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Department of Orthopaedic Surgery
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Thursday, 22 January 2015 16:01

What are Achilles Tendon Injuries

The Achilles tendon is the strongest tendon in the human body. Its purpose is to connect the lower leg muscles and calf to the heel of the foot. This tendon is responsible for facilitating all types of movement, like walking and running. Since this tendon provides an enormous amount of mobility to an individual, any injuries inflicted to this tissue should be immediately brought up with a physician to prevent further damage.

The most common injuries that can trouble the Achilles tendon are tendon ruptures and Achilles tendinitis. Achilles tendinitis is the milder of the two injuries and can be recognized by the following symptoms: inflammation, dull to severe pain, an increased flow of blood to the tendon, thickening of the tendon, and slower movement time. Tendinitis can be treated via several methods and is often diagnosed by an MRI.

An Achilles tendon rupture is trickier to heal, and is by far the most painful injury. It is caused by the tendon ripping or completely snapping. The results are immediate and absolutely devastating, and will render the patient immobile. If a rupture or tear occurs, operative and non-operative methods are available. Once the treatment begins, depending on the severity of the injury, recovery time for these types of issues can take up to a year.

Simple preventative measures can be taken as a means to avoid both injuries. Prior to any movement, taking a few minutes to stretch out the tendon is a great way to stimulate the tissue. Calf raises, squats, leg curls, leg extensions, leg raises, lunges, and leg presses are all suggested ways to help strengthen the lower legs and promote Achilles tendon health.

Many problems arise among athletes and people who overexert themselves while exercising or who do not properly warm up before beginning an activity. Proper, comfortable shoes that fit correctly can also decrease tendon injuries. Some professionals also suggest that when exercising, you should make sure that the floor you are on is cushioned or has a mat, as this will relieve pressure on the heels. As always, a healthy diet will also increase tendon health.

It is very important to seek out a podiatrist if you believe you have an injury in the Achilles region, because further damage could result in severe complications that would make being mobile difficult, if not impossible.

Thursday, 15 January 2015 10:23

Every Day Foot Care

Our feet are of great importance in our everyday lives. The problem is that we tend to neglect them. When this becomes a habit, it can cause significant trouble. Ignoring foot problems can mean pain, limited mobility, and expensive doctor's visits. On the other hand, if the feet are cared for and looked after each day, they will perform without pain or complication.

Routine hygiene is the most basic way to care for the feet. Wash and dry them thoroughly everyday. Remember to get between the toes, and keep the toenails trimmed and short. If the feet feel dry or one can see visual signs of dryness or cracking, use a moisturizer designed for the feet.

When using moisturizer on the feet, try to avoid applying between the toes. If creams or lotions sit in that area, they can cause development of fungi and bacteria. When moisturizer is used between the toes, it can also cause the skin to macerate.

Shoes are also an important aspect of foot care to consider. When one is picking out shoes, make sure that they are the correct size. Shoes need to be snug, but not too tight. On the other hand, if the shoes are too loose they can cause foot problems as well. It is highly recommended that shopping for new shoes be done later in the day. The reason for this is that the feet will have settled and swelled to their full size by then. To keep your feet at their most healthy, avoid wearing high heels or flip flops too often. Instead, choose shoes that are good for your feet, and that pad the soles of your feet and support the arches and ankles.

Socks should also be worn daily with closed-toe shoes. They may feel hot during the summer months, but they absorb sweat and moisture and keep it off the feet. Without socks, the build up of sweat in a closed-toe she can cause fungi problems and athlete's foot.

The best thing to remember in every day foot care is that shoes do make a difference. If you spend much time on your feet, make sure that your shoes show no signs of wear and offer ample support for the arches and the overall foot. Additionally, try to engage in thorough foot cleaning and maintenance a part of your daily routine. If you keep these things in mind, your feet will stay healthy and safe.

Wednesday, 07 January 2015 23:22

How to Prevent Running Injuries

Many common running injuries are caused by overuse and overtraining. Several common injuries can occur due to running. When the back of the kneecap starts wearing away and starts causing pain in the knee, this is commonly referred to as runner’s knee. Runner’s knee can occur because of decreased strength in the quadricep muscles or shoes that do not offer proper support to the inside of the forefoot. Runner’s knee usually is treated with strengthening exercises focusing on the quad muscle and sports orthotic. To prevent runner’s knee, efforts should be focused on hip strengthening. Physical therapy is also beneficial in helping to learn the best exercises to heal runner’s knee. To prevent runner’s knee, strengthen the quad muscles to keep the kneecap aligned.

Overtraining is one cause of a common running injury called iliotibial band syndrome, which occurs when the iliotibial band gets irritated, causing pain and discomfort to the outside knee area. Another common running injury is known as plantar fasciitis, which occurs when the bone in the foot becomes inflamed and irritated. This injury primarily causes pain in the foot. Causes can include a high arch, incorrect footwear, tight muscles and flat feet. The best way to avoid plantar fasciitis is stretching and proper footwear.

Stress fractures are a common injury for runners. These fractures can occur because of overtraining, lack of calcium or running style. In runners, it is common for stress fractures to occur in several locations including the inner bone of the leg, the thighbone, the bone at the base of the spine and the toe bones in the foot. The best approach to preventing stress fractures are proper footwear maintenance and running on a surface with enough “give” to absorb some of the shock produced during running.

Besides overtraining, other causes of these common running injuries are poorly fitting footwear, irregular biomechanics, and lack of flexibility and strength. The best way to avoid running injuries is to prevent them. Fortunately, each of these common running injuries can be prevented. To avoid running injuries it is highly recommended to wear only footwear that fits properly and that suits your needs. Running shoes are the only protective gear that runners have to safeguard them from injury; therefore, choosing the correct footwear for running is important. It is important, too, to think about other aspects of your running routine like training schedules, flexibility and strengthening, and tailor them to your needs in order to minimize the possibility of injury. Regular stretching before and after running should be considered also when trying to avoid running injuries. Stretching keeps muscles limber resulting in greater flexibility.

Thursday, 01 January 2015 00:00

Working on Your Feet

When your feet are overworked your whole body can be affected. Thus, taking care of your feet is a must for overall good health. Standing on the feet all day can cause bunions, callouses and plantar warts. These are all very painful conditions that can be avoided with proper foot care. Good shoe choices and proper posture both contribute to the health of your feet.

Always choose a negative heeled shoe that places the heel slightly lower than the ball of the foot. Shoes designed in this fashion are the best for foot health. And most definitely purchase your shoes from a reputable manufacturer who puts foot health at the forefront of their goals. Having a job that keeps you on your feet all day makes it an especially a good idea to spend the extra money on a good pair of shoes.

The feet were not designed to be enclosed for hours on end. In fact, incorporating some "barefoot" time into your daily routine is not a bad idea to improve overall foot health. There are some other simple things that you can do to help alleviate pain and pressure on the feet from standing all day.

First of all, you can perform some simple foot exercises and even some common yoga moves to improve the function of your feet. A foot work out that incorporates mechanically correct movements will stimulate the blood flow and the muscles of the foot. Also, yoga exercises that stretch the foot out flat on the floor are very beneficial for those who work on their feet, and can help stretch and relax the calf muscles and Achilles tendon. These exercises may be performed every day during your daily routine, perhaps even while you are sitting in your vehicle or standing in line at the grocery store.

If you spend a lot of time on your feet every day, you know what it can be like to have foot pain, and you may begin to think that foot pain is inevitable. It doesn't have to be. Foot stretches and proper footwear can do miracles in alleviating foot pain and preventing further foot problems.

With just a little effort and some education on the proper foot exercises, you can keep your feet healthy and feeling good for years to come. If your feet hurt your whole body will feel the effects over time. Start taking better care of your feet today. They will love you for it!

Monday, 22 December 2014 23:10

Effect of High-Heels on the Feet

For hundreds of years, women have been wearing various kinds of high-heels for mostly aesthetic reasons. Women who wear high-heels appear to be taller and to have longer and thinner legs, and the wearer’s gait and posture changes. Though high-heels have had an association with femininity and have kept them popular over the years, there are definite health problems caused by wearing them too frequently.

The motion of the ankle joints is limited when heels are worn. The ankle joint is very important to the body when it comes to walking. Because of their location, these joints have a great deal of weight put on them. Thus, it is very important to keep them as healthy as possible. The Achilles tendon is the main tendon in the ankle. Wearing high-heels too often, studies have shown, can cause the calf muscle and Achilles tendon to shorten and stiffen, which can cause problems when shoes without heels are worn.

By putting a great deal of pressure on the ball of the foot, by forcing the toes into a small toe box, high-heels can cause or may worsen many foot problems, such as corns, hammertoe, bunions, Morton’s neuroma and plantar fasciitis.

Not only does wearing very high-heels regularly have negative effects on the feet, the rest of the body can suffer as well. The knees, one of the most important joints in the entire body, can be affected by wearing high-heels.  High-heels causes the knees to stay bent all the time. Also, it can cause them to bend slightly inward as well. Doctors believe that women can suffer from osteoarthritis later in life because of constantly walking like this. By limiting the natural motion of the foot during walking, high-heels also cause an increased in stress on the knees.

Similarly, the back may also be affected by high-heels because it causes the back to go out of alignment. If high-heels are worn constantly, the spine’s ability to absorb shock can cause continued back pain. They can compress the vertebrae of the lower back, and can overuse the back muscles.

However, this is not to say that high-heels can never be worn. If worn occasionally, they will not cause serious problems. They should not be worn every day in order to avoid the long-term physical health problems of the feet, knees, ankles, and back like mentioned above.

Are your shoes the right size? Many people are walking around with ill-fitting shoes. Picking the right shoe size is not rocket science, but there are a few things to remember when selecting your next pair.

Most shoe stores and department stores have rulers for measuring your feet, and these can give you an exact size. Be sure to measure with your shoe on. Measuring your foot will give you a different size than your shoe. If you do measure your foot size, you will need to add 1-2 inches to get the proper sizing.

Wiggle room is the most important factor when selecting shoes. Make sure that your toes are not cramped and that you can wiggle them. A rule of thumb is that there should be one inch between your toes and the tip of your shoe. If your shoes are not properly sized, you can experience foot pain, knee pain, blisters and swelling.

Don’t assume that you will always wear the same size in a shoe. Often manufacturers size shoes differently. The size you wear with one company may not be the same as the size you wear with another. Make sure that the company you buy from has a return policy. No one needs a closet full of shoes which they cannot wear.

It is advisable not to buy your shoes in the morning, but rather late in the day. Your feet actually swell as the day goes on and you need plenty of room to walk comfortably. Buying shoes in the morning that are snug is sure to cause problems once the day is done. Also, make sure that you are buying the right sizes for both feet. It is not uncommon for one foot to be larger than the other, and some people have to buy two separate sizes to accommodate different sized feet.

The biggest concern in buying shoes is comfort. Oftentimes people will buy shoes that are not the most comfortable in the store. People think that the shoes simply need to be “broken in”. If a shoe does not fit in the store, it will not fit at home either. Comfort should be the ultimate goal when purchasing a pair of shoes; your feet will thank you.

Let’s face it; we all walk a lot, some of us more than others. Selecting the best shoes for your particular lifestyle is essential. By properly sizing your shoes and buying the proper comfort level, your feet will be dancing all day long.

Thursday, 04 December 2014 15:51

What Are Ankle/Foot Orthotics?

Orthotics is a medical field concerned with the design, manufacture and use of aids used to support weak limbs or direct the proper function of limbs, in this case the foot and ankle. Ankle-foot orthotics, or AFOs, are braces worn at the ankle that encompass some or all of the foot. Diseases that affect the musculature or weaken the affected area require AFOs to strengthen the muscles or train in the proper direction. Tight muscles that need to be lengthened and loosened also benefit from AFOs.

When we think of diseases that affect the musculature we think of the big boys: muscular dystrophy, cerebral palsy, polio and multiple sclerosis. We rarely think that arthritis and stroke can affect the musculature or that there are some who "toe in". But whatever trauma affects that musculature, there is a way to correct it. The orthosis helps to control range of motion, provide support by stabilizing walk, correct deformities and manage pain load. A podiatrist would be consulted for those who "toe in", for instance, or an arthritis sufferer whose ankles suffer through walking on the job or perhaps a victim of stroke whose musculature is wasting away and requires strength.

Before the advent of modern orthotic devices, it wasn’t uncommon to see polio victims wearing metal braces from mid thigh to the bottom of the foot, or children who "toed in" wearing metal braces around their ankle and foot. However, both designs and materials have improved dramatically, allowing for new levels of comfort, functionality, and appearance. Many orthotics are now made from plastics in the shape of an L and designed to fit inside a corrective shoe. These can be rigid, buckling at the calf and extending the length of the foot to support the ankle. This same design except with a hinged ankle provides support while walking by normalizing the gait. In the past boots lined with leather and fiberboard provided the rigidity needed for correction and support. Now corrective shoes are available with built up soles to correct the gait or manage pain by sharing it with another area when the foot spreads during walking.

The podiatrist would prescribe this orthosis in the rigid L shape because the foot moves on a hinge. If the hinge isn't functioning as intended due to an injury or malformation, the muscles tighten up, thus making it difficult to flex the foot. When we walk, the foot flexes and muscles stretch. This brace or AFO would support the ankle and musculature during flexion of the foot, in much the same way a knee brace works. Corrective shoes are for people whose feet hit the ground backward, causing tight muscles and arch problems. Wedges and rocker bars on the heels correct the step to heel first and rock onto the ball of the foot, resulting in relaxed musculature and strengthened ankles.

Appearance also counts when we consider a particular support device, especially if the item is intended for regular, daily wear. The L shaped orthotic is contoured to the calf and flesh-colored, fitting into a sneaker or dress shoe. As present, corrective shoes are more attractive than past models, enabling patients wear such devices with greater comfort and confidence.

Tuesday, 25 November 2014 23:58

Proper Shoe Fitting

Proper shoe fitting is one of the most common concerns people have when it comes to the health of their feet. To some this may not seem like a major issue, but the reality is that improperly fitted shoes account for a tremendous amount of injuries to the foot. Because our feet, our posture, and our gait directly affect the bio-mechanics and the overall structure of our entire body, pains and discomforts felt elsewhere within the body can frequently be attributed to improperly fitted footwear. Here are a few factors to consider, which will help you select the proper footwear when shopping.

Do not purchase shoes with the expectation that they will stretch to accommodate the size of your feet. You are looking for shoes that fit correctly right away. If the shoes you purchase are too large and are slipping in the area of the heel while you walk, do not purchase them. Do not look favorably upon shoes that slip with the intention of wearing thicker socks to compensate for the slippage. Make certain that in the widest portion of the shoes, the ball of your foot, fits comfortably in the shoe.

It may be difficult to focus on these things with all the distractions of shopping, or tempting to ignore them because you badly want an uncomfortable shoe. However, if you cannot wear shoes because they hurt too much to use, your money and time will be wasted. When you get your new shoes home, put them on and walk around on a carpeted surface to see ensure your shoe's fit comfortably with normal activity.

With 33 joints, 26 bones, and over 100 ligaments, the potential for damage to the sensitive components within the foot are greater than many people realize. Finding a properly fitting shoe is the single most important factor you can do to help prevent injury and maintain optimal foot health. Adults tend to forget the fact that our feet continue to change as we grow older. So, even though they may no longer experience growth spurts associated with youth, their feet still change shape as they mature.

If you already have problems with your feet, wearing improperly fitted shoes can potentially exacerbate those problems. Fortunately, it does not require a tremendous amount of effort to find shoes that fit correctly. When shopping for shoes, keep in mind that improperly fitted shoes can not only cause a whole host of disorders and problems to occur within the feet themselves—they can affect the entire bio-mechanical structure of the body. Your posture and your stride are based on your feet, so your footwear can have a tremendous impact on the legs, back, and rest of your body. Finding the proper shoe fitting is essential to keep your feet and body healthly.

Tuesday, 18 November 2014 11:03

Barefoot Running

A new trend in running and jogging has popped up recently, called barefoot running. Barefoot running is a popular and growing trend that is just what it sounds – running without shoes. Before deciding to do any running without shoes, it's best to understand how this kind of running affects the feet.

Running without shoes changes the motion of running. Most running is done by landing on the heel of the feet. Running barefoot requires a different way of running; in a barefoot stride landing is done on the front part of the feet. Because of this, the impact shifts from the heels to the front feet. Runners also shorten their strides to create a softer landing.

Running barefoot does have its advantages. When running and landing on the front feet, the impact on the feet and ankle is reduced, which may reduce the incidence of stress injuries. It strengthens muscles in the feet, and also strengthens muscles in the ankles and lower legs that aren't usually worked. Overall balance of the body is improved and there is greater sensory input from the feet to the rest of the body, making overall position and motion less stressful on the body. It has been found that in countries in which some of the population regularly wear shoes and some do not, numbers of foot and ankle injuries are much higher in those who wear shoes.

People hearing about barefoot running for the first time are skeptical about it, and there are good reasons for skepticism. Running barefoot certainly has its drawbacks, the obvious being no protection of the feet when running. This makes it likely that when runners land on sharp or rough objects,  scrapes, bruises, and cuts on feet will result. Blisters will form when beginning this kind of running especially, you may have plantar fascia problems. Landing on the front feet constantly also increases the risk of getting Achilles tendonitis.

So what can runners do to make barefoot running safe? It’s best to make a slow transition from running shoes to barefoot running. The body is used to wearing shoes so to slowly transition to bare feet, start by walking barefoot for a distance and then increase walking distance. Once the feet begin to adjust, try walking and then jogging and gradually increase the distance. If you have foot problems talk to the doctor first before attempting barefoot running. When starting out, it may also be helpful to begin by running on pavement or other consistent surfaces to avoid sharp or rough objects. Minimalist running shoes may also be an option, as they allow for many of the benefits of barefoot running while also protecting the feet from cuts and scrapes.

Poor blood circulation in the feet and legs is often caused by peripheral artery disease (PAD), which is usually the result of a build up of plaque in the arteries. Plaque build up, or atherosclerosis, can be the result of excess calcium and cholesterol in the bloodstream, which restricts how much blood can flow through arteries. Reduced blood flow to a certain area of the body severely limits the amount of oxygen and nutrients that part of the body receives, causing degeneration in the muscles and other tissues. Sometimes, poor blood circulation in the feet and legs can be caused by other conditions, such as damage to or inflammation of blood vessels, known as vasculitis.

The lack of oxygen and nutrients caused by poor blood circulation can restrict muscle growth and development, as well as cause muscle pain and cramps, weakness, and stiffness. Other common symptoms include numbness in the legs and feet, skin discoloration in the affected limbs, slower nail and hair growth, and erectile dysfunction in men. In more severe cases of PAD, pain can be present even when a person isn't exercising, and may range from mildly uncomfortable to completely debilitating.

Poor blood circulation in the feet and legs is more common in those who are overweight or obese, have diabetes, high blood pressure, high cholesterol, who smoke, or who have a family history of PAD or related conditions (heart attack, stroke, etc.). Diabetes and smoking place a person at greatest risk for developing poor blood circulation, although advanced age (over 50) can also increase risk.

If you are experiencing poor blood circulation in the feet and legs caused by PAD, it is important to make changes to your lifestyle in order to reduce your risk of experiencing a heart attack or stroke caused by this condition. If you smoke, quit completely -- this will increase the amount of oxygen in your bloodstream. Exercising and reducing the saturated fats in your diet (which come from fatty meats, fried foods, whole milk, etc.) can make a difference in improving blood circulation in feet. It is also important to avoid developing influenza and to carefully control your blood sugar if you have diabetes.

Your doctor may recommend combining lifestyle changes with a prescription medication regimen to improve blood circulation. The most commonly-used medications for PAD are called statins and work by blocking the amount of enzymes in your body that produce cholesterol. They are known by the brand names Zocor, Lipitor, Crestor, and others.

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