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MUSCULOSKELETAL CHANGES TO THE FEET IN MENOPAUSE

Musculoskeletal Changes to the feet in Menopause

The following are just some of the common difficulties in Menopause that may affect joint and soft tissue injury in women, due to a reduction in Oestrogen levels. 

Collagen reduction

When hormone levels drop during menopause, the production of collagen slows. Collagen is a blend of elastic tissue that’s a very important ingredient that enables the supporting structures of the feet to stay strong. When collagen is reduced our ligaments that connect our joints and engage muscle function, and our fascia, can become strained more easily and more prone to injury. An example of an injury that relates to this scenario is Plantar Fasciitis, pain at the heel that sometimes extends into the arch due to the elasticity of the fascia being reduced sometimes from lack of collagen. 

Increase in body weight

Unfortunately it has become well known that women in their 50s and 60s can be prone to an increase in body weight depending of course on many genetic and lifestyle factors. An increase in body mass increases the strain on joints and soft tissues of the foot which can eventuate to injury risk due to tissue stress and can also generally increase pressure to the foot. With a lifetime of wear and tear most feet will have some existing biomechanical factors that predispose these risks, and unfortunately weight gain is common and can exacerbate the above potential for injury. The key in treatment of a foot that is suffering under a recent weight gain is to redistribute and share pressure around the foot to ease strain on vulnerable areas and there are many ways this can be done. Feel free to talk to your Podiatrist about your concerns and we can get you back on your feet in no time! 

Fatty pad displacement

Did you know? In our feet we have a natural fat layer that runs throughout the sole of the foot. This fat layer known as “fat pads” provides the feet with natural shock absorption. However, it is a common feature in Menopausal women that the fatty pads dissipate or are displaced slightly, so they no longer apply their cushioning effect to the balls of the foot or areas of the foot where there are bony prominences that need that impact absorption! Having cushioned shoes (wearing runners is great) or cushioned liners (the best are made of a special ingredient called Poron) helps to sooth this issue. Choosing soft surfaces also may help when you are active, and avoiding being barefoot around the house too much. 

But if you are having ball of the foot or heel pain, consult your Podiatrist for a comprehensive examination as fat pad reduction may well not be the predominant issue. 

Reduced bone density

Sometimes, unfortunately Oestrogen reduction can precede a higher risk of bone density problems such as Osteopoenia and Osteoporosis. Especially if you are active, it is important to be aware of this risk so that no acute bone stress reactions or fractures are encountered due to the loads of activity being too high for a reduced bone density to cope with. 

If you are experiencing pain or discomfort, please call us today for an appointment on 5223 1531

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.

 

Our next Complimentary Paediatric Clinic will be held on Wednesday the 28th of July 2021

Complimentary Paediatric Clinic 

Every month at Total Care Podiatry we run a complimentary morning clinic to support the little feet that run around our community. We run short appointments designed to be a screening check of any areas of concern you may have for your child’s feet. 

Commonly we check for: 

  • ‘Tired legs’
  • Being clumsy
  • Walking ‘pigeon-toed’
  • Curly toes
  • ‘Flat feet’

Following a short appointment, we can provide some advice for next steps forward. These may include a more in depth follow up appointment, footwear recommendations or activity changes.

Bookings are essential – please phone our friendly staff on 5223 1531 to secure your free paediatric appoint today

THE EFFECTS OF MENOPAUSE ON THE FEET

The Effects of Menopause on the Feet

As we know, predominantly the function of Menopause in women is to reduce oestrogen levels. Menopause and particularly the decline in Oestrogen hormone levels does promote a few effects on the feet that you may not know! It helps to have consolation that you are not alone if you are starting to see some uncomfortable changes to your feet, many women out there suffer a range of effects, of which the following are merely a summary of common foot changes. 

Decline in Oestrogen can cause:

General Changes to the feet

Reduction in ability for skin to retain moisture

When the feet lose their ability to retain moisture in the skin layers, skin obviously becomes drier. However, when skin becomes drier it is more likely for callouses to form. Callous, also known as Hyperkeratosis (as it sounds literally- hyper production of keratin cells) is a lesion of hardened dead skin cells pushed to the outer layer of skin, forming a thickening in areas of the foot prone to pressure due to an over production of keratin. This is a protective mechanism of the skin! So if you have callous, that may not be the root cause of pressure to that area of the foot. 

If you are concerned about your skin getting drier or pressure or callous areas and are looking for advice, we have our Free Family Foot Check clinic day this Friday July 9th, contact our clinic to make a booking!

Reduction in foot temperature at the extremities

Menopause is also commonly known to cause symptoms of cold feet! The key to keep your feet warm through a chilly coastal winter is to ensure a woolen sock or woolen blend for maximum insulation and get any concerns about circulation addressed. 

Water retention

Although not a prevalent and obvious feature of menopause, water retention due to hormonal changes can cause swelling of the feet. So don’t be too alarmed if this happens as it can simply be a Menopausal feature as opposed to a more serious issue with your vascular circulation. If the swelling is persistent or presents with pain however, consult your doctors and Podiatrist for further assessment. 

If you are experiencing pain or discomfort, please call us today for an appointment on 5223 1531

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.

CHILDHOOD OBESITY LINKED TO FOOT PAIN

Childhood Obesity linked to Foot Pain

Did you know? Our body weight, if not evenly distributed through our skeleton by the help of normal alignment, can result in changes in the way the foot reacts to the forces acting on the foot from the ground up. The higher the BMI (Body Mass Index) of an individual, the more difficult the role of the foot to evenly distribute pressure, hence some areas of the foot and lower limb can be exposed to greater amounts of pressure and thus be prone to injury or tissue stress.

In the growing foot, the above scenario exacerbates. Growth in children’s feet involves fragility of the tissues as they develop. For example, the heel bone of a 14 year old child who is of a BMI within a normal range is still developing and already potentially under stress. When we look at a child of the same age who is obese, this heel bone under a greater amount of body weight will be unable to cope with the normal stresses of growth and development and be more likely to injure, sometimes even a heel stress fracture can occur. 

If a child with obesity is exposed to a foot problem or pain, this will render them less active which can impair physical fitness that is even more important in a child suffering from problems with their weight in their development. 

Mythbusting- are flat feet the problem?

High validity evidence from recent research has found no significant relationship between a flatter foot type and foot pain  in obese children however they did find a high prevalence between children with obesity and having a “flat foot”. From this we can infer that in overweight or obese children although foot problems or pain may not be due to a flat foot, the presence of a flat foot may suggest other biomechanical faults that could be the root cause of the presenting pain. 

This is because we know the foot pronates most often to compensate for other asymmetries or faults in the body which are sometimes in the upper chain. 

So, what effect does Obesity in a child have specifically on the feet?

However, research has found that obesity in children does specifically impact on the foot’s arch by creating disproportionate loading and increased loading particularly affecting the medial longitudinal arch and midfoot. This can mean that regardless of the arch being flatter or not in an overweight child, regardless, the arch will be strained more.  Plantar Fascial heel & arch pain is a common foot condition for children although less common than in adults. 

One contributing factor to excessive strain on the plantar fascia can be a flatter foot type as the arch band of the plantar fascia stretches more in movement. 

Think your child has a foot problem? See our friendly Podiatrists for our monthly free Paediatric foot check and screening held on a Wednesday each month. Contact our helpful Reception team for details, you can also get a referral from your Paediatric nurse. PH: 52231531

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.
Link to research: doi: 10.1371/journal.pone.0149924
Link to research: doi: 10.1111/cob.12091

Complimentary Paediatric Clinic ~ Wednesday the 23rd of June 2021

Complimentary Paediatric Clinic 

Every month at Total Care Podiatry we run a complimentary morning clinic to support the little feet that run around our community. We run short appointments designed to be a screening check of any areas of concern you may have for your child’s feet. 

Commonly we check for: 

  • ‘Tired legs’
  • Being clumsy
  • Walking ‘pigeon-toed’
  • Curly toes
  • ‘Flat feet’

Following a short appointment, we can provide some advice for next steps forward. These may include a more in depth follow up appointment, footwear recommendations or activity changes.

Bookings are essential – please phone our friendly staff on 5223 1531 to secure your free paediatric appoint today

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.

WHEN TO FIX KIDS FEET?

When to fix kids’ feet?

 

Worried about your child’s feet? It is important to know what is a normal presentation for a child in their age group, as opposed to what actually may be considered a “red flag” in their development. When asking the question of whether to “fix my child’s feet” it is crucially important to make an informed decision with the professional advice and assessment of health professionals. Our Podiatrists will thoroughly assess your child and determine what treatment, if any, is suitable at that time of the child’s development and will reassure you what is normal! Depending on your child’s age and the presenting condition, there are treatment windows within a child’s normal physical development within which to correct any structural abnormalities.

Did you know? Recent evidence based research on thousands of children aged 3-15 years shows the most common foot posture or foot type is a ‘flat’ or pronated foot.* From this it can be concluded that a flat foot without any other abnormal characteristics is not abnormal. So, not all “flat feet” need to be fixed as such. Foot pronation in itself is often a compensatory response to other biomechanical and structural adaptations or elements of the lower limb and rest of the body. Hence overpronation of the foot may not be a causative element but an end result, and there may be other elements of the lower limb that are better addressed first before treatment of the flatfoot is considered. 

Did you know? At birth, only some bones of the foot are formed. By only age 5, the last major bone of the foot is formed, the Navicular, which structurally forms the “arch” of the foot. 

Total Care Podiatry believes in the value of assessing children at an early age or at any age in their development to rule out any abnormalities or red flags in musculoskeletal development in particular and to reassure parents what is normal. Total Care runs a Paediatric screening clinic once monthly to offer a free assessment. We ask that to book into this clinic, a small donation be made to Kids Plus foundation. Kids Plus “offers programs that include early treatment and specific intervention strategies to improve children’s abilities across a range of developmental areas.” 

On Friday July 9th 2021, we have a Complimentary Family Foot Check clinic scheduled. If you have any concerns about a family member’s foot health, especially your child of any age; please book in for your free assessment! PH: 5223 1531

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.

 

SURFCOAST TREK RECOVERY

There are many things to consider after the trek – these are some tips we would recommend: 

  1. Take a recovery pair of socks and shoes. Clean and dry your feet and put these on after the event to prevent blisters. Keep warm. 
  2. Go for brunch! Treat yourself. You will be tired, and your body will be hungry for a high protein and carb meal. It is important to refuel!
  3. A light stretch and walk in the afternoon for optimal muscle recovery 
  4. Avoid deep tissue massage in the first week – be gentle and start with light muscle recovery. If you have any pain that is disproportional to what you consider to be normal recovering muscle pain, seek advice from the appropriate healthcare professional be it your GP, physiotherapist, or podiatrist 😊 

If you have any queries before the trek, come in for your free 15 minute foot check! 

PH: 5223 1531

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.

YOU DON’T HAVE TO DEAL WITH SWEATY, STINKY FEET THIS WINTER!

Have you ever wondered why your feet smell, even during winter months?

While you might think excessive sweating or foot odor should be something you only have to deal with in summer, there are a number of things that can contribute to smelly feet in the winter.

One condition that could contribute to the cause is Hyperhidrosis – Abnormally excessive sweating involving the extremities, underarms and face, usually unrelated to body temperature or exercise.

Other Causes of Sweaty Feet

A change in the weather. Any change in the weather can trigger excessive sweating. It’s a process called autonomic regulation and it occurs when your body has to work overtime to tolerate these changes.

Fluctuations in temperature. Fluctuations in temperature – such as when you return indoors after walking in the snow – cause your feet to have to work harder to control the temperature and in doing so, they perspire.

The shoes you choose. In winter, you usually wear warm boots or non-breathing footwear like insulated or rubber boots and waterproof footwear. When your feet are enclosed, bacteria thrive, and they can’t air out.

Layering thick socks. While wearing several pairs of socks can keep your feet toasty and warm, it also locks the sweat in, leading to foot odor. Also, wearing multiple layers of socks can cause friction and pressure and corns and calluses can develop, which may also add to excessive sweating and odor.

Dry skin. Because the air is drier during winter months, our skin tends to dry out more quickly, and the dead skin provides food for the bacteria that can trigger smelly feet.

Cures for Sweaty Feet

There are a number of things you can do to avoid foot odor this winter.

  • Remove your warm boots as soon as you’re back indoors, so they can air out to avoid overheating of your feet.
  • To make sure that the footwear you wear one day dries completely, switch to a dry pair the next day because moistness equals more bacteria.
  • Be sure to change your layers of socks often if you tend to sweat a lot and wear socks that will wick moisture away, keep your feet cool and neutralize odors.
  • Exfoliate your feet using a pumice stone, dry brush, or loofah to remove dead skin cells from the top layer of the skin to keep your feet clean and odor-free.
  • Wear breathable footwear to give your feet a chance to air out.

If you are experiencing pain and/or discomfort during the winter months ~ please call us for an assessment today PH: 5223 1531

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.

GOING SKIING THIS SEASON? Make sure you fit your ski boots correctly to avoid injury!

Vital tips when it comes to Rental Ski Boots and Footwear at the snow this year

Ski boots are one of the most important pieces of equipment and a properly fitting boot will make a large difference in your skiing experience.
Ski boots are measured in Mondo sizes (Mondo (or mondopoint) sizing is basically the length of your foot in centimeters.
It is important to remember that ski boots should not fit like a pair of shoes. You want them to be tight and secure in order to maximize performance, stability and safety.
Most injuries and pain to the foot while skiing/snowboarding occur because of a boot that is too big.
Getting the sizing right goes a long way towards a comfortable time on the slopes.
Make sure to take the time with our ski boot fitting, to ensure that you can have a great day on the mountain.

Do’s

  • Wear loose-fitting pants that can be rolled up
    • Ski socks should be the only thing in your ski boots
  • A quality ski sock is made of wool or synthetic fibers.
  • Buckle up the boots before you make a fitting decision
    • Buckling up the boot will put your foot in the correct position in the boot
  • Walk around in the boot to better ensure you have a good fit
    • Keep them on while you look at skis or accessories
  • Flex your boot forward so that your foot slides into the proper ski position
    • You will naturally be flexed when you ski
  • Attach the Power Strap Firmly
    • The power strap should always be on while skiing

Don’ts

  • Wear multiple pairs of socks
    • This will cause friction in the boot, take up more space, and reduce breathability
  • Wear ankle or cotton socks
    • Your socks should come up above the top of the ski boot
  • Be afraid if your toes are touching the front
    • In a proper fit, your toes should be touching the front when you are upright
  • Choose a boot based on the color
    • Comfort over color!
  • Over tighten your bottom buckles
    • The top buckles are the ones that keep your ankle in place, not the bottom ones
  • Try on a boot based on your shoe size
    • Measure in Mondo size or centimeters
  • Forget that ski boots will continue to pack down
    • Even used ski boots will continue to break in

Don’t Forget to trim your Toenails!

Your feet probably aren’t accustomed to the tight fit of a ski boot and being slammed into the end of the toe box.
Protect your nails from damage and ingrown toenails by trimming your nails short and straight across.

If you are experiencing pain and/or discomfort during or after skiing please call us for an assessment today PH: 5223 1531

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.

WHAT RUNNER IS SUITED TO MY FOOT SIZE AND SHAPE?

What runner is suited to my foot size and shape? 

The choice we make in deciding on an appropriate pair of runners for walking or running can be made in relation to many features of our feet.

First and foremost to address is the size and shape of our feet. 

Our feet can change in size or length, shape and width across the time of our lifespan, including as you age. 

So it is important to get your size and width remeasured each time or every second time you get fit for shoes. 

 

Here are my top tips for fitting shoes to feet of all shapes and sizes!

 

  1. A rule of thumb- test that you have one thumb’s width of airspace compressible just beyond your longest toe in a shoe. 

This allows for the change in size to your foot: 

-When you are more active as your foot slides forward in a shoe

-When your feet swell up during physical exercise 

 

Source: https://www.blister-prevention.com/optimal-shoe-fit/

 

NARROW FEET

–> Ensure the fit of your shoe is secure through the heel and ankle, snug through midfoot and be cautious not to overpull laces too tight across the forefoot as we do require some wriggle room for any foot shape at the toes. 

-The sole or platform of the shoe in a curved last shape may assist to contour your midfoot as visible below

 

-In runners and some dress shoes, for women this means a 2A width (Narrow) and for men in very select shoe styles this means a B width (Narrow). 

-Note that regardless of a shoe’s stated width, some shoestyles may fit more narrow than others-speak to your trusted footwear professional instore for any particular shoe styles that suit!

 

Some of my favourites are:

  • Asics Gel DS Trainer 
  • Asics Glideride 
  • Brooks Ravenna
  • Brooks Transcend 
  • Brooks Adrenaline 2A (or B Width for mens)
  • Asics GT 2000 2A Width (or D width for mens fits more snug) 
  • Nike Pegasus 
  • Mizuno Wave Rider (fits very generously through the forefoot though)
  • Saucony Guide (fits very generously through forefoot though)
  • Brooks Levitate 
  • New Balance Fuel Cell Prism 
  • Brooks Glycerin 17 
  • Hoka Clifton 

 

Lacing technique tip: Lock lace by use of the extra eyelet at your ankle to secure heel and ankle into back of shoe, hugging a narrow heel and preventing slipping around inside. You can always ask your Podiatrist how to lock lace at your next appointment! There are other techniques available for narrow feet. 

 

WIDE FEET or feet with Bunions

–> It’s simple-ensure a wider fitting shoe! If you’re not sure when trying shoes on, compress the sides of the shoe on your foot and if you feel tightness or bony prominences-always if in doubt-go wider!

-The sole or platform of the shoe being wider also helps ie a straight lasted shoe such as visible below

Source: http://hub.therunningworks.net/running-shoes-everything-you-need-to-know/

 

Bunions are a change in alignment of our 1st or 5th Metatarsophalangeal joint that over time can create painful bony prominences to both sides of our forefoot. Excessive pressure to this joint deformity caused by narrow shoes can exacerbate the deformity and pain associated. 

 

It is most helpful upon fitting a shoe to test with your hands by compressing the sides of the shoe. The best case scenario is that there is an air bubble of space surrounding your bunion. 

 

In runners and some dress shoes, for women this means a D width (Wide) or 2E width (Extra Wide) 

For men this means a 2E width (Wide) or 4E width (Extra Wide) 

 

Some of my favourites are:

  • Brooks Dyad or Brooks Addiction 
  • New Balance 940 
  • Saucony Echelon
  • Asics Fortitude 8 
  • Asics Gel Pursue
  • Asics GT 4000 
  • New Balance 880
  • New Balance Fresh Foam Moar 
  • Mizuno Wave Inspire D/2E Width (good for forefoot width) 
  • Hoka Bondi D/2E Width
  • Hoka Gaviota 

 

Lacing technique tip: Start the shoe lacing from the 2nd eyelet from the front of the shoe, skipping the first to ensure the tightest point of fit is not across your bunion joint region. 

 

BROAD FEET, HIGH ARCHED FEET or feet with ORTHOTICS

–> Ensure adequate shoe depth

This will prevent: 

-A feeling of tightness or restriction across the top of your foot when you tie up the laces or fixate your shoe closed

-Heel slippage-commonly occurs in shoes that are too shallow to fit an orthotic. 

 

TOE DEFORMITIES and TOE ALIGNMENT

The toebox of a shoe in a closed toe shoe is the area encompassing all your toes. 

Some brands like Frankie 4 stock shoes with various toe box shapes to suit different toe alignments.

Source: https://commons.wikimedia.org/wiki/File:Toe_box_size.jpg

 

Tips:

-Ensure adequate shoe depth and width in the “toebox” of the shoe

i.e.  Avoid pointed toe shoes 

 

Source: https://www.somfootwear.com/blogs/news/wide-toe-box-shoes

 

This will prevent: 

-Pressure to the tops of claw or hammer toes, to prevent further deformity, pain, callous or corn formation. 

-Prevent interdigital pressure between toes and the formation of bunions. 

If you are experiencing pain or discomfort, please call us today for an appointment on 5223 1531

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.