"After my athletic injury, I had met with several doctors in the Northern Virginia area… many were quick to diagnose, quick to jump into surgery, and quick to misdiagnose. Dr. Pontell not only examined my foot via MRI, Xray, Ultrasound and in person – he explained EVERYTHING to me... After completely healing, at 38 years old I can run longer, and run faster than I ever had been able to run before – even before my injury. I’m in the best shape of my life. I tell everyone all the time that I am able to do what I do because of him - my foot he reconstructed is a million times stronger than my uninjured foot." -A.D.
"I went to Dr. Hallivis based on his reputation and his extensive experience. He definitely stood up to his reputation. He was professional, friendly, approachable and knew everything there was to know about my problem. He treated me and my pain resolved in 2 days. His office ran on time and his staff was warm and helpful. I would recommend him to anyone with a foot problem.” - M.H.
Basic Foot Care Guidelines
- Don’t ignore foot pain. It’s not normal. If the pain persists, contact our office.
- Inspect your feet regularly. Pay attention to changes in color and temperature. Look for thick or discolored nails (a sign of developing fungus), and check for cracks or cuts in the skin. Peeling or scaling on the soles of feet could indicate Athlete’s Foot. Any growth on the foot is not considered normal.
- Wash your feet regularly, especially between the toes, and be sure to dry them completely.
- Trim toenails straight across, but not too short. Be careful not to cut nails in corners or on the sides; it can lead to ingrown toenails. Persons with diabetes, poor circulation, or heart problems should not treat their own feet because they are more prone to infection.
- Make sure that your shoes fit properly. Purchase new shoes later in the day when feet tend to be at their largest, and replace worn out shoes as soon as possible.
- Select and wear the right shoe for the activity that you are engaged in (e.g. running shoes for running).
- Alternate shoes — don’t wear the same pair of shoes every day.
- Avoid walking barefooted. Your feet will be more prone to injury and infection. At the beach or when wearing sandals always use sunblock on your feet as the rest of your body.
- Be cautious when using home remedies for foot ailments. Self-treatment can often turn a minor problem into a major one.
- If you are a diabetic, contact our office and schedule a check-up at least once a year.
Athletic Foot Care
Whether you are a professional athlete or play sports just for fun, the demands made on your feet and lower limbs can lead to a range of injuries, including blisters, sprained ankles, torn ligaments, shin splints, knee pain, lower back pain and other joint or muscle problems. Added to these are common complaints such as corns, calluses and Athlete’s Foot. Your running style, quality of footwear, and even minor limb length differences can contribute to injury.
Here are some tips for athletic foot care:
- Wash your feet every day, and dry thoroughly.
- Wear only good quality, well-fitting cotton socks.
- Always use the correct shoe for each sport and surface.
- Get in shape. Being overweight or out of shape places added stress on the feet. Condition yourself gradually with stretching exercises for 15 to 20 minutes (warm-up and cool-down periods) before and after any activity.
- Wear correct shoes. Footwear should be given the same consideration as any other piece of sporting equipment. Sports shoes should protect as much as possible, be durable, and should be right for the sport and surface.
Most blisters on the feet are caused by friction and do not require medical attention. New skin will form underneath the affected area and the fluid built up in the blister is simply absorbed back into the tissue. You can soothe ordinary blisters with Vitamin E ointment or an aloe-based cream.
Do not puncture a blister unless it is large, painful, or likely to be further irritated. If you have to pop a blister, use a sterilized needle or razor blade. Wash the area thoroughly, then make a small hole and gently squeeze out the clear fluid. Apply a dab of hydrogen peroxide to help protect against infection. Do not remove the skin over a broken blister. The new skin underneath needs this protective cover. Cover the area with a bandage and mild compression.
If the fluid is white or yellow, the blister is infected and needs medical attention.
You can prevent blisters by breaking in new shoes gradually, and putting petroleum jelly or an adhesive bandage on areas that take the rub—before the blister happens. Wear socks that have heels instead of tube socks (they bunch up and cause blisters). Acrylic and other synthetic-fiber socks are good choices. Be sure to wash and dry your feet daily to prevent bacterial infections, such as Athlete’s Foot.
Children with strong, healthy feet avoid many kinds of lower extremity problems later in life. That’s why it is important to inspect your children’s feet periodically.
The size and shape of your baby’s feet change quickly during their first year. Because a baby’s feet are flexible, too much pressure or strain can affect the shape of their feet. It’s important to allow baby to kick and stretch their feet freely. Also, make sure shoes and socks do not squeeze the toes.
Do not to force a toddler to walk before s/he is ready. Once walking begins, watch the toddler’s gait. Many toddlers have a pigeon-toe gait, which is normal. Some initially learn to walk landing on their toes instead of their heels. Most children outgrow both these problems. But other conditions detected early can be treated more easily.
When Foot Care Is Needed
To help with flatfeet, special shoes or orthotics may be prescribed. To correct mild in-toeing or out-toeing, your toddler may need to sit in a different position while playing or watching TV. If your child’s feet turn in or out a lot, corrective shoes, splints, or night braces may be prescribed.
The foot’s bone structure is well-formed by the time your child reaches age 7 or 8, but if a growth plate (the area where bone growth begins) is injured, the damaged plate may cause the bone to grow oddly. With a doctor’s care, however, the risk of future bone problems is reduced.
Remember to check your child’s shoe size often. Make sure there is space between the toes and the end of the shoe and that the shoes are roomy enough to allow the toes to move freely. Don’t let your child wear hand-me-down shoes.
Foot Care for Seniors
It’s normal for people to experience some foot problems as they age. But experts say that problems with feet can be the first sign of more serious medical conditions, particularly among older adults. Health problems, such as arthritis, diabetes, nerve issues, and circulatory disorders, may first be manifested in the feet. That is why it is important to pay attention to your feet and seek medical attention as soon as you notice a problem.
Here are some foot care tips for older adults:
- Practice good foot care. Check your feet regularly or have a member of your family check them for you.
- Keep blood circulating to your feet as much as possible. Do this by putting your feet up when you are sitting or lying down, stretching if you’ve had to sit for a long while, walking, having a gentle foot massage, or taking a warm foot bath.
- Wear comfortable shoes that fit well to prevent pressures that can lead to friction and infection and keep your foot structure properly aligned.
- Avoid exposing your feet to cold temperatures.
- Don’t sit for long periods of time (especially with your legs crossed).
- Don’t smoke because it decreases blood supply and increases the chance of swelling and other circulatory problems.
Foot Self Exam
What should you look for to make sure your feet are healthy? Here are some general guidelines:
- Balance. A good test for balance involves standing on one foot, with your arms out to the side and your eyes closed. If you are less than 30 years old, you should be able to balance for 15 seconds, 30 to 40 years old for 12 seconds, 40 to 50 years old for 10 seconds and over 50 years old for seven seconds. This can be improved with exercises.
- Circulation. Look at the color of your toes. Do they look like a normal nail color or are they leaning towards red, white, purple, or blue? Press down on the nail of your big toe until the color blanches. Now let go and allow the blood flow to return to your toe. The return of normal color should take 2 to 5 seconds in a person with average circulation.
- Flexibility. How flexible are your toes? Try to pick up a marble or a small dish towel with your toes. To test your ankle flexibility, hang your heel off of a stair. Now let the heel go below the level of the stair. If this causes pain, stop the test. If your heel goes below the level of the stair without causing strain in your calf, that is a good sign. If there is some strain, this can be improved with flexibility exercises.
- Pain. A healthy foot does not produce any pain.
- Sensation. Take a pencil eraser and lightly run it on the top, bottom, and both sides of your feet. The sensation should feel equal in all quadrants. It may tickle on the bottom of the feet. That is normal.
- Skin. Check your skin for calluses, blisters, or areas of irritation. Stand next to your shoes. Are they shaped like your feet or are they causing areas of constriction that may result in irritation? Put your hand inside your shoe. Are there seams, tacks, or rough places in the shoe that correspond to calluses or blisters on your feet?
Increased media attention has heightened awareness for the spread of infections from shared instruments and unhygienic practices in many salons. One way to avoid any exposure is to do pedicures for yourself at home. Here are some easy steps to follow that will make sure to keep your feet safe:
- Soak your feet in warm soapy water for approximately 10 minutes. This helps soften and clean skin and nails.
- After the foot soaking, gently rub the skin with a pumice stone or emery board. This gets rid of dead skin cells and calluses. Some body scrub products can help exfoliate dead skin. (Please contact our office if you have deep calluses or corns and need help shaving them.)
- Push back the cuticles with an orange stick or a Hindu stone. Cuticles offer protection from bacteria and infection. Cuticles clearly overhanging the nail margins need to be carefully trimmed. Do not trim any further than the nail margin or draw blood as this can lead to infection.
- Trim toenails straight across rather than in a curved pattern. This helps prevent ingrown toenails, allowing the straight edge of the nail to advance as one unit. Toenails should be trimmed just enough so that you can see a few millimeters of skin just beyond the nail margin. Nails should not overhang the edge of the toe.
- Refine the nail edge with an emery board, maintaining the straight edge.
- Apply cream and moisturizing lotion to the skin and nail margins.
- Massage the cream or lotion into the feet. A foot massage can help relieve tension and tired, aching feet. You can get a good massage at home by rolling your feet back and forth over a rolling pin or bottle. Specialists in the body’s reflexes, called reflexologists, believe that points on the foot correspond to other body parts and ailments can be relieved through reflexology. They believe the ball of the foot has a connection to the lungs, the heel to the lower back, and the great toe to the head. Although no scientific research exists to back up these claims, reflexology does seem to produce positive results in some people.
- Apply nail polish remover to the nails to gently remove excess lotion. This allows nail polish to adhere better to the nail. To apply nail polish, start with a base coat, followed by one or two coats of the nail color, and, finally, a clear topcoat.
- Space your pedicures apart by approximately eight weeks.
Women spend more time on their feet than men at home, and wear shoes with heels that aggravate foot problems at work. Their unique bodies and circumstances call for extra precautions related to the foot. Following are general guidelines for four issues specific to women’s foot health:
Women invite foot problems by wearing high heels. High heels may contribute to knee and back problems, disabling injuries in falls, shortened calf muscles, and an awkward, unnatural gait. In time, high heels may cause enough changes in the feet to impair their proper function. Most women admit high heels make their feet hurt, but they tolerate the discomfort in order to look taller, stylish, and more professional.
There are ways to relieve some of the abusive effects of high heels. Women can limit the time they wear them by alternating with good-quality, oxford-type shoes or flats for part of the day. Keep the heel height to no more than two inches and make sure the fit for the rest of the shoe is good. Varying heel heights whenever possible to wear shoes as low as possible in each situation. For example, there are comfortable and attractive “walking” pumps for women for work and social activities.
Experts say the best shoes for women may be:
- A walking shoe with ties (not a slip-on).
- Shoes with a Vibram-type composition sole.
- A relatively wider heel, no more than a half or three-quarters of an inch in height.
Women who always wear nylon pantyhose expose themselves to a host of foot problems. Nylon doesn’t breathe and the heat that it generates and traps can lead to excessive perspiration. A warm, damp area is an ideal place for fungal infections such as Athlete’s Foot.
Inexpensive nylon pantyhose can also cause forefoot problems, because they don’t allow the normal expansion of the foot when walking, and may pull the toes backward when the pantyhose ride up. The cramping and pressure of the hose can contribute to ingrown toenails and hammertoes. If you must wear pantyhose, be sure they fit properly around the foot. Limit the length of time you wear them whenever possible and, like socks, wash them after every use.
Pregnant women need to observe good foot health to prevent pain and discomfort. Since the body undergoes changes and acquires a new weight-bearing stance, women should wear shoes with broad-based heels that provide support and absorb shock. Additional body weight also calls for more support, to prevent foot “breakdown.”
The expectant mother often experiences more than ordinary swelling of her feet and ankles, which can aggravate existing foot conditions and promote inflammation or irritation. Pregnancy also triggers the release of hormones that enhance loose ligaments, which can contribute to foot strain. To help overcome these problems, allow time each day to stay off your feet. Elevate the feet and legs when you are sitting to help prevent and reduce swelling. Don’t sit for long periods of time. If problems do develop, please contact our office.
Women Over 65
Older women have more trouble with their feet than younger ones, often because fat pads on the bottom of the feet tend to deteriorate in the aging process. Many foot problems for older women can be alleviated simply by wearing properly fitted, well-constructed shoes that provide cushioning and have a soft, flexible upper that will conform to the shape of their feet. Shoes made of leather that “breathes” can also reduce the possibility of skin irritation.
Soles should be lightweight, with enough flexibility and shock-absorbing quality to provide solid footing and not be slippery. Low-heeled shoes provide greater stability, more protection for the feet, and greater comfort. Because older women often have circulatory problems, they have a special need to keep their feet warm in cold weather, to prevent frostbite or chilblains. Most importantly, keep walking and moving around every day so that all the systems in the legs and feet remain stretched and circulation stays healthy.
Your Feet at Work
Productive workers depend on their ability to walk and move about safely, with ease and comfort.
When your job requires you to stand on your feet for long periods, work in potentially hazardous areas or with potentially hazardous materials, you have some increased risk of foot injury. You can do a lot to prevent injuries by keeping your feet healthy and following safe work practices.
According to the National Safety Council, in any given year, there are about 120,000 job-related foot injuries, one-third of them toe injuries.
In addition to following the same basic foot care guidelines for all people, when you are on the job be sure to develop safe work habits and attitudes. This includes wearing protective footwear when appropriate. The National Safety Council also reports that only one out of four victims of job-related foot injury wear any type of safety shoe or boot. The remaining three either are unaware of the benefits of protective footwear or complain about it.
Nutrition For Your Feet
Your feet may be one of the first places to see the effects of osteoporosis. A stress fracture in the foot is often the first sign.
There is a lot you can do throughout your life to prevent osteoporosis, slow its progression and protect yourself from fractures.
- Include adequate amounts of calcium and vitamin D in your diet.
- Exercise regularly.
Foot Health Self-Assessment
Please take our Foot Self-Assessment. The Foot Health Foundation of America offers this simple quiz to pinpoint any warning signs of foot and ankle problems.