Stay a step ahead of clients' needs by learning to recognize the most common woes that may cause pain and disfigurement to clients' toes.
Nix Numbing Neuromas
We all know the uncomfortable sensation of a small stone jabbing the bottom of your foot every time you step — but what do you do when there’s nothing there? People with Morton’s neuroma know there’s no choice but to grit their teeth and hobble on.
Morton’s neuroma results when the tissue surrounding the digital nerve leading to the toes thickens where the nerve passes under the ligament connecting to the toe bones. As with bunions, women account for nine out of 10 sufferers of Morton’s neuroma. Unlike a bunion, however,Morton’s neuroma typically leaves no visible sign. Instead, symptoms range from pain between the toes while walking, the sensation of having a stone in the bottom of the shoe, and a burning pain in the ball of the foot that may radiate into the toes. They may also experience numbness in the toes.
In diagnosing Morton’s neuroma, the American Academy of Orthopedic Surgeons recommends that doctors look for a mass or “click” between the bones of the third and fourth toes (where the tissue thickening typically occurs). The doctor also will rule out arthritis or joint inflammation by checking the range of motion in the toes. An X-ray offers the final proof by ruling out stress fractures or arthritis in nearby joints.
As with bunions and hammertoes, Morton’s neuroma can result from biomechanical deformities and tight and high-heeled shoes. APMA also cites repeated stresses and trauma to the nerve as factors contributing to the condition. AOFAS cites research that concluded roomier shoes, anti-inflammatory medications, custom foot orthotics, and local cortisone injections can provide symptomatic relief. APMA recommends choosing shoes with laces or buckles that allow for width adjustment, as well as footwear with thick, shock-absorbent soles and low heels.
“The primary goal of most early treatment regimens is to relieve pressure on areas where a neuroma develops,” APMA states. Other options include special padding at the ball of the foot and custom shoe inserts. The remaining 20% who get no relief from non-invasive options may opt for surgery to remove a small portion of the nerve or release the tissue around the nerve.
Without diagnosing the condition, advise clients who complain of the above symptoms to seek treatment from a podiatrist — but they can safely wait until after they’ve received their pedicure. Show the same considerations for patients with symptoms ofMorton’s neuroma as you would for patients with bunions and hammertoes, even if the problem isn’t as readily apparent.
10 Shopping Tips to Make the Shoe Fit
According to the American Orthopaedic Foot and Ankle Society (AOFAS), most foot disorders can be tied to improperly fitted shoes. Women are the worst offenders, bowing to the dictates of fashion rather than comfort by donning constricting stockings and topping them with high-heeled shoes and styles with narrow toe boxes. So it should come as no surprise, says the organization, that more than 90% of foot surgeries to correct deformities such as hammertoes and bunions are performed on women.
Help your clients avoid becoming a statistic by following these 10 tips from the AOFAS and the American Podiatric Medicine Association (APMA) when shopping for stockings and shoes.
1. Invest in high-quality stockings that fit properly. APMA notes that the stretch mechanism of inexpensive nylon pantyhose constricts normal expansion of the foot while walking, which can contract the toes.
2. Nylon stockings also promote friction and perspiration, creating the ideal environment for a fungal infection. Whenever possible, wear socks made of cotton or newer synthetic materials that wick moisture away from feet.
3. Shop for shoes late in the day, when feet are largest. Bring the type of socks or stockings you’ll regularly wear with the shoe style you’re seeking.
4. Have both feet measured for length and width every time you shop. Understand, though, that sizes vary by brand and even style, so try on every pair of shoes.
5. Fit shoes to the largest foot, allowing 3/8- to 1/2-inch space between the tip of your longest toe (which isn’t always your big toe) and the end of the shoe.
6. Choose shoes that conform to the shape of your foot. The toe box (the area of the shoe where the toes reside) should allow space for you to freely wiggle all of your toes. The heel of the shoe should fit firmly, with minimal slippage. Finally, the ball of your foot should fit at the widest part of the shoe, which is where the shoe is designed to flex.
7. Flat shoes (no higher than a one-inch heel) are the best choice for optimum foot health. The best all-purpose shoe, says APMA, “is a walking shoe with ties, a Vibram type composition sole, and a relatively wide heel no more than a half or three-quarters of an inch in height.”
8. If you must buy heels, AOFAS recommends limiting the height to two inches or less, and wearing them no longer than three hours at a time. Alternate with good quality flats or athletic shoes.
9. Choose shoes for the intended activity. AOFAS, for example, has seven sub-categories for athletic shoes based on usage demands. For example, the association deems a soft upper, good shock absorption, smooth tread, and a rocker sole design as key qualities in a walking shoe. In contrast, AOFAS recommends judging a jogging shoe based on cushioning, flexibility, control and stability in the heel counter area, lightness, and good traction.
10. Walk around the store several times to make sure the shoes fit and feel good. Don’t purchase shoes that feel too tight, expecting them to stretch. Know the store’s return policy; if possible, “test-walk” the shoes in your home for a few hours.