3 Points on Orthotics and Support Downtown Toronto

We are finally getting warmer weather in Toronto!  Warm weather means footwear changes and walks outside in the sunshine! Summer footwear usually means sandals, flats or less supportive shoes. There is a lot of confusion on less supportive footwear, minimal, support and orthotics. I recently went to a Harvard Sports Medicine foot and ankle injuries conference and I want to share some information on the topic.  

1. My Views on Minimal and Flat Shoes:

Firstly, I want to put it out there that I am not pro minimal and I am not against minimal. Minimal shoes take time to transition to. The transition can take anywhere from 9 months to 16 months of diligent strengthening and slowly weening into a less supportive shoe.   The transition to minimal footwear is very intense and requires stages of gait retraining and strengthening the little muscles of the feet all the way up the chain in progression. This includes training your little foot muscles how to activate and stabilize then engaging movements then combine movements with balance then movements with balance and increasing weight load efforts. Then putting it all together to be active for longer duration.  

2. How to Transition to Less Support, if you are Dedicated Enough !

My entire philosophy of practice is based on rehabilitation, finding imbalances, restoring function and getting stronger. However, I know this may not be a practical effort for people who want to wear some less supportive footwear when they change to spring and summer footwear. It is important to note that putting less supportive footwear on, does not simply make your foot stronger. You need to practice and dedicate time to strengthen all the muscles of the foot and lower limb. This has to be practiced regularly and should be guided by someone with knowledge how to do so . I know how to set up a program to strengthen the lower chain from the bottom up to the hips and can give advice on a program how to do so! This is important to do to avoid injuries when running or wearing minimal shoes for an extended period of time. The foot and ankle do adapt to repetitive use of footwear and sudden changes in a few mm of footwear can cause foot pain and an injury. Foot pain and injury can be prevented by wearing support while continuing to strengthen the feet and lower limb. 

3.I Believe in Combining Support and Strengthening for Pain relief

My approach to treatment is that I give exercises for the foot and calf to restore foot function along with support. In an ideal world it would be excellent to have people diligent about strengthening their foot and lower limb to wear less supportive shoes. However, I do know sometimes it can be a challenge for people to find time doing their strengthening even when they are in pain. For those who have foot pain and need support, orthotics or support can help the tissues rest or take the load off, while continuing to strengthen the foot. The feet do not get much rest as we are always on them, so the little support does help alleviate some strain off the tissues. Additionally, the benefits of orthotics are that they are custom and provides the ability to have specific support in an array of footwear, even footwear of less support.  

Those who want to wear less supportive footwear can do so if they take the appropriate measures to retrain and condition their feet to adapt to these changes. For those who experience foot pain when they wear a less support, they may find relief by wearing support/ orthotics to help them manage their pain. I usually recommend women who work downtown Toronto to wear sneakers or flats to the office and only wear their heels in the office. For those who experience pain in flats, I can make orthotics thin enough to go into flats! For trendy footwear commonly worn in summer, I do think a strengthening and stretching the program combined with the proper support can help those who have foot pain and also prevent foot pain from reoccurring.  

 

 

 

 

Foot Pain on the Ball and Side of the Foot

Foot Pain on the Ball and Side of the Foot

Having a background in kinesiology and being a distance runner, I understand how annoying foot pain can be. If you are suffering from foot pain ,you do not have to. Help is here if you want some relief! Here is a little overview of some different locations of foot pain. I,  Chiropodist Laura Desjardins, is located at Podiatry on Yonge at King. I have extra training that focuses on the treatment of foot pain. For all of these conditions proper prognosis and treatment is based off an examination to determine your individual weaknesses and mobility deficits. 

Ball of the foot pain 

This is pain on located under the bottom of your big toe. It can feel stiff, bruise-like or a burning sensation. Usually pain under the balls of the feet is called metatarsalgia which is a very general term for pain on the balls of the feet. Conditions on the balls of the feet may include  neuromas, sesamoiditis or transverse arch collapses. Sometimes there may be hardened callous or lesions that cause pain in this area. The first place to start is by providing support to the weakened area while one is rehabilitating the foot strength. I am not the type of practitioner who believes in relying on an orthotic, but orthotics can be useful tools to help alleviate tissue stress while one is building the strength back into their feet. The support would be provided by pads, which is located case specific to the patient. Other means of treatment include soft tissue work and modalities such as shockwave to help promote healing. After my conference at Harvard Medical School, I learned the Doctor Professor at Harvard is a big supporter of shockwave as uses it on many conditions of the feet. He has a lot of research supporting its benefit on conditions such as these. It is always important to rule out stress fractures so I will ask you questions pertaining to this.

Side of foot pain 

The foot contains an inside and and outside named medial and lateral. Peroneal tendonitis, Posterior Tibial Tendonitis and Cuboid syndrome are a few conditions located on in this area. There are muscle groups in the lower leg that are important for powering healthy foot function. Tendons are the extension of the muscle which allows the muscle to adhere to bones.  When muscles become overworked and fatigued the tendons can get inflamed and painful. Treating these conditions requires restoring the function of the small foot muscles as well as improving strength in the muscles of the lower leg. Icing , resting or the use of anti inflammatories is useful in the initial stages of this condition. Orthotics to wedge the foot in a certain manner is based on the location of the condition. This helps to alleviate strain and manage the pain symptoms, again while restoring normal function of the foot and lower leg. Shockwave is a great tool used on the tendons. 

There are many different types of foot pain and it is important to not only know what the condition is but to have the proper exercise plan, support and soft tissue treatment therapy to help your feet back to health. I enjoy coaching people one on one for proper form of the exercises. May approach is not only treating the symptoms, but get to the root cause of the problem. In some cases I will refer you off to a sports medicine doctor for imaging or ultrasound in a situation I feel is severe enough to do so. For chronic cases I may also refer you to a sports medicine doctor for other treatment options such as Platelet Rich Plasma injections for those chronic slow healing injuries. If you have any foot troubles, I would love to help you at our downtown Toronto Podiatry / Chiropody office! 

Ingrown Toenail? Here’s Some Solid Advice from Your Toronto Podiatrist

Chris Hastings has the Toronto podiatrist experience you’re looking for. He has served in hospitals and institutions as a consultant. His private practice is thriving and he is a community leader as well. He has information about a variety of issues including ingrown toenails. He has also brought an associate on board, whom he has mentored and passed on years of knowledge to.

Simply put, ingrown toenails occur when the sides of the nail break away and grow into the skin on the toe. It happens a lot and causes redness and swelling. If it’s not treated properly, an ingrown toenail can get infected.

Here’s what you need to do.

As soon as the symptoms start to appear, you should contact us. We are the Toronto podiatrist and chiropodist that look after people with this issue. We are especially concerned if you have diabetes. Complications can also occur if you have foot circulation problems and nerve damage.

Keep in mind that over-the-counter medicines won’t solve the problem. They only mask any pain you’re feeling.

Removing the Nail

Removing the nail is one of the treatment options. That’s because the area can get infected. If that’s the case prescription antibiotics are a good treatment plan.

If your ingrown toenail persists, we might suggest some simple surgery to remove part of the nail. Chris Hastings and Laura Desjardins has experience as a Toronto podiatrist and chiropodist in this area. Chris is an accomplished leader in his field. Chris also understands the importance of being a community leader. His resume includes work with Crime Stoppers and the Cancer Society. Take a few minutes to go through the services offered on his website. You’ll see that Toronto nail care is one of the options. Laura Desjardins is an athlete herself and is no stranger to knowing the trauma toenails are exposed to in running and sports, which may lead to ingrown toenails.

Accurate Diagnosis

You will be able to get an accurate diagnosis for several different conditions with Chris and Laura, the practitioners at Podiatry on Yonge at King. These aren’t just limited to ingrown toenails. Finding out that you have toenail fungus in its early stages allows for prompt treatment.

Establishing regular checkups with our Toronto podiatrist and chiropodist clinic is the first step to good foot health.

Bacteria in the Wound

One of the biggest concerns with an ingrown toenail is infection. This occurs when bacteria enters the wound. If you have any symptoms like redness or swelling, book an appointment with us today.

Your feet need to be well looked after so they can last you a lifetime. Chris Hastings and Laura Desjardins understand this because they are compassionate and professional. Avoiding serious issues means finding out about problems before they become large.

Finally, remember that both Chris Hastings and Laura Desjardins are the Toronto podiatrist and chiropodist that makes a difference.

Big Toronto Foot Problems and Treatments

We understand your feet take a lot of daily punishment and suffer through Toronto foot problems. Whether you’re climbing, walking or running, you might suffer from a variety of issues.
That’s why we put together a list of Toronto foot problems and treatments.

Diabetic Neuropathy

Diabetes can cause nerve damage and high blood sugar levels can make things worse. Diabetic neuropathy occurs when blood sugar levels have not been maintained properly. Symptoms include pain and tingling in your feet. Diabetics suffer from a lack of sensation. This makes diabetic neuropathy more serious since cuts and other injuries go unnoticed.

If you have diabetes, you should get regular foot examinations. Toronto foot problems relating to blood sugar levels can be avoided. One of the first steps is to maintain control over your blood sugar.

You should also have your toenails trimmed professionally. Don’t hesitate to get medical attention as soon as you notice a cut or injury on your feet.

Bunions

Bunions are very common. They usually develop as a bump on the big toe and can cause the big toe to migrate outwards. Women are more likely to have these particular Toronto foot problems because they wear narrow shoes.

People with a family history are also at risk. There are other conditions like arthritis that can increase your chances of getting a bunion. There are several symptoms including tenderness and a visible bump on the big toe.

A bunion can also appear like a callous. If you’ve got trouble moving your big toe, you might have this issue. One of the most common symptoms is pain when you are walking.

We have experience in looking after Toronto foot problems just like this. As your Toronto podiatrist and chiropodist, we can prescribe shoes with inserts that are custom-made. When the situation doesn’t correct itself, surgery is another option.

Plantar fasciitis

When the strong connective tissue, called fascia, on the bottom of the foot becomes enlarged, Plantar fasciitis is the result. This is one of the more common causes of heel pain for most adults. Symptoms include discomfort on the bottom of the foot. It gets worse the more you move around. Many patients tell us it is severe early in the morning.

Get in touch with us if you are suffering from any of these issues. We have experience with a variety of Toronto foot problems. We offer a full biomechanical and gait analysis to find the root cause of your plantar fasciitis. Our Podiatrist, Chris Hastings, is one of the most experienced in the city and has a lot of knowledge with this condition. Our Chiropodist, Laura Desjardins, is highly focused on sports medicine and foot pain and offers individualized treatment plans,soft tissue treatment, custom orthotics and shockwave therapy for those suffering with this condition.

5 Tips on Achilles Tendon Pain Treatment

5 Tips on Achilles Tendon Pain Treatment 

At Podiatry on Yonge at King, I care about your foot health and would like to take the time to chat about some key factors in footwear that can impact your foot health. Being a runner, I constantly subject myself to repetitive impact and movements. This leads to the susceptibility of overuse injuries or imbalances. Achilles injuries are one of the injuries commonly found in runners and the walking population. Achilles injuries are commonly caused by overuse, fatigue and biomechanical imbalances. Here are some key points to help manage or prevent these injuries and debunk some myths in the footwear and foot health field.

1. Footwear, this has a huge impact on our predisposition to these injuries. The amount of load placed on the tendon can be influenced by our footwear. At a point I recall there was a trend in wearing runners of a lower drop. What does a lower drop mean? It means the difference from the rear foot to the forefoot. That difference in height between the rearfoot and forefoot can make a big impact on the connective tissue around your ankles. Have a little higher heel than the forefoot can help reduce strain on the tendon. Doing high impact repetitive activities in a lower drop causes more elongated and more contraction to happen around the lower limb and ankle. This can lead to plantar fasciitis or Achilles tendinitis, especially if there is any overuse or weakness. It is best to stick to a consistent heel height among your footwear. I put an example of a hoe I recommend at the start of this blog. I am a big fan of 10mm drops. I tried to go into a lower drop, proper transition and I still was not a fan of how it sparked an injury in myself!

2. Strength : Walking movement and running requires us to raise our heels off the ground as we move forward. It requires muscular strength in both of the calf muscles. However, overuse can lead to fatigue and weakness in these muscles. In the beginning of strengthening, heel raises may put too much unwanted strain on the achilles. That is why I advise doing a progression in strengthening for the achilles. I typically start out with isometric holds then move to added difficulty with either increasing weight or eccentric heel drops. I am also a big fan of also adding exercises for glutes and core, as weakness in these areas can lead to compensation by excessive overuse on the calf complex. If the calf is not strong enough the achilles will get angry!

3. Flexibility helps connective tissue to stretch within a range of motion. It is important to stretch the calf muscles and achilles especially since we contract them so many times when we walk or run. Those who do wear high heels should try to incorporate more stretching into their day to day regimen.

4. Pronation or flat feet can also cause this injury. Pronation is when the feet collapse inwards toward the middle of the body. This can create excessive strain on the tendon . It is important to also strengthen the ankle with this injury. This can be corrected with exercises and supportive shoes. Someone who has a flat foot should not be in flimsy shoes.

5. Slowly increasing your mileage or intensity. It is not wise to move up more than 10% of weekly mileage in a given week.  Ease back into training if you are injured and trying to get back to running from this injury. I recommend easing back to activity by starting out wearing heel lifts or orthotics with posts in their non flat running shoe. It is not fun being injured, but you can maintain some level of fitness by cross training then progressing to the treadmill. The reason I like the treadmill is because it is lower impact and it isn’t as difficult as outdoor running. Once you are  strong and flexible enough, I remove that lift, while moving you through a progression in difficulty of load and exercises.

Like any injury, it does take time and patience. So do not be too hard on yourself. All we can do is focus on the positive aspects, such as our exercises and rehab in order to get over our injury.