Pilates exercises on the Reformer, Trapeze Table, and Wunda Chair help to stretch and strengthen the feet through a full range of motion against spring resistance in non-weight bearing to full body weight positions.  Excellent for retraining the body’s muscle and joint systems to function optimally.  Joseph Pilates also created two pieces of apparatus specifically for exercising the feet – the Toe Tensometer, and the Foot Corrector.
• Yoga is another great wellness program to utilize, stretch, strengthen, and realign the body in it’s natural barefoot state of being.  A sense of grounding, balance, grace, flexibility, and total body awareness and control can be achieved during a Yoga practice to increase fitness and decrease risk of injury.
• Dance another fun option for fancy footwork!  Different forms of dance require shoes, or no shoes.  Modern Dance, Belly Dance, and Tribal Dance forms are all practiced with bare feet.  Being able to hop, skip, jump and move with grace and rhythm is fantastic for foot strengthening.
• Foot Exercises.  If you don’t feel like taking up a new sport or recreational activity just to help your bare feet get a better workout…  there are specific and targeted foot fitness exercises for healthy feet, ankles, arches, and toes that you can quickly and easily incorporate into your current lifestyle and wellness program to help you keep your feet fit and healthy!

Another Athlete’s Story:

As a high school athlete and gymnast, I was diagnosed with degenerative arthritis in my ankles.  The challenge….every step I took HURT (a lot!)  I was rubbing bone on bone at the tender age of 16 and wondering if I was going to be in a wheelchair by 30.  After a year of nothing but exercising in the pool, where I wasn’t pounding on my feet, I managed to head off to college pain-free to complete my degree in Modern Dance!  Which then led me to my career as a Pilates Teacher!  Hmmmm… two of the three great exercise options listed above.  Now, almost 30 years later…. I continue to walk and run 2-4 miles a couple of times a week, completely pain-free!

Knowing that my clients plagued with foot problems needed some easy exercises they could learn and do at home, I wrote the book Fantastic Feet!  Exercises to Strengthen the Ankles, Arches, and Toes. This book is filled with many simple and quick exercises that I found beneficial for my own foot pain recovery program.

There are also a few other nifty foot-care products available that can add great value to your Pilates program, Yoga practice, Dance career, Walking, or Running Program.

Whether you’re a recreational fitness jogger, 5K or 10K runner, marathon, or ultra-marathon runner, AND whether you opt to wear shoes or run barefoot – the Fantastic Feet exercises and foot fitness products available at Centerworks are worth adding to your gym bag and incorporating into your weekly workout routine for healthy and happy feet.

It’s time to stand up and listen to your soles!

Generally speaking, all we do with our feet is shove them in a pair of shoes and head out the door.  Time spent exercising the feet barefoot can make a big difference to improve your health!  When was the last time you tip-toed through the tulips, walked barefoot on the beach, or actively did exercises barefoot to help keep your body fit and injury-free?

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My Suggestion:

Try barefoot fitness and comment on your experience!  Would you recommend barefoot exercise?  What do you dislike about exercising without shoes?  What do you like about being barefoot for fitness?  How has exercising without shoes benefited your health?  Love to hear your comments!

Here are Her Foot Related Questions:

“I will be seeing a podiatrist in a couple of weeks to address “metatarsalgia” of the second and fourth toes of my right foot. My second toe has also been trying to become a hammer toe for quite some time. I had a bunionectomy 30+ years ago. This current situation came up once before about 12 years ago, got an orthotic at that time which “suspended” the second joint through a dip in the orthotic material. That doctor is no longer in this area, so going to a new doctor soon.

Any suggestions? Does your book specifically address what to do for the met. problem? I’m sure it does for hammer toe since that is listed in the description about the book. Any help would be greatly appreciated. Thank you.” – Deborah K.

And Here was My Reply:

Thanks for your inquiry! It’s not possible for me to give you any specific opinions about what to do to help your feet without actually seeing you for an appointment to get an idea of your posture, body alignment, and how you walk, sit, and stand. Sounds like your feet have had many years worth of medical assistance for improving alignment and structure.

As I’m not a podiatrist or medical professional, it’s great that you’re scheduled to see a doctor for an evaluation. From reading up on metatarsalgia it looks like the conservative treatments are rest, ice, pain-relievers, good shoes, and arch supports or metatarsal pads. Perhaps after an evaluation, your podiatrist will recommend some of this, or be familiar with other alternative treatments. It looks like if conservative treatment options don’t work, surgery to realign the metatarsal bones may be recommended.

Now, here’s my personal OPINION, having not seen your feet! In my experience, the specific toe and foot exercises that I’ve included in the Fantastic Feet book have helped many of my clients and workshop participants improve the strength, flexibility, and alignment of the foot. If the muscles of your toes, ankle, and arches are not appropriately strong and flexible the bones will not be held in the correct alignment.

Since we are on our feet for a lifetime of getting around (against gravity,) if things are not working optimally, sooner or later injuries and pain somewhere else in the body will appear. (Whether it’s the feet, knees, hips, back, or neck & shoulders…) Pain anywhere else in the body, could potentially be coming from issues at the feet!

I haven’t seen too many (if any) traditional fitness professionals spend time teaching clients about specific foot-care exercises. It’s generally accepted that if you’re wearing a good shoe and walking or running, you are exercising the feet. In my experience, lots can be improved with very easy exercises if people only knew what to do and how relatively easy it is to begin seeing a change. This is why I wrote my book Fantastic Feet!  Exercises to Strengthen the Ankles, Arches, and Toes, and began teaching Foot Fitness workshops!

If you spend any time at all wearing flip-flops, or shoes that do not have a strap across the heel… I would encourage you to throw them away, they are only aggravating the problems with your toes and metatarsals.

To answer your question about exercises in my book specifically addressing your metatarsal problem:

The exercises in the Fantastic Feet book are not written to read: if you have this problem, do this exercise, or that problem, do a different exercise, because I come from a background and philosophy that you can’t spot-fix a problem. It is actually the process of doing a series of exercises to work the feet (or body) in all directions that will help identify the strengths and weaknesses in your feet (and the rest of your body) and help provide optimal overall benefits to alleviate pain and help solve strength, flexibility, and alignment issues.

In my experience, I recommend clients starting with the Terrific Toe Series, which should begin to open the joints and re-train the muscles under the foot to work properly. If you have a high arch, your feet will feel flatter to the floor when you’ve finished the “toe series.” If you have a flat foot – you will notice that the arch is more lifted after the exercises. So the body will get what it needs by completing the full series of exercises which work the joints in all ranges of motion. This is started non-weight bearing with the assistance of the hands (chances are the toe muscles won’t be able to do the work because they don’t know how!) and over time props and toys are added, then semi-weight bearing, and back to a standing position.

I don’t think that I have ever had a copy of my book returned! But to ease your mind, there is a money-back guarantee. Consult with your podiatrist as to if he/she would recommend exercise as beneficial for your problems. You might even consider bringing a copy of the book with you to your appointment so they can see the things you would like to do if they feel it might be appropriate. Lots of things can be corrected with the right exercises in your weekly routine!

Hope this information is helpful to you. Drop me a note and give me an update – I always enjoy hearing how it’s going for folks and if you’ve had success in alleviating problems. I’m also available to travel and teach workshops – so if there is a Pilates studio, fitness center, or any place in your area that might be interested in hosting a Fantastic Feet workshop, let me know who to contact and perhaps I could see your feet live and in person to tweak your technique and personally show you the foot-care exercises in my book!

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If you have thoughts, questions, or suggestions about this post, please make a comment below.  The more information people can find to help enjoy a healthy life, the better!

This Foot Care Question was just submitted to my inbox by Nicole, thought perhaps there are others out there searching for answers on how to alleviate foot problems and curious to know if exercise might help.

“I have some problems with my feet.  Hyper mobile forefoot and hypo mobile mid-foot with some posterior tibular tendonitis.”

“I was wondering if there are foot care exercises I could do to help?”

Thanks for your question about exercises for your feet.  It is impossible for me to give you specific exercises that I think would be beneficial without actually having a chance to see you, work with you, and evaluate your feet.

Based on your comments about the problem, I do have some thoughts about what I would look for, and I am confident that yes, there probably are some specific foot fitness exercises that you could do to help improve your feet.

I suspect that something in the hind-foot, or ankle might be locked up.  (This potentially could be related to an issue at the knee, hip, or pelvis, or could just be a stuck ankle.)  From a Pilates perspective, we’re always looking at the whole body and how things inter-relate.  Sometimes this can be corrected with the right exercises, other times a manipulation by a kinesiologist, chiropractor, or osteopathic physician can get things moving again quickly, and then the right exercises can help reinforce new muscle habits to keep things working properly.

If any joints are hyper mobile, the muscles that move them, may not be strong enough, or understand how to work correctly to move the bones. Somewhere farther up the chain, the body gets a message to “hold on tighter for support.”  The problem is that over time, this message never shuts off and the body accepts how it’s moving as the correct pattern.  Opening all the joints of the foot and ankle, and improving the strength of your fore foot, arches, and toes, might just provide the support needed to help facilitate more correct movement through the entire foot.

Your alignment for walking and running, and how the body and legs move from the hips are also a factor in how the muscles of the feet fire to propel you through space. Incorrect firing patterns through the whole leg with every step you take, only continue to reinforce problems and may be a reason for the aggravation of posterior tibular tendonitis, as well as the hyper/hypo foot issues.

The exercises in my book Fantastic Feet! I have taught to LOTS of people with a variety of foot issues with great success!  The Yamuna Foot Savers, and Circulator Foot Reflexology Mat are also great tools for improving alignment and muscle use.

Since you know you have diagnosed problems, I would recommend showing the exercises in the book Fantastic Feet! to your foot doctor, physical therapist, chiropractor, or kinesiologist, and have them assist you with selecting the most appropriate exercises for you to start with. Always best to refer to an expert!  If there are any Pilates Studios near you, I’d also recommend checking into a few lessons to have your posture and movement habits evaluated from a whole-body perspective.

It’s great to learn what’s helped other people fix their foot problems -  and this provides possible solutions for folks still looking for their best answer to enjoy happy pain-free feet!  Please feel free to comment below and share what’s worked for you to help fix your foot problems!

Check out the Centerworks Awesome Workshops

Check out this AWESOME WORKSHOP!

Fantastic Feet!  Exercises to Strengthen the Ankles, Arches, and Toes

with Aliesa George and Centerworks®

Discover:

• Why it’s important to focus on foot fitness!
• Lots of easy exercises to help you improve strength, and flexibility!
• How this simple foot-care system can help reduce foot pain!
• Enjoy healthy and happy feet! And the rest of your body will feel better too!

Don’t miss this FUN, exercise-packed Fantastic Feet Workshop!

Thursday, February 26th from 5:30 – 8:30pm!

Location:  The Pilates Studio of Little Rock, 5515 Kavanaugh Blvd., Little Rock, AR

To register contact www.PilatesLittleRock.com

P.S.

If you can’t make it to this workshop…

Check out all the great foot-fitness products available at www.foot-care-help.com

Studio Owners – If you’d like to host a workshop at your facility, contact Aliesa George now!

I’m thrilled to see foot-care and foot exercise making national headlines! 

 Did you happen to see or hear the news?  I’m not a regular National Public Radio listener, but fate stepped in and brought it to my attention. So how did I find out?   It was a double whammy….which to me was a sign that I had to check it out. 

First, someone that heard the story on NPR and Googled Pilates & Foot Exercise which led them to my site to order Fantastic Feet and a Centerworks Pilates Foot Fitness Kit.  Bless them for commenting on their order form as to how the found me and my foot fitness products. 

My second wake up and take notice…was from a client at the health club I’m teaching at – who came in for a lesson and said – NPR had a story about the same problem I have with my feet (plantar fasciitis) and Pilates!  She was so excited and encouraged that Pilates was a great thing for her to be doing to improve not only her overall fitness level, but to really help reduce the pain in her feet and get her back to a normal lifestyle.

The information she heard in this story helped lend credibility to her Pilates teacher, that they’re on the right track with her Pilates exercise program and addressing her foot issues.

I think it’s great to have articles like this in the news that help reinforce the variety of benefits that clients can receive and achieve with a Pilates workout program.  I haven’t seen a lot written for the general public about the benefits of good shoes and exercising the feet.  Our feet desperately need more attention and usually don’t get addressed until a problem arises. (Unless someone is regularly participating in barefoot activities like Pilates, Yoga, or dance.) 

People actually think that it’s ok for their feet to hurt, and don’t think too much about the shoes their wearing and how they might be causing foot problems.  So I think it’s great that the NPR story addressed the problems with wearing Flip-flops, and open backed shoes.  There’s also a nice video from Podiatrist-turned-Pilates instructor Colleen Schwartz that demonstrates a few helpful exercises to get you going for foot care that can help reduce heel pain and help stretch the plantar fascia.

How great – A Podiatrist/Pilates instructor encouraging people to exercise their feet!  This is a wonderful tool for Pilates promotion to markets where general exercise is a problem due to foot issues. 

If the excuse is “I can’t exercise because it hurts my feet.” 

The reply is – “You can do Pilates, and over time we may be able to reduce or eliminate your foot pain, are you interested in learning more?”  

I found that so many of my clients benefited from a focus on specific exercises for the feet – that it’s the reason I wrote Fantastic Feet – Exercises to Strengthen the Ankles, Arches, and Toes.  I wanted people to have a resource to help develop a foot exercise program for home and travel.

If you’ve got friends, family or clients with foot issues encourage them to check out the NPR website and read the article “How to Keep your Feet Happy” by Allison Aubrey.  They can also watch the short foot exercise video that’s linked to this story in the Health & Fitness section.  Then if you’d be so kind, please spread the word about the foot-fitness resources available from Centerworks Pilates!