An ancient practice in China was to bind the foot of young girls to stop them growing. They were tightly bound and it was painful. In that culture at the time a smaller foot was considered more erotic and a higher price could be demanded by the brides family prior to marriage if the feet were smaller. The practice was barbaric, disabling and brutal and was widely practiced, especially in rural China. The practice was banned many years ago and is no longer done. There are still some older Chinese women alive in remote rural areas who were subjected to this as children.

Chinese Foot Binding

Once this was done, there was no treatment for the pain and the best option for them was to keep the feet bound. Chinese food binding has also been shown to affect cortical issues in the brain.

While this practice has ended in China, a number of social anthropologists have drawn parallels between Chinese foot binding and the practice of women wearing tight fitting shoes in today’s society. Both practices are argued as being something that is done to please the male members of society and both practices are harmful and brutal to the foot.

In the news this morning is a report on the well-known entertainer Bert Newton undergoing a leg amputation. Bert is 82 years of age and has had a number of well-publicised health problems including a quadruple heart bypass in 2012 and a hospital admission for pneumonia in 2017.

Todays report on the leg amputation is an important lesson on not ignoring the little things that go wrong with the foot. His problem started off as a simple infection on a toe. It got worse to the stage that the infection spread and there was no option but to remove the leg to prevent further spread and potentially stop it from being fatal.

“It got worse … he was seeing doctors and specialists and they couldn’t seem to get it right, it kept on spreading. Basically he was told last week, you have a couple of months to live, or if you have your leg amputated, you’ll probably have a few years. So, he agreed to have the leg amputated on Saturday,”

Do not ignore minor problems with your feet. It can have serious consequences.

We all wish Bert well in his recovery.

Obesity has become a significant risk factor for so many medical conditions that is becoming much more common. A few years ago it was estimated that 67% of the Australian population over the age of 18 were either overweight or in the obese category. This has major public health implications.

The risk for so many different medical conditions is increased by being overweight. Foot problems are no exception. It should be obvious that carrying more weight than necessary is going to increase the chance of getting a whole range of different foot problems as well as making existing foot problems more severe.

A recent study has shown that a simulated reduction in weight loss improved the symptoms in the foot for those with arthritis. There is a high correlation between plantar fasciitis and the body mass index reported in another study. This goes to show just how important keeping weight under control is for preventing foot problems (and a multitude of other health problems) and the importance of loosing weight to help recalcitrant foot problems (and a multitude of other health problems).

We are now a year into this pandemic. What a year it has been!

One thing that has changed for a lot of people is our exercise habits. Due to the various stages of lockdowns, some people have started exercising more and some have started exercising less. This has led to some interesting outcomes with regards to getting an injury from that. My co-host on PodChatLive, Ian Griffiths, was the first one to use the word “coverload” to describe some of the problems that are being seen.

The human body is remarkable and can adapt to exercise loads that are put on it, providing those loads are increased slowly and gradually and the body is given enough rest to adapt to those loads. If there is insufficient time given for the body to adapt then an overuse injury is often the result from those loads being too high for the body to take.

What is happening in those who might, for example, run 2-3 times a week start running 6-7 times a week during a COVID-19 related lockdown as we are generally still allowed to exercise. That can be too much for the body to handle as not enough time was given for the body to adapt to the increased loads, so on overuse injury might result; ie coverload.

On the other hand some people exercised less during the lockdowns as, for example, the gyms were closed. This meant that the tissues in the body de-adapted to the exercise loads. After the lockdown was over they went back to the gym and started exercising body parts that were not yet ready to take the loads that were being applied, so an injury might result; ie coverload.

All this means that you need to make sure that your body is given time to adapt to any increasing load that is place on it. Be careful and take you time. Don’t be a victim of coverload.

A new school year is starting soon and so is that tradition of getting the new school shoes for the year.

back to school shoes

As the feet of children are still growing, they are malleable which means that getting the fit of shoes wrong can result the potential of affecting the normal development of the foot and lead to problems later in life. The role of the shoe is to protect your child’s feet and ensure that normal development can happen. This is even more important for school shoes, since your child spends so much time in them. To ensure that their shoes do fit properly, make sure you have your children’s feet measured regularly for length and width each time you buy shoes.

Specifically, the toe area of the shoe should allow your child’s toes to move freely about and not be squashed from the top or the sides by the shoes. Make sure there is around 1cm growing room between the end of the child’s longest toe and the top end of their shoe. The shoe should fit comfortably around the back of the heel as well and be too loose or too tight.

Going to a specialty footwear retailer to have shoes fitted by a store that offers trained assistants can also help ensure that your child gets the correct size and shape of shoe.

When should you seek advice from a podiatrist?

A podiatrist can help ensure your child’s school shoes are fitted correctly. An evaluation by a podiatrist is also recommended if you notice changes happening, such as uneven shoe wear on the heels or if there is pain in your child’s feet. You should also consider getting the help of a podiatrist if you notice your child walks on their tip toes, or their walk does not look the same on both feet and legs; or if you have any other general concerns about your child’s foot health.

Burning feet is a common issue that we get asked about and it is often hard to get to the bottom of and difficult to deal with as it will often not be apparent what is causing the symptoms. The burning feet syndrome is frequently characterised by the sensation of burning and a heavy feeling that occurs within the legs and feet. In the past, it was first described by Grierson in 1826 who had been the first person to report the signs and symptoms of burning feet. An even more comprehensive account was written about by by Gopalan in 1946, so for a while the burning feet syndrome has also been often known as Grierson-Gopalan syndrome.

There is normally not any specific cause of burning feet and the cause is often not found. It might be connected with nutritional or endocrine causes such as a vitamin B insufficiency, the painful neuropathy occurring in diabetes, in those with kidney failure especially if on renal dialysis, or with hypothyroidism. The could be a local pinched or irritated nerve problem. Burning feet tend to be more common in people older than 50 years but it could and does come about at all ages. The signs and symptoms are typically characterised by way of burning sensation, a heaviness, a numbness or a boring ache that occurs predominantly in the foot. It tends to follow a ‘sock’ distribution rather than be patchy. In most cases it is just on the bottom of the feet but may ascend to affect the top of the foot, ankles or up the lower legs sometimes. The forearms and palms of the hands are typically not impacted, but when they can be, then this really needs to be investigated further. Sometimes people may possibly report ‘pins and needles’ or tingling kind of discomfort in the feet rather than just the ‘burning’. Normally, the symptoms are usually a whole lot worse during the night and are somewhat improved throughout the day time. They’re also not really made worse with an increased levels of activity or standing which may signal a musculoskeletal condition as opposed to the neural involvement in burning foot syndrome. Evaluation of your feet and legs by a health professional frequently locates no objective signs and symptoms. A range of investigations, especially blood tests are generally often carried out to look for any of the particular problems that might cause the condition.

The therapy for burning feet syndrome will either have specific measures which can be aimed at what’s causing it (eg diabetic neuropathy, pinched nerves, thyroid conditions) and general steps that can be useful in most cases. These common options range from the using of open and comfortable shoes, perhaps those having arch supports, as well as wearing natural cotton socks might possibly be somewhat helpful. Relief from the signs and symptoms may be obtained by immersing the feet in chillier water for around 15 minutes. It’s also vital that you steer clear of exposing the feet to sources of heating. There are pharmacological therapies that include tricyclic antidepressants and other drugs such carbamazepine and gabapentin which can be used in the more significant conditions. You will find side affects associated with these drugs, but they are essential at giving reduction to the symptoms when it’s necessary. Despite having the usage of drugs, the treating of the symptoms could be a tough and some individuals will have to be evaluated by a specialist pain facility and presented strategies to help live with the pain sensation.

Short version: no

Long version: no, they don’t.

do circulation boosters really work

There are several brands of the so-called ‘circulation boosters’ on the market that make cautious claims about boosting the circulation. The claims are made with caution as there is no evidence that they actually do. You often see them being promoted on the morning TV shows, in infomercials and commercials with celebrity endorsements (I have certainly lost respect for those that do endorse the circulation boosters). The concept behind a circulation booster is that it uses electric muscle stimulation to contract and relax the muscles, thereby increasing blood flow to your legs and feet. They may well do that for the short time that you are using that device, but the effect will last no longer. If you really want to boost your circulation then get out and go for a walk. That will do substantially more for improving your circulation than spending money on one of these devices.

The electrical stimulation may prove usual for some people with some type of neurological pain in their feet, so there is no shortages of testimonials that they “work” as they could help some of these problems. They do not help by improving the circulation. Despite the length of time that these have been on the market there is a distinct and obvious lack of scientific and medical research supporting their use.

Another way of looking at it, why are all the vascular surgeons not recommending the circulation boosters for their patients? There is a reason for that.

There is also a reason why so many are being sold second hand on eBay and Gumtree. That is because the circulation boosters no not really boost the circulation and so many are selling their devices.

Here is one of the many things that we can do with the Archie arch supporting thongs that so many people like. Craig is demonstrating a MOSI foot orthotic modification that can be made to the thongs. It is a bit on the technical side as it is designed for podiatrists to watch, but hopefully you get the gist of what he is talking about.

Watch the video on the Archies MOSI:

As an aside, we do stock the Archies in the clinic and the range has just been updated with the smaller size 4’s being added and two new colours: tan and peach.

Short answer: with difficulty.

Ballet flats are a particular shoe design inspired by the shoes used by ballet dancers. By design these shoes are very minimalist. They do very little to the foot except cover it and come in a wide range of attractive designs. They also tend to be very snug fitting to help them stay on the foot. There is nothing inherently wrong with these types of shoes provided that are fitted properly and are of the right size for the user.

The issue with these minimalist types of footwear is if there is a foot problem that needs some sort of arch support, even on a temporary basis. The main sorts of problems that this might be needed are especially if you are on your feet all day and the feet and legs get very tired. Due to the minimalist nature of the design and the typically snug fit of the footwear, there is not going to be a lot of room in the shoes to do much. Clinically, choices or options can be limited if you spend most of your time in this type of footwear. There is simply no way that a typical foot orthotic is going to fit into these types of shoe. Sometimes a cut down foot orthotic might be able to fit in the shoe. Other times the problem can be managed by changing to a different type of footwear that foot orthotics can easily be used in for a period of time until the problem gets better. It is always best to see a podiatrist and discuss the options that you have if you really do need some sort of support and if it can be accommodated in your ballet flats style footwear.

Arch Support in Ballet Flats

There are a very limited number of ballet flats on the market that do have arch support type designs built into them. However, they are hard to find and may not be suitable for you. There are the instant arches types of self adhesive pads that can be stuck in the shoe to give some sort of support and this is often a good compromise if that is what is needed to deal with your problem. We do use them from time to time when there is no other more suitable workaround to getting support into a ballet flat type of shoe.

Long answer: it can be done, but there has to be compromises made.

Do you have restless legs syndrome? It is a miserable condition to have and we see it in multiple patients that we see (though they have come to us for another reason). We can only empathise with the impact that it has on their sleep and quality of life.

Restless Legs Syndrome is a nerve condition that is typically characterised by annoying sensations within the lower limbs and the compelling need to slowly move the legs, commonly only when attempting to rest. This peculiar feeling, often in the calves, is explained as a form of a cramp, ache or simply a creeping, crawling sensation. Some compare the sensation to being like shooting darts of electricity, and even invasive bugs inside the legs. These feelings range in extent from uncomfortable to irritating to agonizing.

One of the most unique feature of the condition is that lying down and seeking to relax leads to the restlessness. Because of this, a lot of people with restless legs syndrome experience difficulty going to sleep and also remaining asleep. Left untreated, the disorder results in lethargy and day time weariness.

Individuals with restless legs syndrome sense unpleasant sensations within their lower limbs, particularly if seated or lying down, together with an hard to resist urge to move the legs. These types of feelings commonly take place deep within the leg, typically between knee and ankle; and less often, they will appear in the feet, thighs, arms, and even the hands. Although the symptoms can happen on just one side of the body, they generally impact both sides. Since moving the lower limbs reduces the discomfort, individuals with restless legs syndrome generally keep their lower limbs in motion to attenuate or stay away from the sensations. They may pace the floor, constantly moving the legs while sitting, and move when in bed.

A lot of sufferers notice the feelings of restless legs syndrome being much less apparent during the day and more noticeable later in the day or at night, primarily during the start of sleep. For some people, the symptoms disappear by early morning, allowing for more refreshing sleep at that time. Other triggering situations are periods of inactivity such as long car trips, sitting in a movie theatre, long-distance flights, immobilisation in a cast, or relaxation exercises.

The cause is unknown but people with a family background of restless legs syndrome make-up about 50% of the cases, and sufferers with reduced iron ranges or anaemia, chronic diseases for example kidney failure, all forms of diabetes, Parkinson’s disease, and peripheral neuropathy, some women who are pregnant during the last trimester and people taking particular prescription drugs are most often more prone to to be affected by restless legs syndrome.

Restless legs syndrome can impact anyone of any age, although the problem is much more frequent with advancing age. This happens in both genders, even though the occurrence may be somewhat higher in women. At times individuals will experience spontaneous reduction on symptoms over a duration of weeks or months. While uncommon, spontaneous improvement following a number of years may take place. In the event that these improvements come about, in most cases during the early stages of the disorder. In most cases, however, sensations are more serious over time.

The clinical diagnosis of restless legs syndrome might be hard to establish. Doctors must depend mostly on the sufferer’s descriptions of symptoms and details using their medical history, including earlier health conditions, family history, and also present prescription drugs. Patients might well be inquired about how often, length, as well as the intensity of sensations along with their inclination toward day sleeping patterns and sleepiness, disruption of sleep, or daytime function. In case a persons history is an indication of restless legs symptoms, clinical assessments can be implemented to eliminate other issues and confirm the diagnosis of restless legs syndrome. Blood tests, assessments to measure electrical signals in the muscles as well as nerves, and other assessments in order to look at muscle signals with the legs may be suggested. These kinds of tests can easily document any accompanying injury or disease in the nerves or neural roots or some other leg-related motion disorders.