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Feet, Don’t Fail Me Now

Feet, Don’t Fail Me Now

Torrance Memorial foot specialists can help keep you moving, pain-free.

Written by John Ferrari

Our feet and ankles support us all day long—from the moment we step out of bed until the end of the day: standing, walking, maybe jogging or playing a sport, perhaps even dancing. But how often do we think about them ... until something happens? That’s when Torrance Memorial Medical Center’s specialists can help us, well, get back on our feet.

People take thousands of steps a day, day after day, year after year, notes Keri Zickuhr, MD. An orthopedic surgeon with Torrance Memorial Physician Network, she sees a gamut of foot ailments—from sprains, tendonitis and fractures to arthritis and complications from diabetes.

“My goal is to get patients back to their activities, back to the shoes they like to wear, without pain,” Dr. Zickuhr explains. “I see a whole host of problems. Every patient is unique.”

That said, foot and ankle injuries most often result from overexertion, complications from diabetes or plain bad luck. The good news: There are steps you can take to avoid pain and injuries from overuse.

Practicing good form and technique when exercising is important, but even before lacing up your running shoes you can minimize your risk of injury by choosing shoes that have good shock absorption and arch support. Once your shoes are on, “Make sure you do a light warm-up before you exercise.”

Stress injuries often begin with mild aches that worsen, Dr. Zickuhr adds. “Listen to your body. If it’s giving you signs, don’t ignore it.”

The Importance Of Physical Therapy

For people who do experience a foot or ankle condition—from tendonitis to plantar fasciitis—physical therapy is as important as the initial treatment, Dr. Zickuhr says. That’s where Richard Shen, DPT, comes in. Shen, a physical therapist at Torrance Memorial’s South Bay orthopedics clinic, sees a lot of patients who’ve simply overdone it.

One of the most common injuries—ankle sprain—can be caused by something as simple and unavoidable as stepping off a curb the wrong way. Initially, the best treatment for these and similar injuries is simple: rest, ice and anti-inflammatories to reduce swelling and pain. After that, physical therapy can help “retrain” the ligaments and muscles to work together correctly.

The foot is part of a “kinetic chain,” Shen explains, linking the foot, ankle, knee and hip. A foot or ankle injury can affect the entire body—up into the core muscles and the spine—so orthopedic physical therapy focuses not only on the foot and ankle but on the entire kinetic chain, helping the patient improve flexibility, regain balance and return to a normal gait.

Unlike sprains, tendonitis and similar complaints, some ankle injuries can cause a problem long after they occur, such as arthritis. Using the ankle joint—walking and jumping—can cause inflammation and pain in the short term, joint stiffness and eventually bone spurs and arthritis, Dr. Zickuhr says. Although some ankle arthritis is caused by aging, most instances are the result of a previous trauma—like a bad fracture—that damages the cartilage.

While ankle arthritis may be an intractable problem, there have been advances in its treatment. “The gold standard used to be ankle fusion to correct arthritis, resulting in no motion,” Dr. Zickuhr explains. “Over the past decade, the technology for ankle replacement has really evolved. It’s now better than fusion for many patients, and people can keep some of the motion they have.”

Diabetic Complications

Another intractable problem, diabetes, is the other main cause of foot injuries. “The majority of the patients I see have problems with their feet as a result of diabetes,” says podiatrist Karen Shum, DPM. Dr. Shum, medical director of Torrance Memorial’s Amputation Prevention Center, says approximately half of people with diabetes develop a loss of sensation (neuropathy) in their feet.

Even a blister or small cut, unnoticed and untreated, can lead to an open ulcer—especially because diabetes also causes poor circulation, which leads to slower healing times and an increased risk of infection. “The problems compound with each added issue,” Dr. Shum notes.

Prevention is the best course, and the preventive measures are simple, Dr. Shum says - careful foot inspections, including top, bottom and between the toes. She also recommends closed-toe shoes for patients with diabetic neuropathy, light-colored socks to reveal stains caused by any open sore and close blood glucose control.

The Holistic Approach

Whether they’re caused by overexertion, diabetes or bad luck, foot and ankle injuries have one thing in common: pain. Integrative medicine—combining Western approaches with complementary therapies including acupressure and reflexology—can play an important role in reducing pain and helping a patient regain strength, balance and flexibility. The National Institute of Health reports a clinical trial showing reflexology is effective at reducing chronic low back pain in nurses.

“A lot of pain is caused by inflammation,” says Dr. Zickuhr. Drugs can reduce inflammation and pain, but so can acupressure, reflexology and other hands-on therapies—even simple foot massage. Foot therapy can stimulate the release of endorphins, increasing relaxation and reducing anxiety she adds. “Feet allow us a great opportunity with therapeutic touch to communicate with the whole body.” 

Happy Feet

  • Tips to keep your toes in top shape
  • Stay light on your feet. Extra pounds add to the pressure and stress your foot experiences with every step, exacerbating foot pain. Three times the body’s weight is concentrated in the feet due to gravity.
  • Wear sensible shoes. Avoid styles that pinch your toes or concentrate all of your weight on one part of your foot. Keep it cushy. As a rough guide, replace athletic shoes every 300 to 500 miles of running or jogging or every 300 hours of exercise classes.
  • Shake it out. Always do a light warm-up before exercising and end your workout with stretches.
  • Listen up. If you experience aches or pains in your feet, don’t ignore them. Work with a trainer, coach, physical therapist, podiatrist, CAM practitioner or medical professional to find the root cause and take care of it.
  • Pamper your tootsies. Foot massages and soaking can relax your feet and your whole body, stimulating the release of endorphins and reducing anxiety. Ahhh …

Keri Zickuhr, MD, is an orthopedic surgeon with Torrance Memorial Physician Network in Torrance. She can be reached at 310-517-1216.