Hiking Pacific Northwest

Hiking Pacific Northwest

The mountains are calling… where are my hiking boots?!?!

Here in the Pacific Northwest, the rains are subsiding and more sunny days are peaking through the winter cloud cover. Generally, this is when we all begin daydreaming about the beautiful hikes we will be attempting this season. But before you just throw on last years hiking boots or shoes, take a minute to inspect them to make sure they are adequate for what you need or want to do. Should you decide you need new shoes, there are some things to consider during your search.

The first decision should involve what type of shoe you are looking for- be that hiking shoes, day hiking boots or backpacking boots. For information on the differences between them, a great site for information is REI’s hiking boot advice at: https://www.rei.com/learn/expert-advice/hiking-boots.html

Most important despite the type of shoe you look for, is the fit. Here are some rules you can follow:

  • Try your boots on at the end of the day with the socks you plan to wear. Our feet swell as the day goes on and this is the size you want your boot to be.
  • Bring your orthotics if you have them- it is important to see how this will affect the fit of the boot.
  • If you do not wear orthotics, consider some separate insoles. Many brands of hiking shoes are flat on the inside without much arch support. It is important to add arch support if you are usually most comfortable in tennis shoes or other shoes with arch support during regular activity.
  • Get measured for your boot size- it will be a different size than your shoes.
  • Make sure you understand how best to lace your hiking shoes. The should be snug everywhere, but not tight or applying pressure to any one area of your feet.
  • Wear your boots around the store for awhile to really determine comfort. If you feel any pressure spots or rubbing, know that this will only get WORSE when you are out on the trails!
  • Break your boots in first on a shorter walk or trail. Often, stores like REI have policies where you can bring the shoes/boots back to exchange them if you find the fit is not right. This is important to figure out before your boots’ inaugural venture.


Tendonitis

Tendonitis

This time of year we are starting to think about those summer beach bodies, and the pressure of fitting into last year’s summer clothes has us rushing to our running shoes. Unfortunately, a lot of information online has fitness routines that advertise getting that “beach bod” or “tight toned legs” within just a matter of weeks. The truth is, frequently these routines do not include stretching exercises before and after your workout, which can lead to sudden leg and foot pain from tendonitis.

When you have sudden onset pain, without much recollection of a specific injury or incidence, it is often due to tendons being over-stressed and having too much tension. Stretching will help significantly decrease your chances of having injuries. Below, we have outlined some of the common tendonitis’ that occur as well as some stretching information to help each muscle group.

Achilles Tendonitis:

Symptoms: Pain to the back of your heel after activity or upon first steps after rest

Achilles Tendon Function: The achilles tendon functions as your major calf flexor and to help lift your foot off the ground.

Stretches: This is one of the most important muscle groups to stretch, as a tear or snap of this tendon will result in an extensive recovery and time off from working out. Standing with your heels off the end of a stair and allowing your heels to slowly slip down off the edge is a great way to do this stretch.

*Be sure not to just flex your toes upwards towards you as your version of a “Calf stretch”. While it might seem like you feel some stretch here, you are over-straining the opposing muscle tendons and are possibly making yourself prone to other forms of tendonitis.

Posterior Tibial Tendonitis:

Symptoms: Pain in your arch after activity. Generally, the more activity you do, the more pain you have.

Posterior Tibial Tendon Function: This tendon holds up the arch on the inside of your foot during all weight bearing activity- standing, walking or running.

Stretches: Any calf stretch will help this muscle group. Again, standing with your heels off the end of a stair and allowing your heels to slowly slip down off the edge is a great way to do this stretch.

Anterior Tibial Tendonitis:

Symptoms: Pain to the top of your foot, just short of your big toe joint. Most pain is on flexing your foot upward towards you or when you are driving

Anterior Tibial Tendon Function: This tendon helps stabilize your foot and allows you to flex your forefoot up towards you

Stretches: Usually this tendon starts to have issues when your calf muscles are tight, so any calf stretches will also help with this tendon. Additionally, pointing your toes and holding this stretch for 20-30 seconds will help some as well.

Peroneal Tendons:

Symptoms: Pain to the outside of your foot and ankle, especially after walking distances.

Peroneal Tendon Function: This group is made up of 2 tendons (Peroneus Longus and Peroneus Brevis) that function to help stabilize the foot and keep your foot from turning inward.

Stretches: Generally, pain to this area infers that there is some change in how you are walking, either due to incorrect shoegear or compensation for another injury. Analyze your shoes first to make sure this isn’t the cause. If you aren’t sure, having a podiatrist look at your feet and shoes is always a good idea. Any peroneal stretches you can find online will be sufficient for these muscles since this is usually more of a positional issue.

Click here for more information on what conditions may be causing specific foot/leg pain: https://peninsulapod.com/where-does-it-hurt/

The interactive link allows you to hover over different areas of the foot and lower leg, and click on areas you want more information on.


Help my unsightly toes! Do my toenails have fungus?

Help my unsightly toes! Do my toenails have fungus?

Unsightly toenails and toenail fungus are some of the most common complaints that come into my office leading into the summer season and sandals weather. And this complaint is not limited to just women; many of my male patients are concerned about the look and condition of their toenails as well. While there are many different ads on TV and online that advertise quick remedies to completely eliminate nail fungus, there are some general facts about nail and foot fungus that I tell all my patients to help them avoid frustrations.

Things to know:

  • Fungus lives on our feet ALL THE TIME. It’s a natural part of life and does NOT mean you have poor foot hygiene. Fungus is an organism that is trying to survive like any other, and it just happens to really enjoy dark, damp and warm environments (much like the insides of our shoes and socks). This makes feet prone to harboring fungus. That said, just because you have gotten rid of foot or toenail fungus, does not mean it will never come back. Periodic treatment of your feet with antifungal creams will be necessary to keep the fungal load down
  • Topical antifungals are less effective than we would all like, but there is a good reason for that. The fungus actually lives under your toenails, using the nail itself as a barrier for protection from your attempts at treatment. One key technique in treatment using topical antifungals is the filing down of the top of the nail to create pores down to the nail bed. This allows the topical creams or lacquers to get down to where the fungus lives.
  • Oral antifungals are much more effective than topical treatments, however these medications are hard on your liver. Your physician will need to order blood tests to evaluate your liver function before you start the medication and halfway through your treatment. The oral pill is taken daily for 3 months.
  • Nails take a long time to grow out! Toenails can take up to one full year before there is much noticeable difference in your nails appearance. Make sure your expectations are reasonable; don’t plan on the nails looking great after just 3 months of treatments.
  • Make sure your shoes fit. One of the common ways fungus gets under the nails is from the tips of the toes/toenails hitting the inside of the shoes when walking. This causes the nails to lift from the nail bed just enough for fungus to get under there.
  • Use foot sprays in your gym shoes/ hiking boots. Any shoes you wear that cause your feet to sweat will harbor more fungus. It is imperative to spray out these shoes and allow them to dry after each use.


Yard Work Shoes

Yard Work Shoes

The Grass is Always Greener in Your Yard… Until the Heel Pain Strikes! The trouble is your yard work shoes…

Here in the Pacific Northwest (and much of the country), the weather is finally nice enough to be outside and people are hurrying to get out into their yards to work. Whether gardening and landscaping, mowing lawns or starting new outdoor projects all together, we all slip on that worn out pair of tennis shoes and race out our back door. Its become a sign of the change in seasons and the long-awaited welcome of the summer months.

Now how could a podiatrist weigh in on yard work, you might ask? Its all about the shoes.

One of the most common issues seen in my office during the summer is newly onset plantar fasciitis (heel pain). The pain comes on in the morning and each time you first stand up. Most people are dismayed to have this problem arise now that they can finally be outside working, and they choose to ignore the pain. That is, until the frustration is too great, their summer months seem potentially ruined this year, and they limp into the office. For more information on plantar fasciitis and treatments, see: https://peninsulapod.com/heel-pain-plantar-fasciitis/

The truth is, this could be avoided just by ensuring you are using the right shoes! The most common denominator reported to me this time of year is that people’s “yard shoes” are their old pair of tennis shoes they don’t wear anymore. But think about this. Yard work involves walking, standing on uneven surfaces, crouching on your toes and forefeet, and getting up and down off the ground in the form of a lunge. If you thought about your movements in terms of a workout routine, you’ve just launched yourself into some kind of intense, cross-fit-type workout routine… and you’ve decided to do so with the shoes you wont even walk around the neighborhood in anymore. Seems to make less sense, doesn’t it?

While I understand the need not to “ruin new shoes” with yard work, it is important to remember that this drastic change in routine, combined with unsupportive, worn-out shoe gear, is the perfect combination for tendon issues and plantar fasciitis.

The best recommendation I give patients is to obtain boots or shoes that are supportive and rigid to work in, and to stretch their calf muscles twice a day. Stretching exercises can be seen here: https://peninsulapod.com/2018/01/07/heel-stretching-exercise/

Your yard work shoes should not be flexible in the sole or able to be bent in half with the heel and toes anywhere near touching. It is important to think of yard work as a new physical exercise routine and to chose shoes that would best facilitate this. For more information on choosing a shoe, make an appointment with your local podiatrist for recommendations.