Walk with Ease - Q&A

On June 27, we hosted the 2nd event in our Healthy Pursuits event series – Walk with Ease.  In partnership with the Arthritis Foundation, these FREE community activities and educational sessions  offer men and women information and insight on a variety of joint health and arthritis topics.  Click for a complete list of the upcoming Healthy Pursuits events!
 
During Walk with Ease, Jeffrey Wu, MD, orthopaedic foot and ankle surgeon, and Stacey DeJulius, owner of Fleet Feet Sports, discussed foot and ankle care, including information on shoes, shoe inserts, exercises and other tips to prevent pain. In case you missed it, we ended the night answering a variety of questions from attendees, which include some of the questions below!

If you have your own questions that need to be answered, please call 513-557-4900.

Walk with Ease Q&A 

  1. I have a previously broken bone in my foot.  It has been healed for two years.  It still is causing pain when I wear 2” heels.  Thoughts?

    • Wu: This depends on the fracture itself.  As long as the fracture is healed properly, there should not be much long-lasting pain.  There may be other issues especially wearing high heels such as a Morton’s neuroma.  I would recommend avoiding heels for the time being or consider using an over-the-counter metatarsal pad in her shoe.
  2. Is there anything we can do to alleviate the pain of swollen ankles?

    • Wu: Swelling in the ankles can be from multiple causes.  It can be from an injury, from arthritis, or circulatory issues.  It can be a sign of issues with blood pressure or medications.  Regardless of the cause, it is important to try to treat the symptoms.  With swelling usually comes discomfort/pain.  I would recommend trying compression stockings as a first step to see if this alleviates the pain. 
    • DeJulius: I’m a big fan of compression stockings - CEP is the brand we prefer at Fleet Feet Sports.  It’s medical grade compression and we measure your calf and ankle circumference to get the correct size. Again, there’s probably something else causing your swollen ankles, that you should look into, however, compression socks can help alleviate the pain and swelling.
  3. Will foot arthritis be aggravated more by the distance of walking or the speed that you walk?

    • Wu: Arthritis tends to be affected by activity.  The greater distance you walk, the higher the likelihood of having flare-ups or increased pain.  The speed at which you walk can affect arthritis as well.  Typically, with faster walking, you will tend to put more forced down on the foot with each step.
    • DeJulius: Getting fit for the best shoes for your biomechanics and activity could help give you more shock absorption, taking away some of that higher impact as you pick up your walking pace. 
  4. Tips for at home arthritis relief?  Ice vs. heat, Epsom salts, other options?

    • Wu: Ice and heat are both helpful.  In general, I recommend ice for more acute issues such as an injury.  Epsom salts are sometimes helpful for swelling.  Occasional use of anti-inflammatory medications, such as ibuprofen or naproxen, are helpful.
  5. How much are good shoes with inserts? 

    • DeJulius: A good quality pair of shoes will range from $120 to $160.  Insoles range from $45 to $55.  So your total would be anywhere from $165 - $215.
  6. Please talk about “the aging foot”.  What happens to feet as you get older and how to manage those effects?

    • Wu: As Your foot “ages” you can develop some arthritis.  There can be some stiffness in the foot.  You can lose some of the padding in the ball of the foot leading to metatarsalgia. Staying in a well fitted shoe is very important as you try to maintain activity and exercise.  The over-the-counter orthotics can provide both support as well as increased padding.
    • DeJulius: Proper footwear can definitely keep you more comfortable as you lose some of the padding in your feet.  People will often prefer a higher cushion shoe and a good insole to evenly distribute the pressure on the bottom of your foot.  We can also help you find a higher cushioned non-cotton sock, which not only provides more padding, but will help prevent blisters, callouses and hotspots on your feet.
  7. Should you wear the same pair of shoes every day?

    • Wu: It is fine to wear the same pair of shoes every day.  More importantly, it is wise to wear the correct pair of shoes for the specific activity.
    • DeJulius: Yes, it’s okay to wear the same pair of shoes every day, just be sure to replace them every 400 miles.  (NOTE:  If your goal is to get 10,000 steps in a day, that’s 5 miles per day.  If you meet that goal, you should be replacing that pair of shoes every 3-4 months). At the very least, your shoes should never have a birthday.  If it’s been a year, it’s time to replace them! 
  8. What causes pain up the side of the foot?

    • Wu: Pain in the side of the foot can be from many causes.  Typical issues range from arthritis to stress fractures to tendinitis.  The peroneal tendons run up the side of the foot and the outside/back of the ankle and are frequent cause of tendinitis.
  9. What stretches are best for tendinitis or back of heel up to Achilles tendon area?

    • Wu: Stretching out your foot and calf is helpful for many issues including tendinitis, plantar fasciitis, and even pain in the ball of the foot.  The best stretching to do is standing on the end of the step with your heel hanging off. A slow steady stretch for about 30 seconds at a time is recommended.  Doing about five minutes of stretching total, four times a day is my main recommendation.
  10. Why would you have plantar fasciitis in one foot and not both?

    • Wu: Whether it is tendinitis or plantar fasciitis or stress injuries, it is typical to have this just on one side. Our bodies are just not perfectly symmetric.
    • DeJulius: When we are measuring people’s feet and watching them walk barefoot, we often see differences not only in size, but in arch flexibility and gait.  This can definitely be a cause of pain in one foot and not the other.
  11. Should we walk around barefoot?  What about barefoot running?

    • Wu: Walking around barefoot is certainly okay.  The only situation that I would recommend not walking barefoot is if you have any sort of neuropathy or nerve damage, such as from diabetes.  I typically do not recommend barefoot running.  There has been some people that are proponent of this, however I do not think that this is beneficial for the general population.  It can lead to other injuries, such as stress fractures.
    • DeJulius: I am a believer in shoes!  However, if you are set on trying barefoot running, there’s a lot you need to do before you take off your shoes and go.  I would definitely spend time working on your running efficiency and form to make sure you are comfortable striking on your forefoot.  There are also more minimal shoes with a 4mm heel to toe drop that you could try as a transition.  
  12. What causes shin splints?  What makes them go away?

    • Wu: Shin splints are typically in inflammation of the lining around the bone where the muscle attaches to the leg.  This is usually associated with running or sports.  The main treatment for this involves stretching and sometimes a mild orthotic in your shoe.
    • DeJulius: Getting fit for the right shoes and insoles will definitely help take the stress off your calves.  When your calves get overworked and tight, that’s typically when we see people with the shin pain.  So good shoes, insoles and a lot of stretching and massage on your calves.  I like to use the Addaday stick to massage my calves.
  13. Does having flat feet affect your knees/knee pain?

    • Wu: Yes, flat feet can affect the alignment in the knees and in the hips.  If you have arthritis in the knees, sometimes changing the alignment in your foot can help some.  This is dependent on the pattern of arthritis in your knee.  If he did have significant issues in the knee, it is worth getting it looked at first to determine what part of your knee is affected to see if any change in your foot alignment will help.
    • DeJulius: We often see knee pain go away in our runners and walkers with flat feet, after they’ve been fit in right insoles and shoes. 
  14. What’s best to do to relive the pain of corns?

    • Wu: Corns are usually a symptom of either an underlying deformity, such as a hammertoe, or a problem with shoes that are too narrow or tight.  There are some over-the-counter devices that you can use to pad the toe.  One example is a digital toe pad made by Silipos.  It is important to minimize development of corns and calluses.  Sometimes using a pumice stone is helpful.  It is good to keep the foot moisturized so that the skin does not get dry or cracked.
  15. Over the counter vs. prescription inserts.  What are the pros and cons?

    • Wu: Prescription custom orthotics will provide the best fit for your feet.  However, most insurances do not cover these and they can get rather expensive.  For the majority of patients, a good over-the-counter orthotic can be adequate and is always worth a try.
    • DeJulius: We are a fan of custom orthotics, but as Dr. Wu said, they can be very expensive.  The key here is getting a QUALITY over the counter orthotic, and making sure you are fit properly for them.  After a lot of product research, my two favorite brands that we sell are Superfeet and Powerstep


Join us for the next sessions of Healthy Pursuits, each focused around a different aspect of thriving happily and healthily with arthritis and other joint and spine conditions.