A young, athletic patient presented to my Grapevine, Texas office complaining of a painful, funky looking toenail. She thought she has a little fungus or ingrown toenail starting. Turned out to be much more!
The toenail had a firm nodule that was palpable in the corner of the nail bed. As I suspected, an X-ray revealed a small benign bone tumor was growing out of the tip of her toe. This is what was causing her toenail to be deformed and painful!
Luckily these tumors are usually an osteochondroma, which is a benign growth. These are more just annoying but they do have a high recurrence rate.
Bye bye bone tumor!
The purpose of this case study is to remind you to not just assume your toenail troubles are no big deal! Get any abnormal changes in the look and feel of your toenails checked out!
I have a closet full of shoes, like most women. I even have a few pairs of “sit down” shoes; i.e. pretty but painful; so, you only wear them to sit down events like weddings. It has been said that the modern woman has an average of 30 pairs of shoes and only 3 or 4 are comfortable. In fact, it has also been cited that the average woman wants to remove her dress shoes after 34 minutes of wearing them. Really? Last time I checked that’s not the average work day. Ladies, this needs to change! Why are we torturing ourselves just to be “fashionable”? And who gets to decide what is “fashionable” anyway?
I am probably the exception to the rule because last time I counted, I had 14 pairs of “dress shoes and/or sandals” and 10 pairs of running shoes in various degrees of wear. After my last pregnancy, I had to heed my own advice (please, don’t tell anyone) and do a shoe purge. All those pretty shoes didn’t fit anymore. The thank you goes to my 3 daughters! I had been preaching for years that your shoe size goes up at least half a size with the first two pregnancies; then it seems to stabilize. Turns out it’s true! I was a US 5.5 when I was 18 and at 50, I’m a US 7!
The lovely aging process also changes our feet. We tend to get little lumps, bumps and other crazy things happening; but that’s a topic for another day.
I’m not saying that we all should go out and buy and wear my favorite comfort shoes from Dansko (My daughters call them my doll clogs); but let’s work on actually wearing shoes that fit!
Here are 8 tips to think about when buying your next pair of shoes. And while you are at it, do a closet shoe purge BEFORE you go shopping!
Purchase shoes at the end of the work day or after sports for the best fit. Your feet will swell during the day, so night shopping is best for fit. As for running shoes, your feet will also swell about 15 minutes into your run especially in the summer; so, when in doubt size up at least a half a size.
Don’t forget to measure both feet! Yes, I said measure them! Feet change with age, pregnancy and weight gain (or loss). Measure both feet and pick the size of the larger foot. Most people are not perfectly symmetrical.
Wiggle your toes in the toe box. Are they rubbing? Do they feel crowded? If so, go up a half a size or to a wide width.
Make sure the widest part of your foot is still in the shoe, not hanging over the edge of the sole. This leads to blisters and can aggravate bunions.
Don’t rely on “breaking in” the shoe. It should be comfortable right out of the box or newsflash – It doesn’t fit!
Try on shoes with the same socks or lack of socks that you will be wearing in them. Sock thickness can make a real difference in fit!
A pet peeve of mine, if you can bend the shoe so much that you can make a burrito out of it – don’t buy it. You will thank me later. A stiffer sole is much more comfortable, and your feet don’t fatigue as fast. A built in arch support can make it even more comfortable!
Walk around the store for a few minutes and make sure you are comfortable before buying. When in doubt, take them home and walk around on carpet. As long as you don’t wear them outside or have any visible wear, most stores will let you return them after a few days if you are not 100% ecstatic about your new kicks.
Time to get some new shoes? Make sure they fit and are comfortable! Your feet will thank you. If you have any questions about whether a shoe fits, feel free to make an appointment with your favorite podiatrist.
What a gorgeous morning at Dallas Athletes’ Texas Man Triathlon Sunday, May 5th. The sun came up over a calm lake and in the water we went. Over 700 athletes participated in one of 3 distances; sprint, olympic or X50.
First wet suit swim for me in ages, but I held my own. A little slow but steady. The water temperature was perfect for a swim and the lake was very calm. Great bike course of rolling Texas hills. Too bad we can’t convince the county to repave the roads; the asphalt was a wee bit bumpy. In transition, I thought I might need to check my fillings! I was happy to see that my training mostly on the Peloton really helped my bike fitness. The run course was nice, pretty flat and shaded; which helped as the temperature rose. My run was a bit slow, but given my lack of focused training; I was happy with my effort.
I was shocked and ecstatic to find out I was third in my age group, qualifying me for the Best of the Best Triathlon in November! And I even got a cute little trophy for my desk.
It was so great to see so many friends and patients out on the course; either participating, cheering, or volunteering. It takes a village to put on a quality race and Dallas Athletes always deliver a great race!
Art, of course, was the #1 sherpa; making sure I was well taken care of and even gave me a celebratory Shiner after I finished.
Welcome back triathlon season! Let’s get after it gang!
Saturday May 4, 2109 was the rescheduled Run4Elise 5K and Water Safety Awareness Event benefitting our sponsored charity (full disclosure, I’m on the board). This was initially scheduled for April 6th on a day when the North Texas weather was not cooperating. Thunderstorms and tornado warning necessitated rescheduling the event.
What a gorgeous day and a huge turnout! More than 600 runners and walkers, with their families enjoyed the warm sunshine and mild breeze while completing a two loop course meandering around Gateway Church campus in Southlake, TX.
I was blessed to have my mother, Betty Crane, as well as my two younger daughters, Caitlin and Sasha, participate with me. My office staff at FAANT also showed up in full force. Many neighbors and friends were also in attendance as well as most of the Southlake City Council and the Carroll ISD School Board and staff. It was the place to be on Saturday.
My lovely 18-year-old daughter placed 2nd overall for women ( she claims she let the other girl win) and 1st in her AG. My youngest daughter, Sasha, did the one mile fun run; although she looks in pain in the picture she had fun. (just hates getting her picture taken!). My mother and I walked to 5K and my 78-years young Mom came in 3rd in her AG! Go Mom!
The message of water safety cannot be overstated. Elise was a vibrant, athletic, motivated competitive swimmer who tragically drowned on June 20, 2016 in the CISD Natatorium. We hope that no family will ever have to go through what the Cerami family has suffered. No one is down-proof! Please follow the link to Swim4Elise to learn more about the water safety message. Donations are also gratefully received.
Join us next year for the 4th annual Run4Elise in the Spring of 2020 which would’ve been the spring of Elise’s high school graduation.
In today’s episode Yoga for Runners #5: Half Lord of the Fishes Pose: Dr Shyla Arya and Dr Marybeth Crane, from Foot and Ankle Associates of North Texas. demonstrate a great spine twist for runners that opens up the chest, stretches the neck, shoulders and hips as well as energizing the spine.
What is the Achilles tendon? Why does it hurt? What can I do to fix it? All good questions!
A tendon is a band of tissue that connects a muscle to a bone. The Achilles tendon is the longest tendon in the body and runs down the back of the lower leg and connects the calf muscle to the heel bone. The Achilles tendon helps you walk by raising the heel off the ground.
Common Achilles Troubles:
Two common disorders that occurred in the Achilles tendon are tendonitis and tendonosis.
Achilles tendonitis is an inflammation of the tendon that is typically short in duration. If this inflammation persists and progresses, over time the tendon starts to degenerate and tendonosis occurs. Tendonosis is when the tendon loses its organized structure and is likely to develop microscopic tears and even rupture.
The symptoms associated with Achilles tendonitis and tendonosis include:
Pain: aching, stiffness, soreness and tenderness within the tendon, especially when palpated. This may occur anywhere along the tendons path from the insertion on the heel to the muscle belly that is attached in the calf. Pain is usually worse in the morning or after periods of rest and may warm-up or get better with increased activity.
Enlargement of the tendon: A nodule may form in the area where the tendon is degenerated and swelling will go up and down with activity.
The cause of Achilles tendonitis and tendonosis is usually a sudden increase a repetitive activity that includes the tendon. Think too much, too soon, and too fast. These activities put too much stress on the tendon too quickly leading to micro injury to the tendon fibers. Due to this ongoing stress to the tendon, the body is unable to repair the injured tissue and this leads to the formation of tendonitis.
Athletes are at the highest risk of developing disorders of the Achilles tendon; but it is also common in patients who work on their feet and ankles such as laborers, waitresses, factory workers, nurses and anyone who spends a lot of time standing or pushing and pulling objects with their feet. People with excessively flat feet are a higher risk due to the increased demand on the tendon while walking. It is also true that people with a very high arches are at higher risk of Achilles issues due to having very tight calf muscles which causes excessive stress to the Achilles tendon.
Diagnosis of Achilles tendonitis and tendonosis is made by physical exam, x-rays to determine if any spurring is involved, and possibly a diagnostic ultrasound or MRI to determine the extent of damage to the tendon.
Treatment of Achilles tendon disorders are based on how long the injury has been present and the degree of damage to the tendon.
Early treatments are focused on decreasing acute inflammation with ice, anti-inflammatories, gentle stretching, and possibly immobilization and physical therapy. Often a night splint and arch supports or orthotics coupled with better shoe gear are necessary to control tendonitis.
If conservative therapy is unable to resolve tendon issues, surgery may be necessary. This may include stem cell or PRP injections, debridement of damaged tendon, removal of spurring and repair of the remaining tendon.
When it comes to treatment of Achilles tendon pain, the earlier treatment equals faster and better outcomes. If you are experiencing Achilles tendon problems, please visit your favorite podiatrist. Early diagnosis and treatment are the best options to get you back to running, jumping, and playing with the other kids.
In part Four of Yoga for Runners: Dr Shyla Arya and Dr Marybeth Crane from Foot and Ankle Associates of North Texas in Grapevine and Keller Texas demonstrate the Seated Reclined Pigeon pose. This is a great stretch for runners with tight hips. It really gives you an intense deep stretch of the hip flexors.
In today’s episode of Yoga for Runners, Dr Shyla Arya, from Foot and Ankle Associates of North Texas, helps Dr Crane demonstrate the seated forward fold. This is a great pose for runners because it gives an intense stretch of your shoulders, back, hamstrings and calves.