Newsletter Edition 6


 

 

Live Life, "Feet First"

Fall is in full swing, and winter is coming fast! Whether you’re a fashionista or a marathoner (or both!), this time of year can bring a whole new set of challenges when it comes to foot health.
 
In this issue, we’ll share our take on the fall shoe trends that are the worst for your feet via my interview with WhoWhatWear and address common question on topics ranging from why your feet may be falling asleep to how hydration impacts you from head to toe.
 
And with Thanksgiving coming up in a few short weeks, we at Gotham Footcare also want to thank you, our patients, for letting us help you put your best – and healthiest, pain-free – foot forward. (The foot puns just keep coming!).
 
But seriously, thank you for allowing the Gotham Footcare team to serve you, and please don’t hesitate to book an appointment for that Athlete’s Foot or bunion… the holidays are coming and we want you to be in tip top shape to dance the night away with friends and loved ones.
 
Happy Fall!
Dr. Gotham

 

 


 


 



 

Ask

DOCTOR

GOTHAM

 

 

 

Dear Dr. Gotham,

Everyone always tells me that my obsession with heels will come back to bite me. No matter how much they kill my feet, my motto is “the higher the heel, the better.” What are the long-term effects of wearing high heels?

Sincerely,
Heel Obsessed

Dear Heel,

The common misconception is that flat shoes are better for your feet than a heel. That’s not always true. I typically recommend shoes that are 1 inch in height as opposed to a shoe that is completely flat as it places less tension on the Achilles Tendon and will feel more comfortable. With that said, heels exceeding a 1-inch height can include long term damage to your toenails, agitate bunions and encourage hammertoes.

Long term effects to wearing high heels include:

1) Damage to the toenails. Wearing high heels compresses the toes together causing the big toe nail to grow into the skin and eventually resulting in an ingrown toenail. An ingrown toenail is a common condition typically affecting the great toe, in which the corner or side of the nail becomes incurvated (turned inward) and grows into the skin and soft flesh of the toe. This results in irritation of the surrounding soft tissue, often causing pain, redness, swelling, warmth, and sometimes and infection.

2) Bunions. A bunion is a biomechanical imbalance involving the great toe joint. It is often described as a bump on the side of the big toe. High heels also aggravate the symptoms and progression of bunion deformities as the shape of the shoe does not accommodate the normal structure of the forefoot. A heel-type shoe will press up against the great toe pushing it over towards the second toe further exacerbating bunion deformities.

3) Metatarsalgia. When wearing high heels most of your body weight is pushed forward to the balls of your feet and this can lead to metatarsalgia (pain and inflammation in the ball of the foot). Shoes with a narrow toe box can also cause this condition. 

4) Hammertoes. Hammertoes are contractions of the toe caused by a muscular imbalance in the foot where the tendons on the bottom of the foot over power the tendons on the top of the foot. This condition is frequently developed by wearing heels. The heel height forces the toes to bend as they lean forward. Overtime, the bent toe can no longer straighten on its own.

5) Achilles Tendonitis. Achilles tendonitis is inflammation along the Achilles tendon. The Achilles tendon is the largest tendon in the body and is responsible for plantarflexion of the ankle (causing the front of the foot to lower and lift the heel off the ground). When wearing high heels you put constant pressure on the Achilles tendon by shortening and tightening it. Repeated and extended wear of high heels shorten the tendon permanently. This leads to inflammation and pain when you wear flat shoes and forces the tight tendon to stretch.

6) Arthritis in the toe joints. It is possible that years of wearing high heels can lead to arthritis of the toe joints.  When you wear heels you shift your center of gravity forward leading to a biomechanical imbalance that alters the pressure distribution of weight across your foot and onto your toe joints. The accumulation of weight onto your toe joints over time may lead to the erosion of cartilage and the formation of boney spurs that restrict the motion of your toes ultimately leading to painful and debilitating arthritis.

7) Sprained ankles. It’s not uncommon for heels to be flimsy with no supportive structure to the shoe. These shoes can bend easily, and get stuck in a sidewalk crack leading to a bad ankle sprain.

8) Knee and back pain. Heels with a height exceeding 3 inches changes the biomechanics of how you walk. This leads to shorter strides, more pressure is placed on the balls of your feet which throws off your center of gravity putting unneeded and unnecessary stress on your knees and lower back.
 
Good luck!
Dr. Gotham


Winter is coming. What does that mean for our feet? 

Winter is… here? As the weather gets cooler and we swap out our flip-flops for boots, many of us don’t realize the toll it takes on our feet. How we treat our feet in the summer affects us in the fall and into the winter. As a result of the shoes we choose to wear (if any at all), the cycle continues year-round and can put them at risk. Our feet are precious – yet we often take them for granted until we injure ourselves or develop a blister from the latest shoe trend or exacerbate an underlying issue. Here are a few foot injuries you may experience this winter.
 
1) Ingrown nails. Transitioning from the summer to the fall/winter brings forth this common problem. As you go from open toe to closed toe, feet still have swelling from summer activities and humid weather. As a result, an ingrown toenail happens due to irritation of the surrounding soft tissue, often causing pain and sometimes infection.
 
2) Plantar Fasciitis. Plantar fascia is a band that stretches from your heel to your toes to support the muscles and arch of your foot. Too much tension on the tissue can cause it to stretch too far, resulting in tiny tears that cause pain and inflammation. Transitioning from flat shoes to boots can throw off your arch and aggravate this underlying condition.
 
3) Shin splints. Walking with flip flops for prolonged periods of time as well as barefoot on hard surfaces allows our foot to collapse, which can lead to a tremendous amount of stress not only to the foot but to the rest of the body. This imbalance can start the progression of shin splints, affecting someone further down the line.
 
4) Bunions and hammertoes. Similar to shin splints, bunions and hammertoes can be caused by barefoot walking or shoes without an arch. This imbalance and stress also further progresses these underlying foot deformities.
 
5) Athlete’s Foot. A common condition in the summer months, as people go to pools and gyms more often (and barefoot). But because we wear thicker shoes and boots in the winter that air out less, athlete’s foot can be exacerbated and cause more issues during this season.
 
6) General foot pain. It takes time for our feet to adjust to different shoes, especially if it forces our gait or arch to change. If you don’t experience any of the problems above, it’s still possible to feel general foot aches and pains as weather and foot fashion changes.  


Foot Care 101: Hydrate!

If you’re dealing with cracked heels H20 may be your best friend. Dehydration can have a negative impact on your feet – causing them to become dry and cracked. I encourage my patients to hydrate by drinking plenty of water and eating water rich foods such as cucumbers and watermelons. This helps soften the skin on your feet and other areas. If your skin remains dry even after a lot of water intake, schedule an appointment with your podiatrist. You may suffer from a fungal infection that could easily be treated with some ointments or prescribed medications.


Health Focus: Ankle Sprain 

Ligaments help stabilize the ankle joint and prevent excess motion. Ankle injuries occur when ligaments are stretched beyond their normal range of motion and the ankle moves in an awkward motion beyond the normal range of that joint. The most common mechanism of ankle sprain is a combination of plantarflexion and inversion, or a downward-inward motion of the foot about the ankle.  When this takes place, the 3 main outer ankle ligaments stretch or tear depending on the severity. With severe ankle injuries, fractures and joint displacement can occur. READ MORE.


Product Plug: Betadine 

Many people think they should apply Neosporin to a blister, but that doesn’t help dry it out. We have normal hydration to our bodies so whenever something is too wet, you want to dry it out. Whenever something’s too dry, you want to wet it. While Neosporin is great for something like a scab, betadine is much better for blisters because the underlying skin is wet and raw. Applying Betadine several times a day will help dry out the blister. This medication is also an antiseptic that can prevent infection and help your blister feel better.


 
PATIENT TESTIMONIAL- BUNION SURGERY

When I decided to have a bunionectomy and my fifth toe corrected I searched online for a podiatrist and came across Dr. Miguel Cunha's name of Gotham Footcare.  I made an appointment and met him.  After giving me a detailed explanation, the procedure was scheduled.  Day of the surgery, the surgical coordinator was so wonderful and really eased the anxiety feeling of a pre-op patient.  Dr. Cunha, Dr. Lee and the rest of the OR staff were so kind and gentle and made me feel very comfortable.  Post-op care is great, I felt so special.  Aside from Dr. Cunha's utmost care, all the staff are so professional in providing their services to patients.  Laura, the medical scribe is very helpful and knowledgeable and also very accommodating to answer any questions that needed that to be addressed.  I highly recommend Dr.Miguel Cunha to my family and friends.  He is not only a highly skilled Podiatrist but also very compassionate.  I am so pleased with the result of my surgery.  THANK YOU Dr. Cunha..and to all the staff of Gotham Footcare. Please enjoy the cake!

-Nerida Concepcion
 

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