Toe Straighteners

There are a number of different devices that come under the category of “toe straighteners”. There are a number of different commercial brands (eg Correct Toes ) and a number of different types of devices that do slightly different things that fall into this category of products.

The purpose of the toe straighteners are to change the alignment of the the toes to help fix problems like hammer and claw toes. They are very useful to help a number of problems with the metatarsal bones such a metatarsalgia, plantar plate tears and Morton’s neuromas.

Some toe straighteners are more between the toes and work by separating the toes. Other toe straighteners are more below the toes and work by pulling the toes down into alignment. Other toe straighteners or spacers work by using a combination of the separation and pulling down of the toes.

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Which foot cream for dry and cracked skin?

Dry and cracked skin around the heels is common and the regular application of a cream to help that is commonly advised. The problem there are literally 100’s of different foot creams and everyone who uses them has an opinion on them. So which is the best foot cream to use?

The research evidence on which is the best foot cream is not that helpful as most variations do have some evidence for them but very little comparing the outcomes between the different creams, so what is one to use and what is the cream that a health professional should be recommending?

One thing that is known is that in dry skin there is a well documented deficiency of urea, so it could be logical to start with using a urea based cream initially. The other advantage of the urea creams is that they are available in different concentrations of urea so they can have different affects on different skins. The lower concentration of urea in the cream (less than around 20%) are good to moisturize the skin. The concentration of over around 20% are good to help get rid of the drier flaky like skin. The concentrations of around 40% can be used on that thicker hard skin. So it is a matter of choosing the one that best matches the needs of the skin on the foot or each person. This is a good place to start and experiment with from there until you find a cream that best suits your skin and needs.

Of more importance that the actual foot cream that you use is to actually use it. It does need to be used, perhaps, twice a day to start with to get the problem under control and then daily after that. There is no point in buying a good foot cream and then not using it!

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What to do about Severs Disease?

severs disease

What is it?
Severs disease is a problem of the growth area in children at the back of the heel bone. It is considered an overuse injury and is more common in active kids, overweight kids and those that are taller. It is only a problem around ages 10-12 as from the early teenage years the growth plate merges with the rest of the heel bone and it can not be a problem. It is not really a disease and is more appropriately called calcaneal apophysitis.

What can you do about it?
Severs disease is best managed with reducing the activity levels and using cushioned heel pads as well as applying ice after exercise if it is particularly painful. Education and understanding the nature of the conditions is important. The condition is self limiting and it will go away on its own eventually, so its a matter of managing the symptoms.

When to see the doctor?
It is often asked: “How long does Severs disease last?” The answer will depend on how much activity is reduced. If all activity is cut out, then is will heal up very quickly. However, that is almost impossible to achieve in children. You should see the podiatrist or doctor if the pain is severe or the child is not getting better or if they are not complying with the activity reduction, as often an “authority” figure other than the parents to get them to cut back is needed.

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What are they?

Chilblains are reddish colored lesions that normally occur on the toes as a result of changes in the temperature. They only occur in the colder climates. They are also itchy and painful. If they become chronic, they take on a darker blue color.

How to manage them?

The best way is to prevent them by keeping the feet warm with good socks and shoes. if the foot does get cold, then do not warm it up too quickly and give the circulation a chance to respond to the warming up slowly. If the chilblain develops, then keep it well protected and use a cream to gently to rub the area to stimulate the circulation.

When to see the doctor?

If it becomes chronic or the skin breaks down, then see a podiatrist or your doctor for more advice to manage the chilblains. Sometimes nifedipine is used for chilblains

More information

PodChatLive had this livestream on chilblains and it is worth listening to or watching:

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Strapping for a Plantar Plate Tear

What is a plantar plate tear?

A plantar plate tear is a reasonably common strain or partial tear of a strong ligament under the metatarsophalangeal joints in the ball of the foot. The pain is most commonly under the head and distal to the head of the second metatarsal.

How to strap it

The best way to treat this initially is to tape or strap the toe in a plantarflexed position. This is relatively easy to do yourself without the doctor:

If this is done properly and for an extended period of time, a plantar plate tear can heal on its own. While this taping is useful, an alternative is the Fix Toe device which is much more convenient.

When to see the doctor?

It is probably best to see the doctor when:

  • to get the diagnosis right. There are a number of clinical tests that can be done to help so this and sometimes an ultrasound is used
  • if the strapping does not help. Sometimes the tear needs to be corrected surgically.
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Bunion Correctors

Can you doctor your own feet with bunion correctors? These are a splint or brace that you are supposed to wear at night and they are alleged to correct bunions, but do they?

bunion correctors

A lot of questions get asked in forums and social media about do bunion correctors work? There is a lot of opinion and information on them, some of it fake as it is so easy to fake the before and after photos. The bunions are the enlargement of the joint and hallux valgus is the deviation of big toe laterally and it is that deviation of the big toe that the bunion correctors are supposed to correct. So do they do it? They have been around for over a century, so that is more then enough time for research to have been done to investigate further. This has not been the case.

One study has shown that, yes there is a few degrees improvement in them angle of the toe after one months use. Is that enough to say they work and are worth using. No information is available if it corrects more with more than one months use, nor if that correction is sustainable for more then one month or if it go back if you stop using it.

So, are they worth using? Probably. There will be a small improvement in the angle, but and probably more important they will help keep the joint mobile and flexible which is a healthy thing.

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Archies Arch Support Thongs

In Australia, they call thongs what the rest of the world call flip flops. This product is from Australia.

Archies Arch Support Thongs

These Archie Thongs are proving to be very popular with Podiatrists in Australia and they can make a useful adjunct to foot orthotics and in some cases be used instead of foot orthotic therapy. The amount of arch support in these flip flops or thongs is the same as you would probably get from an over-the-counter foot support, so they can be useful for that.

In Australia, they are being stocked and selling well in Podiatry clinics with many podiatrists using them for themselves and family. A lot of comments often get made about these to the affect of you just have to try them on and them you will buy them.

They are going to be particularity useful to those who need foot supports or orthotics and for whatever reason they do not have footwear in which to wear them in. This is probably why they are so popular in Australia, its a lifestyle thing.

For more see:
Archies Thongs are selling themselves
Archies Arch Support Thongs
Archies Arch Support Thongs

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Shoes for Children

Moms and dads so often worry about their children’s teeth, eyes, and most other regions of the body, but don’t get worried so much over the growing feet. As many adult foot conditions can have their beginnings when people are young, attention to shoes in children can minimize the risk of these issues in adults.

Significance of the footwear to the child:
Inadequately fitting children’s footwear can cause a number of conditions in adults such as hammer toes, ingrown toe nails, foot corns, calluses and deformed joints. Due to the high level of discomfort and pain that these conditions can cause, it is obviously sensible to attempt to prevent these disorders by ensuring that the child’s footwear is fitted appropriately. Foot conditions in kids are usually avoidable.

Fitting footwear for the child:
The most crucial factor in shoes for a kid is that they fit. Ideally, this means that shoes are fitted by somebody who has had some special training in the fitting of children’s footwear.

Tips for the fitting of children’s footwear:
* Children should have their feet measured around every three months (thus making sure the need for new footwear if required).
* Usually, for a shoe to be accurately fitted, there really should be a thumb width between the end of the shoe and the end of the longest toe.
* When looking at the bottom (sole) of the shoe, it should be fairly straight (not curved in too much) – the foot is straight, so the shoe needs to be straight.
* The attachment mechanism (laces, velcro, buckles) must hold the heel securely in the back of the shoe (the foot ought not to be able to slip forward in the footwear).
* the heel counter (back portion of the shoe) should be strong and stable.
* the shoe should be flexible along the ball of the foot, as this is where the foot flexes.
* Leather and canvas are a better material – they are stronger and can breathe. Man-made materials usually do not breathe as well, unless they are of the ‘open weave’ variety. Steer clear of plastics.
* Check that the footwear have curved toe boxes to give the toes more room to move and grow.
* Shoes should not need to be “broken in”. If they do, they can be either poorly developed or inadequately fitted.
* An absorbent insole is useful, as the feet can sweat a lot – kids are quite active!
* A number of retail stores concentrate on footwear for the child – make use of them!
* Fitting shoes adequately in adults is also just as important

3 tips for checking the child’s shoe:
There has to be a thumb width between the end of the footwear and the end of the longest toe = length is correct.
You ought to be able to pinch the upper of the footwear between the thumb and forefinger (this can depend on the nature of the material) = width is correct.
Does the footwear fit snugly around the heel and arch? How stable is the shoe when trying to ‘pull off’ the shoe? = great fit.

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How to Help Your Plantar Fasciitis

Plantar Fasciitis

What is it?
Plantar fasciitis is the most common cause of heel pain in adults. It is a painful condition of the plantar fascia which is a long ligament that’s role is to pretty much support the arch of the foot. The pain is most often near where it attaches to the the bottom of the heel bone. The classic symptom of plantar fasciitis is that it is most painful after rest. This can be especially bad when getting out of bed in the morning after a nights rest.

How to manage it?
There are lots of myths and bad advice being given online as well as snake oil being sold for plantar fasciitis. The condition is due to too much load on the plantar fascia, so obviously the best way to treat it is to reduce that load. You do that by lots of calf muscle stretching, wearing good foot supports and if you can, loose weight. It is that simple. If you get that right, it will generally go away. If it doesn’t, then do more of it and then also add in some ice, anti-inflammatories and other physical therapies to help it heal. However, it is still crucial that the load is reduced. Once it starts to get better then add in some strengthening exercises.

When to see the doctor?
If none of that helps, then its time to see the doctor for more aggressive therapies such a proper foot orthotics, shock wave therapy or even surgery in the most resistant cases.

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Do MBT Shoes Work?

MBT Shoes

What are they?
MBT shoes were originally development in Switzerland and were the first of the toning shoes to come on the market. These are shoes that are deliberately made unstable to encourage the muscles to work differently. The MBT shoes do this via a rocker sole. Like the toning shoes in general, a lot of health claims get made for this type of shoe.

Do the MBT Shoes work?
The evidence is that the shoes do work at altering the gait and changing the pattern of muscle firing. What the evidence does not support is the wide ranging health claims that get made for these types of shoes. The change in gait may help some people and hurt others; with a lot depending an which structures are made to work harder by the change and which structures do not have to work so hard. There is a strong suggestion that the rocker nature of the shoes may help those with hallux rigidus.

For More:

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