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Foot problems are a common complaint and are also a common cause of aches and pains in other areas, including the knees, hips, and lower back.  In most cases, foot problems begin as a result of neglect.  There are some simple steps you can take to make your feet happy and solve a host of other muscle and joint pains at the same time.

Step One:  Go barefoot whenever possible.  The feet have many nerve receptors on the bottom of them that analyze pressure on various points on the feet and use that information to help you keep your balance.  In addition, those nerve receptors tell the muscles in the feet when to contract and when to relax, so as to maintain the arches of the feet and aid in mechanical stabilization.  When you wear shoes, the nerve receptors are in constant contact with the shoes, and are much less able to determine differences in pressure on the separate points of the feet.  This leads to poor muscle coordination in the feet and in most cases, eventual loss of the arches, making the feet and the whole body much more susceptible to the effects of mechanical shock.  Unfortunately, going barefoot most of the day is not practical for those of us who work for a living, so the best you can do is take Step Two…

Step Two:  Choose good shoes.  Now, by “good shoes”, I’m not talking about some expensive designer brand and I’m not talking about 3 inch pumps that look really hot.  I’m talking about shoes with good arch support and some shock-absorbing materials to take stress off of your feet.  Are such shoes ugly?  That’s a matter of opinion, but if you have to make a choice between good shoes and good looking shoes, I suggest you go with the good shoes at least most of the time.

 Step Three:  Use arch supports and/or shock dissipation shoe inserts.  Depending on your particular needs, some generic arch supports or gel shoe inserts may work very well for you.  If you already have some significant foot problems, I suggest you look into getting custom-fitted orthotics for your shoes.  There are various types of orthotics.  “Old-school” podiatrists may recommend rigid orthotics which do an excellent job of arch support, but have no shock absorption whatsoever and can be very uncomfortable, particularly for those who spend long hours on their feet, or engage in high-shock activities like running.  I usually recommend “semi-flexible” orthotics that not only support the arches but have built-in shock absorbing materials.  These are much more comfortable for most people and do a good job of not only helping the feet, but also helping with knee, hip, and back pain.

Step Four:  Exercise your feet.  I once saw a video about a woman who was born without arms and she did a lot of the things that you and I do with our hands with her feet.  In my professional training, I learned that the feet are actually anatomically structured to where one can develop fine joint and motor control that is equivalent to the hands, but most people never train the feet for this purpose, except for people like the woman in the video who have a compelling reason to develop foot dexterity.  Now, you don’t need to exercise your feet to the point of being able to sign your name using your foot, but some basic arch conditioning can go a long way toward making your feet feel better.  A very simple foot exercise is to place a towel on the floor and then place your foot on top of it and use your toes to “scrunch” up the towel. 

Step Five:  Massage your feet (or get someone else to).  Because most of us can’t avoid wearing shoes and spending a lot of time on our feet, even just a brief foot massage a few times per week can go a long way toward easing foot pain.  Masage can be done by using the hands to rub and press on tight areas, or you can use a foot roller, a golf ball, or any firm, round object to roll your foot on and rub out the soreness.  The massage effects can be further enhanced by rubbing or rolling the feet while you soak them in warm water. 

So there you have it, the five steps to happy feet.

Stay tuned to my natural remedies blog for more recommendations for healthy feet.

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 Spraining an ankle once is bad enough, but for those who repeatedly injure the same ankle, it can develop into a major long-term problem. A chronically unstable ankle will usually become arthritic over time, leading to chronic pain and difficulty running, walking, or even just standing.

The ankles have considerable stress placed on them, and once one or more of the supporting ligaments are damaged, the joint will probably never be 100% as stable as it should be, but with appropriate care, repetitive ankle injuries  can be avoided and much of the degenerative arthritis that develops subsequent to joint instability can be prevented.

The primary way to achieve this is through exercises to strengthen the surrounding muscles enough to provide support that the damaged ligaments cannot.  Most people who have sustained a significant ankle sprain have gone through rehabilitation for this purpose, but in many cases, the rehab exercises fall by the wayside after the major pain is gone, and over time without ongoing exercises to keep them strong, the muscles will decondition.

In a future post, I’ll be providing you with a video of exercises to keep the muscles around the ankle strong and supportive.  Look for that in the next few weeks here on my natural remedies blog.   Until then, if you have already gone through ankle rehab, but you’ve stopped doing your exercises, I highly recommend you get back to doing them on a regular basis again.  Your ankle may feel fine right now, but it’s better to put forth a little effort to keep it that way than to get lazy and allow things to deteriorate to the point where you’re having pain ankle trouble all the time and there’s not much you can do about it.

Until next time…

Dr. George Best

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There is considerable confusion regarding the conditions sciatica and piriformis syndrome. Some think that they are the same thing, but although they have very similar symptoms in many cases and can be present simultaneously, the underlying causes of sciatica and piriformis syndrome can be quite different.Sciatica refers to irritation of the sciatic (often mis-spelled as syatic or psyatic) nerve, that arises from nerve roots in the lumbar spine. The most common cause of sciatic nerve irritation, or “true” sciatica is compression of one or more of its component nerve roots due to disc herniation or spinal degeneration in the lower lumbar region. Depending on the severity of the compression and/or inflammation of the sciatic nerve components, sciatica may extend into the buttock area, into the thigh, or sometimes all the way down the leg to the foot.

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Many people suffer with heel spurs and the usual medical approach to this problem is to treat the heel.  The problem is, most heel spurs are not caused by problems in the heel itself, that’s just where the mechanical stress ends up.

 Yes, a cortisone injection into the area of a heel spur may sometimes decrease the pain, but all the cortisone is doing is decreasing inflammation - it’s not healing, er, fixing the heel.

So, what causes a heel spur to develop?  In most cases, it’s excessive tension on the soft tissue attachments at the bottom of the heel bone.  This excessive tension pulls on the bone, and the body’s response is to add bone to the area to reinforce it.  Over time, a spur grows. 

Have you, or someone you know, ever had a heel spur surgically removed, only to have another one grow back in the same place within a few years.  This is a common occurrence, because the surgery does not address the soft tissue tension.  The ONLY long term solution for heel spurs in most cases is to address the soft tissue tension directly.

 So, how do you do that?  You have to either massage or stretch (or both) the muscles in the calf and foot.  A simple calf stretch can be done by grabbing a towel at both ends, looping the middle around the ball of your foot, and pulling the front of your foot towards your body (you should feel a pull in the calf when you do this).  This will also stretch the foot to an extent.  Massage can be done by just gripping behind the lower leg and massaging the muscles with your fingers.  Massaging the feet can be done the same way, or by rolling your foot over a golf ball or other firm, round object.

Frequency is the key to getting good results.  When I recommend such treatments to my patients who have heel spurs, most will start out doing them regularly, but many stop doing them after a few days or may only do them for 30 seconds or so at a time and then complain that they didn’t work.  In those cases, I will proceed to do an intensive (some have used the term “painful”) stretching and massage treatment on them for one or two sessions and this usually fixes the problem.  Basically, you can do it the easy way or the hard way.  If you want to alleviate your own heel spurs without the expense and perhaps physical pain of a professional treatment, I recommend using a combination of stretching and massage as just described at least once a day for at least a few weeks.  In most cases, even once the heel spur is feeling better, it will be necessary to stretch at least a couple of times per week to keep the symptoms from coming back.

 Getting back to the title of today’s post, the interesting thing is that the pain that’s blamed on a heel spur can change drastically with these self-treatment measures within a few days or weeks - even though there’s usually no visible change in the spur itself on X-rays in that short of a period of time (over several months or years, the spur may gradually go away if the soft tissue tension that caused it is prevented from returning).  So, if the spur is still there, but the pain is gone, what was causing the pain?  I think you’d have to agree that it was the soft tissue. 

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