Ask America's Podiatrist: Recent Topics

Susan Phillips on "Metatarsus Adductus Adult"

Susan Phillips — Thu, 22 Jul 2010 18:41:22 +0000

I am a 60 year old female, who discovered I had met adductus two years ago, when consulting a podiatrist for another problem. I also have very high arches. I have been clumsy all my life and wonder if this might be a causative factor. Thank you.

viaaLeqendary on "Toenails"

viaaLeqendary — Thu, 22 Jul 2010 13:18:57 +0000

Okay, so I have a brownish/yellowish toenail on my right big toe and it seems as if it was dying. There is no pain, but I see there is another toenail growing under because of a crack on it when i hit the toenail. How do I remove the dying toenail.

JL on "neuroma and flat feet."

JL — Tue, 20 Jul 2010 13:25:39 +0000

After years of trouble with knee pain, I have been able to get back into running, thanks to my chiropractor who has administered active release technique (ART). I still fight it, but it's kept at bay. I started training for a triathlon a few months ago, and the biggest problem i've had so far is my left foot. I have what i believe to be morton's neuroma. it was suggested by chiropractor and i also went to a podiatrist who said the same. The pain is dull and inconsistent, between my 3rd and 4th metatarsals. I rarely notice it while running, and it's typically worst the day after speed work (sprints), and often accompanied by arch pain/stiffness. I have since switched from a motion control shoe to a neutral shoe(brooks ghost). The symptoms have remained largely unchanged despite continuing my triathlon training. The podiatrist said i have flat feet and was quick to blame it on that. he recommended i get orthotics, but i had orthotics for my knees, which did not work, so i stopped using them. I'm confused by all of this. i agree that my arches are not as high as they should be, but they don't seem "flat" to me. i much prefer the neutral running shoe to the clunky motion control. i've tried throwing in some barefoot running to strengthen my feet, but with the neuroma it quickly becomes unbearable. should i shelve the barefoot running idea until i recover from the neuroma? are orthotics a reasonable approach for this? What steps should I take to recover from this, and prevent it from happening again? Thanks!

jnazarian on "red/brown bumps under skin, die and peel, random, no pain/itch"

jnazarian — Wed, 30 Jun 2010 18:56:10 +0000

I have had off and on bumps on my left foot only. They are randomly placed, sometimes on side, sometimes in arch, sometimes between toes, never on the top (but do sometimes extend to the outside edge. They are sometimes pin-sized bumps under the surface of the skin. Hard. Do not itch or hurt. Sometimes they are bigger, like the size of a beebee. Right now some have formed one large cluster, if I push against it it hurts the tissue underneath. They come in clusters, start out like a redish color, turn dark brown, then skin around them starts peeling, and they peel off eventually with the skin. Like-cycle about 3-4 weeks. Sometimes they disappear for 3-8 months. When they come back they will start in one area, die out in 3 or so weeks but spread to another area before dieing out completely. Any idea what this is? Antifungal didn't work. One dermatologist gave me 3 different ointments/creams. One made worse, two others did nothing.

cad21303 on "2 toes are still numb almost 1 week later!!"

cad21303 — Thu, 15 Jul 2010 15:06:41 +0000

Hi Dr. Nirenberg, I went out dancing with my friends last Saturday. I was wearing 2 inch healed shoes for about 9 hours and for about 3 hours straight we were dancing when I started having intense foot soreness. It was so painful that I had to remove my shoes because I could barely walk and even without the shoes I still could barely walk the rest of the night. Now, it is 5 days later and I still do not have complete feeling back to 2 of my toes, 1 on each foot. It feels like they are almost numb when I am walking on them and they don't feel totally right when I touch them. I am able to move them with no problem though. Will the feeling come back eventually or should I see a podiatrist in my area?? Thank you, Cheryl

Anders on "Top of foot pain - rehab strategies"

Anders — Mon, 28 Jun 2010 15:29:47 +0000

Pain at the top of the foot seems to be a very common injury among people that are beginning with barefoot activity, perhaps especially among those doing barefoot running. The pain is typically located to the extensor hallucis longus tendon around midfoot. It so happens that I've got that exact problem. If this would have been tendinitis on the Achilles, part of the rehab program would probably be eccentric calf strengthening and light excercise, not complete rest (apart from the initial stages). However, for this hallucis longus tendon problem I don't find any other suggestion than rest until completely gone. What do you think?

Poesjenel on "Toe Still Numb 21 hours later"

Poesjenel — Wed, 30 Jun 2010 10:50:22 +0000

I had my ingrown toenails removed yesterday but my big toe is still numb all these hours later. I'm worried since I can't feel the big toe.

tduong5 on "Same type of children's shoes over and over OK?"

tduong5 — Wed, 23 Jun 2010 20:53:42 +0000

Hi Doc, My 3 yr old son has wide, thick, chubby feet. His grandma bought him a pair of shoes called TT Transporter by Stride Rite. When he outgrew them, I bought him a pair in the next size up. Now that he's outgrown his 2nd pair, I've bought him the same type of shoe in the next 2 sizes up. Because the shoes are now discontinued and harder to find, I'm considering stocking up and buying him 3 more pairs. I know it all sounds rather obsessive but it's really hard to find him shoes that are wide and high enough at the toes. I've bought him other pairs but the Transporter ends up being the ones worn on a daily basis. I thought I heard somewhere that you shouldn't wear the same shoes all the time. With my son being so young, am I messing up my son's feet by having him wear the same type of shoes for the next 2 or so years???

andrewp on "5th toe injury, slow recovery."

andrewp — Wed, 23 Jun 2010 11:00:15 +0000

Greetings Dr. Nirenberg. I enjoyed your interview on Living Barefoot and hope you can help me. In the first week of April I struck my left 5th toe walking in the dark. The pain was enough to cause me to become light headed. I was unable to put weight on it, flex, or extend it without causing significant pain. There was noticeable swelling with bruising in the webbing between the 4th and 5th toes and a small impact bruise at the last 5th toe joint (DIP). I began taping it to its neighbor and icing it. I had an xray taken the following week but was told there were no fractures seen. I continued taping and occasional icing my little toe for two more weeks with no improvement. Pain was spreading up the outer edge of my foot and it still could not bear weight. I finally saw a podiatrist who advised a cortisone injection into the MTP joint. This brought relief to the pain spreading up the foot. Two weeks later the pain in the toe itself persisted and I was given another cortisone injection, this one in the toe. This brought immediate relief however the pain returned after a few days. I received a third injection two weeks later which resulted in the same. I discovered I have been wearing shoes a full size too small for many years (I'm 27). This has resulted in some mild claw-toe in my 4th and 5th toes on both feet, and on my left foot the injured 5th toe is also slightly rotated so the nail faces out. I suspect this may be a factor in this being so hard to heal. I have included photos to show this. I realized I can not bend the toe at the last joint, but I'm not sure if this is new. I am now able to walk without limping. Despite moving up a size, shoes still cause me pain so I go barefoot as often as possible. I believe there is still some mild swelling. I can flex the toe without pain, however stretching it back towards me or putting weight directly on the toe is still painful. I think the pain is coming from the DIP joint. If I rub it there is some tenderness. I have begun stretching and exercises. Moving small rocks back and forth using just my little toe and doing foot curls in an elastic strap. It is too soon to know for sure but I think this may be helping. Can you recommend any additional action or treatment? Any special stretches or exercises? Your advice is greatly appreciated.

kat83 on "daughter's feet"

kat83 — Mon, 21 Jun 2010 21:31:47 +0000

I need shoes for my 10 year old daughter. She severely toes in and wears her shoes on the inside of the heel. any brand of shoe is shot in 2 weeks. I've had an orthopedic surgeon and her primary physician say that she is normal. She has lately been complaining that her feet hurt. HELP!

bird on "pain after mini tightrope bunion procedure"

bird — Fri, 18 Jun 2010 19:52:13 +0000

Hi Dr. Nirenberg, I had a bilateral mini tightrope bunion procedure on May 14, 2010. My recovery up to this last week has been fairly unremarkable. There has been some pain and swelling, mostly stiffness in the big toes, but I could tell that I was walking better as time went on. My main issue up to this point was the big toe stiffness. I was in surgical shoes with bandages for about a week and a half, and then continued with bandages but was able to transfer to a shoe big enough to accommodate my bandaged feet. By June 3rd, I was switched to removable bandages with toe spacers. I was told to keep both on for one week, and then the just the toe spacers without the bandages for an additional week. Once I took off the removable bandages on June 10th, I noticed increased pain, mostly on the tops of my feet. Since then, the left foot pain has subsided some (pain is about 3 out of 10, weight bearing), but the right foot is still really bothering me (pain about 5.5 out of 10, weight bearing) and does not seem to be subsiding. It's causing me to limp. In addition, a couple of days ago I stubbed my toes on the right foot, although at the time it didn't seem like I stubbed them that bad. I saw my doctor yesterday, and he said my pain is perfectly normal and that I shouldn't worry (although I forgot to mention that I stubbed my toes). He hasn't taken any x-rays since my my first post-op visit which was three days after my surgery. What is your opinion? Is it possible I did some damage when I stubbed my toes? I had the same kind of pain on prior to to the stubbing, but as I said, the left seems to be getting a little better but not the right. Any insights would be greatly appreciated! Thanks so much!

Evan on "Does your arch fall or rise as the foot adjusts to going barefoot?"

Evan — Wed, 16 Jun 2010 15:29:37 +0000

This question has been discussed a bit on the Minimalist Runner Google group with no consensus. My own experience suggests that my arches have 'fallen' (if indeed that is what structurally has happened) because after about a year of barefoot and minimalist running, I can no longer wear shoes with any kind of contoured footbed or insole because of the pain that brings to my arches; as if the arch of those structured shoes is too high for my foot.

gerry957 on "Hurting Toes"

gerry957 — Thu, 17 Jun 2010 12:29:51 +0000

Dr. Nirenberg, I have responded to a couple of posts of yours over at the barefoot forum on Runners World and I am hoping you might be able to assist me this time. About a month ago I was running in huaraches on a very slippery trail. The shoes moved around quite a bit, by the end of the run I was in quite a bit of pain. The pain started on the top of my second toe and top of the third toe, and then worked up the front of my foot to the ankle. Every time I have tried to run after that I have experienced the same pain. I have seen a doctor and he had me quit running for awhile then tried a cortisone shot, then on the last appointment he said just don't run on it if it hurts. Since the cortisone shot there has been some additional numbness on the toes and my doctor has decided that it is now a nerve entrapment. I know you are very busy so I am not really asking for a diagnosis, just an opinion as to what you would do next since it appears as though my sports medicine doctor is not really interested in moving forward. Would you see a neurologist, a podiatrist (which is tough to find one that doesn’t frown on barefoot running) or maybe even an ART practitioner? I have a link to my YouTube video about my injury if you have the time and it would help, otherwise any advice as to who to see would be appreciated. Link: <a href="http://www.youtube.com/watch?v=iHj73zbMSlg" rel="nofollow">http://www.youtube.com/watch?v=iHj73zbMSlg</a> By the way thanks for what you do to support the barefoot community. Gerry

Barefoot@56 on "bunion"

Barefoot@56 — Tue, 08 Jun 2010 08:27:41 +0000

Thanks for having this forum I have had a bunion or hallux rigidus or something on the side of one big toe for over 15 years. Now in the past 2 years it's happening on the other side. I have never been a runner. Recently discovered the running barefoot concept. So far I love it. Do you think more barefoot walking and/or running could reverse this condition? Have you ever seen a patient that has eliminated bunions w/out surgery?

katrinita on "stess fracture effects"

katrinita — Sun, 06 Jun 2010 23:11:49 +0000

Hi! Do you think being on crutches for 2 months due to a tibial stress fracture would have any effect on the lateral side of the top of the foot? In the brand new pair of running shoes I have, it feels tight. Just wondering if you think there is any connection. thankyou!

sa on "Plantar Fasciitis"

sa — Thu, 18 Mar 2010 09:03:55 +0000

I recently switched from Ascis running shoes to Vibram 5 fingers barefoot shoes to help minimize knee pain associated with running. While the Vibram "barefoot" experience did eliminate my knee pain and made me a more efficient runner, I decided that I needed some level of cushioning to help me transition from shod running to barefoot running. I purchased a trainer shoe made by Saucony which has minimal cusioning and is very light. Unfortunately, I developed planar fasciitis after a 9 mile run last weekend. Having never suffered from PF, I'm wondering if I need to go back to my traditional Asics running shoe or go back to the Vibram?

maam on "Rotating 5th toe"

maam — Thu, 10 Jun 2010 11:23:57 +0000

Hello, I recently realized that my fifth toe on my left foot has rotated and that its nail is now turned to the left side rather than facing up, like all my other toes. My toe on my right foot is fine and faces the sky normally. I have tried to be more aware of my feet, trying to walk barefoot more often and I am transitionning to better shoes (less hills, no support, more room even though it is hard to find roomy and cute shoes for women and I am guessing that is the problem, room) Do you have any tips for me to work on helping my fifth toe to face the sky again ? Thank you in advance, Maam

tikabodine on "Spread of toes"

tikabodine — Sun, 13 Jun 2010 10:40:10 +0000

I have unusual looking feet in that my toes are spreading with the 1st 2 toes together - then a gap (like a "V" and the last 3 toes together (pointing inward). It appears the last 2 toes slope to left with a curve. Is there any hope at all that these can all be straightened out and closer together with treatment? What kind of treatment do you suggest?

ladolcevita86 on "barefoot friendly doctor in philadelphia area"

ladolcevita86 — Fri, 11 Jun 2010 11:06:23 +0000

Hello Dr. N, I was wondering if there was a doctor in the Philadelphia/Southern New Jersey area who knows about barefooting? I recently purchased a pair of Vibram 5 fingers to wear due to lower back pain I have been experiencing. They have helped to reduce and nearly eliminate the pain, however, my job deems them "unprofessional" due to their strange appearance. The only way I can wear them is with a doctors note. I can not go back to wearing conventional sneakers because even my Nike Shox cause pain. Thanks so much

Anders on "Soreness in underside of foot after barefoot activity"

Anders — Wed, 09 Jun 2010 11:37:12 +0000

While at asking questions about barefoot activity, here's another one that I have not found any answer to: I'm into a transition program, moving from supportive shoes to minimal/barefoot. This of course mean to progress very slowly and listen to the body. Back off when there is pain. However, like with all training, there is a difference between soreness and pain. For example when lifting weights in the gym, experienced people can safely train with some light soreness in the muscles. People who train often are always lightly sore somewhere. With experience one learns to differ between "good soreness" and bad. Not good to feel soreness in tendons for example. However, with barefoot activity I've come across a type of soreness which I don't know how to respond to. It is the same type of soreness one can get when standing a whole day on a hard floor, you get sore under the foot. It does not feel like a hurting muscles, but soreness in the same way as fingers get sore when playing a steel-stringed guitar. It is more often under the heel than under the forefoot, but the forefoot can also get this soreness. I guess it is the plantar fascia complaining. So I back off and don't let it get too bad, however, if I would respond to it as "complete rest until completely gone", there would be extreme slow progress, if any at all. (after 3 weeks, I'm now up to doing 1 mile walks, and never two days in a row so I haven't exactly rushed into it). So my current philosophy is to allow soreness be there, as long as it is not too bad, just as I do with muscle soreness when I train in the gym. However, say if it would be a tendon, I would not do it like that. To summarize, what I'm worried about is that if I keep the undersides of my feet more or less constantly lightly sore for several months or perhaps a year (transition takes time) that I perhaps could develop some long-term problem without noting it until it is too late, like heel spur or something.

Anders on "Is over-pronation a problem for barefoot activity?"

Anders — Wed, 09 Jun 2010 08:07:06 +0000

It is said that most people over-pronate / hyper-pronate, I've seen numbers like 70%. As a comment on this which I find interesting -- in running shoes I've noted that many over-pronate in neutral lightweight running shoes, but have seemingly normal pronation barefoot or in stable running shoes. The reason for this is the soft midsole that often is more compressed on the inside in the stance phase, increasing the pronation angle. I have attached an example showing myself run barefoot, stable motion control shoes and with a lightweight shoe. Perhaps if people would be tested barefoot the number would not be as high as 70%? Anyway, here in Sweden there is a lot of focus on over-pronation, so much that people most often skip the "over" or "hyper" and just say "pronation", and many worry about it. The barefoot activity trend is coming here though too, and a question that then arises which is hard to find answer for is if over-pronation is something to worry about. Of course there will always be extremes, but now I'm talking about the major group that are healthy and have feet that are not deformed, but are generally recommended arch support and motion control shoes anyway (like myself). If it is to worry about, that would mean that those 70% that are "over-pronators" should not get into barefoot activity. I guess that is exactly what most podiatrists will say too, but it would nice to hear what a barefoot-friendly podiatrist has to say about this. When people hear that I've started some barefoot activity, I often get the comment "cool, I'd like to try too, but I can't since I over-pronate and must have arch support". I've also noted a thing which I am a bit curious about, when I stand still barefoot, it feels like the feet are slightly pronated, it is not really visible but I can feel that the weight is more on the inside of the foot than exactly in the middle. Should this be considered normal, or a biomechanical issue? If it is I think it is small enough to not worry about, but it is a thing that have come up a few times so it would be nice to get a comment on that. Friends that have tried barefoot shoes or barefoot and got that sensation when they stand still get worried about it.

Hope on "The bone that sticks out of the side of the ankle that is round."

Hope — Tue, 01 Jun 2010 20:55:19 +0000

I think I should give you a bit of my history. I was injuried at work. I has ruptures and tears on the outside and I ruptured my Achillies tendon. I will try and make this as short as possible so please bare with me. I had ankle reconstruction. Then the Achillies repair. After this was healed enough I was at rehad and rolled my ankle. I was sent for another MRI the findings were. That I again ruptured my achillis and the tendons and ligaments. Now I'm not sure If I'm telling you the technical names. Then after this last surgery I developed RSD/CRPS. My pain management doctor uses them both. So they put though a couple tests and once they got it all back in. I went in and they told me that yes this is what I have RSD. I went thought a few other test before we decided to do a trial for a spinal cord stimulator(Boston Scientific) SO. It implanted and I just has a revision done today. Ok thier is more but I want to get to my question. Would you or could please tell me. If the outside ligs and tendon are in a rest position when your foot is hanging down? Kind of like a rest position. Or is it when you have your foot in a 90 degree angle flat on the floor. Now this is really my question....The reason I ask is because when my foot is in a rested with my toed pointing down ward it feels as if if it's pulling on the ligament and tendons that are at the bone site. The bone just kills me. You can not touch the bone because it's to painful. I can tell the difference between the RDF pain and the pain that is in that area. This pain ruins my whold day. I do where an AFO because I and my doctor feels it would be the safest thing to do. Because he does not want me to roll my ankle. I guess what I am asking is their some way to take these ligament and trndons out or off the bone and just leave it that way. I know in my heart of hearts that something Is wrong and I am pain because of it. I can tell the difference between the ligament and tendons pain. I have to live with my ankle everyday and to be honest. I don't think I can live with this for much longer. I did leave out alo. SO if you want to as me a question please just ask. I am sorry for leaving so many questions. Please just ask!! Thank your time Chris

paleyd on "barefoot friendly doctor in nyc?"

paleyd — Sun, 30 May 2010 11:35:08 +0000

hi dr. n, i'm hoping you can make a recommendation for a doctor in NYC that is sympathetic to the barefoot movement? thanks in advance!

jamilkhoury on "Pronation and Five Fingers"

jamilkhoury — Thu, 27 May 2010 15:58:59 +0000

Dear Dr. Nirenberg, I'm interested in purchasing Vibram Five Fingers running shoes, but have hyperpronation and have been wearing an orthotic for years. Is this shoe helpful or harmful for us flat footed folks? Thanks!

justwondering. . . on "It feels like there is a rock under the ball of my foot. . ."

justwondering. . . — Tue, 25 May 2010 13:20:41 +0000

I am a female, 48, 5'0 and about 50 pounds overweight, and have been most of my life. I had four children, and have been active all my life. Recently I started to increase my exercise in order to feel better and lose weight. I had been walking several miles at least two days a week, however, I now do more resistance training than walking. For some reason, I have developed a condition in which it feels like there is a small rock or pebble in my shoe under the ball of my foot. As soon as I take pressure off my foot, the feeling disappears. The feeling is most prevalent when I am driving or standing. As soon as I start walking, the feeling pretty much disappears. I can't feel anything in my foot that seems to be abnormal, and the only pain that I feel is caused primarily by the fact that I am pretty much wrecking the rest of my foot by trying to avoid putting pressure on the rock in my shoe. That isn't really there. The last time I went to a podiatrist I had a really bad experience, so, I have not been again. But, I am feeling something going on in my other foot as well, and I am just way too young to be crippled!

eers on "Foot Sensitivity"

eers — Thu, 20 May 2010 17:14:11 +0000

I am a 38 yo male with a lot of issues I'm currently struggling with. I have slightly high BP and cholesterol. I am hypothyroid and currently taking Synthroid 75mg. However, my most prevalent symptom is this weird wooziness/dizziness that is always in the background. Every now and then it gets aggravated by motion and I get a strong sense that I'm about to fall or that things are starting to turn around me, it's very unsettling. I've gone to about 1/2 dozen doctors in the last year (including ENT and neurologist) but they can't find anything wrong with me other than a Vit D deficiency found last fall (I'm currently taking about 6000 IUs daily and was found to be at 38 several months ago - so I think I should be a good position there). I have very sensitive feet. My wooziness/dizziness seems to get aggravated when I'm walking on a harder surface - even if it's with shoes on. Sometimes my toes on my left foot get numb as well. It's so sensitive that I can feel the dips and divits on a hard wood floor it seems. Other times, this recedes and isn't so bad. I have had two blood tests in the last year that show my blood sugar at low 90s and mid 80s which makes me thinks it's not diabetes. Can you please help me start putting these clues together and let me know your thoughts. Thank you so much in advance...

wayne342 on "broken metetarlsel from getting my ankle and side of foot ran over"

wayne342 — Wed, 05 May 2010 11:39:58 +0000

i am healing a broken 2nd metatarsal on my left foot i am out of the brace now that i was in for two months was on crutches for six weeks then in the brace for 2 and a half weeks do you have exercise suggestions and healing suggestions for mobility, balance, strength, routine, and what would be a good shoe, what do you think about the foot glove. my calf and other leg muscles did atrify from the injury. i have been out of the brace since may 3rd. please help. slightly scared.

bmnacc on "Do I have a stuck nerve in my foot - any solution?"

bmnacc — Fri, 07 May 2010 00:46:43 +0000

Hi, I occasionally have a strange pain in my right foot after running for a while where it feels kind of tight, however it is not a cramp. I have been told by someone else (not a doctor) that it may be a stuck nerve? Any ideas? It is on (my) left hand side of my right food, on the bottom. Thanks :)

af12 on "Athletes foot or something more?"

af12 — Wed, 19 May 2010 21:03:40 +0000

For a while now I have had this issue with my left foot only. I get a really bad itching on my toes, usually between them, but recently under a couple. Once I start scratching, it is almost impossible to stop. Then I can feel tiny hard spots under my skin. When I continue to scratch a blister forms where I felt the hard spot. Once I scratch the blisters open then of course scab up and go away. What is this??? Do I have some sort of fungal infection or is it something different?

grinchygirl on "On/Off Burning/Painful Sensation Outside of Foot Midway Between Toes and Heel"

grinchygirl — Tue, 18 May 2010 14:25:08 +0000

A couple of weeks ago I was on a trip for work. Most of the time, the trip involved standing or sitting and not a lot in-between. On the last day, the side of my left foot, midway between toes and heel, was feeling bruised. I thought it was due to the thick socks in my boots and my feet being feed up with the socks and boots. It only lasted the one day. About a week later I noticed an on-again/off-again mild bruising sensation but it did not appear bruised. There was no swelling or discoloration. Then this weekend after gardening, I noticed the pain came back again by the end of the day and disappeared overnight. This time it felt more like bruising and swelling (but it wasn’t). The next day (another weekend day), it returned in the mid-afternoon only this time it was so painful I could even feel it when I wasn’t moving the foot at all and could barely stand to walk on it. The day after that (today), it felt tender in the morning and thought it was going to be okay, but it became painful again by lunch time. The odd part is that I notice the painful bruising/swelling sensation more when I wear my ultra-comfortable tennis shoes. Wearing casual sandals or dress shoes for the office doesn’t SEEM to aggravate the side of the foot. What is likely causing this and what kind of home remedy can I try?