LER: Foot Health – December 2016
From the editor:
Hope for hallux valgus
One of the most frustrating things about managing a patient with hallux valgus—or being one—is that so often the emphasis is on the negative. But new research suggests clinicians’ advice to patients with bunions could be much more than just telling them what not to wear.
In a study published in the November issue of Medicine, Spanish researchers found that the thickness and cross sectional area of the abductor hallucis and the flexor hallucis brevis muscles were significantly smaller in the feet of 10 patients with hallux valgus than in the feet of 10 controls.
Similar studies have identified intrinsic foot muscle atrophy in patients with a range of other foot conditions, and have motivated clinicians to consider intrinsic strengthening exercises to help alleviate symptoms and potentially delay disease progression (see “Importance of intrinsic muscles for foot health,” June 2016, page 15).
It’s far too early to say whether intrinsic strengthening in patients with hallux valgus might help stave off corrective surgery or even reverse the condition’s progress, or whether such interventions might be more effective in certain patient subgroups than in others.
But we know the ability to wear fashionable shoes is a priority for many women with hallux valgus (see “Most women who want to wear heels after bunion surgery do so,” page 6), even when warned that high heels and tight toe boxes will make their symptoms worse.
This highly motivated patient population, while notoriously noncompliant when it comes to what not to wear, might well be responsive to the suggestion that intrinsic strengthening exercises could allow them to more comfortably indulge in less-sensible styles, at least occasionally.
And I’m sure clinicians would welcome the chance to be more positive when advising hallux valgus patients. Because having to say no all the time is almost as frustrating as having to hear it.
By Jordana Bieze Foster
But many still experience discomfort – Most women who want to return to wearing high heels after hallux valgus surgery do so, but may sacrifice comfort for style, according to research from the University of Manchester in the UK. Clinicians in the US say many of the study’s findings—although not all—are consistent with their experience.
By Emily Delzell
Device wear delays braking response – A recently published study from the Temple University School of Podiatric Medicine in Philadelphia bolsters previous research suggesting that wearing a lower extremity immobilization device on the right foot could negatively affect driving performance.
By Lori Roniger
Soccer is the most popular sport in the world,1 with 265 million male and female players (4% of the world’s population), and the game’s injuries are associated with a whopping estimated annual cost of US $30 billion per year.2 Soccer is the third-most played team sport in the US, behind only basketball…
By Howard Kashefsky, DPM
Typical interventions in patients with active diabetic foot ulcers include offloading devices and a decrease in activity. And an increasing number of tools are becoming available to help lower extremity clinicians determine how well their patients are actually adhering to such interventions.
By Cary Groner
Foot health experts say that, overall, women are less enthusiastic about high-heeled shoes and smarter about wearing them in moderation. But those who still feel the need to wear heels in professional or social situations can benefit from clinicians’ advice and, at times, footwear modifications.
By Lori Roniger
Help your patients step out in style
The lightweight (8.8 oz) No. 52 Casual Dress shoe from Anodyne features a near seamless, microfiber lining to reduce shearing and heel slippage. It also features a leather upper, a microfiber lining treated with an antimicrobial and antifungal protectant, a hook and loop closure…
The Charlotte Ballet style from revere is designed with comfort and style in mind. Soft breathable mesh uppers that stretch and mold to the foot make the Charlotte feel as good as it looks. Don’t be fooled by the sleek, low-profile midsole: There is plenty of room for…
Ped-Lite’s latest offering for women is its lightest shoe. The Edie, a Mary Jane style that combines a leather and Lycra upper with an ultra-light sole, weighs just 4.4 oz. The Edie’s Lycra toe box is designed to make this shoe ideal for patients with difficult-to-fit forefeet…
Arcopédico’s updated Vega knit sandal for women, part of the company’s cork sole collection, effortlessly adds style to warm weather strolls. Featuring a Greek-inspired V-strap design with a soft nylon knit strap across the vamp, the Vega has a contoured footbed with reflexology technology to…
Your patients can keep their toes free and their soles supported with the classic, adjustable Indulge Relax Slipper for women. Featuring the same tried and tested Orthaheel contoured foot-bed technology as other Vionic styles, these slippers surround the foot with padded terrycloth and…
The newest member of Samuel Hubbard’s Go To Work collection now offers extra protection from the elements. The Rainy Day Founder is designed to keep feet looking sharp and staying dry—in rain, shine, ice, or sleet. The Rainy Day Founder’s full-grain leather uppers…
The Nomad Moc from Spenco is designed to be a “do everything” shoe. Total Support insole technology is complimented by an oiled nubuck and neoprene collared upper for a casual outdoor look. The lightweight, nonslip, two-part outsole is made of…
Sole’s Cork Flips feature cork footbeds that mold to the shape of a foot over time, providing support just where it’s needed to help people who suffer from plantar fasciitis and other orthopedic issues. Supportive arches, metatarsal pads, and deep heel cups are designed to…