Pretty pain-free feet

 Do you fe t scream with pain?A well-known photographer once told me you can tell if a woman’s feet hurt by looking at her picture. He said women with sore feet get a pinched look on their faces when they smile. I think he is right. I saw so many women barefoot at the end of the night — their pricey sandals in their hands — because their feet hurt. I wonder why they didn’t have a good foot doctor.


I love high heels and I hardly ever have foot pain. I swear it is because I take good care of my feet, and never tolerate shoes that hurt. Life is too short for painful feet.
Dr. Robert Klein is a podiatric physician and foot surgeon, with 16 years of experience. He answered all our questions and told us how to have beautiful, pain-free feet and nails. He even shares a few trade secrets!
Dr. Klein practices in the Orthopedic and Podiatry Department of the Collom & Carney Clinic in Texarkana, Texas. He has previously served as an attending physician treating hard to heal wounds of the foot at a specialty Wound Care and HyperbaricCenter
Dr. Robert KleinSo if you want to shop till you drop, dance all night long, and have feet you can show off without embarrassment in yoga class – don’t miss a word of this valuable interview!
DD: What causes nail fungus?  How can you get rid of it quickly?
Dr. R: As the name implies, nail fungus results from a fungal infection, typically from a group of fungi called dermatophytes. Occasionally yeast can also cause an infection.

A nail fungus may start out as a yellow, white, or discolored area on your toenail. As the fungal infection spreads it can cause thickening of the nail, discoloration of the nail, fungal debris can accumulate under the nail causing the nail to not adhere to the underlying nail bed. Pain can develop.

Nail fungus is fairly common and can be picked up in communal areas such as pools, gyms, locker rooms, even nail salons. Nail fungus is common on the toenails because of the warm, moist, and dark environment of our shoes and socks – the perfect environment for fungi to thrive.

There are a variety of treatment options available ranging from topical to oral therapy. Unfortunately, nails grow slowly, and depending on the severity of the infection, complete resolution may take some time — upwards of four to six months.

Oral medications such as Lamisil and Sporanoxare are sometimes used for fungal nail infections. Oral medications may cause some side effects. Careful review of the medications the patient is on is important, as there are some potential drug-to-drug interactions, and monitoring of blood work is recommended.

Other safer options include topical medications. I routinely recommend Miranel, an over-the-counter topical antifungal combining an active anti-fungal such as Miconazole along with homeopathic remedies. Occasionally, surgery is recommended for either temporary or permanent removal of the nail.

Treating nail fungus with laser therapy is also an option. This type of therapy is very costly and may not be available everywhere, nor covered by your health insurance.

DD: What is the best way to avoid cracked heels? Is there an effective way to treat them?
Dr.R: Avoiding cracked heels can be difficult. Cracked heels are common in the winter when it’s cold and dry. Secrets and tips that I share with my patients to avoid cracking of the heels includes exfoliating your heels regularly. I recommend using a pumice stone or callus file regularly while bathing.

In addition, applying a lotion that exfoliates the skin can help prevent cracking and fissuring of the skin. In my practice, I recommend AmLactin Foot Therapy Cream. It contains lactic acid alpha-hydroxy moisturizers that exfoliate and hydrate the skin. Lastly, I’ll have the patient apply the AmLactin Cream at night time, and have them wear a thin pair of white cotton socks to aid with penetration.

DD:  Are exercise to keep the feet supple, such as those done in yoga, or Yamuna foot rollers good for your feet?
Dr. R: Yes, I think exercises to keep your feet supple, as those done in yoga, can help. Yoga can certainly improve the flexibility of your feet, strengthen the core muscle of your feet, as well as the muscle and tendons that insert into your feet.

(The makers of) Yamuna foot rollers claim to promote flexibility and increase circulation. I have no first-hand experience with the Yamuna rollers, but in reviewing their website, their claims that it increases flexibility seem quite plausible.

DD: What are the best types of socks to wear with boots or for exercise?
Dr. R: For exercising I recommend choosing a sock made from synthetic materials, such as polyester, coolmax, or acrylic. The reason I like these materials is that it wicks away moisture from the skin thus preventing blisters.

For boots, especially during winter time, I recommend wool blends. The wool will keep the skin warm. I don’t recommend cotton socks, as they retain moisture and don’t wick the moisture away from the skin.

DD: Is it safe to wear fleece or sheepskin boots without socks?
Dr. R: The warmth of the fleece or sheepskin boot should be sufficient to keep the feet warm enough without socks. I would have no problems if someone wearing those types of boots (e.g. Ugg’s) did so without socks. 
 DD: Are you at risk from infection on a dry surface at a yoga class — or only on wet surface at the gym?
Dr. R: Fungus likes moist, dark, and damp environments. I think you’re more at risk of developing a fungal infection by using the public mats at a yoga studio. I’d recommend bringing your own mat, washing it regularly, and wearing a pair of flip flops when walking in the studio or locker room.

Wet surfaces at the gym also can cause a fungal foot infection. Once again, having a pair of flip flops that you wear in the locker room and shower should help prevent developing a fungal foot infection.

 DD: How should you cut your nails?
Dr. R: Cutting your toenails sounds like it would be simple and it can be with these simple suggestions:
1. Choose the proper toenail clipper. Do not share them with anyone, and cleanse the clipper with alcohol between use.

2. Trim the nail slowly, making 2-3 cuts across the nail vs in one big bite of the nail clipper.

3. Cut the nails straight across and exercise caution not to dig into the corners.

DD: are pedicures safe? What should one look for when choosing a place to have pedicure?
Dr. R: Pedicures are safe and can be quite enjoyable when care is taken to ensure your nail salon is creating a safe environment for you. Simple suggestions: The spa chairs should be cleaned and wiped down after each use. The foot spa tubs also should be cleaned out after use with a disinfectant. The filter systems of the tubs should be cleaned regularly. Instruments should be cleaned and autoclaved after each use. Some salons will provide individual instruments for their regular clients. If not, consider purchasing your own pedicure instruments. Make sure your nail tech washes their hands… Look at the overall cleanliness of the salon. If there is debris or dirt on the floor, the chairs are dirty, consider another salon.
DD: How damaging are tight and badly-fitting shoes?
Dr. R: Tight or badly-fitting shoes can be damaging to your feet. One of the more common complaints I see in my office from tight or badly-fitting shoes is Morton’s neuroma. It is basically an irritation of a nerve in your foot, often attributed to tight-fitting shoes.

Badly-fitting shoes can also exacerbate and/or irritate bunion deformities and hammertoes, as well as cause corns to develop on your toes.

Lastly, tight-fitting or badly-fitting shoes can be very problematic in diabetic patients, patients with poor circulation, or patients with impaired nerve function. Sores and ulcerations can develop.

DD: If high heels fit well and cause no pain, are they safe to wear?
Dr. R: My patients ask me this all the time. High heels can affect your feet in many ways. They can alter your posture. High heels put more pressure on your forefoot. Your body compensates whereby the upper part of your body leans back to maintain balance. High heels can cause your calf muscles to shorten because of the heel height. When switching back and forth from heels to flats, you can wind up irritating the heel cord and developing Achilles tendonitis.

The narrow toe-boxes of high heels can irritate or create a Morton’s neuroma, a painful nerve condition that frequently occurs between the third and fourth toes.
Narrow toe-boxes can irritate bunion deformities and hammertoes, as well as cause calluses and corns to develop.

High heels aren’t as stable as a flats; ankle injuries and sprains are possible.

With that said, with proper selection and moderation, heels can be safe to wear. But, probably not as an everyday shoe.

DD: Do flip flops damage feet?
Dr. R: With the exception of wearing flip flops at the beach, or in the gym, flip flops can be problematic. They provide little heel and arch support. Heel and arch pain can result. There’s not much to flip flops, and as a result your muscles and tendons really work hard to walk in flip flops. You’ve probably noticed that your toes wind up gripping and contracting more when wearing flip flops which can lead to toe pain. Running in flip flops can be very dangerous. If your catch the tip of the flip flop against the ground you could easily fall and cut/lacerate, or pull a layer of skin off, or even a toenail. Flip flops offer no protection from dropping an object on your foot, and from rocks and debris on the ground kicking up and injuring your feet.

From the constant pounding of your foot against the ground and little if any cushioning, you can quickly develop unsightly calluses and cracks on your heels when wearing flip flops.

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