5 Shoe Lacing Techniques for Common Foot Problems with Dr. Jennifer Flo

Though foot anatomy can vary widely among individuals, we generally use a common approach to tie our shoes.

But there are actually more than 20 ways to lace shoes, and Dr. Jennifer Flo, a podiatric physician at Ankle & Foot Care Centers, recommends five specific techniques that accommodate different foot structures and can alleviate pain or discomfort.

“Individuals with a high instep, bunions, wide feet, pain in their toes or heel slippage can benefit from these different shoe lacing techniques,” said Dr. Flo. “Instead of getting rid of shoes that don’t fit comfortably, individuals can adjust the lacing and experience a difference in fit, providing better support and saving the cost of new shoes.”

Here are five common issues people experience and a shoe lacing solution for each. Watch the video to see Dr. Flo demonstrate each lacing modification style step-by-step.

1. Gap Lacing for High Instep

Side lacing begins with a normal criss-cross at the second set of eyelets and then skipping the next set, but keeping the laces on the same side and weaving through the fourth set of eyelets and then continuing with the criss-cross to the top. This way, the laces open up the middle of the shoe, but are still secured along the outside.

2. Increasing Forefoot Width for Bunions

Skipping the first set of eyelets at the forefoot allows for more breathing room toward the toes, taking pressure off of the bunions to prevent numbness and irritation.

3. Lock Lacing for Heel Rubbing/Blisters

Lock lacing utilizes the top set of eyelets (the two holes that are usually ignored), to secure a tighter fit around the top of the shoe and the ankle, preventing heel slippage.

4. Diagonal Toe-Cap Lacing for Toe Pain

If you start with the eyelet closest to the big toe and run the lace diagonally up to the last eyelet (closest to your ankle), and then take the other side of the lace back down to the other first eyelet and criss-cross regularly from there, the single diagonal stretch of lace from the first eyelet to the last will loosen the pressure toward the toes with a tug on the top of the lace.

5. Bar Lacing for Wide Feet

For bar lacing, start from the first set of eyelets with a criss-cross lace but skip a set of eyelets toward the center, to allow for more flexibility and breathing room.

Every Foot is Unique

While Dr. Flo recommends trying these different lacing techniques, she also points out that if at any point you have to strain to get your shoelaces tight enough to fit, the shoes are the wrong size and shape and you shouldn’t try to force them to fit.

For those who don’t have the mobility to tie their shoes, Dr. Flo recommends shoes with velcro or elastic draw string-closures, instead of slip-on shoes that lack support.

When looking to purchase shoes, be sure to choose a pair with eyelets that allow for lacing flexibility.

“Listen to your feet and find what works best for you,” said Dr. Flo. “If you have any questions about additional lacing techniques or other foot conditions, call your podiatric physician today.”

Click the image for a downloadable PDF.

Foot and Ankle Sports Injury Prevention with Dr. Kwame Williams

Whether you take part in regular exercise or play intramural or competitive sports, athletic-related injuries can be common if proper care is not taken, says Dr. Kwame A. Williams, a podiatric physician at Ankle & Foot Care Centers.

Dr. Williams specializes in sports medicine and often treats patients for injuries related to overuse, lack of stretching or improper support, which he says can be avoided with proper care.

There are two major areas of injuries, which often occur simultaneously: soft-tissue injuries and bone injuries.

Soft Tissue Injuries

Injuries of the muscles, tendons and ligaments can occur due to micro-trauma, which is a result of overuse, or from sudden impact, twists or falls, known as macro-trauma.

Micro-trauma soft tissue injuries. Often times, when individuals exercise they don’t allow for enough recovery time in between workouts, causing tightness, tenderness and pain.

“Also referred to as repetitive micro-trauma, overuse injuries are common in high school and college athletes who are likely to over-train,” said Dr. Williams. “We also see this a lot at the start of conditioning or training, as a result of rushing into the movements and increasing the intensity too rapidly.”

Micro-trauma can cause tears or sprains in the connective tissues, as well as over-stretch the tendons, often resulting in swelling and discomfort.

Dr. Williams often treats athletes with plantar fasciitis and/or Achilles tendonitis, which is the swelling of tissues and tendons.

Macro-trauma soft tissue injuries. Sprains and strains are common macro-trauma injuries, caused by sudden impact.

Ankles and knees take on extreme pressure during sports and can result in differing degrees of tears to the ligaments (sprains) or injuries to the muscles and tendons (strains).

“Contact sports put athletes at risk for high-impact injuries,” said Dr. Williams. “But so do sports involving sudden starts and stops, such as track, cross-country or basketball” said Dr. Williams.

Similar to soft tissue injuries, bone injuries can also result from overuse and pressure, or from high impact trauma.

Bone Injuries

Bone injuries occur in every sport, not just contact sports, from repetitive trauma or sudden impact.

Micro-trauma bone injuries. Two of the most common lower-extremity bone injuries caused by overuse are stress reactions and stress fractures.

Stress reactions occur prior to a stress fracture, when the bone structure breaks down and becomes weaker.

Stress fractures occur when small cracks begin to form in the bone, and can result from over-use or not wearing proper shoes.

“Stress fractures are common in runners, who are often increasing their mileage each week, or are switching from running trails to pavement to grass,” said Dr. Williams.

Macro-trauma bone injuries. Similar to high impact trauma on soft tissue, bone injuries occur as a result of a fall, twist or some form of contact.

They also can eventually turn into a macro-trauma injury if not treated early. Broken bones are often a result of hairline fractures left untreated.

Fortunately, there are several ways to prevent and/or treat soft-tissue and bone injuries.

Tips for Prevention/Treatment

  • Proper shoe wear: Athletes should wear supportive shoes that are designed specifically for the sport. Shoes are built to take on different levels of impact and provide support and cushion in different spots. When evaluating shoes for impact sports, the best are wide, stabilized straight-lasted shoes, which are heavier and provide more support under the arch.
  • Stretch, warm up, vary exercises: Overuse injuries are often a result of not stretching enough before and after exercising. Athletes should warm up their calves and hamstrings prior to exertion and increase their heartbeats prior to a practice or game, says Dr. Williams. He also encourages athletes to vary their workout routines, so the body is not taking the same impact over and over again.
  • Custom orthotics: Custom orthotics are inserts that are designed to fit the shape of the foot and provide extra support. They can be worn in athletic shoes and everyday footwear.
  • Compression stockings: The gentle squeeze of compression stockings allows blood to flow up your legs and reduces swelling. “Compression stockings are the “best anti-inflammatory in the world,” says Dr. Williams.

These simple strategies can prevent a lot of injuries caused by stress, pressure and the pulling and pushing of the soft tissues and bones.

“If you feel any sort of pain or discomfort, allow your body to rest,” says Dr. Williams. “Listen to your body and if the pain persists, get checked out by your podiatric physician.”

Dr. Fahim Discusses Remedies for Heel Pain

In a new video, Dr. Ramy Fahim, a foot and ankle surgeon with Ankle & Foot Care Centers in Warren, Ohio, talks about heel pain and remedies for the condition.

Most cases of plantar fasciitis, commonly called heel pain, can be treated successfully without surgery, Dr. Fahim points out.

Go for the Gold When It Comes to Winter Sports Safety

By Dr. Craig Beaudis

Some of us will spend hours watching the best amateur athletes from around the world compete for gold during the 2014 Winter Olympics in the next few weeks.

These athletes are highly-trained and talented in events like skiing, ice skating, speed skating, bobsledding and hockey. Sometimes, they make success look so attainable that they inspire us to lace up our ice skates or jump on our sleds in a quest to duplicate their feats.

But while participating in winter sports can be good for the body and mind, as with any physical activity, it requires some planning and caution to avoid injury.

“Common winter sports injuries include sprains, strains, fractures and dislocations in the foot and ankle,” said Dr. Beaudis, a podiatric physician with Ankle & Foot Care Centers. “Many of these injuries can be prevented if precautions are made. A fun day on the slopes or rink can easily end with a trip to the hospital unless safety is a priority.”

Dr. Beaudis and the group of podiatrists at Ankle & Foot Care Centers, the region’s largest podiatric care provider, with physicians and surgeons serving patients at 20 local offices, offers these safety tips when participating in winter sports:

Participate with a partner. If possible, skiers, snowboarders and sledders should stay with a partner and within sight of each other. Also, make sure someone who is not participating is aware of your plans and probable whereabouts before heading outdoors.

Check the weather for snow and ice conditions prior to heading outdoors. Pay attention to warnings about upcoming storms and severe drops in temperature. Make adjustments for icy conditions, deep snow powder, wet snow and adverse weather conditions.

Know and abide by all rules of the sport in which you are participating. Take a lesson from a qualified instructor, especially in sports like skiing and snowboarding. Learning how to fall correctly and safely can reduce the risk of injury.

Dress for the occasion. Wear several layers of light, loose and water- and wind-resistant clothing for warmth and protection. Layering allows you to accommodate your body’s constantly changing temperature. Wear proper footwear that provides warmth and dryness, as well as ample ankle support.

Also wear appropriate protective gear, including goggles, helmets, gloves and padding and check that all equipment is kept in good working order.

Warm up thoroughly before playing and exercising. Cold muscles, tendons and ligaments are vulnerable to injury. It’s important to warm up by taking it easy on the first few runs.

Drink plenty of water before, during and after activities.

Always carry a cell phone in case of an emergency.

Seek shelter and medical attention immediately if you, or anyone with you, is experiencing hypothermia or frostbite. Make sure everyone is aware of proper procedures for getting help, if injuries occur.

If you were to experience a cold weather related injury, visit your physician ASAP or go to your closest emergency room for immediate treatment to avoid any long-term consequences.

For more information about foot and ankle care or to schedule an appointment, call Ankle & Foot Care Centers at 888-881-8805.

Running Can Be Fun and Injury-Free

Running doesn’t always have to feel like a punishment for doing something wrong – it can be a fun and healthy experience. But in order for running to provide health benefits without causing lower extremity injuries, you must follow proper technique.

Runners commonly battle foot and ankle injuries, as the impact of every step is the equivalent of up to two times a person’s body weight. The top five running injuries are stress fractures, tendonitis, plantar fasciitis, runner’s knee and shin splints.

Former high school and college runner and podiatric physician Dr. Kwame Williams treats patients out of Ankle & Foot Care Centers’ Northside, Liberty and Boardman offices. He offers the following tips for minimizing your injury risk and keeping running fun.

  • Increase your turnover. Focus on taking quick, light steps while keeping your core ‘tighter.’ Pretend you’re stepping on hot coals, or run as if you’re trying not to create a sound. The culmination of these efforts make your stride and cadence most efficient.
  • Mix in intervals. Go to a track, run one lap at your fastest minute per mile pace, walk half or quarter to recover, then do it again. Work your way up to five to five times. If you can’t find a track, run from light post to light post or stop sign to stop sign.
  • Try some hills. Find a steep hill about a football field in length at most and sprint it hard, jog back down, and do it again. At maximum effort, you should only be able to get in about four of these.
  • Rest. Running hard every day makes you slow and it’s no fun. Running is violent to your body –  it’s critical to recover and repair. Without rest, you will never built upon your success.

Remember to warm up. A quick way is to do 30 pushups, 30 sit-ups and one minute of jumping jacks and you’re good to go.

For more information on healthy running or injury treatment, contact Dr. Williams at 330.629.8800.

7 Reasons to Mind Your Feet as You Resolve to Exercise More

More than half of Americans annually resolve to exercise more, according to polls, but before you hit the gym be sure to address how a workout can impact your feet.

Podiatric physicians Dr. Craig Beaudis and Dr. Michael Daniels at Ankle & Foot Care Centers, with 18 offices in the Mahoning Valley, recommend heeding the following advice:

  1. Time for new shoes. Athletic shoes that are more than a year old have lost their support and may cause an increase in foot pain or possibly injury. Invest in a new pair of shoes.
  2. If the shoe fits. Be measured by an experienced salesperson or podiatric physician, and purchase shoes based on fit, comfort and its intended use. A running shoe, for instance, will not provide the lateral support needed for tennis or basketball.
  3. About that blister. Blisters are caused by wrinkles in socks, poor-fitting shoes, excessive moisture or deformities. Powder or additional padding can help avoid blisters. Avoid the temptation to pop the blister.
  4. Heel pain can be a warning sign. Don’t ignore persistent pain in the heel, especially if it occurs in the morning or after resting. This may be plantar fasciitis. If stretching before taking your first steps in the morning and after sitting for long periods does not resolve the pain, see a podiatric physician.
  5. Don’t ignore nagging pain. Chronic foot and ankle pain after exercising should be checked out. A podiatric physician can develop a treatment plan that alleviates your pain and improves your exercise regimen.
  6. Diabetics can exercise, too. People with diabetes should have annual foot exams, at minimum; more frequently if you have poor blood flow or loss of sensation. Most diabetics are also eligible for diabetic shoes, which are designed to reduce the incidence of foot ulcers. A podiatric physician can provide proper measurements for therapeutic footwear.
  7. Too much, too soon. Tendinitis may occur by overdoing it too soon. Slowly begin your exercise program, and warm up and stretch appropriately. Treat tendinitis with rest, ice and anti-inflammatories. If it does not resolve, see a podiatric physician.

Injuries to the feet are among the more common reasons why the “exercising more” resolution gets broken. Without healthy feet it’s difficult to maintain the momentum and good habits the well-intentioned set out to achieve. Best wishes for staying true to your resolution, and have a safe and healthy new year.

If you need further advice on how to care for your feet upon starting an exercise program, the expert podiatrists at Ankle & Foot Care Centers can help. To schedule your appointment today at one of 19 locations, visit the website at http://www.ankleandfootcare.com/.

The Dangers of Overuse

Sports injuries to the feet, ankles and legs are commonly caused by overuse—when athletes, whether professional and amateur, put too much strain on their muscles, bones and tendons. This can happen, for instance, when runners add too much mileage too quickly, or when an athlete returns to a sport after an off season with very minimal training.

These injuries of overuse can include pulled muscles, ruptured Achilles tendons, plantar fasciitis and many more. In most cases, though, they are preventable through proper training.

When you begin an exercise regime or other physical activity, it’s important to gradually build up to your desired level of activity. Over time, your feet, ankles and legs can adjust to the demands your activity places upon them, reducing your risk of injury tremendously.

If you need advice on starting a new exercise regime or suffer from an injury of overuse, the expert podiatrists at Ankle & Foot Care Centers can help. To schedule your appointment today at one of 19 locations, visit the website at http://www.ankleandfootcare.com/.