Dr. Steven Rosenberg - Foot Care


How to Stay Healthy When Exercising

Dr. Steven Rosenberg - Wednesday, March 27 2024

Incorporating rest and recovery into your fitness routine can help you avoid injuries and allow you to feel your best. Getting the proper amount of sleep each day is a vitally crucial factor in staying healthy. The more rest combined with exercise and a healthy diet will impact how you perform in the workforce. Exercising regularly decreases work stress, staying pain free and getting the proper amount of sleep is the recipe for a balanced and successful lifestyle.

Who, Why and How Injuries Occur

Those who are vulnerable to upset that balance, are health-conscious active people who exercise and train regularly. There are many types of exercisers, weekend warriors, gym rats who work out for hours at the gym, competitive runners that train for 10 k’s or marathons while others play pickleball, tennis, golf, softball or walk counting their steps each day. Patients will tell me that once they hit a certain level of activity if not in shape their body fatigues and they are more prone to injuries, it is the too much, too soon, too quickly syndrome we are all vulnerable too. Regardless of what form of exercise you choose, your feet play a significant role, they are the engines that keep your body moving. So, when your feet hurt, you hurt all over, the engine shuts down, your energy changes and your normal sleep patterns are disrupted.

Injuries occur from soft tissues inability to stabilize unstable bone segments. Repetitive Stress of a specific exercise movement can cause muscle imbalances and muscle fatigue. The main contributing factors as to why injuries occur when exercising are as follows. Poor technique of your exercise routine and abnormal foot bio-mechanics in your lower extremity creates unhealthy habits which can lead to repetitive overuse injuries. Repetitive overuse syndrome is the result of gradual micro trauma due to an increase of stress on a particular body part such as your legs or feet. Structural limitations in our bodies can limit our ability to perform at a high or any level for prolonged periods of time and the body breaks down. These two factors can trigger problems leading to plantar fasciitis, muscle / tendon strains, shin splints, ankle and knee Joint pain and ligament sprains. Finally, the shoes you wear during exercise and the types of surfaces that you participate on are also major factors causing injuries. Something as simple as wearing the wrong type of footwear for a sport or the wrong size can be a major factor in answering the mystery of why” I got hurt.” Court shoes are for racket and paddle sports whereas running shoes are for runners and walkers but should not be worn while playing tennis, pickle-ball or other court sports. Wearing a shoe that is too narrow and tight in the toe box area can trigger painful ingrown toenail problems which can impact the way you walk and your sleep. Hard unyielding playing surfaces such as concrete can fatigue your muscles faster and wear you down. If you are a runner, grass, dirt, or all-weather surfaces are better shock absorbing ones giving your feet and lower legs a softer landing by reducing the impact load and stress on your body.

There are two types of injuries that active exercisers can experience. Acute which is pain with sudden onset, your “OMG, OUCH” moment. The injured area becomes inflamed quickly and often micro edema / swelling is present. Aggressive treatment will minimize your down time. I usually recommend using ice packs or ice in a zip lock bag for 15 minutes on and 15 minutes off the first few hours, over the counter topical remedies in gel or cream form that have a homeopathic remedy called arnica in it which is a natural anti-inflammatory, rest, compression and sometimes elevation. These types of injuries may require additional treatment by a medical professional if you do not see a positive change in the first 24-36 hours. Obviously, if the injured area usually resolves quickly and normal healing occurs your back exercising quickly. However, “Never wish and hope an injury will get better on its own after a day or two” if you are still experiencing constant pain. Soft tissue injuries that are not treated immediately can become chronic over time which can last for days, weeks or months.

Most injuries that exercisers experience in their lower extremity are soft tissue in nature, usually affecting the legs and feet. The common ones are plantar fasciitis and shin splints.

The treatment falls into two categories traditional and alternative. Traditional treatments would consist of cortisone injections, physical therapy, oral non-steroidal anti- inflammatory medications known as NSAID’S, custom made orthotics or over the counter arch supports and a last resort surgery. Alternative therapy options include homeopathy injections with arnica as the main anti-inflammatory which comes in oral and topical forms, stem cell therapy, prolo – therapy (proliferation therapy), acupuncture or electrical current therapy using a variety of electrical frequencies (i.e., Interferential) to increase blood flow and reduce swelling.

The reason that acute injuries become chronic is because of denial and lack of urgency to take the time to seek medical treatment. The most common excuse is “I thought it would get better on its own” or “it only hurt a little bit and I can push through it.” As we all know, “when your feet hurt everything hurts” which can disrupt normal sleep causing focus and alertness problems in the workplace.

Foot Surgery or Custom Orthotics?

Dr. Steven Rosenberg - Friday, October 28, 2016

Is it better to have foot surgery on foot problems such as a bunion deformity, heel spurs, plantar fasciitis, metatarsalgia (ball of the foot pain) or neuromas (benign nerve tumor) or try a custom orthotic? That is the big question people have grapple with when their feet hurt. Although surgery may be the first thing that comes to mind when you visit a foot specialist, it is not always the best solution. Most patients are not signing up for surgery so quickly. In my opinion the only reason why you should ever consider foot surgery is when all other conservative treatments have failed. Mostly all foot problems can be helped with a custom made orthotic by a podiatrist. Although there many health care professionals in today’s medical world that say they make orthotics, choose an expert who has vast knowledge of foot biomechanics and understands how important it is to have the proper type. You can always have surgery if the problem is not resolved to your satisfaction.

Custom made orthotics will help solve many foot complaints and allow the foot to function biomechanically more efficiently. The key to the success is having them made properly so they will support and correct the abnormal biomechanical forces in the joints of the foot that create pathology that may warrant foot surgery. Orthotics when made correctly and placed in closed shoes will support the important joints of the foot and therefore aide in slowing down bunion formation and the development of heel spurs and plantar fasciitis. They also create space in between the metatarsal bones to decrease neuromas from forming or getting larger. They help eliminate joint pain in the great toe joint by increasing the space in that joint between the 1st metatarsal bone and the base of the proximal phalanx. Orthotics prevent the arch of the foot from collapsing and stop the jamming forces in the great toe joint by stopping abnormal pronation.

Using custom orthotics when you have ball of the foot pain, heel spurs or plantar fasciitis will support the arch of the foot and the joints in the mid-foot. They prevent the pulling of the plantar fascia away from its attachment to the heel bone and reduce the chance of developing a heel spur. Orthotics can magically solve many structural problems in the entire body. Wearing arch supports prevent abnormal pronation forces that are contributing factors in the formation of plantar fasciitis, heel spurs, metatarsalgia (ball of the foot pain) and neuroma pain.

When your feet feel better you will feel better and the thought of having foot surgery will be a distant memory.

Always try conservative treatment first because once you have foot surgery you cannot make changes back to its original state.

Taking Care of Your Feet Is Very Important

Dr. Steven Rosenberg - Wednesday, April 13, 2016

Each foot has approximately 26 bones, 36 ligaments, 33 joints and 20 muscles so when the feet hit the ground it can add up to a whole lot of misery when they are mistreated. Walking, running, standing, working out, dancing are just a few of the things we use our feet for and they take a beating over a life time because of it! Add in the fact that some of us have flat feet and others have high arches it makes for a complicated dynamic structure to take care of day in and day out. Podiatrists are highly trained doctors that are foot specialists and all they do is treat foot pain and other related foot problems whether they are dermatological, neurological, vascular or orthopedic.

One question that is always asked is, “do shoes cause foot problems” The answer is that shoes can trigger foot problems if the shoes are too tight, too small, too big or does not adequate arch support. Everyone is born with a predisposition for foot problems and it is brought out due to overuse. If someone has a bunion problem that is because the joints of their feet excessively pronate and it can cause the great toe joint to eventually dislocate over time forming a bunion. Wearing shoes that are too tight without proper arch support can trigger bunion pain.

Many of my patients exercise and develop foot, leg and back pain. The reason this happens is because the foot pronates and the muscles, tendons and joints are more susceptible to injury. The term of repetitive overuse comes into play and it is the act of repeating that one movement over a prolonged period of time. The result of this is soft tissue breakdown and ultimately foot pain. The solution to solving these types of foot problems that resulted in foot pain in your heel, ball of the foot, plantar surface of your foot or joints of your foot are devices called orthotics. Orthotics devices are made from a slipper cast of your foot and will reflect your foot problem. The orthotic is made out of plastic and it will support your foot, placing it in the corrected position in your exercise shoe. These devices will help reduce the impact load from the ground when performing your favorite sport.

Often times patients toe nails are thick and yellow. This can be due to toenail fungus or trauma to the nail plate. Toenail fungus comes from walking barefoot in locker rooms, public showers and sometimes from pedicurist salons. Toenail trauma is due to someone stepping on your toes or dropping a heavy object on your toes. So pay attention to where you are and what you were doing if you begin to notice your toenails getting yellow and thick.

Whether you are a runner, golfer, tennis player, or an avid exerciser you may experience at some point foot pain during those activities and in all likely hood it will be from overuse.