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“WALKING THROUGH COVID – 19 ONE STEP AT A TIME”

‘’I haven’t walked or run this much in years” is what my patients have been telling me since February 2020. The month that got us out of the house or office and on to the sidewalks, streets, parks and walking trails. The gyms closed at the beginning of the virus and now have restricted hours […]

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‘’I haven’t walked or run this much in years” is what my patients have been telling me since February 2020. The month that got us out of the house or office and on to the sidewalks, streets, parks and walking trails. The gyms closed at the beginning of the virus and now have restricted hours or are closed once again. The only way to get exercise is by walking, running or biking. For some individuals it will be the first time exercising and their feet are paying the price. For others, they are just increasing their miles and experiencing new aches and pains. Patients are now reluctant to see their doctor unless it is an emergency and probably using Dr. Google to solve their foot problems!

Patients are coming into the office with a variety of foot problems such as arch pain, heel spurs, tendonitis, blisters and ingrown toenails. In order to navigate through these difficult times, I will discuss the cause and treatment solutions to get the thousands of exercisers back on their feet.

Soft tissue pain in patient’s feet have been the common thread over the last 5 months due to all the miles of walking and running they have been doing. The underlying cause is due to repetitive overuse. Overuse injuries occur because of walking or running too many miles too quickly and not gradually increasing it over time. Fatigue begins to occur and your feet begin to break down resulting in soft tissue overuse injuries. Our body is just not prepared for this sudden increase in exercise.

Arch pain can manifest itself either as muscle spasms, plantar fasciitis or heel spur formation and is a byproduct of people’s arches collapsing or flattening when weight bearing. The collapsing of the arch known as pronation occurs when the joints in the foot (mid-tarsal and subtalar) become unstable and flatten towards the ground. It becomes painful when the arch flattens too much, which is known as abnormal pronation. This is a structural biomechanical issue and can be linked to a genetic predisposition within a family. If one’s parents or grandparents have flat feet, so could you.

Abnormal pronation can also cause tendonitis which occurs when one of the tendons in the foot gets injured and becomes inflamed. The areas most affected in the foot are the back of the heel known as the Achilles tendon, the base of the 5th metatarsal bone where the Peroneal tendon attaches or the Posterior Tibial tendon as it crosses the ankle joint and inserts in the arch area of the foot. All of these can be attributed to repetitive overuse and associated with overextending yourself while walking or running.

Wearing the proper footwear that provides functional support is a major factor in preventing foot injuries. Many new exercisers are probably wearing old or worn out footwear because that is what was in their closet. It is important to wear new exercise shoes that do not have a lot of wear or tear on them. Old or worn shoes are broken down and will not provide the foot with the proper support and comfort that is required to log miles upon miles.

The best way to avoid these foot problems and reduce the chance of developing arch pain, heel spurs, tendonitis or plantar fasciitis is by additionally wearing over the counter arch supports; instant arches or custom orthotics made by a foot specialist in your’ shoes. These devices help to biomechanically support the bones and joints of your foot by preventing excessive arch collapse as well as taking pressure off the ball of the foot. The foot will then be able to function in a more stable environment.

Icing the painful areas is very important because it reduces local inflammation and swelling. Over the counter non – steroidal medications can help as well as homeopathic anti-inflammatory products that contains arnica. Arnica is a natural plant product that helps reduce pain, bruising and swelling.

Ingrown toenails have also become a problem during the pandemic either because of cutting your toenails incorrectly or wearing tight ill-fitting footwear. Since nail salons have been closed the majority of the pandemic, women are left to their own devices. Cutting toenails too short or cutting too deep into the corners of the nail are some of the reasons for developing painful nails. I recommend that my patients cut their toenails straight across and use an emery board to smooth or round the corners of the nail. Do not perform bathroom surgery on yourself because it can lead to infected ingrown toenails.

Footwear can cause toenail problems too because of tightly fitting shoes or shoes that may be too short or narrow at the toe box and the nails will hit the top, tip and side of the shoe when walking or running.

Along those same line’s blisters can form because of friction and foot slippage in footwear that may be too loose or too big for the foot. Heat is created by that movement and the tops, tips, bottoms and sides of the toes are mostly affected. If the blister pops and drains or your ingrown nail looks red and puffy it may be infected. Clean the infected areas with antiseptic solutions such as alcohol or peroxide. Use a topical antibiotic ointment or cream to prevent skin infections from developing. Soaking your feet in Epsom salts is another way to help keep the area clean.  

Since nobody knows at this time how long we will be exercising in this manner it is important to take care of your feet. Consult a foot specialist if you continue having problems.  

The goal is to stay healthy “And Walk Happily Ever After” one step at a time! 

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