I remember it was a Wednesday night. I was lying in bed. Off the next day to just have some fun vacation time before the Christmas holidays came. Sound asleep and then it hit me. The most unbelievable throbbing in my toe. Yeah… my toe! It was like my toe had a heartbeat and it was hot. I got up to investigate and there it was. A huge, gross, ingrown toenail. The pain was crazy and I could tell there was a bunch of infection. Ugh… I spent the next day soaking it in Epsom salt and trying to get into a doctor. After this happened to me, I started thinking about my feet and how I didn't really know how to take care of my feet. Sure, I get pedicures but is that enough? I wanted to get some information and set the record straight about foot issues, so I reached out to foot and ankle orthopedic surgeon Dr. Robert Kulwin and podiatrist Dr. Douglas Schuckmann with The Christ Hospital. I also asked the doctors some great questions submitted by the Jeff and Jenn Morning Show listeners.
Causes of Foot Pain
Dr. Kulwin explained there is a huge range of things that can cause foot pain. The two that he sees most frequently are heel pain from plantar fasciitis and pain under the ball of the feet called metatarsalgia. Fortunately, both can get a lot better with stretches and time.
Jeff and Jenn listener Brenda asked about plantar fasciitis and how it is treated. Her mom was just diagnosed with plantar fasciitis. Dr. Kulwin explained the plantar fascia is a band of thick and strong tissue that connects the heel to the ball of the foot. Sometimes, the part of the fascia that comes from the heel (usually on the front and inside part) can get irritated and painful, which is called plantar fasciitis. Dr. Schuckmann explained that while it can take a long time to get better, plantar fasciitis almost always gets better with conservative treatment such as anti-inflammatory medications, stretching, and physical therapy. Sometimes steroid injections and occasionally surgery can be necessary, but that is usually not required.
As I mentioned, my pain was caused by an ingrown toenail. I found out that sometimes ingrown toenails cannot be prevented but there are ways to minimize the chance. Nails should be cut straight across with corners rounded to minimize risk. Common reasons for ingrown nails include improper toenail cutting or cutting too far down the sides, footwear that is too tight, infected nails, and trauma to the nail. He said fortunately, ingrown toenails can be treated with an in-office procedure called a matricectomy, where the entire nail or one side is removed. That's the procedure I had to resolve my ingrown toenail.
Proper Footwear
I learned that footwear is KEY when it comes to taking care of your feet. Dr. Schuckmann suggested wearing appropriate shoes for your surroundings that are supportive. Things like shock absorption and arch supports are helpful. Dr. Kulwin had a big warning for people who wear high heels. He said that you should limit wearing high heels and that high heel wearers keep him busy. I also learned about supportive super-expensive gym shoes. Recently I've been getting targeted with ads for Hoka shoes and I was wondering if buying the $180 would be worth it for my ingrown toenail issues. I learned that decent shoes should not be cost prohibitive, but that Dr. Kulwin thinks Hoka are worth every penny and specifically recommends them to his patients. He says they are a great solution for hallux rigidis (toe arthritis), midfoot arthritis, and plantar fasciitis.
If Hokas are financially beyond your reach, Dr. Schuckmann says an average-priced shoe with a reasonable arch support is often a good mix. And don't forget the flip flops! Dr. Schuckmann isn't a fan of flip flops because they are dangerous, don't provide any support and are an easy way to injure your feet or sprain an ankle.
Impact of Running on Foot Health
A couple Jeff and Jenn listeners brought up running and the impact that has had on their feet. Jeff and Jenn listener Candice said she was having issues with pain in her arches. She started doing Couch to 5K a few months ago and began having pain. Dr. Kulwin shared there are many causes of arch pain. Most frequently, especially with mild pain, this can be due to needing to have more flexible Achilles tendons, or warming up better. More severe pain though can be related to arthritis, tendonitis, or even a stress fracture and is a good reason to seek out professional care.
Listener Katie is a regular runner. She asked about the kind of stretching she should be doing with her feet before and after she runs. Dr. Schuckmann, who is also a runner, suggested a proper warmup and stretches. He explained that he and many other runners jog for 10-15 minutes to warm up their muscles, then do a series of range of motion stretches in the foot and ankle, calf, quad, hamstring, hips, back and arms. He also suggested a running group for beginners, to learn good running practices. Stretching after the run is also helpful, and you can use ice as needed. Foam rollers for trouble spots are also helpful, especially the IT band (a thick band of tissue that runs down the outside of the leg).
Taking care of your feet is super important and there are lots of ways to do that from proper toenail care to avoiding flip flops and high heels. Another way to help take care of your feet that I learned about was arch supports and they don't even have to be expensive. Dr. Schuckmann is a big advocate for decent arch supports. There are many decent, inexpensive over-the-counter arch supports for under $50 that help most people most of the time. Sometimes prescription devices called orthotics are needed but you should reach out to a doctor for those.
Learn more about the foot and ankle care at The Christ Hospital Health Network.