You’ve probably seen clothing that’s purportedly ‘one size fits all.’ As though a scarf designed for a giraffe would fit on a pug dog. Or a jacket suited for a wallaby could work well for a rhino. Not that we’re quite as different as these animals, but all too often, t-shirts or hats or (heaven forbid) shoes that are produced with the ‘one size fits all’ mentality fit a very few somewhat well, but are voluminous for some, and way too tiny for others. Or the size is right, but the cut of the thing is all wrong. Perhaps products like this should be known as ‘one size fits most badly.’ The truth is that, while our bodies are all pretty much human-shaped, we have substantial differences between individuals. These differences are significant enough that mass-produced clothing or footwear can be uncomfortable, or worse, damaging. This is especially true of foot orthoses.

Orthotics really need to be calibrated to your specific foot in order to work well. It’s like getting a prescription for glasses. You wouldn’t give everyone who’s nearsighted the same eyeglasses, would you? Of course not! And just as optometrists need to evaluate people’s eyesight to determine the specific eyeglass shapes that are right for them, so too do trained podiatrists need to evaluate patients’ feet to design orthotics that fit their needs.

Feet are kind of funny things, though. They need to be flexible in order to adapt to changes in terrain (a state known as pronation), and they also need to be rigid in order to give us leverage as we take a step (a state known as supination). The problem is that many people have trouble with over-pronation of their feet. This is probably due to our being, as a whole, a bit (ahem) larger and less active, which leads to more downward stress on the feet, and also to the harder flooring we tend to be exposed to. When the ligaments of our feet have stretched out from this stress, they can no longer provide the rigid structure needed in supination.

As people with over-pronated feet walk around, their feet attempt to compensate for the lack of rigidity. Unfortunately, this compensation puts strain on parts of the foot that aren’t really equipped to take it, and can lead to complications such as bunions, plantar fasciitis, neuromas, stiff big toe joints, and even issues further up in the body like the knees, hips and lower back. These problems can be treated in many different ways, but to really heal, it’s important to correct the improper function of the foot that’s causing the problems.

This is where orthotics come in. Unfortunately, as mentioned above, many orthotics manufacturers adopt a ‘one size fits all’ approach to inserts that are supposedly custom-made. They may have doctors simply take scans of a patient walking across a pressure plate (which offers only a one-dimensional view of the foot), or doctors may take casts of a patient’s foot in an improper position. Proper casting of the foot in the corrected position ensures that orthotics are made that will support the arch of the foot properly. The height of the arch as well as the three-dimensional shape of the foot must be taken into account, as well as how much the patient weighs, how flexible the foot is, and what kinds of activities the patient engages in. Taking all of these factors into account when shaping orthotics helps these inserts to be as supportive as possible for your individual needs.

Okay. So sometimes ‘one size fits all’ works pretty well, like with baseball caps or mumus. But do you really want to take that approach with your feet? Getting expertly prescribed and crafted orthotics can mean the difference between support and healing, or more pain and problems. So, get those mass-produced caps and robes if you must, but let your podiatrist prescribe the orthotic that is 100% custom-fit for you.

The stats helper monkeys at WordPress.com mulled over how this blog did in 2010, and here’s a high level summary of its overall blog health:

The Blog-Health-o-Meter™ reads Fresher than ever.

A Boeing 747-400 passenger jet can hold 416 passengers. This blog was viewed about 2,900 times in 2010. That’s about 7 full 747s.

In 2010, there were 43 new posts, growing the total archive of this blog to 53 posts.

The busiest day of the year was July 19th with 51 views. The most popular post that day was Heel Pain AKA Plantar Fasciitis – What It Is and What You Can Do About It.

Where did they come from?

The top referring sites in 2010 were puebloankleandfoot.com, facebook.com, righthealth.com, search.aol.com, and podiatry.wordpress.com.

Some visitors came searching, mostly for sweaty feet rash, nerves in your foot, lumpy feet, neuromas in feet, and podiatry.

Attractions in 2010

These are the posts and pages that got the most views in 2010.

Heel Pain AKA Plantar Fasciitis – What It Is and What You Can Do About It May 2010
2 comments

Neuroma – The Ticked Off Nerve In Your Foot April 2010
5 comments

Diabetic Foot Care: 8 Things To Avoid If You Have Diabetic Peripheral Neuropathy March 2010
1 comment

Diabetes: Top 6 Foot Problems You Should Look For February 2010
1 comment

Lumpy Feet – Do You Have Them? March 2010
2 comments

People have a sort of love-hate relationship with winter. We tend to love winter sports, like skiing, snowboarding, sledding, and snowball-pelting. But driving around on icy roads is anything but enjoyable (unless you actually enjoy unintentional 360s on the highway), and winter is, let’s face it, just darn cold. The truth is that as fun as building snowmen and snow forts can be, the cold of winter can actually be dangerous, particularly to the parts of our bodies that are furthest from our cores (like our hands and feet) and those most exposed to the cold (like ears and noses). In fact, nearly half of all frostbite cases involve the feet and ankles. If your body is exposed to cold temperatures long enough, particularly if you have circulation problems (like you do with diabetes), you may develop frostbite.

Your body has a good deal of water in it, but like any water this fluid can develop ice crystals when it gets cold enough. Ice crystals can rupture cell walls and cause cell death, and they usually form in parts of the body that have restricted bloodflow. It’s not exactly something you want to have happening to the water in your body. So, once you’ve gotten ice crystals in your extremities, you officially have frostbite.

Frostbite can vary in severity. Mild frostbite affects just the skin, although as it progresses, it will start to affect deeper tissues such as nerves, muscles, and bone. If very serious, frostbite can result in tissue death (gangrene) and amputation.

The first warning sign of frostbite is a prickly sensation in the affected body part, or mild irritation or pain in your skin. Your skin will probably look pale and feel cold. (If thawed at this point, your frostbitten skin will likely be red and painful.) As the frostbite gets worse, you may experience some dull throbbing or aching in the area, followed by numbness. You may also develop blisters, and the skin of the affected area will probably look white. Eventually, as deeper and deeper tissues are frozen, the whole area will become insensate (lose all sensation), and will feel solid, like a block of wood. Once blood vessels have been frozen, the area may blacken and die.

Obviously, warming up the affected body part is important in administering first aid. However, if you’re unable to keep the body part warmed up before getting medical help, it’s probably best to wait to warm it until afterward, since damage can be worse from re-freezing than from the original frostbite itself.

First of all, you’ll want to get somewhere warm and seek medical attention as soon as possible. Remove any wet clothing, since wet clothes provide almost no insulation from the cold, and can actually draw heat away from the body. Wrap the affected area (in this article, of course, the focus is on the feet) in sterile bandages.

If medical attention isn’t available immediately, you’ll need to warm up the feet yourself. Immerse them in warm (NOT hot) water (about 100º Fahrenheit) for about 20 to 30 minutes (keep warm water circulating to maintain the temperature) until you’re able to feel your feet fully again. Warning: You’ll likely experience burning pain as sensation returns. Fully thawed feet will have soft (not hard, frozen) skin and will have regained color. You can also repeatedly apply warm cloths to the affected area if you cannot immerse it.

1) DON’T go around walking on your feet, either. You should really not move the frostbitten area at all if you can help it.

2) DON’T use direct heat like a fire or hair dryer, since the numbed tissue won’t be able to feel the heat, and can be burned easily.

3) DON’T try to warm your feet by rubbing or massaging them, since this can actually seriously damage frozen tissue.

4) DON’T pop or otherwise disturb the blisters on frostbitten skin, or disturb gangrenous (blackened) skin.

5) DON’T smoke or drink alcohol while you recover from frostbite, since both can impair your circulation and slow or prevent full healing.

You can do a lot to prevent frostbite, including the following:

1) DO check the weather. If temperatures are expected to be extremely cold, particularly wet or especially windy, you may want to reschedule your winter excursion for another time.

2) DO wear dry, well-insulated clothing for the outdoors. Avoid tight clothing and cramped conditions, since these can reduce bloodflow and make you more prone to frostbite. Wearing mittens (rather than gloves), putting on clothing that resists wind and water, layering your clothes, donning two pairs of socks, and sporting winter hats and scarves are all good ideas when the weather gets chilly.

3) Do avoid smoking and alcohol before going out (and while you’re out), since this can affect your circulation and make frostbite more likely. Some medications and medical conditions (such as diabetes) can also reduce circulation. Discuss these with your doctor for recommendations on dealing with cold temperatures.

4) DO stay hydrated and get plenty of rest.

5) If you do start to feel pain or tingling in your extremities – DO find a warm place as soon as you can. If you’re caught in a snowstorm, keep up physical activity to keep your body warm and seek shelter as quickly as possible.

There’s really no reason why you shouldn’t enjoy winter. (Even if shoveling snow is on your list of the 10 worst activities ever.) Just prepare yourself properly for the cold, and winter won’t be your enemy—it’ll be more like the weird uncle who comes a little too early and stays a little too long at family gatherings, but sometimes has pretty good stories to tell.

Prosthetic limbs aren’t really anything new. The ancient Egyptians first developed fiber-based artificial limbs thousands of years ago. Later prosthetic devices were made of wood and metal, leather and paper, and, more recently, plastic, aluminum and silicone. But recent innovations in the field of prosthetics have brought us closer than ever to making artificial legs and feet that feel like walking on the real thing. And we have one man in particular to thank for that.

Hugh Herr was only 17 when he lost both feet to frostbite. He and a friend had gotten lost in a January snowstorm while climbing, and spent three days huddled together in the freezing cold. Tragically, a member of the search party was killed by an avalanche, and Jeff Batzer, Herr’s climbing companion, lost part of his left leg, his other toes, and some of his fingers. Hugh Herr also had significant frostbite damage, and had to have both legs amputated a little below the knee.

While the loss of his lower legs was difficult, Herr managed not only to salvage his life, but to make it something wonderful, a life that would benefit amputees the world over. Now working as an associate professor at MIT, Herr specializes in biomechatronics and has revolutionized the field of prosthetic devices. Herr has realized that artificial limbs don’t have to just attempt to be as good as a human foot—they can actually improve on it. He’s developed prosthetics for himself that enable him to be a better climber, giving himself greater height (to reach higher handholds) and the ability to stand on narrow ledges too slim for a human foot.

Perhaps most importantly, his forays into making intelligent and responsive prosthetic devices have produced artificial limbs that allow for walking on different terrains, including uphill (difficult at best with previous prosthetic models), and that recreate a normal human gait. Using springs, microprocessors, and a 25-volt battery, this artificial foot (the PowerFoot) reproduces (and even improves on) the human body’s use of tendons, ligaments and nerves to move the body forward, and does it even more efficiently than a fully biological human foot. A special liquid in the device thickens when exposed to a magnetic field, enabling the artificial foot to brake as needed (much as a human ankle does) when walking downhill.

While the human body has been the standard for natural beauty for millennia, Hugh Herr takes the view that artificial limbs can be as aesthetically appealing as natural limbs, or even more so. Not one to hide his work, Herr often poses for photographs with pant-legs rolled up to expose the metal-and-microprocessor devices he’s developed. And, with his slight smile and relaxed posture, he makes us all realize what a wonder these artificial limbs can be.

You’ve probably seen clothing that’s purportedly ‘one size fits all.’ As though a scarf designed for a giraffe would fit on a pug dog. Or a jacket suited for a wallaby could work well for a rhino. Not that we’re quite as different as these animals, but all too often, t-shirts or hats or (heaven forbid) shoes that are produced with the ‘one size fits all’ mentality fit a very few somewhat well, but are voluminous for some, and way too tiny for others. Or the size is right, but the cut of the thing is all wrong. Perhaps products like this should be known as ‘one size fits most badly.’ The truth is that, while our bodies are all pretty much human-shaped, we have substantial differences between individuals. These differences are significant enough that mass-produced clothing or footwear can be uncomfortable, or worse, damaging. This is especially true of foot orthoses.

Orthotics really need to be calibrated to your specific foot in order to work well. It’s like getting a prescription for glasses. You wouldn’t give everyone who’s nearsighted the same eyeglasses, would you? Of course not! And just as optometrists need to evaluate people’s eyesight to determine the specific eyeglass shapes that are right for them, so too do trained podiatrists need to evaluate patients’ feet to design orthotics that fit their needs.

Feet are kind of funny things, though. They need to be flexible in order to adapt to changes in terrain (a state known as pronation), and they also need to be rigid in order to give us leverage as we take a step (a state known as supination). The problem is that many people have trouble with over-pronation of their feet. This is probably due to our being, as a whole, a bit (ahem) larger and less active, which leads to more downward stress on the feet, and also to the harder flooring we tend to be exposed to. When the ligaments of our feet have stretched out from this stress, they can no longer provide the rigid structure needed in supination.

As people with over-pronated feet walk around, their feet attempt to compensate for the lack of rigidity. Unfortunately, this compensation puts strain on parts of the foot that aren’t really equipped to take it, and can lead to complications such as bunions, plantar fasciitis, neuromas, stiff big toe joints, and even issues further up in the body like the knees, hips and lower back. These problems can be treated in many different ways, but to really heal, it’s important to correct the improper function of the foot that’s causing the problems.

This is where orthotics come in. Unfortunately, as mentioned above, many orthotics manufacturers adopt a ‘one size fits all’ approach to inserts that are supposedly custom-made. They may have doctors simply take scans of a patient walking across a pressure plate (which offers only a one-dimensional view of the foot), or doctors may take casts of a patient’s foot in an improper position. Proper casting of the foot in the corrected position ensures that orthotics are made that will support the arch of the foot properly. The height of the arch as well as the three-dimensional shape of the foot must be taken into account, as well as how much the patient weighs, how flexible the foot is, and what kinds of activities the patient engages in. Taking all of these factors into account when shaping orthotics helps these inserts to be as supportive as possible for your individual needs.

Okay. So sometimes ‘one size fits all’ works pretty well, like with baseball caps or mumus. But do you really want to take that approach with your feet? Getting expertly prescribed and crafted orthotics can mean the difference between support and healing, or more pain and problems. So, get those mass-produced caps and robes if you must, but let your podiatrist prescribe the orthotic that is 100% custom-fit for you.

Prosthetic limbs aren’t really anything new. The ancient Egyptians first developed fiber-based artificial limbs thousands of years ago. Later prosthetic devices were made of wood and metal, leather and paper, and, more recently, plastic, aluminum and silicone. But recent innovations in the field of prosthetics have brought us closer than ever to making artificial legs and feet that feel like walking on the real thing. And we have one man in particular to thank for that.

Hugh Herr was only 17 when he lost both feet to frostbite. He and a friend had gotten lost in a January snowstorm while climbing, and spent three days huddled together in the freezing cold. Tragically, a member of the search party was killed by an avalanche, and Jeff Batzer, Herr’s climbing companion, lost part of his left leg, his other toes, and some of his fingers. Hugh Herr also had significant frostbite damage, and had to have both legs amputated a little below the knee. While the loss of his lower legs was difficult, Herr managed not only to salvage his life, but to make it something wonderful, a life that would benefit amputees the world over.

Now working as an associate professor at MIT, Herr specializes in biomechatronics and has revolutionized the field of prosthetic devices. Herr has realized that artificial limbs don’t have to just attempt to be as good as a human foot—they can actually improve on it. He’s developed prosthetics for himself that enable him to be a better climber, giving himself greater height (to reach higher handholds) and the ability to stand on narrow ledges too slim for a human foot.

Perhaps most importantly, his forays into making intelligent and responsive prosthetic devices have produced artificial limbs that allow for walking on different terrains, including uphill (difficult at best with previous prosthetic models), and that recreate a normal human gait. Using springs, microprocessors, and a 25-volt battery, this artificial foot (the PowerFoot) reproduces (and even improves on) the human body’s use of tendons, ligaments and nerves to move the body forward, and does it even more efficiently than a fully biological human foot. A special liquid in the device thickens when exposed to a magnetic field, enabling the artificial foot to brake as needed (much as a human ankle does) when walking downhill.

While the human body has been the standard for natural beauty for millennia, Hugh Herr takes the view that artificial limbs can be as aesthetically appealing as natural limbs, or even more so. Not one to hide his work, Herr often poses for photographs with pant-legs rolled up to expose the metal-and-microprocessor devices he’s developed. And, with his slight smile and relaxed posture, he makes us all realize what a wonder these artificial limbs can be.

Chances are you have probably been to a shoe store at some time in your life. Possibly recently, and possibly just this morning (where you picked up the most adorable pair of mid-calf suede boots, just perfect for sauntering around in the fall leaves). Unless you are positively a shoe junkie (and there are plenty of you out there—no shame in it, really), the sheer number of shoes, with the varieties of sizes, styles, functionality, (and sometimes even the music the shoes can play—good grief!) can be overwhelming. Fortunately, there are a few tips that may help your shoe selection just a little bit easier.

First of all, it’s probably best to make your visit to the shoe store later in the day. Feet swell a bit while you walk around, and you’ll want to make sure the shoes you select fit your feet at their largest. If the store has staff members trained in shoe fitting, have them measure each of your feet while you’re standing up. Measuring just one simply won’t do, since your feet may differ significantly in length. (If your feet do differ a bit in length, buy shoes that fit the larger foot.) Your feet may change in length as you get older, so be sure to get your feet measured every time you go shoe shopping.

Now, once you’ve found the best-looking shoe in the store (and in your size, too!), you’ll want to test it out to make sure it works for your feet. Check the heel—if it’s taller than 2 inches, you’ll probably want to avoid it. High heels can cause or exacerbate numerous problems with your feet and ankles, including bunions, hammertoes, corns, ankle sprains, neuromas (inflamed nerves), and even stress fractures.

Also, once you’ve put on the shoes, make sure your toes have plenty of room in the toe box (the area at the end of the shoe where your toes go). There should be about a half inch of space in between the end of your toes and the inside of the shoe, enough room to wiggle your toes around. If the toe box is pointed and narrow, you’re more likely to develop problems such as hammertoes and corns.

You’ll also want to make sure the widest part of the shoe corresponds with the widest part of your foot. Not all shoes will work perfectly with your feet. You may even notice that the best shoe size for you differs from brand to brand. Always pick a shoe based on comfort, not just size.

While you’re trying out your shoes, be sure to wear the type of socks or stocking you’ll be pairing with the shoes later when you go out on the town (or hiking, jogging, or country dancing). Take a good walk around in your shoes, and be sure to try out both shoes in the pair, not just one. If they feel uncomfortable at all, you shouldn’t buy them. Shoes should not require a break-in period. (Although, of course, if you develop blisters after wearing a shoe, there are products that can help.) You may have to try several pairs before you find the right one, but, if you’re especially fond of shoe shopping, that may not be a problem at all.

Buying shoes doesn’t have to be too complicated, and it may even be enjoyable. But however you do it, it’s important to select shoes that will support your feet in the thing they do best: supporting you.

We’ve all seen those disaster movies. You know, the ones where failing valves seem to be a major plot point (at least those involving overly complex machines that blow up when they encounter some unsolvable problem, like “What is love?”). Pressure builds, steam screams from fissures in the machinery, and valves fail to hold back the flood of destruction.

Okay, guys. Let’s talk a little bit about taking the time to recover from a serious injury. Take a broken foot, for instance. Now, sometimes broken bones in the foot are stress fractures (hairline cracks in the bone that develop over time), and sometimes they’re more traumatic breaks. Bone injuries can happen a lot in sports, particularly in football. Sadly, in last Sunday’s game against the New York Jets, Matthew Willis of the Denver Broncos broke his foot so badly that surgery will be necessary to fix it.  As of this blog post I am still unclear of what kind of fracture Matt sustained and cannot give an opinion about recovery times.

Visiting amusement parks can be darn good times. Being thrown around on wild roller coasters, eating too-expensive but horribly delicious food, and seeing kids get so excited about meeting their favorite cartoon character that they’re nearly fainting in your arms, all make wonderful memories (and even better photographs). Unfortunately, a visit to an amusement park also means standing in hour-long (or longer) lines, threading your way through crowds and chasing after escaped toddlers. By the end of the day your feet will probably be killing you.