Transcription:
Why Do My Feet Hurt?

Melanie Cole (Host):  Foot and ankle pain can affect every single aspect of your life, and if you’re like me, you know that it can prevent you from exercising or staying active.  It can affect your job—so many things.  It’s your base of support, but the good news is you can prevent or at least help many foot issues with some simple everyday foot care.  This is Aspirus Health Talk.  I’m Melanie Cole, and today we’re talking with Dr. Jared Scherr.  He’s a podiatrist and foot and ankle surgeon at Aspirus.  Dr. Scherr, I’m so glad to have you with us today.  What are some of the most common foot issues that you see every single day? 

Jared Scherr, DPM (Guest):  Some of the more common issues or complaints that I see among patients is bunions for foot pain or pain in the ball of the foot, hammertoes.  Another common one is heel pain or pain along the posterior aspect of the heel with the Achilles.  Those are more common complaints I see amongst patients.

Host:  Well, then, let’s get into some of those.  As an exercise physiologist, you know, I see people with foot issues every single day, and bunions seem to be a big one as does plantar fasciitis.  So, tell us about those two things and how sometimes—and most of the time, Dr. Scherr—foot issues are kind of all related.  One will cause problems for another and up the body they go, and they can cause knee problems and hip problems and back problems.  So, tell us a little bit about plantar fasciitis and bunions.

Dr. Scherr:  They are all very interrelated, and one thing can certainly cause you to compensate and cause pain in another area, and like you said, to the knee, hip, right up the body it goes, but to start off with bunions.  Bunions are typically caused by the way our foot is structured or the biomechanics.  The motion that occurs in our foot when we put weight on it, the most common cause is people who have a flat foot or pronate, have a tendency to put a little bit more weight on the ball of the foot, causing that bunion deformity and the toe to kind of slightly move over towards the lesser toes and cause that kind of deformity there.  Another common cause—and you can thank your parents and your grandparents for this one but—is just genetics.  I see it a lot in a mother and a daughter and in families where they are definitely inherited. 

Host:  What can we do about them?  Do we do anything about them?

Dr. Scherr:  Yeah, definitely.  There’s easy things to do at home.  I tell a lot of my patients to always wear supportive shoe gear.  I know the ladies—my female patients—love to wear those high heels.  I would definitely try to put them towards the back of your closet.  Put the more supportive shoes in the front of your closet.  I always tell my patients to go to the shoe store and try to bend the shoe in half from toe to the back.  If you can bend it in half, that is not a good sign.  You definitely want a shoe that’s very supportive—that’s going to support your foot and prevent and help with these common deformities. 

Host:  Well, I’m a big fan of the sensible shoe line, there, Dr. Scherr, for sure.  Now, tell us about things that can help that a podiatrist could help with as far as these kinds of things, like orthotics.  We hear about orthotics.  We hear about custom made versus the ones you can get at the good running stores, you know.  There’s Superfeet and Spenco and all these ones.  What do you think about orthotics and when are they necessary? 

Dr. Scherr:  There is a wide variety of orthotics.  It’s almost overwhelming—in most stores you walk into and try to find the right pair.  I typically tell my patients to avoid the very soft, cushiony silicone ones.  Those orthotics are not providing the support that they need to.  I tell my patients to buy the more rigid orthotics with a little bit of polypropylene or plastic in them with a padded top cover.  Those are the orthotics or inserts that you want to have in your shoes. 

Host:  Well, it certainly makes a big difference.  I can attest to that, and what about shoes?  When you were mentioning shoes before.  Running shoes—we like to stay active.  Walking shoes versus running shoes; going to a good shoe store that knows how to look at your feet and knows what shoe might fit you the best for activity.  

Dr. Scherr:  Right.  So, the biggest thing is, you need to know what type of foot type you are.  If you have a high arch, I would recommend a shoe that controls supination.  If you have a flat arch, you definitely want to look for a shoe that controls pronation, or for the over pronators, I like to recommend, again, the supportive shoes.  If you’re a runner and looking for a great shoe, go into the shoe store, know your foot type, and look for that supportive shoe.  Like I said, if it can bend easily, we want to stay away from that and get a good supportive shoe for you.

Host:  Well, that’s really great advice, and back to the Achilles and that whole area of our foot—plantar fasciitis.  You get up wobbling around in the morning; can barely step on your foot.  What do you recommend we do for that?

Dr. Scherr:  So, for plantar fasciitis, there’s quite a few etiologies or things that cause it.  It can be a sudden change in shoe gear.  For plantar fasciitis, I typically call the plantar fasciitis season typically spring.  So, it’s coming up on us here where patients go from a winter boot or closed-toed shoe to those flat sandals and that change in shoe gear can definitely illicit the plantar fasciitis or heel pain—the ligament on the bottom of our foot there.  I like to recommend stretching.  Stretch as much as you can.  If you suffer with heel pain, go to the bottom step at home, drop your heel down.  Feel that stretch for a good 30 seconds and try to repeat it.  Another thing is icing.  I recommend to all my patients that develop sudden foot pain, especially in the heel is to ice, elevate for a good 20 minutes and then also back to the supportive shoes and the inserts.  Those definitely help heel pain in plantar fasciitis.

Host:  And what about things like hammertoes?  Are there solutions for that?  I guess I’m asking when do you feel that some of these foot issues, Dr. Scherr, require a visit to the podiatrist?

Dr. Scherr:  You bet.  I hope that all the conservative things that I had mentioned about bunions and heel pain definitely resolve the pain, but unfortunately, if it does not, I would recommend visiting your podiatrist in regards to bunions.  There’s multiple surgical techniques.  I perform many of them that we can do to correct the bunion deformity and help with that pain there.  You’d mentioned hammertoes.  Once hammertoes become very painful, start rubbing in your shoes, I would recommend to see the podiatrist.  There’s multiple surgical treatment options in regards to hammertoes, and then the plantar fasciitis as well.  If that’s just not resolving, there is surgical solutions as well for that.  

Host:  Now, I know this is not something everybody wants to talk about, but our toenails, Dr. Scherr, are something that people sometimes neglect, and they get very long and then they rub on those shoes, and they can cause problems as well.  Do you recommend seeing a podiatrist to get our nails trimmed?  What do you want us to know when we’re trimming our own?

Dr. Scherr:  I see patients all the time that try to trim their toenails, trim them way too short and then end up performing a “bathroom surgery” as I’d like to call it where they’re trying to cut at such an angle.  I usually tell my patients and would tell anyone else to definitely not cut at an angle that’s only going to make the problem worse.  I recommend to trim straight across.  That’s where you want your toenails is right across, and if you do experience toenail pain, redness, drainage, anything like that near the toenail, go see your podiatrist.  We do have different solutions.  We can perform procedures in the office to help with that.

Host:  And as we’re talking about in office, what can you do to diagnose the problem?  If somebody has pain in the top of their foot, in the top of their arch, or in their toe, what do you do to diagnose what the situation is whether they have arthritis, or they have some kind of tendinitis going on?

Dr. Scherr:  Definitely, the biggest thing that I always keep in mind is 90% of my diagnosis comes from the history.  So, I listen to my patient.  I like to get to know my patients.  If it’s a sudden problem or if it’s a more ongoing—that right there could tell you the difference between a fracture or ligament strain compared to arthritis.  A lot of it is physical examination as well where we can do different things in office to help diagnose different problems as well as get X-rays and other imaging to support our diagnosis and to find out what’s going on with your foot or ankle.

Host:  If you had to give the listeners one best piece of advice about taking care of our feet—good care of our feet—what would you tell them?

Dr. Scherr:  I would definitely say try to take care of your feet now, so you do not have to worry about them later.  Like you said earlier, they’re the base of our support.  They keep us going every day.  Try to inspect your feet every day.  Some great foot hygiene tips would be to wear clean socks every day.  Rotate two pairs of shoes.  When you’re not wearing a pair of shoes, set those in a sunny window seal.  Let them dry out.  Get the moisture out of them.  Another thing is applying an antifungal or perspirant powder.  I would avoid the antifungal moisturizers and wearing, you know, clean shoes and looking at your feet every day, and if you need help, go to your podiatrist, see the local foot and ankle expert.  

Host:  Such great information, Dr. Scherr, thank you so much, for coming on and sharing your expertise and giving us such great tips.  That concludes today’s episode of Aspirus Health Talk.  Check out our website at aspirus.org for more clinic information and to get connected with one of our providers.  Please remember to subscribe, rate, and review this podcast and all the other Aspirus podcasts.  For more health tips and updates, follow us on your social channels.  I’m Melanie Cole.