Transcription:
Warmer Weather and What You Can Do For Your Feet

With spring and bloom and summer just around the corner, fewer layers of clothes are being worn, including those layers that protect your feet. But what can that mean for the health and safety of your feet?

Prakash Chandran (Host): Today, Dr. Mark Lipton, a Podiatrist at the Centers for Advanced Orthopedics, Orthopedic Associates of Central Maryland Division is sharing information regarding possible foot health hazards that you should be aware of as the weather warms up.

This is A Bone To Fix, the orthopedic podcast from the Orthopedic Associates of Central Maryland. My name is Prakash Chandran. So, first of all, Dr. Lipton, great to have you here today. Let us start by understanding a little bit more around how we can proactively prepare our feet as the weather starts to warm.

Marc Lipton, D.P.M. (Guest): Thank you for having me. The thing I think about most with people in the summertime is travel and the one thing I'll recommend is that you should have appropriate shoes for travel and definitely want to purchase them well before your trip to make sure that you break them in, make sure they're comfortable for you.

A lot of people tend to buy shoes and then just take off on their trip and then end up with blisters infections, sores on their feet as a result of poorly fitting shoes. And the other thing I would mention as well, is that the shoe needs to be specifically purposed for what you're going to be doing. If you're hiking in the mountains or walking on city streets, the shoes should be appropriate for that.

Host: Yeah, that actually reminds me of a story of when I went backpacking, I bought a pair of hiking boots. I didn't wear them in at all. And I just kind of took off on my trip. And all of the things that you said happened, I got blisters. It was really uncomfortable. So, is there a rule of thumb or maybe a certain amount of time that someone should wear the shoe before going off on their trip?

Dr. Lipton: Oh, yeah, absolutely. I think about a month ahead of time is a good time. And once you buy the shoes, I would take them out on the test run. Do what you're planning on doing on your trip. If it's hiking or walking on the city streets and make sure the shoes are comfortable and then wear them as much as you can before your trip, so you feel comfortable with them.

Host: Yeah, that makes a lot of sense. Another thing I wanted to ask you about is as the weather warms up, inevitably, people are going to start wearing flip-flops and some people wear them everywhere. I see it all the time. I know that this is something that doctors don't like. So, can you speak to this a little bit?

Dr. Lipton: Well, as you can imagine, flip-flops are totally open shoes, so very easy to injure yourself. And if you're wearing it as an all day shoe, you may have occasion to run or move quickly or do something where you wouldn't have the protection of a regular type of shoe and it's easy to stub a toe or twist your ankle.

So, I think that flip-flops are not very protective. I think they're okay to wear for around the pool or for, you know, maybe even in the house and some flip-flops are better than others. Some have some form fitting soles where they're maybe a little bit more conforming, a little bit more supportive, but still I would not use this in all day shoe. I just think there are too many options for injury or mishaps by wearing flip-flops.

Host: Yeah. So, for those of you going to beach communities, what I'm hearing from you is wear them at the beach, wear them around the pool. But as soon as you leave that area and go off to do other things, you should definitely change into something that protects your entire foot. Am I correct in saying that?

Dr. Lipton: Yeah, that's exactly what I tell my patients. They're a good thing to wear just to protect your feet for very short distances, and in those situations.

Host: Okay. Another thing that happens as the weather starts to warm is obviously people want to get outside and they want to start running and they want to start running on all different types of surfaces, enjoying that warm weather. What advice might you give to them by way of the things that they should be wearing on their feet when they go to do that?

Dr. Lipton: Well, again running depends on your proper equipment to have a good run. And the first thing I would start with is make sure you have a good fitting well broken in running shoe that's appropriate for your foot type. So, we recommend going to either good running store or having someone knowledgeable with you to help pick out a running shoe. And just make sure that they are comfortable. They support your feet enough and you'll feel comfortable running in them. The other thing I tell people is don't get frustrated. You can't go out and run three miles on your first go round. You have to start out slowly. And that may mean doing a lot of walking. And a lot more walking than running initially, and then gradually turning that walk into a run and then gradually increasing your running over a period of time. So, if your goal is to run three miles, don't try to do it all in one week, give yourself six or eight weeks to get up to that three miles or maybe even longer for some people. And then once you're there you'll be much happier.

Host: Yeah. And there's two things that I want to highlight there. One is that it seems like everyone's foot is different. So, the importance of going to a store where they're going to really evaluate your foot and pick the right shoe for you is really paramount to having a comfortable experience when you run. And the second piece of it is just starting slowly, right? Making sure that you're not just going from zero to 100, but working your way up to the ultimate goal that you want to reach. Am I correct in saying that?

Dr. Lipton: Absolutely. That's correct. Yeah, that's what we recommend.

Host: I know that there is a cohort of people that just love going barefoot, everywhere. What are your thoughts and opinions on this?

Dr. Lipton: Well, obviously, you know, you can't go barefoot everywhere. You don't know what you're going to step on, on concrete or asphalt. It's very easy to injure your foot. I think, for some people, on the beach or in the backyard, that sort of thing, it's probably okay. But I would not walk barefoot all day. I think your feet are not accustomed to this. We don't have the thickened skin and callousing on the bottom of the feet that the other cultures may have who go barefoot more than we do. And I just think it sets you up for more injuries. A lot of people, speaking of running earlier, a lot of the people have adapted the barefoot running program.

And I just feel that sets you up for more problems than benefits. I think people have had more injuries than we would expect. And used to see a lot more people running barefoot, but that has since slowed down to some degree because of the amount of injuries that people were incurring from that.

Host: Yeah. I have a friend that was doing that for a while that also injured himself. But one thing that he did tell me was that there was a certain way that you're supposed to run, not the heel toe, but the toe heel. Can you talk to us a little bit about your running form and if that makes a difference in terms of minimizing your injury?

Dr. Lipton: I think the best way to minimize your injury is to run in your natural gait. Once you try to change your natural gait, then I think you set yourself up for injury. So, if you're a heel striker first, and that's the way you like to run and that's the way you feel most comfortable, I would stick with it. There are some people that strike with their forefoot first, and that seems more natural to them. But when you start trying to switch from being a heel striker to a forefoot striker, or vice versa, I think that's when people get into trouble and get injured.

Host: Understood. I want to shift the conversation to the different demographics of people and who might be more predisposed to injury. I've heard, for example, diabetic patients need to be extra careful about their feet in the warmer months. Can you maybe speak to this a little bit?

Dr. Lipton: Oh, absolutely diabetics. They have a specific issue with insensitivity in their feet. And in other words, the elevated blood sugars over time have caused damage to the nerves and they develop not everyone, but many develop something called diabetic peripheral neuropathy that makes it so they can't really feel their feet as well. There's another type of diabetic neuropathy called painful diabetic neuropathy, which is a little bit different, but it's the people with insensitive feet that I worry about the most. If they buy shoes that don't fit well, or if they develop a sore or an ingrown nail or they step on something, they might not recognize it. As a result of that, they can develop an infection and if they develop an infection, they could get worse quickly because the metabolic issues with diabetes make healing infections much more difficult. And those people could end up in the hospital just in a matter of days from onset of the problem to when it gets really bad when they notice it. They also don't check their feet on a regular basis because they can't really feel them. So, they don't feel like there's an issue going on. In reality, they should be checking their feet two and three times a day to make sure there are no problems.

Host: Got it. So, you know, Dr. Lipton, one of the things I wanted to ask you was, I guess, a bit about prevention and the way that I like to ask is, you know, during the summer months or a little before, I'm sure that you have seen throughout your years of practicing so many different types of patients. What's one thing that you wish more patients did or something that you wish more patients knew before it got so bad that they needed to come to see you.

Dr. Lipton: Well, I think the first thing that really bothers me is when they see people come into the office wearing shoes without socks, I think socks are really important. They are an interface between your foot and the shoe and they prevent a lot of the problems. Nowadays, we have socks that wick moisture away from skin, keeping the foot dryer. And I think that solves a lot of issues before they even start. One issue to speak of is simple fungal infections of the foot. And I think that solves a lot of the problems. People who put their feet into a shoe, sweat. That shoe gets really moist. The moisture attracts fungus, the fungus grows and it can infect your foot.

It's important to remember not to wear the same shoe every day and to let the shoe air out and dry. And once a shoe gets to the point where it's always moist, I think it's time to get rid of it.

Host: Okay. Understood. And I think my wife is going to like the advice of changing your shoe every single day, when she listens to this. You know, one of the things just related to what you were saying about wearing socks, is that as the weather worms there's going to be people whose feet start to swell or just sweat more during this hot weather. Outside of wearing socks, is there anything that can be done to stay comfortable or just avoid this altogether?

Dr. Lipton: Well, I mean, people who swell, they swell for various reasons. My best recommendation is to just get off your feet, elevate your feet and let some of that swelling subside. Let your feet dry off. And once you notice the swelling going down, go ahead and get back up. I think one of the common things that causes swelling is excessive salt in the diet. So, maybe watch your diet and make sure you're not eating too many salty foods and that can contribute to swelling and that would help reduce the chance of that happening.

Host: Well, Dr. Lipton, this has been a very insightful conversation. Anything else you'd like to share with our audience before we sign off today?

Dr. Lipton: Well, don't forget about your feet. They do a lot for you. They're probably the most neglected part of your body. And just remember wear what's appropriate for what you're doing. Just like you dress appropriately in the winter, you want to dress appropriately in the summer. Don't overdo it. If you develop pain in your foot and it's not going away after a day or two, don't try to run it out or walk it out. It will get worse. And if you have a problem, you're not sure what's going on, it's not getting better on its own, after a few days, seek out help and make an appointment with the podiatrist.

Host: Well, Dr. Lipton, I think that's the perfect place to end. Thank you so much for your time today. That's Dr. Mark Lipton, a Podiatrist for the Orthopedic Associates of Central Maryland Division. For more information, head to mdbonedocs.com. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you.

Thanks for checking out this episode of A Bone To Fix. My name is Prakash and we'll talk next time.