Your foot pain is telling you something and here is how to respond

That first painful step in the morning is not your imagination and it is not something you should just “push through.” We dig into plantar fasciitis, why heel pain can feel like you are stepping on broken glass, and what actually helps: supportive shoes, orthotics and gel pads, smart activity changes, and specific plantar fascia and calf stretches you can do at home. We also talk about the frustrating truth behind tendons and fascia: these tissues have slow turnover and limited blood supply, so healing can take time, especially for midlife women dealing with repeated strain, poor sleep, nutrition gaps, or unbalanced training.

Then we zoom out to a newer concept that may reshape how we think about chronic pain and recovery: the interstitium, often described as a hidden network of fluid-filled pathways in connective tissue. If this “third circulatory system” influences inflammation and movement of cells and fluid, it may help explain why certain integrative therapies work for some people. 

We also reprise our Devil Wears Prada-inspired footwear conversation because shoes matter more than most people realize. We cover common foot problems in women, from bunions and Morton’s neuroma to arthritis and Achilles tendinitis, plus diabetic foot care warnings and the red flags that mean you should call your clinician. If you want less pain and more freedom to walk, work, dance, and travel, this one is for you.

Transcript

Why Heel Pain Lingers

Dr. \ 0:09

Welcome to the Speaking of Women's Health podcast. I'm your host, Dr. Holly Thacker, and I am back in the Sunflower House for some new information, focus on plantar fasciitis and the interstitium, the so-called third circulatory system recently described. And then we're going to reprise last July of 2025's podcast on The Devil Wears Prada. So the foot and the feet are something that you really uh need. And it takes a beating, and you've got to take care of those Tootsies. And in that July of 2025 podcast, I went over a lot of different causes of foot pain, a lot of different treatments, a lot of tips. But what I wanted to do on this podcast is really delve into plantar fasciitis and also talk a little bit more broadly about musculoskeletal problems that vex so many midlife women that I see. Whether it's tendinitis, whether it's slow-to-heal musculoskeletal injuries, uh, whether it's uh gluteus tendinosis that can afflict a lot of midlife women and cause horrible pain, whether it's plantar fasciitis that feels like you're stepping on broken glass until you kind of stretch all the fibrosis of the plantar fascia, which supports the bottom of your foot. And I want to focus on the interstitial. Now, Dr. Feng is no longer at the Cleveland Clinic. He's since went back to uh China to Macaw with his family, but we do have other acupuncturists on staff at the clinic. And wherever you are listening to this, hopefully you could find a certified acupuncturist if you need it for tendon problems, musculoskeletal problems, or maybe even plantar fasciitis. But I was talking to this acupuncturist

Meet The Interstitium

Dr. \ 3:05

about the interstitium, and is that part of how acupuncture works? And um he thought that's a strong possibility. So this article that was in the New York Times titled Inside the Interstitium, the Human Body's Hidden Pathways, it was a very um interesting discussion about our third circulatory system. Now, we have known um since we started doing anatomy that we have a circulatory system made up of arteries and veins that carry the blood and little tiny arterioles. We've also known about the lymphatic system, which drains lymph fluids. But it's only really recently um that we've talked about the third circulatory system, the interstitian. And it may help bridge the difference between classic Western allopathic medicine that I practice that helps lots of things, but falls short in other areas, and Eastern medicine. So for centuries, we in Western medicine have recognized the two uh systems, blood and lymph, but we missed one apparently. And in response, the American Medical Association, uh, which a lot of physicians actually don't belong to, but nonetheless, they issued a statement saying they're cautiously optimistic that the human body does not contain any more surprises, and that they're reasonably confident that we found all the important parts. Well, I always like to think of new things on the horizon and keeping an open mind. And so there's a number of conditions that have vexed my patients that conventional allopathic medicine hasn't found a solution for. And I think much to the Cleveland Clinic's credit, they've expanded integrative medicine, functional medicine, holistic medicine, uh, brought in many different types of practitioners from chiropractors to acupuncturists to reke, offered a whole panopoly of different approaches to help people, particularly with chronic problems. So researchers were studying tattoo ink migration in the body, and they found these fluid-filled interstitial spaces throughout the body's connective tissue that were not just isolated pockets like we thought they were. They actually are one continuous network, and they're called the interstitium, which has some pretty interesting implications. So having this third fluid-filled pathway might explain how cancer cells metastasize, not just through the usual lymphatics. You know, when patients have cancer surgery, the surgeon dissects the lymph node that that tissue drains uh from. It also may have a role in inflammation in the body. And importantly, it could explain how acupuncture works. Because I've been trying to wrap my mind around how acupuncture works for a long time. And I certainly have referred people to acupuncture for chronic pain, headaches, menstrual cramps. Uh, I've been fascinated how it works with neurologic problems, peripheral neuropathy, even stroke, uh Bell's palsy, facial paralysis, uh, and plantar fasciitis, too, which we're going to uh talk a little bit more about. So um by looking at inflammation and blood flow in places of the body where there's not direct blood vessels. So that would include like your plantar fascia,

Acupuncture For Slow Healing Tissues

Dr. \ 7:20

that would include tendons, cartilage, and with age, these tissues are um takes a long, long, long time to heal. There's very slow turnover. Surgery uh a lot of times does not change the integrity of the tendon. There's been some new thoughts in physical therapy about stressing the tendon to help improve the remodeling of it. And Vince Whalen, who was on earlier in the summer of 2026, talked about some of their physical therapy treatments of tendinitis. Years ago, I had acupuncture for uh tennis elbow. I went from playing tennis once a week to twice a week, and that was too much. I couldn't even lift up a coffee cup. And acupuncture dramatically improved it. I've been sending some patients with refractory plantar fasciitis for acupuncture. And what the acupuncture said is that it does improve blood flow, which blood flow helps with repair and helps get nutrients there. Also, it may stimulate stem cells, which help in the tissue recovery. And other things that might help these slow to regenerate tissues besides just good nutrition is massage. Uh, and massage and wearing good support uh with uh gel pads, inserts, arch supports, wearing good footwear, stretching the plantar fascia can help. Also, topical uh treatments like arnica. I did a podcast on common remedies that uh can help the skin. Arnica is an herb that dermatologists use to reduce xenilperpora, bruising, injury to tissue. And some folks have applied arnica uh to tendons or fascia like the bottom of the foot where there's pain, followed it up with some DMSO, which is a solvent which causes deep penetration into the tissue. Things like camphor and benthol and frankincense topically have been used to help musculoskeletal problems. I think we're going to see big growth of growth peptides, a small little amino acids that help in tissue repair. Red light uh therapy, which Dr. Sobia Khan, who's one of our women's health functional medicine doctors, uh, did a nice column in October of 2024 on speaking of women's health.com. It stimulated me to do a podcast. If you didn't hear that podcast on red light therapy from June 11th, 2025, uh applying the right wavelengths to the skin. A lot of women, you'll see them wear these masks. I saw my niece who came to visit me, who's had some trouble with androgenic alopecia, have the cap for 15 minutes a day to improve blood flow to the scalp. Uh, I've certainly used it for shoulder tendinitis and musculoskeletal problems. I've told patients to try it in addition to stretching good footwear and seeing their podiatrist when they have plantar fasciitis, as well as possibly topical treatments. And then the ancient art of acupuncture, the fact that it may stimulate blood throat, blood flow through the interstitium and help stimulate the body to recover is really extremely exciting. And so I think that even though when we don't understand why things work, if they do work and they have a pretty known safe side effect profile like acupuncture, that prior to getting cortic cortisone injections, which may give temporary relief when you inject it into the plantar fascia, or you inject it into a joint, or you inject it into a tendon area. Sometimes that can give you pain relief and it can reduce inflammation. But sometimes it's not inflammation, it's just degeneration of the tissue for lack of blood flow, and certainly poor nutrition, cigarette smoking, repetitive trauma, not having balanced musculature, not getting enough restorative sleep. All of those things can make it so much harder for you to recover. One of the other therapies that I wonder if it has something to do with the interstitium is um shockwave like lithotripsy therapy. And some insurance will cover acupuncture, some will not. Most insurances are not covering for PRP, which is platelet-rich uh plasma that is injected into areas like the plantar fascia or like tendinitis or light knee arthritis, which a lot of patients are looking into this more regenerative type of therapy, as opposed to just using steroids to treat the symptoms,

Footwear Lessons From Devil Wears Prada

Dr. \ 12:50

which doesn't really generally affect the underlying problem. And this lithotripsy shock therapy is offered, you know, for planner fascia. And I think prior to going for surgical release, uh, which you know has variable outcomes, that some of these alternative therapies may be looked into. And I've certainly referred patients to physical therapy, to acupuncturists, as well as to sports medicine using some of these therapies. And whether it's dry needling or acupuncture or resistance training of the tendon, I have to wonder if this somehow does stimulate the interstitium. And with that background, uh, we want to talk about The Devil Wears Prada. I heard that that movie has, I think, a part two. I don't know if it's come out, but if it has, I'm gonna have to watch it. I love shoes, and I think women's feet take a beating. And so I hope you enjoy this reprise of The Devil Wears Prada. Welcome to the Speaking of Women's Health Podcast. I'm your host, Dr. Holly Thacker, and I am back in the Sunflower House for a brand new episode of Speaking of Women's Health Podcast. And on this new episode, I'm talking all about the Devil Wears Prada, meaning footwear and taking care of your feet. Those Tootsies are pretty darn important. I had a good friend who just recently had foot surgery, and I have lots of patients who have to undergo foot surgery, and it really throws them back. Our feet take a lot of abuse. I'm going to take some information uh from uh one of our columns that was published several years ago by Dr. Anna Camille Moreno, and she's a graduate of our Center for Specialized Women's Health Fellowship. She went on and practiced in specialty women's health at Duke Women's Health Associates, and now she is the director of the University of Utah's Midlife Women's Health Program. And she has done guest lecturing on our physician uh and APP continuing medical education program that we do through menopauselearning.com with the nonprofit that I work with advancing health uh after hysterectomy. Aha. And Dr. Moreno, when she was a fellow, wrote a column on our speakingandwomen's health.com website, the nonprofit, dedicated to empowering women to be strong, be healthy, and be in charge. And she wrote it with a Cleveland Clinic podiatrist, Dr. Georgianne Botech of the Cleveland Clinic about really common foot disorders in women. And when I started uh speaking of women's health in the Cleveland area as an offshoot of the nonprofit, before it was gifted to us uh by the wonderful uh founder and our creative strategist, Diane Dunklan, also known as Lady Die, who's quite a stylish dresser with great clothes and footwear. Uh we had live events with health screenings and lots of breakout sessions. And one of the popular sessions we had was called The Devil Wears Prada after that uh popular book and movie titled The Devil Wears Prada. So we don't want your shoes to be the devil, but we women want to wear stylish, stylish shoes um within reason. And some of my favorite shoes, you know, do seem a bit devilish with uh, you know, such spikes, snakeskin. Here's another one of my favorite shoes, open toe, but also pretty high-heeled. I wore these uh at Stetson's wedding. Um, by the time we got to my second son, Emerson's wedding, I wore a little bit more responsible shoes because I knew I would be on the dance floor. And of course, we had to practice that mother-son dance. Um, but your feet take a lot of abuse. And I really wish that when I was younger, I would have worn uh better shoes running up and down stairs and concrete floors of the hospital, running to codes, uh, being up late at night, you know, tracking miles and miles a day. Because it's important not just for your feet, but your knees and your hips and your back. So if you're listening to this and think you don't have foot problems, you might not have them now, but you could have them in the future. Our feet uh put on hundreds of thousands of miles, and we really need to take good care of them. And whether you're a walker or a runner or a dancer or just a regular person who wants to walk comfortably, it's important to wear appropriate supportive footwear,

How Feet Work And Why They Hurt

Dr. \ 18:30

and it can be stylish too. Now, I did draw the line at uh Christian Louboutin shoes. My husband bought me a pair, and I just could not comfortably wear them. Now, each foot contains about 26 bones, 33 joints, and more than 120 muscles, ligaments, tendons, and nerves. And the feet has um, or the foot, each foot, we have two feet, has four important functions. Supports the weight of your body, hence another reason not to even be a pound or two overweight, certainly not 10, 20, 30 pounds, which a lot of women gain at midlife. Weight is our number one topic, and we have had podcasts on intermittent fasting, nutrition, exercise, an interview with one of our graduate uh fellows who also has her uh board certification in obesity medicine, Dr. Tara Eyer, who is at Harvard running their midlife women's uh health program. Uh so people interested in getting the weight down after you listen to this, go back and re-listen. There's so many great nuggets of information. Our feet act as shock absorbers, uh, they flex and push us forward with each step, and they help with balance and help us from falling. And balance and risk of falling goes up significantly, especially after age 80. And so, really, once you're over 60, you should be doing regular balance exercises. So, how common are foot problems? Well, they're very common in women of all ages, and many times foot specialists like your friendly podiatrist, just like Dr. Georgian Botec is for several of our patients, uh, they might recommend surgery on your shoes before your feet. Uh, and that sounds a lot better to me. And you do need two good feet uh to help keep you in good shape and allow you to walk and also potentially run. And so these feet take a lot of beating. So one in three women over the age of 65 has foot pain, aching, or foot stiffness. In the United States of America, up to 87% of people will have painful feet at some point in their lives. Foot problems worsen with age, like most things. And uh the most common complaint in women is pain in the ball of the foot or their heel. Most common foot problems are triggered from poor fitting shoes, including these pointy-toed, high-heeled shoes, or those with slippery soles, or those that offer no support. And of course, if you're overweight, it's more prevalent if you have diabetes, heart disease, osteoporosis, or known osteoarthritis in other parts of your body. For foot disorders in women, such as osteoarthritis, also Problems or plantar fasciitis, and is important to stretch your feet, like do a uh like wearing a reverse high heel or like a clog where the front part is higher, and that helps stretch that plantar fascia. Bunions, the big uh big toe joint. A lot of people start getting osteoarthritis in their 20s in that bunion joint. So most podiatrists will recommend well-fitting shoes that have some orthotic uh foot support, and that might include shoes that have orthopaedic uh supportive arches. I was just noticing my grandson uh feet, he was running around barefoot when I was there to see the new baby, his sister, Vivian Vera, and I noticed that he had fallen arches, uh, which aren't too uncommon in children and sometimes do need treatment. Other times uh will get better over time, but we all need adequate support of our arches, and sometimes inserts called orthotics uh may be prescribed. Now there's different types of athletic shoes, some have more or less arch support and ankle support, and certainly depending on what sports you're doing, may dictate the type of footwear. I know that when my sons were in high school and playing three sports, they had different shoes for running versus soccer versus basketball versus baseball, golf shoes, man, and with their feet growing and growing so often with three of them, I don't, I just we had so many shoes. We spent a lot of money on shoes. Um, and it's important that the money that you spend is worth it and really takes good care of your feet. And when you go in to see your physician or your podiatrist, if you've got any kind of foot or ankle or gait or knee problems, you should bring in several pairs of your shoes that you frequently wear because that will tell them a lot. They can look at how the wear of the shoe is, as well as what type of shoe it is, if it's if it's not particularly appropriate for the design and the anatomy of your feet. Um, and there are some local foot stores that sell

Common Foot Disorders And Shoe Fixes

Dr. \ 24:35

shoes, local shoe stores that can provide assistance that have some special expertise, uh, and that uh may be very helpful for you. With age, we tend to lose the fat pads or the natural cushions on our heels. We seem to gain it in other places, but lose it in the heels, and that can make a lot of foot problems worse. So, to help prevent foot pain, generally wearing wider, comfortable low-heeled shoes, avoiding tight or ill-fitting shoes. And if you're gonna wear these super duper fancy uh high-heeled shoes, spikes basically limit the time that you wear them. And so I always pack a pair of comfortable shoes or sneakers for when I'm walking around getting ready before I'm at whatever event that I want to put on a pair of high heels, then I slip into the high heels and to not have to walk for a longer distance. So, what are the most common foot problems in women? Well, one of them is called a tailor's bunion, also known as a bunionette. It's often a hereditary trait commonly seen amongst family members. So take a look at your family, family's feet. I remember when Artemis uh her parents were expecting her delivery. Well, my son Stetson has very large feet. Um, he can still buy them off the shelf, but he's just only one size shy of having to have them specially ordered. And his wife Laura has pretty good size feet as well. And I thought for sure this child was going to be born with flipper feet. Uh, they're a little bit bigger than average, but um, it is a good idea to look at your relative's feet. Um, now this bunionette can be described as a bony lump that forms on the outside surface of the foot, uh, near the little baby toe, the little piggy. It can increase in size and it could cause skin irritation over that bony lump due to you know friction from the footwear. Now, a bunion is very similar to a tailor's bunion, but it's always affecting the big toe. When we say bunion, we mean the big toe. And the medical term for this that we physicians and podiatrists call it, is a bunion hallux valgus. And it forms when the bone or the tissue at the joint of the bottom of the big toe moves out of place. So years of abnormal motion, pressure on the joint forces that big toe to bend forward towards the others, which can cause oftentimes a very painful bunion on the joint. Tight shoes that compress the toes can typically rub against this protuberance, and it can cause other issues like calluses and corns and skin irritations. Bunions can have a hereditary component, so you may notice this in your other family members. Bunions are generally permanent unless you undergo surgery to correct them. But you can treat the bunion at home to slow the progression. Wear shoes that fit well with plenty of space for the toes. The toes are not meant to be pointed into just a pointy single toe. You might want to protect the bunion with bunion pad cushions. You may need shoe inserts. You might want to apply ice if if the foot is injured or later heat to help with healing. Sometimes wearing a splint at night can hold the toe straight while it's on. Now, a neuroma is thickening of nerve tissue due to continuous irritation of the nerves from compression. Commonly affecting the foot between the third and fourth toe is called a Morton's neuroma. And common symptoms include tingling, burning, numbness, like there's something inside the ball of the foot. So women who wear tapered toe box shoes or high heels, those that have bunions and hammer toes, which are crooked toes pointing downward, and those people with flat feet are definitely at increased risk of developing a neuroma. Plantar fasciitis is probably one of the most common causes of foot pain in women. And the most common symptom of this is pain beneath the heel and the sole of the foot. And it traditionally the pain occurs at the bottom of the foot, and it's noticed when you get out of bed in the morning and first step down and start walking. And it's because you're stretching and tearing some of the little microfibers that have formed. It's typically caused by repetitive motions like running long distances in improper or old shoes, or excessive training with a very steep increase in activity level. If you're a midlife woman, you need to stretch before and after exercise, you need to have a warm-up period, you need to make sure that the muscles are balanced, that you're protecting your joints, that you have good footwear, and that you're not just a weekend warrior, like you're throwing yourself into incredible exercise to try to make up for not exercising for the last few weeks. If you have flat feet or very high arches, it can make the situation worse. So some of the ways plantar fasciitis is treated is decreasing your activity level, icing, investing in new supportive shoes, and in general, you should avoid barefoot walking or barefoot standing. Now, barefoot's primarily for babies that have all that nice baby fat cushioning around their feet. Generally, it's not for adults. I know it's kind of popular to be grounded, to go outside and have your feet on the ground. And maybe if you're in soft grass with a kind of spongy uh ness to the surface that you're standing on. But certainly like running or walking briskly on concrete is not a good thing to do in your bare feet as an adult. Now there are heel gel pads that can be used. There's orthotic arch supports. And the one thing that I recommend to my patients who complain to plannar fasciitis is do planner foot stretches. Stretch out your calf muscle. You can put your toes at the top of the stairs

Plantar Fasciitis Stretches That Help

Dr. \ 31:55

and then put the bottom of your heel down to do that natural stretch of the planner fascia. And there's several different ways you can stretch your calves. You can also pull your toe forward to lengthen your calf muscles and your kit Achilles tendon. You can stand with the ball of your foot on a step and drop your heel down as I demonstrated with my hands. You can stand facing a wall and place the ball of the foot on the wall while keeping your heel on the floor. You can sit on the floor with one leg extended and loop a towel or resistance band around the ball of your foot and pull your toes towards you, keeping your leg and knee straight. You can roll your foot over a tennis ball or a frozen water bottle. And combining cold and massage can be very helpful for breaking up those microfibers. Halx rigidus is a common type of arthritis in the great toe. And a lot of times this can be changed simply by changing your footwear, specifically avoiding pressure on that joint line. Now you may need an orthotic foot support device, and insurance may or may not pay for these orthotic devices, and there may be some expense associated with it. General arthritis. So arthritis in general is one of the most common causes of foot pain in women. And we talked about practical tips on low-impact exercises that help your joint health, as well as evidence-based advice on managing it with diet and supplements. Degenerative arthritis can cause inflammation, can cause wear and tear of the joints and cartilage and ligaments and tendons that connect to your bones. Severe types of arthritis can lead to degeneration of the arch of your foot. Osteophytes or bone spurs can cause pressure on the nerves of your feet, which can cause burning, tingling, or even numbness, and do need to be addressed by a foot specialist like a podiatrist. You have been listening to the Speaking of Women's Health podcast. I'm your host, Dr. Holly Thacker in the Sunflower House, talking all things the devil wears Prada, foot problems, foot pain, a serious foot problem that we deal with in the field of medicine is diabetic foot. It's a complication from poorly controlled diabetes. And we've had podcasts on diabetes, on being less sweet, on superfoods, on foods that may be toxic, that should be avoided, that are common in our American food supply, but banned in other countries. So diabetes, diabetesity, too much sugar really poisons the peripheral nerves. And the nerves that are farthest away from your spinal cord are the nerves in your feet because they have the farthest to travel. And that's where usually we see complications first. Now, a diabetic foot may present with an ulcer, an infection, a neuropathy that might be like a pins and needles type sensation. And unfortunately, people that have metabolic conditions, abnormal blood sugar, type 1 or type 2 diabetes are definitely more prone to getting foot ulcers due to the reduced ability to feel pain because of their diabetic neuropathy. So it's important to examine your feet every night, wear protective shoes, and examine your feet regularly, as well as keeping your blood sugar tightly controlled. Really, if you have diabetic neuropathy or any kind of metabolic sugar problem, you should have no sugar in your diet, take out all the simple carbs, focus on heart-healthy fats and proteins, and staying hydrated and avoiding alcohol and other toxins that also can damage the nerves. It's important to see someone who specializes in diabetes as well as a podiatrist that specializes in diabetic foot problems. There is a prescription vitamin Metanex, which is methylated vitamins, that may help

Arthritis And Diabetic Foot Warnings

Dr. \ 36:55

diabetic neuropathy. It's very important if you're someone with sugar diabetes to avoid going barefoot. Ingrown toenail. And it occurs when the edges of the nail grow directly deeply into the skin next to the nail, causing redness and swelling. Common among those with diabetes and peripheral vascular disease, or those people with circulatory problems, or anyone who has trauma to the foot and the toenails. If you're someone who likes to go to the spa to get a manny petty, okay, I'm confessing I do, you do have to be careful. And there can be infections, bacterial, and fungal that you can get depending on if things are not sterilized appropriately. If you're expecting upcoming surgery like a joint replacement or spinal surgery or cardiac surgery, you'll probably be specifically advised to avoid having any of these spa type services done on your limbs at least a few weeks in advance. Now you can do your own little spa treatment at home by soaking your feet in Epsom salts, which are basically magnesium salts, which can be very relaxing to the to the muscles and the legs and the feet. You generally always want to avoid cutting toenails too short. I'll never forget my husband. He had the little baby clippers out. And our son Emerson was kind of born with long fingernails, and he wanted to clip them right away so that he wouldn't scratch himself. But he actually clipped them so close that he took a little bit of skin off and it was causing poor Emerson to bleed and to cry. So anytime you're cutting your own fingernails or toenails or a squirming child, it's very important that you don't get it too close. If you're going to be using Epsom salts, particularly if there's any breaks in the skin, it should be fragrance-free, which is less expensive if you just get the plain Epsom salts. If you notice any signs of infection like redness or heat or swelling, and you're not feeling well if it's an older person, maybe they just are getting confused. They may not even manifest a fever. It's very important to seek medical attention. Hammer toes. In which the knuckle becomes bent. The knuckle may be flexible and correctable, or it might be stiff and rigid. What causes a hammer toe? Well, they're caused by muscle imbalances in the toes. Heredity plays a role, trauma, arthritis, wearing poor footwear or tight shoes or very tight stockings can all lead to hammer toe formation. In fact, uh it's kind of an interesting fad, but not necessarily a fad, is you can get socks or uh stockings that have individual components for each toe. And if you happen to have toes that might rub together and you want to kind of keep them straightened, uh that might be something to slip on at night. Uh, I frequently tell women just to wear little white cotton socks, um, like ankle socks around their feet just to keep the feet warm because a lot of times that will help with sleep by slightly warming up the feet. You lower the central body temperature and you tend to get deeper sleep. So you might want to look uh for those uh fun little stockings or socks. I have a pair that I use when I golf because it by spreading out my toes a little bit, I think it helps my balance and my swing. So, what are the symptoms of a hammer toe? Well, it's pain at the top of the knuckle from the shoes rubbing on it. You might see that you have a corn, which is thickening skin at the top of the knuckle or the tip of the toe. There might be redness or swelling, there could be restriction in the range of motion of the toe, and you might also have pain in the ball of the foot at the base of the affected toe. So you might wonder how's hammer toe treated? Well, pads can relieve pressure over the knuckles. Wearing the right shoes and socks with a deep wide toe box helps alleviate irritation, and sometimes surgery can be performed if non-surgical treatments fail. And the surgery for a hammer toe aims to correct the deformity, alleviate the pain, and make wearing shoes more comfortable. Next up is Achilles tendinitis, which is an inflammation of the tendon. And it

Nails Hammer Toes And Achilles Pain

Dr. \ 42:25

can develop because of activities that put a lot of strain on the Achilles, which can include basketball, running, cycling, even brisk walking. Tendinitis can develop when there's been a change in the person's usual activity. So it might begin after you start a new jogging program or after you start a new fitness class. What are the symptoms of Achilles tendonitis? Pain and stiffness in the back of the ankle and tendon, particularly when stretching or bending the foot back. You might even notice a little swelling along the tendon. And if the tendonitis has been there a long time, it might appear enlarged because of scar tissue forming. Orthotics, whether they're wedges or heel lifts or stable shoes, they can help correct the biomechanical imbalances that might be contributing to your Achilles tendonitis. Sometimes braces or immobilization boots need to be done. And it's very important to get the boot to be sized and fitted correctly so you don't develop other orthopedic problems, which I've seen happen. Sometimes prescription non steroidal anti inflammatory agents like ibuprofen might be prescribed. Generally, once the pain, acute pain, has subsided, stretching is recommended to help prevent recurrence. Stretching should be gentle and proceed. Only until tightness is felt. If stretching becomes painful, then you're just pushing a bit too far. You might want to lean against a wall while trying to keep the foot and heel flat on the ground. That's an excellent stretch for your Achilles. Strengthening your calf muscles helps strengthen your tendon in the Achilles, particularly lowering down very slowly after going up on your tippy toes has been shown to be very beneficial for treatment of Achilles tendonitis. Sometimes ultrasound is used to stimulate the formation of new tissue, while phonophoresis might be used to reduce swelling and promote healing. Shockwave therapy may reduce pain and promote healing of this condition. This type of energy wave treatment, strong sound waves, many times is tried before going to surgery. If the symptoms fail to subside after six months of conservative therapy, surgery to repair the damaged tendon becomes an option. Surgery usually involves removal of the abnormal tendon, and in severe cases, a nearby tendon is rerouted to help further strengthen the Achilles. And that's why we always talk about the Achilles tendon in terms of using it as a description to describe someone's weak spot because the Achilles tendon takes a lot of beating and unfortunately is a weak spot for people. And rupture of the Achilles tendon is a big problem, can be very painful, and may require surgical intervention. The tendons are very slow to heal. And as someone who's had tendinitis of the wrist and the shoulder and the elbow from both tennis and golf, I certainly know firsthand how frustratingly slow a lot of the recovery can be. So it's better to try to prevent inflaming your tendons. In some women, the lack of estrogen, like after childbearing, I had both of my wrists in splints because of decorvaine's tenosinivitis. I see a lot of women referred to me by hand surgeons after a menopause, they have so much swelling in the tendons of their hands that they can see that on MRI, and a lot of times this will resolve with estrogen therapy. The only protein that helps with tendon repair is whey protein. Now, poorly healing foot metatarsal fractures can cause persistent foot pain. And there's a condition called calcific periarthritis and chondrocalcinosis associated with osteomalacia or soft bones and fractures. And usually people who present with this to podiatrist have very poorly healing metatarsal fractures. And for the last decade, uh there has been asphatase alpha, also known as strenzic, which is a recombinant alkaline phosphatase that's been actually approved to treat this condition. Now, before having to deal with things like medications and surgery and orthotics and physical therapy, just taking good care of your feet with good footwear, paying attention to early pain, getting excellent nutrition, and adequate vitamin D3 with K2 is very important for musculoskeletal health as well as several other conditions. So some of the take-home points on foot care. Take good care of those Tootsies, wash and moisturize your feet regularly. Please avoid tight-fitting or ill-fitting shoes, or at least significantly limit the time that you're wearing those fancy high heels, and always have a backup of comfortable shoes or sneakers to slip into when you're wearing those stilettos, especially if you have to walk for any distance. And the one thing I've always thought about is what if there's a fire that breaks out, or what if there's an emergency where you have to run? And so I think every day that you're putting on your shoes, you know, you should should be ready for that kind of a situation. It's generally good to wear uh shoes that have good supportive arches or get an orthotic, which is an arch support insert, to help improve your foot alignment. Generally speaking, wide low-heeled shoes with good support and cushioning tend to be the most comfortable. You can stretch and/or mobilize or manipulate your feet to improve joint mobility and/or to treat and prevent plantar fasciitis. You should use bunion or callus pads to prevent constant irritation. Lamb's wool can be used to separate the toes. There can be little toe pads that you can apply if you have a corn between the toes. Icing, use of either topical or occasionally oral NSAIDs like ibuprofen or asper cream. Read the label. Just because it's over the counter doesn't mean you can use it excessively or more than what is recommended. If you're using oral acetametophen or Tylenol, it doesn't take very much to cause liver damage. So again, you must be very specific on what you're taking based on your age and body weight. And it's important to keep these over-the-counter medications or liniments or ointment out of the reach of children. And if you're having pain or problems that you need treatment and relief, it's best to do it under the supervision of your healthcare team. You should schedule an appointment with your primary care physician

Runner Tips Kids Shoes And Closing

Dr. \ 50:35

or specifically a podiatrist for foot examinations, particularly if you have other complicating medical conditions that can affect your feet. So now we're going to move on to some tips for long-distance runners and high endurance athletes. Yes, I have to say that I started to run when I was 16, and that running career ended by the time I was 16. I decided that running was for the birds, or actually, I'd rather just fly like a bird than run. But there are people that are really well designed for running. They get the runners high, and they're very distressed when they can't run. So if you're a long-distance runner or a very high-endurance athlete, you need adequate hydration. You may need to apply some softener or high hydration like tiger balm to your feet. Afterwards, you might need a pumice stone to rid your feet of accumulated calluses. You might want to consider getting a professional pedicure a week or two before your race, although there can be some infection risk with manicures and pedicures, so beware. And if you're immunocompromised or have sugar diabetes, this may not be the best option. You do need to change your running shoes regularly after so many miles. I always ask my running patients that. Tips for finding the best fitting shoes for kids 18 and under. A lot of adult foot problems start because of ill-fitting shoes or poor foot experiences in childhood. A child's foot can continue to grow until at least age 18, sometimes in males a little longer. And it's important to measure the feet and get the right proper fitting. And foot shoes that don't fit correctly can cause pain, calluses, bruising, corns, blisters, and the dreaded ingrown toenail. In the long run, more serious issues like foot and toe deformities can develop. And if a child wears ill-fitting shoes throughout his or her development years, especially before age five, it can lead to other problems with posture, walking, even causing low back pain later in life. So get your child's foot measured in a shoe store instead of trying to do it at home yourself. Usually foot stores have the special equipment to measure both the length and the width. So we all deserve to look good and feel good. But remember to be sensible with your footwear. Seek medical attention for aching feet that don't respond to just common sense foot care. And foot pain can be a sign of a more serious condition. So talk to your physician if the pain is severe, sharp, or not improving. And also if you have any issues with standing or walking or any discoloration like redness or bruising, any numbness or tingling, any open sore that doesn't heal, or any severe swelling, or if you just have swelling in one foot alone. A tip from podiatrist Dr. Botech: if you're seeing a physician or a podiatrist for a foot problem, bring in those shoes so they can examine your footwear as well. Thank you for listening to our Speaking of Women's Health podcast. Don't miss a future episode. Subscribe, hit that follow or subscribe button on Apple Podcasts, Spotify, TuneIn, or wherever you listen to podcasts. If you enjoyed this podcast and you want to help support the podcast, share it with others. You can donate to our nonprofit on speakingandwomen's health.com. You can leave a five star rating. Thanks again, and I'll see you next time in the Sunflower House. Remember, be strong, be healthy, and be in charge.