Thursday, April 30, 2009

Be smart about shoe fitting

To help busy parents with shoe choices, foot and ankle surgeons recommend some simple guidelines to prevent or minimize possible foot problems from inappropriate shoes, such as painful ingrown toenails, blisters, heel pain and flat feet.

When choosing kids’ shoes, size and shock absorption are the key considerations, especially if your child has flat feet that can worsen from improper fitting or worn-out shoes. Also, a child’s foot can grow a size or two within six months, so it’s critical to allow room for growth in the toe box—about a finger’s width from the longest toe.

Snug shoes put pressure on the toes, causing ingrown nails. The nail compresses and grows down into the skin.

According to, the ACFAS consumer website, infection can occur when an ingrown nail breaks through the skin.

If there’s pain, redness and fluid draining from the area, it’s probably infected. The ingrown nail can be removed in a simple, in-office procedure. Don’t try to remove a child’s ingrown nail at home; this can cause the condition to worsen.

Tight-fitting shoes also cause blisters, corns and calluses on the toes and blisters on the back of the heels.

Never buy shoes that feel tight and uncomfortable in the store. Don’t assume they will stretch or break in over time.

Conversely, shoes that are too loose can cause problems, too.

If a shoe is too loose, the foot slides forward and puts excessive pressure on the toes.

Parents should carefully inspect both new and old shoes to check for proper cushioning and arch support.

Shoes lose their shock absorption over time, and wear and tear around the edges of the sole usually indicate it’s worn out and should be replaced. If a child keeps wearing worn-out or non-supportive dress or athletic shoes, it elevates the risk for developing heel pain, Achilles tendonitis and even ankle sprains and stress fractures.

A good tip for parents when buying new shoes: The toe box should flex easily and the shoe shouldn’t bend in the middle of the sole.

For children with flat feet, parents should buy oxford, lace-up shoes that have enough depth for an orthotic insert, if necessary.

Unfortunately, there isn’t much choice for kids with flat, wide feet. They need shoes with a wide toe box and maximum arch support and shock absorption. Slip-on loafers aren’t right for them.

Please contact Dr. Vail if you have questions about buying the correct shoe for your child. 419-423-1888 or

Wednesday, April 29, 2009

Sports Season Linked to Ankle Injuries

If your children are playing sports, pay attention to six tips that could protect them from serious ankle injuries.

Many foot and ankle surgeons notice an increase in ankle injuries among young athletes. Football, soccer and basketball are the sports most likely to lead to sprains, broken bones and other problems.

Podiatrists’ top recommendation is for parents to get ankle injuries treated right away.

What seems like a sprain is not always a sprain; in addition to cartilage injuries, your son or daughter might have injured other bones in the foot without knowing it. Have a qualified doctor examine the injury. The sooner rehabilitation starts, the sooner you can prevent long-term problems like instability or arthritis, and the sooner your child can get back into competition.

Podiatrists say parents should also follow these additional tips from the American College of Foot and Ankle Surgeons' Web site,

--Have old sprains checked by a doctor before the season starts. A medical check-up can reveal whether your child's previously injured ankle might be vulnerable to sprains, and could possibly benefit from wearing a supportive ankle brace during competition.

--Buy the right shoe for the sport. Different sports require different shoe gear. Players shouldn't mix baseball cleats with football shoes.

--Children should start the season with new shoes. Old shoes can wear down like a car tire and become uneven on the bottom, causing the ankle to tilt because the foot can't lie flat.

--Check playing fields for dips, divots and holes. Most sports-related ankle sprains are caused by jumping and running on uneven surfaces. That's why some surgeons recommend parents walk the field, especially when children compete in non-professional settings like public parks, for spots that could catch a player's foot and throw them to the ground. Alert coaching officials to any irregularities.

--Encourage stretching and warm-up exercises. Calf stretches and light jogging before competition helps warm up ligaments and blood vessels, reducing the risk for ankle injuries.

Tuesday, April 28, 2009

Prevent your child from getting this painful foot problem...

Ingrown toenails are one of the most frequent conditions podiatrists treat in children. Many kids hide their ingrown toenails from their parents, even though the condition can cause significant pain. An ingrown nail can break the skin and lead to dangerous infections.

Podiatrists blame tight shoes, tight socks and incorrect nail trimming for most cases. In others, the children may inherit the tendency for nails to curve. The following tips from the American College of Foot and Ankle Surgeons can help to prevent this problem:

Teach children how to trim their toenails properly. Trim toenails in a fairly straight line, and don't cut them too short.

Make sure children's shoes fit. Shoe width is more important than length. Make sure that the widest part of the shoe matches the widest part of your child's foot.

If a child develops a painful ingrown toenail, reduce the inflammation by soaking the child's foot in room-temperature water and gently massaging the side of the nail fold.

The only proper way to treat a child's ingrown toenail is with a minor surgical procedure at a doctor's office. Parents should never try to dig the nail out or cut it off. These dangerous "bathroom surgeries" carry a high risk for infection. Podiatrists may prescribe antibiotics to children with infected ingrown toenails.

Thursday, April 23, 2009


Many of us are welcoming the warmer weather sporting flip-flop sandals, however, their popularity among teens and young adults is responsible for a growing epidemic of heel pain in this population.

There is more heel pain than ever in patients 15 to 25 years old, a group that usually doesn’t have this problem. A major contributor is wearing flip-flop sandals with paper-thin soles everyday to school. Flip-flops have no arch support and can accentuate any abnormal biomechanics in foot motion, and this eventually brings pain and inflammation.

Many podiatrists recommend wearing sandals with reasonably strong soles and arch support.
Especially for girls and young women, thicker soled sandals with supportive arches might not be considered stylish, but if you want to wear sandals most of the time, you’ll avoid heel pain if you choose sturdier, perhaps less fashionable styles.

It is estimated that 15 percent of all adult foot complaints involve plantar fasciitis, the type of heel pain caused by chronic inflammation of the connective tissue extending from the heel bone to the toes. Being overweight and wearing inappropriate footwear are common contributing factors.

The pain is most noticeable after getting out of bed in the morning, and it tends to decrease after a few minutes and returns during the day as time on the feet increases. Not all heel pain, however, is caused by plantar fasciitis. It also can occur from inflammation of the Achilles tendon, bursitis, arthritis, gout, stress fractures, or irritation of one or more of the nerves in the region. Therefore, diagnosis by a foot and ankle surgeon to rule out other causes is advised.

Initial treatment options for heel pain caused by plantar fasciitis should include anti-inflammatory medications, padding and strapping of the foot and physical therapy. Patients also should stretch their calf muscles regularly, avoid wearing flat shoes and walking barefoot, use over-the-counter arch supports and heel cushions, and limit the frequency of extended physical activities.

Most patients with plantar fasciitis respond to non-surgical treatment within six weeks. However, surgery is sometimes necessary to relieve severe, persistent pain.

Wednesday, April 22, 2009

In Honor of Earth Day - April 22, 2009

Looking for a creative way to recycle? Try this!

Clean plastic bottle
Double-sided tape
Yarn (we used 24 yards to cover a 10-inch-tall bottle)
Wooden spoon
Paint, markers, or crayons
Optional Materials
Accessories such as googly eyes, ribbon, beads, and tacky glue

1. Place 4 equally spaced strips of double-sided tape vertically up the sides of the bottle. Wrap double-sided tape horizontally around the bottom and top edges of the bottle and around any contours where the yarn might slip.

2. Attach one end of the yarn near the bottom edge of the bottle with a small piece of double-sided tape. Then, working from the bottom up, wrap the entire bottle with the yarn. Make your rows tight enough that you no longer see the plastic, but not so snug that the yarn is stretched thin.

3. To switch to a different color, simply knot the new shade to the old and snip off any dangling threads. Once the entire bottle is covered, tie off the yarn at the neck.

4. Draw facial features on the bowl of the spoon with paint, markers, or crayons. Decorate the rest of the doll any way you like. You might glue on yarn hair, tie on a pretty necklace, or add clothing, such as a doily skirt. Once you're finished, drop the handle of the spoon into the bottle. (If yours is top-heavy, put some dry lentils or rice in the bottom.)

Tuesday, April 21, 2009

Overweight Children and Foot Problems

Many podiatrists say they are noticing more and more overweight and obese children with foot and ankle pain in their examining rooms, mirroring a national epidemic of childhood obesity.

An estimated 16 percent of U.S. children ages six to 19 are overweight, according to the Centers for Disease Control and Prevention. Poor diet, lack of exercise and genetics can play a role. A “vicious cycle" of foot pain and obesity traps some children.

“You want overweight children to exercise and lose weight, but because of their weight, their feet hurt and they can’t exercise.” How can this problem be solved?

The foot is a complex structure consisting of 26 bones, 33 joints and more than 100 muscles, tendons and ligaments. Last November, researchers in Britain reported “alarming new evidence that childhood obesity changes foot structure and results in instability when walking.” Being overweight flattens the foot, straining the plantar fascia, a band of tissue which runs from the heel to the base of the toes, causing heel pain.

Because the heel bone is not fully developed until age 14 or older, overweight children are more prone to Sever’s disease. Although not an actual disease, it involves an inflammation of the heel’s growth plate due to muscle strain and repetitive stress. Walking makes the pain worse. Being overweight may also cause stress fractures, or hairline fractures (breaks) in a child’s heel bone.
According to the ACFAS Web site, some overweight children suffer foot pain from congenital or inherited foot conditions, such as bunions, hammertoes, pediatric flatfoot and tarsal coalition, an abnormal connection between two or more bones in the back of the foot. Children with these deformities may be less active because of pain. Sometimes a child will complain of calf or arch pain. This results from a flatfoot that is flexible. The collapsing of the arch can require more energy, making it more difficult for a child to walk and run.

Foot and ankle surgeons treat many overweight children with custom orthotic devices (shoe inserts), physical therapy and other conservative measures to reduce or eliminate pain. But treating painful feet and ankles is only part of the childhood weight loss equation.

Foot and ankle surgeons can reduce the aches and pains so these children can run around and play like all the other kids, but parents need to take responsibility for watching their children’s’ lifestyles and diet.

Thursday, April 16, 2009

Toes and feet can take a beating, especially from sports...

Snug cleats, repeated kicking can contribute to a painful problem:

Foot and ankle surgeons treat many soccer-playing children for ingrown toenails. Doctors blame improper toenail trimming, snug soccer cleats, and repetitive kicking for creating this painful problem.

“Many kids wear hand-me-down cleats that don’t fit,” says one podiatrist. “Older children like tighter cleats. They believe it gives them a better feel for the ball and the field.”

Many podiatrists say there are steps soccer moms and dads can take to prevent their children from suffering a painful ingrown toenail. First, teach children how to trim their toenails properly. Trim toenails in a fairly straight line, and don’t cut them too short. Second, make sure cleats fit properly.

A child’s shoe size can change within a single soccer season.

If a child develops a painful ingrown toenail, soaking their foot in room-temperature water and gently massaging the side of the nail fold can reduce the inflammation. But doctors warn parents against home treatments, which can be dangerous. The American College of Foot and Ankle Surgeons lists myths about ingrown toenail home treatments on its Web site,

If your son’s or daughter’s ingrown toenails show signs of infection, it’s definitely time to seek medical care.

A foot and ankle surgeon can remove a child’s ingrown toenail, and prevent it from returning, with a simple, 10-minute surgical procedure. During the short procedure, the doctor numbs the toe and removes the ingrown portion of the nail. Various techniques can permanently remove part of a nail’s root too, preventing it from growing back.

Most children experience very little pain afterwards and can resume normal activity the next day.

If you child has an ingrown toenail, do not delay, call Dr. Vail for an appointment!

Wednesday, April 15, 2009

More Books About Feet!

It's Always Good To Check...

Parents anxiously await their child's first steps. All eyes and video recorders are positioned to catch this momentous occasion. However, according to the America College of Foot and Ankle Surgeons, all the steps a child takes after that are just as important.

ACSAS recommends that parents observe their child's walking and shoe wear patterns. Things to watch out for include:

Walking with the toes pointed inward or outward is a common cause for concern. In some cases, these types of walking are normal. Excessive out-toeing or in-toeing needs to be evaluated.

Excessively flat feet - This is a common finding when infants first begin to walk. As they become older, this becomes less of an issue. Excessively flat feet may become painful with time and may need to be treated for this reason.

High arches - This is not a part of normal development and it needs to be investigated to be sure it is not part of a larger problem.

If you have concerns about your child's feet, please call Dr. Vail to set up an appointment! 419-423-1888

Tuesday, April 14, 2009

Some Interesting Foot Facts!

Twenty-five percent of the bones in the human body are located in the feet.

The average person walks about 10,000 steps a day. During a lifetime it is thought that a person has walked enough steps to have traveled around the planet more that four times, which is approximately 115,000 miles!

The largest feet in the world belong to Matthew McGory who lives in the USA. He is 7 feet, 4 inches tall and has a shoe size of 28.5!

One in four children sleepwalk at least once between the ages of 7 and 12.

You need to use 200 muscles in your body to walk.

The feet contain approximately 250,000 sweat glands that produce as much as half a pint of moisture every day.

Feet are strong enough to support up to four times the body's weight during high impact activities, yet sensetive enough to detect a grain of sand.

Friday, April 10, 2009

Be Cautious of Flip-Flop(ers)

Flip-flops are the summer footwear of choice for many kids. But while these sandals are inexpensive and stylish, they don’t cushion or support the foot, leading to problems. After wearing flip-flops all summer, some kids will develop foot pain and even injuries. Dr. Vail reminds parents and kids that foot pain isn’t normal and can be reduced or eliminated.

“People may not realize that even into your mid-teens, there’s new bone growing in your heel,” says Dr. Vail. “Flip-flops don’t cushion the heel, so repetitive stress from walking can inflame that heel bone growth area and cause pain and tenderness.”

Heel pain and arch pain rank among the most common complaints among kids who wear flip-flops. Other flip-flop feet problems include inflammation of the Achilles tendon, painful pinched nerves, sprained ankles, broken or sprained toes, cuts and scrapes, plantar warts, Athlete’s foot, and callus build-up on the heels and toes.

Foot and ankle surgeons can usually reduce or eliminate foot pain with simple treatment methods including stretching exercises, ice massage, anti-inflammatory medications, and custom or over-the-counter shoe inserts.

Thursday, April 9, 2009

If the Shoe Fits... Does Your Child Have Healthy Feet?

It seems that every few months your children need new shoes and you may try to stretch your budget by fixing their current shoes or by giving them a pair a big sister or brother has discarded. Unfortunately, either solution may not be good for the feet of the child who needs a shoe fix. Some health issues caused by improperly fitted, worn out or hand me down shoes include plantar fasciitis, Morton's neuroma, excessive sweating, hammertoes, corns, bunions and blisters.

Feet are critical to the overall health of the human body. Your children have 26 bones in their feet with almost half of them located in the toes. In addition to bones they have 19 muscles, 107 ligaments and 33 joints making their feet incredibly complex. As an adult you know from experience what problems foot pain or injuries can cause in your day-to-day life and this is even more frustrating for a child.

One way you can reduce or eliminate the possibility of problems with your children's feet is by inspecting their feet and shoes frequently. A foot inspection will alert you to problems your child has not yet found painful, and a shoe inspection will help you decide whether or not you want to repair or replace them. Following is a suggested checklist of issues to be considered.

Let's start with the foot inspection:
1. What is the size of the feet being inspected? Most people have one foot larger than the rest. If you are not sure of the size take your child to a shoe store to be sized properly.

2. Are there any obvious defects such as blisters, fissures, bunions, corns or spots that are just plain red and irritated?
3. Do you see any large patches of excessively dry skin?
4. Give your child a foot massage and watch for signs of pain or cramping.
5. Make note of any problems that necessitate a visit to your pediatrician.

Next, we'll move on to the shoe inspection:
1. Pay attention to the size of the shoes as compared to the current size your child wears. It may be possible to continue wearing shoes slightly bigger than the current size but never let them wear shoes that are to small.

2. How does the sole of the shoe look? Was it thin to begin with or has it thinned in response to use?
3. Is either heel loose?
4. Ask your child to put the shoes back on and check if they have adequate toe room or places where there the shoe causes friction against their skin.
5. Have your child walk in the shoes so you can see their gait.

When you have finished looking at your child's feet and shoes consider if you can repair any issues without harming the feet that wear the shoes. If there is no toe room but the shoes otherwise fit you may be able to stretch the toe box with stretching spray and a shoe stretcher depending on the fabric of the shoes.

If the soles of the shoe have become very flimsy or stretch easily in response to pressure then your child may develop plantar fasciitis which is a painful inflammation of the connective tissues in the arch of the foot. If you can flex the shoes below the toe box then the shoes need to be replaced.

When the heel of your child's shoes are too loose compared to the rest of the shoe, use a heel insert made for children. You want to avoid having your child develop hammertoes caused by using their toes to keep the shoes from slipping off. Calluses on the tops of the toes is a giveaway that the heels of the shoes are too lose.

If the shoes fit well but there a few spots of pressure, try using different socks. Socks now come in a variety of thickness and weight. Your little one may need a thicker sock to prevent pressure wear particularly if they often wear sports shoes.

If the issues with your child's feet seem ongoing despite new and well fitting shoes, they may need an orthotic device. Ask your pediatrician to recommend an orthopedist or podiatrist for an evaluation. Most orthotic devices are made of plastic and help distribute body weight evenly and realign the foot.

The feet your child is born with are the feet they need to carry them throughout their life. Paying attention to their feet can improve their overall health by eliminating leg, back and neck pain. A child will walk the distance around the earth three or four times during their lifetime.

Don't you want to make that journey as pain free and comfortable as possible?

Be sure to set up an appointment with Dr. Vail to make sure you have the right shoes for your child!

Wednesday, April 8, 2009

A Drawing Contest

The American Podiatric Medical Association sponsors a monthly drawing contest...and if your drawing is selected, you could win a new pair of shoes!

Tuesday, April 7, 2009

Not to Worry!

The following study abstract was provided by the National Center for Biotechnology Information - a service of U.S National Library of Medicine and the National Institutes of Health:

OBJECTIVE: Because the controversy about the relation of foot morphology and foot function is still present, we find it surprising that there are no studies published dealing with motor skills and athletic performance in flat-footed school children. Our aim in this study was to determine if there is an association between the degree of foot flatness and several motor skills that are necessary for sport performance.

METHODS: The feet of 218 children aged 11 to 15 years were scanned, and the arch index was determined. The value of the arch index was corrected for the influence of age, and then the entire sample was categorized into 4 groups according to the flatness of their feet. The children were tested for eccentric-concentric contraction and hopping on a Kistler force platform, speed-coordination polygon (Newtest system), balance (3 tests), toe flexion (textile crunching), tiptoe standing angle, and repetitive leg movements. Altogether, 17 measures of athletic performance were measured.

RESULTS: No significant correlations between the arch height and 17 motor skills were found. Categorizing the sample into 4 groups did not reveal any differences between the groups in athletic performance. Also, several multivariate analysis of variance sets of multiple independent variables referring to a particular motor ability were not found to be significant. The differences were not found even after comparing only the 2 extreme groups, meaning children with very low and children with very high arches.

CONCLUSIONS: No disadvantages in sport performance originating from flat-footedness were confirmed. Children with flat and children with "normal" feet were equally successful at accomplishing all motor tests; thus, we suggest that there is no need for treatment of flexible flat feet with the sole purpose of improving athletic performance, as traditionally advised by many.

Be sure to contact Dr. Vail if you have any questions or concerns.

Wednesday, April 1, 2009

No More Yellow Journalism!

Kids - are you interested in becoming a roving reporter who wants to be the one to get the first exclusive scoop on the latest news about the most stylish but yet podiatrist-approved shoes to wear at your next school dance? Check out this website and begin creating your own newspaper and you might just one day become the next Walter Cronkite!

CRAYON is a tool for managing news sources on the Internet and the World Wide Web.

CRAYON uses a simple analogy that everyone can understand - a newspaper to organize periodical information.

The result is a news page customized for you with the daily information that you are most interested in.

Happy Feet...

Happy Feet...

= Happy Kids...

= Happy Kids...

= Happy Family!

= Happy Family!