Tuesday, April 23, 2013

Baby and Toddler Shoes

Before babies starts walking, they don't need shoes. In fact, supportive shoes like hard-soled Mary Janes may actually get in the way of your child's developing mobility. Socks, booties, and soft-soled baby shoes are useful for warmth, but bare feet are fine, too. In actuality their feet are very adaptable to the ground, whether it is carpeted or wood and tile. And early on it allows their proprioceptive feedback to allow them to balance easier and develop more readily in the very early stages without shoes. 

Once your child takes those first steps, it's time for a pair of real shoes. Unlike "baby shoes," which are more like slippers, first shoes will have a flexible, nonskid sole (probably rubber) and a more substantial upper. Shoes protect kids' feet outdoors and anywhere else that could be hazardous – a splintery surface, for example.

Note: Your child's foot is still developing, so it won't look (or act) like an adult foot. If your child still has a padding of baby fat under the arches, for example, she might appear a bit flat-footed. Or she may have a tendency to turn her toes in when she walks, called in-toeing or toeing in.Indoors (and outdoors on safe surfaces, such as sand), it's still a good idea to let new walkers wear soft baby shoes or socks. Your child can even go barefoot, if it's warm enough. Toddling around with feet bare or lightly covered actually helps little ones build strength and coordination in their legs and feet.
Mention any concerns to your child's doctor. It's easier to correct foot problems when your child is younger.

What to look for when buying
Choose a breathable, lightweight material. Soft leather or cloth is best. Avoid stiff leather shoes, which can hinder foot development, and synthetics, which don't breathe. Bend the soles. They should be flexible and gripping, not smooth and stiff. A nonskid rubber sole with ridges will offer good traction.

Check the fit. Have your child try on the shoes and stand up. There should be just enough room to squeeze your pinky between your child's heel and the heel of the shoe, and a full thumb-width between the end of your child's longest toe and the front of the shoe. The shoe should provide just enough wiggle room without being too big. Because baby feet grow quickly, it's a good idea to check every month to make sure the shoes still fit.
Give it a squeeze. If the shoe is made of soft fabric, try to grab some of the material on the top of the foot when your child is wearing them. If you can't, the shoes might be too tight.
Shop later in the day. Babies' feet swell and are often bigger at the end of the day. Shoes purchased in the morning might feel tight in the evening so usually try shoes on before dinner before you buy.
Look for problem spots. Your baby's shoes shouldn't need any breaking in. Let your child toddle around indoors wearing the shoes, then take them off and look for any irritated areas on your child's foot which could be red areas or blisters, and in more rare cases even a callus formation can occur but this is not common.
Make the choice: laces versus Velcro. Velcro fasteners make it easier to get shoes on and off, and you won't have to worry about retying laces all day. But a child may figure out how to remove his shoes and take them off when you wish he wouldn't! If you choose shoes with laces, make sure they're long enough to tie into double knots, so they won't come undone as often.

Achilles Tendonitis

The Achilles tendon is the thickest and strongest tendon in the human body. This tendon, which runs along the back of the leg and inserts onto the heel, can endure forces of up to 6 to 8 times the body weight during repetitive activities such as running.  Because of the high load of stress it must endure, the Achilles tendon is prone to injury and inflammation. This condition is known as Achilles tendinitis and is a common cause of leg and heel pain in the active individual. 

There are many factors which may contribute to the development of Achilles tendinitis, but it is commonly an overuse injury which results from a sudden change in activity level without proper training or conditioning. Other factors include tight leg muscles, improper shoes, and biomechanical faults within the foot and leg. 

Signs of Achilles tendinitis often begin with swelling and a dull ache or stiffness in the back of the leg and heel that typically occurs at the end of activities. If left untreated, the pain can worsen and become present at the start of activities or even during normal walking. In severe cases, the tendon may even partially or completely rupture. 

Early cases of Achilles tendinitis can be treated conservatively with rest, ice, and gentle stretching. Orthotics and heel lifts may help relieve tension on the tendon. Physical therapy can be initiated to provide additional reduction of inflammation and pain. In some cases, the Achilles tendon may require temporary immobilized within a walking boot. 

Surgery may be necessary for individuals with pain that persists or worsens despite conservative treatments. However, it may be possible to avoid surgery through the use of advanced therapies such as extracorporeal shock wave therapy or platelet gel injections. Once the pain resolves, it is important to have a gradual return to activities to avoid re-aggravating the Achilles tendon. 

Participation in a regular physical activity is an important part of maintaining a healthy lifestyle. Proper shoes, stretching, and strengthening exercises can help prevent injuries. For any foot or ankle pain, a podiatrist should be seen for a full assessment and treatment.

Sunday, April 14, 2013

Treatment and Prevention of Blisters

A common complaint athletes have is the formation of blisters on their feet. They arise in areas that are subjected to excessive and repetitive friction. In addition, heat and moisture contribute to blister formation by softening the outer layer of skin. These factors are all present during activities such as running. While blisters typically are a painful nuisance, they may develop into an infection if not properly cared for.

Some blisters will resolve if left alone, but if the blister is painful, it may be drained. Using rubbing alcohol, sterilize a needle and the skin over the blister. Carefully lance the thin, outer layer of the blister and drain the fluid. Apply an antiseptic (iodine or antibiotic ointment) and cover with a bandage. Continue to watch for any signs of infection over the next few days as the blister heals.

If you develop recurrent blisters, you may treat them after they form; however, a better solution is to prevent their formation.

There are numerous products available that can decrease the coefficient of friction. These products (Body Glide, Bag Balm, or petroleum jelly) act as a lubricant when applied to the skin.

If your feet sweat a lot, your skin will soften over time increasing the likelihood of a blister. Foot powders can help absorb excess moisture keeping your skin dry and intact. Spraying your feet with an antiperspirant is another easy option.

The next step in prevention is wearing proper socks which should be made from a synthetic, moisture-wicking fabric. Consider wearing a double-layered sock (WrightSock) as it reduces friction against your skin. If you tend to develop blisters between your toes, a toesock (Injinji) provide extra protection.

And finally, the most common cause of blister formation is improperly fitting shoes. Make sure your shoes fit properly around your heel and that there is plenty of room in the toebox. Shoes that are too long or wide can cause your heel to slide and lead to a heel blister. Shoes that are too short or narrow increase the frictional forces upon your toes.

The best treatment of blisters is pro-active prevention. By following these suggestions, blisters do not have to be a part of your sport or exercise routine.

Time for New Shoes?

You’ve finally found the perfect pair of running shoes. They fit and feel wonderful. You feel as if you can run forever in them, but they are now starting to show some wear. Is it time toss your favorite shoes and get a new pair?

There are several things to consider when deciding if your athletic shoes need to be replaced. First, how much has the shoe been used? For high-impact activities such as basketball or tennis, shoes should be replaced after roughly 60 hours of use. A simple guideline for running shoes is to change them every 300-500 miles, but there are many factors than can shorten or extend the life of a shoe. For example, a petite runner will have less wear than a heavy runner. The type of running surface can also make a difference as a soft trail will result in less wear than a concrete sidewalk.

Next, check for signs of wear on the outsole. Place your shoes on a flat surface and examine them from behind. Excessive wear may cause the shoe to tilt to one side. If the heels are not perpendicular to the ground, the shoes need to be replaced. For most heel-striking runners, a normal wear pattern is on the outside corner of the heel. If one typically runs on a road or track with a cant (cross slope), an asymmetric wear pattern may develop. A significant asymmetry should be evaluated by a podiatrist as it may be caused by an issue that may be improved through the use of a custom orthotic. 

Finally, it is important to know that the cushioning and support of a shoe will eventually wear down, even if the visible exterior remains in good condition. Athletic shoe midsoles are typically made of EVA which is a compressible material that loses its shock absorptive capabilities with prolonged use. Other factors can speed the degradation of EVA such as high heat or UV light. Loss of cushioning can lead to injuries such as stress fractures or shin splints. Another part of the shoe that can wear out is the upper which holds the shoe onto the foot. This supportive portion of the shoe can become over-stretched with use. When this occurs, the foot has more room to move inside the shoe which can lead to injuries and sprains. 

Good shoes are important in all activities as they provide support, stability, and shock absorption. With continued use, the loss of these protective functions can potentially lead to overuse injuries of the foot and leg such as plantar fasciitis, stress fractures, ankle sprains, and shin splints. The decision to replace your shoes depends on several factors, but if your shoes appear worn, it is time for new shoes.