High Heels are Worse than We Thought !

The New York Times recently ran a story on the scientific look at the dangers of high heels.  (http://well.blogs.nytimes.com/2012/01/25/scientists-look-at-the-dangers-of-high-heels/)

As podiatrist we see the changes that happen to women’s feet from long term wearing of high heel including worsening bunion, hammertoes, metatarsalgia, ankle equinus, and Achilles tendinitis pathology.  In this research it was demonstrated that when women that rarely wore heels walked, their tendons (for example the Achilles tendon) elongated and stretched as expected, whereas in the group of women that regularly wore heels, their tendons were not as engaged but rather the muscle belly attached to the same tendon. This leads to more rigid function which can progress to tendinitis and potential abnormal pull.  Previous research has shown the greatest strength and efficiency of the muscle/tendon unit occurs when the muscle stays relatively the same length and the tendon lengthens.  This also happened when the heel wearing women walked barefoot.  The alteration of the muscle function puts these women at higher risk for tendinitis, especially when wearing tennis shoes and flats when more stretch is required by the tendon to place the heel on the ground.

The recommendation was not to stop wearing heels, but rather to slowly lower the heel height worn and to reserve the extra high heels for 1-2 times a week.

We can show you a dynamic ultrasound which can demonstrate this in the ACHILLES tendon right in the office.

- Dr TIMM 

Minimal Invasive Flatfoot Surgery Being Recognized in the Literature

Journal of Foot and Ankle Surgery
Volume 52, Issue 4 , Pages 432-443, July 2013

Plantar Pressure Distribution in a Hyperpronated Foot before and after Intervention with an Extraosseous Talotarsal Stabilization Device—A Retrospective Study

Plantar pressure measurements have long been used by clinicians to provide information regarding potential impairments and disorders of the foot and ankle. Elevations in peak plantar pressures or a poor distribution of these pressures can be an indication of pathomechanics in the foot. Lower extremity deficits such as sensory impairment, foot deformities, limited joint mobility, and reduced plantar tissue thickness have been associated with high plantar pressures. The total pressures, pressure distribution, and peak pressures provide useful information to evaluate the abnormal functioning of the talotarsal joint. Instability of the talotarsal joint can result in excessive forces exerted on the joints and surrounding tissues in the foot that can then lead to dysfunction of the proximal musculoskeletal kinetic chain. In the present study, we performed a retrograde analysis of the pre- and postoperative measurements of the peak plantar pressures, peak forces, and area of contact between the foot and the ground during each phase of the gait cycle for 6 patients (12 feet) who had undergone a bilateral extraosseous talotarsal stabilization procedure using a type II extraosseous talotarsal stabilization device. After the procedure, a significant reduction was seen in the peak pressures (42%) over the entire foot and a significant increase in the contact area (19.7%) between the foot and the floor. This could imply that the extraosseous talotarsal stabilization procedure was effective in stabilizing the talotarsal joint complex, thus eliminating abnormal hindfoot motion and restoring the normal biomechanics of the foot and ankle complex, as indicated by a reduction and realignment of the peak plantar pressures and forces.

In essence, from a surgical standpoint, as well as from a patient recovery standpoint, utilization of the HYPROCURE implant may improve function and redistribute abnormal forces in the foot which may  lead to reduced symptoms in appropriate patient populations with faster recovery and improved biomechanical function.

- Dr Timm

Weight Gain is Related to Diet Soda Consumption

New data gleaned from five years of studies have shown that artificial sweeteners can lead to weight gain as the body forgets how to process real sugar.

Sweet taste without the guilt — this has long been the promise of diet sodas.

But researchers at Purdue University have found by reviewing studies done over the past five years that diet soda and other artificially sweetened products could cause the same health problems as regular soda. In review, Susan E. Swithers, a Purdue professor of behavioral neuroscience, discovered that with consuming artificial sweeteners like sucralose, aspartame and saccharin, the body loses its ability to process real sugar, which could result in weight gain.

With real sugar, messages are released to the brain and the gullet via hormones that regulate digestion and intake of food, blood sugar levels, and even perception of fullness and satisfaction from the food consumed. However, with no actual calories to process with artificial sweeteners, the body doesn't know how to react.

"You've messed up the whole system, so when you consume real sugar, your body doesn't know if it should try to process it because it's been tricked by the fake sugar so many times," says Swithers to CNN.

The end result, says Swithers, is that the body's metabolic system stops reacting to real sugars and doesn’t release the hormones that say, “That was delicious, I’m full.” This can cause an endless cycle of feeling hungry and wanting more sugar.

It has also been shown that people who regularly drink diet soda have a higher risk of weight gain, obesity and type 2 diabetes and heart disease.

However, representatives of the American Beverage Association disagree and argue that low-calorie products can be effective tools for weight control, calling the study “an opinion piece,” in a released statement, according to CNN.

Theresa Hedrick, nutrition and scientific affairs specialist for the Calorie Control Council lobbying group, told WebMD, "I think it's important to remember that low-calorie sweeteners are one aspect of a multifaceted approach to health or obesity prevention. ...They aren't magic bullets."

Weight gain is a major contributor to all foot and ankle problems, and our patients need to understand that weight loss therefore will directly impact the reduction of most foot and ankle pain. Ask us about your weight loss options today, or at your next appointment.

- Dr Timm