A CLOSER LOOK AT MINIMALIST RUNNING SHOES

Minimalist footwear is the newest and fastest growing segment of the athletic footwear industry today!  The appeal for consumers seems to be the purported benefits of decreased injury risk and/or performance enhancing effects of minimalist shoes.

            Manufacturers are marketing these shoes as more natural and more like being barefoot. Despite the fact that athletic footwear manufacturers spent the previous four decades extolling the virtues of their cushioning technologies and stability devices, some have now changed their tune and want to make sure you know that their shoes are now much more like being barefoot.  There is a whole new way of thinking about running footwear and we can sum this up as “less is more.”  The established manufacturers such as Brooks, New Balance, Asics, Adidas and others have introduced minimalist lines to compliment their established models. 

            The minimalist type of footwear has been available all along.  For some unknown reason, the tipping point came recently and piqued the interest of the media and running consumers.  Prior to the recent launch of the wave of minimalist shoes, traditional running shoes had been moving, even if slowly, toward thinner midsoles and lighter weight. 

What exactly is a Minimalist Shoe?

This really depends on who you ask.  As with any other category of footwear, there are no strict criteria that formally define a minimalist shoe.  The manufacturers seem to be setting their own criteria.  They are made to be light, flexible and minimally restrictive of foot motion within the shoe. 

            If you are going to decide to choose the Minimalist Shoe, there are a couple of things you need to consider. Only 10% of people are able to wear them because they only work for certain foot types.  You need to also consider the terrain that you are running on and if it works well for these types of shoes.   In conclusions, we will have to wait for the final verdict if the minimalist shoe can support the needs of the many.  Enjoy pain free running!

Preventing Falls in the Elderly

PREVENTING FALLS IN THE ELDERLY

            An important public health issue that has become more prevalent in podiatry today is the issue of fall prevention in the elderly.  One in three adults over the age of 65 falls each year and a half of these people fall multiple times.  The Centers for Disease Control and Prevention report that falls are the leading cause of injury related deaths in people over the age of 65.  In 2000, the cost of treating non-fatal fall related injuries was $19 billion and is expected to double by 2020.

What are the risk factors for falling?

            With multiple levels of input and output from the central nervous system to provide us with proper muscular activation to respond to unexpected hazards, it is easy to see how numerous risk factors associated with aging can predispose people to traumatic falls.  The medical literature has identified many independent risk factors for falling. The risk factors include previous falls, balance impairment, decreased muscle strength, visual impairment,  more than four medications,  psychoactive drugs, gait impairment, and walking difficulty, depression, dizziness or orthostasis, age older than 80 years, female sex, incontinence, cognitive impairment arthritis, diabetes, and pain. 

            More than one risk factor increases the risk of falling, with no risk factors the risk of falling is 8 percent and grows to 78 percent with four.  More alarming is the finding that the risk of falling quadruples for a patient within two weeks of discharge from the hospital. 

            Medications that physicians commonly prescribe for elderly patients can negatively affect all aspects of our neuromuscular control of the body during gait.  While the use of four or more medications from any category of drugs will increase the risk of falling, identifying certain drugs that can independently increase the risk is more difficult.  In general, an increased risk of falling is associated with the following medications:  serotonin reuptake inhibitors, tricylic antidepressants, neuroleptic agents, benzodiazepines, anticonvulsants and class IA antiarrhythmic medications.  Withdrawal of these medications becomes a complicated issue when considering fall prevention.  Many times the condition patients are taking the medication for is itself a risk factor for falling.

            Most of our elderly patients experience a decline in balance and muscle strength.  The combination of this decline with visual and vestibular compromise increases the risk of falling. What can be done? One way that podiatrists offer relief from imbalance issues is the MBB or Moore Balance Brace. It is all about making it easy for the elderly. The MBB has been designed to easily fit into a variety of different shoes. Because the MBB is so light weight and has a sleek design, the MBB is easy to wear.
            The type of shoe used with MBB is important and should not be left to the patient alone to figure out. There are many light weight stable shoes that are options for seniors, but care needs to be taken to make sure that the MBB is not being used in a house shoe or slipper or without shoes. You should see your Podiatrist to evaluate your needs because your quality of life is the most important to us.    

Recognizing and Treating Lower Extremity Gout

Recognizing and Treating Lower Extremity Gout

Gout is an inflammatory arthritis that results from high uric acid in the blood, from either the body’s overproduction or under excretion of uric acid.  It typically presents with acute onset and can be recurrent.  The first metatarsophalangeal joint (MPJ) is involved in 90% of individuals with gout. Gout can result in joint deterioration and destruction. 

            For the last two years, gout has been much more recognizable to the public in print, TV, and other forms of media.  The painful condition of gout is now more appreciated as the number of gout medications, formulations and reformulations has changed the landscape for the public and patient base, and thus changed the management by physicians. 

The actual number of true gout cases is likely underestimated.  Many times patients and physicians treat this with OTC analgesics or anti-inflammatories without the proper diagnosis and workup for gout.  High uric acid in the blood is the cause of gout.  There is an increasing prevalence with significant presence of one or more disorders (or diseases) including cardiovascular disease, hypertension, renal insufficiency and metabolic syndrome. 

Researchers have stated that gout affects approximately 5 to 6 million people in the United States with prevalence on the rise. Gout reportedly occurs more in men that in women, affecting 2 percent of men older than 30 years of age.  Risk factors include being male, postmenopausal, a strong family history, kidney disease, organ transplants, excessive alcohol use, a diet high in purines, (red meat and seafood) metabolic syndrome, obesity, dehydration, and exercise.   Studies have shown that heavy alcohol use in general, particularly beer, increase the incidence of gout whereas moderate use of red wine, did not.

            It is well known that the incidence of gout is higher in people with increased dietary intake of purines, particularly meat and seafood, as well as ingestion of beer and spirits, soft drinks and fructose.  It is lower in those with increased intake of coffee, dairy products and vitamin C (all lower uric acid levels).  It must be clarified that coffee and tea can also increase uric acid levels and the presentation of gout.  Purine-rich foods such as fruits, vegetables and foods that include a high citrus content can affect the balance between urate reabsorption and secretion which is critically linked to the uric acid elimination in urine. 

            In conclusion, gout is relatively common inflammatory arthritis that occurs in all age groups.  It can be particularly debilitating disease, causing limitation of activity and lowering the quality of life.  It is now associated with the comorbidity of other systemic diseases. If you feel you may have gout or any symptoms of gout, see your doctor to help diagnose and treat this disease. 

How To Prevent Ingrown Toenails

HOW TO PREVENT INGROWN TOENAILS

An ingrown toenail is one of the most painful foot conditions we often bring on ourselves. Although sometimes ingrown toenails are hereditary, they're most often caused by incorrect nail trimming -- and they become even more painful when they're squeezed by shoes that are too short and tight. Fortunately, there are simple steps you can follow to help prevent ingrown toenails.

The best tip for preventing ingrown toenails is: trim your nails straight across the top -- NOT in a rounded shape. In addition, avoid wearing shoes or socks that squeeze your toes together.

If you are diabetic or have poor circulation, seek professional attention.

Suggestion to prevent a problem:

• Switch to longer shoes with a bigger toe box at least 1/2 an inch from tip of your longest toe.
• Soak your foot in a solution of 1/4 cup of white vinegar to one gallon warm water for 10 minutes twice a day if infection is present and contact your Podiatrist
• If you believe you have the start of an ingrown toenail, then apply an antiseptic or betadine ointment after you have soaked in vinegar solution. This is especially important, because one of the greatest dangers of ingrown toenails is the possibility of infection.  And seek Podiatric care.

Another great way to prevent ingrown toenails is to come in to see a Podiatric Nail Technician for a professional pedicure or manicure!