As the sportsman’s injury, plantar fasciitis makes sports headlines in the USA, UK podiatrist, Martine Abrahams sheds some light on this common, often debilitating condition

High profile athletes might create headlines, but this painful condition can affect us all.

The plantar tendon and its function:

Albert Pujols, player for Los Angeles Angels of Anaheim, the latest elite athlete left sitting on the bench, thanks to plantar fasciitis

The plantar tendon runs the length of the bottom of your foot, spanning the area from the base of the toes to the front of your heel. The two ends of the tendon attach at the base of the toes and at the front of the heel bone by means of fascia, a strong fibrous membrane. The plantar tendon keeps the arch of the foot from flattening completely when the foot bears weight, providing cushioning and shock absorption during walking, running or standing. This tendon also allows you to point your toes.

Albert Pujols, player for Los Angeles Angels of Anaheim, the latest elite athlete left sitting on the bench, thanks to plantar fasciitis.

What is Plantar Fasciitits?
When the plantar plantar fascititis 1fascia tissue is stressed, small tears can occur, which in turn, causes extreme pain during movement or even weight bearing – or any movement that creates a pull on the tendon.
Stressors can be varied in nature and include: regular exercise/sport, heel striking during striding, tight calves, inflexible Achilles tendon and wearing high heels.

 

 

Other common causes of plantar fasciitis include:

  • Wearing inflexible or worn out shoes
  • Very low or high arches
  • Being overweight
  • Spending long hours on your feet
  • Tight calf muscles or tight/stiff ankle muscles
  • Walking barefoot in soft sand for long distances
  • Those with natural flat feet (hyper-pronation) seem to suffer this condition more than others

Symptoms of Plantar Fasciitis:
Pain can be extreme and is often felt on the underside of the heel and more intense at the start of the day: “You almost want to pee in your bed rather than go to the bathroom,” Pujols told USA TODAY Sports. “It’s really painful in the morning.”

Treatment:
This condition can be difficult to treat and, perhaps most annoying for those who enjoy exercise, is that the main solution is rest, combined with physiotherapy, anti-inflammatory medications, corticosteroid injections and/or night splints to stretch the injured fascia.
As a short-term pain relief measure, you can roll the bottom of the foot back and forth over a tennis ball or cold bottle of water, to gently stretch out the tendon and disperse the fluid that pools there.

Stretching exercises can also help:

Orthotics can be worn to help support the foot arch:

Ultimately, prevention is probably better than cure where plantar fasciitis is concerned. Wear good shoes with adequate arch support; stretch the area well before and after exercise and regular foot massages will all help.

Festival-goers BEWARE – fungal spores lurk in dark, damp conditions, waiting to take hold in those vulnerable nail beds!

glast sunshineGlastonbury Festival 2013 is upon us and I hope all you intrepid campers have fun in the sun, but, JUST in case the British summer does what it does best, please remember to take good care of your feet. Clearly foot care will not be your number one priority, but maybe it should move up the list – at least a little!

Why? Fungal spores love dark, damp and dirty conditions and the fields of the Glastonbury Festival provide the perfect breeding ground – especially when the heavens open!

During the summer months I see an increasing number of holidaymakers who made the brave decision to camp in the UK, only to come home with fungal nail infections and Athlete’s Foot.
Fungal spores enter via any small break in the skin integrity and soon take hold. Once established, the infections can be difficult to eradicate.

Here are some practical tips to help avoid nail fungal infections during the long weekend:

  • Trim your nail short before you go
  • Dry feet thoroughly after bathing – try to keep your towel clean and dry (!)
  • Wear 100% cotton or wool socks – helps absorb the sweat and moisture
  • Wear shoes that have wide space for your toes to ‘breathe’
  • In wet and moist areas, avoid walking in barefoot
  • If possible, wear shower shoes, sandals or flip flops when going to public areas
  • Before going to bed, try to thoroughly dry your feet
  • NEVER share shoes and sandals with others
  • Avoid injury to nails, nail beds, and nail plates

If you do suspect a fungal nail infection has taken hold, then book in to see your local podiatrist. Over-the-counter solutions are not particularly effective and you may well need a more sophisticated treatment such as state-of-the-art Lunula Laser.

Symptoms of nail fungus:

  • Thickened nails
  • Crumbly or brittle nails
  • Nail distorted in shape or separated
  • Nail with no lustre or shine
  • White, yellow or brown coloured nail

glast wet 1How does it work? Unlike conventional solutions, the Lunula Low Level Laser is the first treatment to tackle the root cause of nail fungus – not just the symptoms. Known as the ‘COLD’ laser – this new device does not rely on heat to treat, instead utilises two light wavelengths, 635nm and 405nm, to tackle differing cell membranes.

Have a fabulous time – if nothing else, keep your feet happy by avoiding walking barefoot around the venue, and let’s hope you will all be basking in sunshine. (I’ll save my sunscreen lecture for next year!)

Groundbreaking ‘cold’ laser battling locker room foot fungus (onychomycosis). 2013 has already seen a dramatic increase in number of cases – possibly due to record breaking wet weather

Athletes beware, silent and unsightly, fungal spores lurk in dark, damp, warm places, waiting to get a hold through chapped or cut skin

trainers in rainLatest, technological advance in laser therapy produces a device that delivers light waves directly to the cause of the infection, killing spores and yet is PAIN FREE – truly revolutionary.

Until now, treatments for fungal nail infections have been rather hit and miss, with oral medication causing side effects, topical treatments unable to penetrate the nail bed and surgical options limited to complete removal of the nail. The PinPointe Foot Laser proved a useful (but quite uncomfortable) remedy. In 2012, the Rolls Royce of foot lasers launched – the ‘cold’ laser or Lunula Low Level Laser – and is now in the UK, revolutionising fungal treatments. Not only PAIN FREE, this innovative technology tackles the underlying cause of the infection, rather than just the symptoms.

Laser specialist podiatrist, Mrs Martine Abrahams of the London Nail Laser Clinic, owner of the first UK ‘cold’ laser: “We have always seen a steady number of athletes seek us out for fungal treatments, but for the last 2 months, we have seen a 40% increase on last year. The condition is both unpleasant and unsightly and will not disappear on its own. This surge has to be explained by the horrendous weather we have had to tolerate this winter.”

Fungal spores find their way in via an impaired nail seal and thrive in the damp, dark conditions found in an unventilated shoe or trainer. Add other factors to the mix such as dirty nail cutting equipment, smoking, poor foot hygiene, exercise trauma, ill-fitting footwear and medical conditions such as diabetes or psoriasis, and a rip-roaring infection can result.

Symptoms of nail fungus:
• Thickened nails
• Crumbly or brittle nails
• Nail distorted in shape or separated
• Nail with no lustre or shine
• White, yellow or brown coloured nail

How does it work? Unlike conventional solutions, the Lunula Low Level Laser is the first treatment to tackle the root cause of nail fungus – not just the symptoms. Known as the ‘COLD’ laser – this new device does not rely on heat to treat, instead utilises two light wavelengths, 635nm and 405nm, to tackle differing cell membranes. The light is passed over the whole foot, which has a four-fold benefit:
1. stimulates and improves nail bed blood supply (great news for diabetic patients)
2. improves immune response
3. breaks down the fungal cells walls by disturbing their oxygen content, killing spores
4. it has also been seen to improve Athlete’s Foot

The London Nail Laser Clinic opened in 2009 by husband and wife podiatrist team, Martine and Michael Abrahams. With more than 30 years combined experience, the Abrahams’ have become widely accepted amongst peers as experts in laser foot therapies. UK pioneers of the PinPointe Foot Laser, Martine and Michael recognised the improved benefits offered by the Lunula Laser system, and were the first to bring it to the UK in the autumn of 2012. With only two systems in the UK, the London Nail Laser Clinic is well positioned to become the centre of excellence for all foot related issues.

Leading Podiatrist, Martine Abrahams on GOUT – “the disease of kings” or “rich man’s disease”

The agony of goutThe topic for my blog this month is gout – an unpleasant and often debilitating disease, which can put you out of action for several weeks.  There have been a number of high profile sufferers throughout history – Henry VIII, Pavarotti, Jim Belushi and more recently, Jared Leto, who contracted gout symptoms after piling on 60lbs for a film role.

The incidence of gout has increased over the past few decades and now an estimated 1-2% of the Western population are affected by it at some time during their lives.  The main reasons for this trend seem to be the Western lifestyle/diet and longer life expectancy.

Gout is a type of arthritis, in which crystals of uric acid produced by the body, can form inside joints.

 

The most common symptom is sudden and severe pain in the joint, along with swelling and redness. The joint of the big toe is usually affected, but it can develop in any joint.

Symptoms can develop rapidly to their worst point in 6-24 hours and usually last for 3-10 days (this is sometimes known as a gout attack). After this time, the joint will start to feel normal again and any pain or discomfort should eventually disappear completely.

Most people with gout will have further attacks in the future.

The crystals may cause two problems:

  • Some may spill over into the soft lining of the joint (synovium), which causes the pain and inflammation associated with gout
  • Some pack together to form hard, slowly expanding lumps of crystals (“tophi”) which can cause progressive damage to the joint and nearby bone; this eventually leads to irreversible joint damage which causes pain and stiffness when the joint is being used

Factors that increase your risk of gout include:

  • age and gender
  • being overweight or obese
  • high blood pressure or diabetes
  • close relatives with gout (gout often runs in families)
  • long-term kidney problems that reduce the elimination of uric acid
  • a diet rich in purines; such as frequently eating sardines and liver
  • drinking too much beer or spirits – these types of alcoholic drinks contain relatively high levels of purines

There are two main goals in treating gout, relieving the symptoms with painkillers such as non-steroidal anti-inflammatory drugs (NSAIDs) and preventing future attacks with Allopurinol which can help lower levels if uric acid.  Lifestyle changes can also help – reducing weight and alcohol intake.

There is some good news for us women – men are more likely to suffer gout, as oestrogen reduces a woman’s levels of uric acid by increasing excretion of uric acid via the kidneys.  Sadly however, we catch up with men after menopause!

Gout can be very painful and distressing, but if you do suffer from acute episodes don’t despair, as attacks are usually short lived and lifestyle changes combined with anti-inflammatories can help a great deal.