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Healthy You

The Right Steps: Understanding Good Foot Health

April 27, 2016 10:59 AM with Dr. Michael Weisman

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Many of us are on our feet every day, and it’s easy to forget how important they are in our lives. They help support proper alignment and allow us to be active on a daily basis. Not paying attention to the aches, pains and physical changes in your feet may cause you to miss an underlying foot condition or an even bigger issue. Find out more about keeping your feet healthy in our chat with Michael Weisman, DPM, Podiatrist within NorthShore's Orthopaedic Institute. He will be answering your questions about foot pain and conditions, providing foot care tips and discussing the importance of foot health as an indicator of your overall health.


Michael Weisman (NorthShore) - 10:58 AM:
Hello; I'm Dr. Michael Weisman, Division Head of Podiatry at NorthShore University HealthSystem. Ready to chat.

Kathryn (Moderator) - 11:00 AM:
Our chat on foot health is now open. You can submit questions at any time during this chat.

  Cheryle (San Angelo, TX) - 11:01 AM:
Are there just simple exercises I can do with my feet to stop pain and swelling? I have plantar fasciitis in both feet with 2 heel bone spurs in the left and one in the right, and they are inoperable.
Michael Weisman (NorthShore)
I'm actually glad to hear you say they are inoperable. Surgery is rarely necessary to treat plantar fasciitis. The most effective stretches are those that increase ankle dorsiflexion (upward bending of the foot at the ankle). The runner's (wall) stretch is my favorite.

  Elizabeth (Barrington, IL) - 11:03 AM:
Hi! The skin on my heels is so tough; it's discolored and very rough. I've tried so many things to soften it, but nothing seems to work. Is this something a podiatrist can help with? What can be done about it?
Michael Weisman (NorthShore)
This is a very common problem. In light of the discoloration, I would see a podiatrist to make certain that there is no infectious component to your rough skin. If it is just the dryness and individual tendency to form callus, then there are a variety of things to try. Aquaphor is a good OTC start, although I suspect you have tried this already. Gentle abrasion of callus can be done with the Ped Egg, followed by the use of a moisturizer. Urea-based creams can be helpful, and are available in a variety of strengths.

  Toni (Chicago, IL) - 11:08 AM:
I keep getting calluses on the bottom of my feet, especially on the left foot. Is there anything I can do to prevent them? By the way, I rarely wear high heels because of the discomfort of the calluses.
Michael Weisman (NorthShore)
Calluses are generally the result of excess pressure distributed over a small surface area. They sometimes become nucleated, meaning that the tissue grows inward causing more pain with weight bearing. If you haven't already, I would see a podiatrist to evaluate this and remove the dead tissue. Following this, the best approach is trying to avoid with thick soled shoes and metatarsal pads. Keeping them well lubricated helps as well.

  Sergio (Des Plaines iL) - 11:11 AM:
Is there a good way to determine what would be the best shoes for your feet? Are there any brands you normally recommend?
Michael Weisman (NorthShore)
The choice of shoes depends on many factors including foot type or shape, and your needs. Are you on your feet most of the day? Do you have to dress to a certain standard? Rather than recommending specific brands I generally direct people to stores that specialize in proper fitting, and stock quality shoes. The Walking Company does a good job, as does Comfort Shoes, Waxbergs and SAS.

  Katie (Evanston, IL) - 11:14 AM:
I have had issues with supination for a long time - my shoes always wear unevenly (even my dance shoes!). I was told this can be an issue of weak muscles in the big toe. What kind of things can I do to fix this? Would orthotics help?
Michael Weisman (NorthShore)
I have found that controlling supination can actually be more challenging than controlling pronation. Don't base your supination on outside (lateral) heel wear alone. The normal place to wear the heels is on the outer 1/3. Orthotics can help control supination but sometimes simple cushioned insoles can be equally effective. There are exercised that can help strengthen selected muscles in the foot. I don't have a link at hand, but you should be able to find them online. A podiatrist or physical therapist could help here.

  Alison (Evanston, IL) - 11:19 AM:
I experience numbness in my feet when working out on the elliptical at about 30 min into my workout (this has been going on for years). Wondering why this might be happening and if you have suggestions?
Michael Weisman (NorthShore)
Numbness is usually the result of compression on a nerve. If your numbness is on the sole of the forefoot it may well be compression of an intermetatarsal nerve or Morton's Neuroma. It is also possible that numbness with certain activity is the result of compression of a nerve root in the lumbar spine. The first thing to do is make sure your shoes are wide enough. Sounds simple, but we eliminate alot of forefoot numbness by decompressing the foot with a larger wider shoe.

  Sunita (Skokie, IL) - 11:22 AM:
I am a diabetic patient. I am worried about amputations. How can I take care of my feet? What are some symptoms I might feel if my diabetes is affecting my feet?
Michael Weisman (NorthShore)
The risk posed to the lower extremity with diabetes varies considerably depending on the individual's status. Good control of blood glucose / A1C is a great starting point. You should make a preventitive visit with a podiatrist who will check the pulses in your feet, evaluate color and temperature, check for sensory deficits, etc. If you have any diabetic neuropathy you should be doing self inspection of your feet on a daily basis. Use a mirror to see the soles of your feet. Carefull selection of shoes is of great importance. Doing these things dramatically lowers risk of amputation.

  Cindy (Chicago, IL) - 11:27 AM:
I have struggled with plantar fasciitis for the past 6 months, to the point where I have had to have steroid injections in each foot. My pain is now gone, however I find that my feet are weak and easily fatigued. As an avid walker/hiker what are some suggestions for rebuilding my strength in time for the summer out door season?
Michael Weisman (NorthShore)
Continued weight bearing activity (walking) is a good idea as long as you have the proper shoes and enough arch support. If you stick with it you should be able to build strength. Make sure there are no other factors at work here, such as circulatory or nutritional issues. It sounds like a program of foot / ankle exercise might help with your symptoms. A podiatrist should be able to suggest these to you, and physical therapy can be a valuable addition.

  Samantha (Glenview, IL) - 11:31 AM:
Are heels unhealthy? I love wearing them, but hear a lot about how they aren’t good for your bones.
Michael Weisman (NorthShore)
Like everything, moderation is the key. The occassional use of heels is usually not that detrimental but wearing them all the time can cause problems. Excessive pressure on the sole of the forefoot can cause metatarsalgia (pain on the sole of the forefoot). It can increase the likelihood of developing bunions and hammertoes (although the most important factor here is heredity).

  Lisa (Evanston, IL) - 11:33 AM:
I have noticed discoloration under my toenail; what could this mean?
Michael Weisman (NorthShore)
Lisa, there are several potential causes of discoloration under or in a toenail. Among them are hematoma (bleeding under the nail), toenail fungus, and lesions of the nail bed. This last one is the most important. You should see a podiatrist or dermatologist to evaluate it to be sure it's nothing of consequence.

  Edward (Buffalo Grove, IL) - 11:37 AM:
I have on and off pain with achilles tendonitis and gout pain in my ankle. Happens on both feet but not at the same time. I am worried that it might occur at same time in both feet and wont be able to walk. I have noticed that after I started taking allopurinol, my gout attacks were frequent. What would be a path to recover from this pain?
Michael Weisman (NorthShore)
Edward- have you confirmed that the pain in your ankles is really caused by gout? If so, it's not unusual to have a gouty episode immediately after starting allopurinol. This generally stops on it's own. If you've been on the med for awhile perhaps there is another cause of your ankle pain. In way of reassurance, gout is considered a monoarthropathy. This means that it rarely affects more than one joint at a time.

  Jeremy (Chicago, IL) - 11:42 AM:
I notice that my ankle cracks – I’m a runner, and haven’t really felt any pain from it, though I’ve dealt with injuries in the past. Does this mean something’s wrong?
Michael Weisman (NorthShore)
Jeremy, cracking of joints does not necessarily suggest a problem. We think it may be the result of air / gas bubbles in the joint, or the subtle lateral snapping of tendons over bony prominences. Most of the time we aren't certain of the cause. I would not be concerned about this in the absence of symptoms.

  Amanda (Chicago, IL) - 11:44 AM:
Are pedicures good for the skin of the foot? I love getting them done, but wouldn’t want to hurt my skin.
Michael Weisman (NorthShore)
Amanda, pedicures are fine as long as you are not at increased risk (vascular, neurological, or diabetic). Of course it makes sense that the pedicurist is not overly aggressive.

  Ken (Evanston, IL) - 11:47 AM:
Is posture affected by your foot position? I notice that my doctor examines my feet when we’re talking about my problems with alignment.
Michael Weisman (NorthShore)
Definitely, Ken. It is well documented that collapse of the foot can cause internal rotation of the legs which can change the lumbo-sacral angle (small of the back).

  Jenny (Wilmette, IL) - 11:49 AM:
Should I look for anything specific when I pick out shoes for my kids (ages 7 and 10)? I know they’re going through some big growth phases, and want to make sure their feet are safe.
Michael Weisman (NorthShore)
Good fit is first and foremost. This can be tricky, because the kids do go through growth spurts. We like to allow a small amount of room for growth but not at the expense of too large a shoe. I probably haven't told you anything you don't know. Good quality is important as well- avoid excess use of materials that don't breath such as some plastics. These can contribute to dermatological issues in that age group.

  John (Lombard, IL) - 11:52 AM:
Do warts come back? I seem to get them in the same spot, and am not sure if I'm not using the right treatment.
Michael Weisman (NorthShore)
Warts are very recurrent. They often appear on areas of great pressure or irritation. Although there are many treatments available, I find that we often fail to emphasize the importance of addressing the mechanics that can cause this irritation. Of course make certain that they are in fact warts (a viral lesion), not a pressure keratoma (corn).

  Eve (Evanston, IL) - 11:56 AM:
My daughter is starting to work with pointe shoes in ballet. Is there anything we can do to start caring for her feet, as I know that pointe shoes add a lot of strain and pressure, especially over time.
Michael Weisman (NorthShore)
Eve, this is a tough question. The jury is still out on what age young people should start on pointe. We consider not only age but the individuals body type and physical abilities. A good instructor should help assess this.

  Harold (Oak Park, IL) - 11:59 AM:
My feet seem to itch a lot after I work out; does this mean there’s a problem, or does sweat just irritate my skin?
Michael Weisman (NorthShore)
Sweat can definitely irritate the skin and cause itching, but tinea pedis (fungal infection) can also itch more with sweating. Should be an easy call by a podiatrist. You might try OTC antifungal cream twice daily to see if that changes your symptoms.

Kathryn (Moderator) - 12:02 PM:
This will be the end of our chat. Thank you for your questions. For more information on foot health, or to set up an appointment with a specialist like Dr. Weisman, contact the NorthShore's Orthopaedic Institute.

Michael Weisman (NorthShore) - 12:02 PM:
Thank you all for your questions. I hope I have shed some light on them.

This chat has ended.

Thank you very much for your participation.