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Steven Long--Yourfootcare Podiatrist

Lu ‘Knife King’ Keshui

Yuk factor in this story: Chinese foot masseur Lu ‘Knife King’ Keshui has made a large sculpture from nail and skin clippings from his clients feet ! Mr Keshui of Wuhu, in the south eastern Anhui province 安徽 , used the clippings from 10,000 people to make sculptures of 550 people and 60 animals for his collage. I shall resist a picture !

Flip flops for revellers !


More on flip flops ! Sunny Torbay has a fun night life that seems to leave revellers without their shoes ! After a night on the happy juice the flip flops are aimed at women that have had a few too many. Costing the council some £30,000 to implement the scheme, they hope the flip flops will help prevent ankle injuries. So instead of falling off their high heels they will wear this inexpensive flat footwear–and the flip flops have a safety message about alcohol on them as well. The police have said this is just part of their drink awareness campaign and hope the scheme will help keep some of the party goers from turning up at Casualty with injuries. Interesting to see how it works out !

Risky flip flops

flip flop

They might not be the most attractive footwear but they are popular. Flip flops come in a variety of colours and styles however they have been found to alter the gait of the wearer with a potential to cause low back pain. US researchers at Auburn University recruited 39 men and women for their study in to flip flops. They recorded the patterns of walking, comparing the users also in athletic shoes. The findings indicated the wearers took shorter steps gripping their toes to hold them on. The measurement of vertical force placed on the ground along with limb angles and stride length enabled the researchers to view the changes that were happening from the foot up towards the hip. The gripping or clawing of toes to hold the flip flops on has been eliminated in other versions of the footwear. The removal of the thong from between the toes and adding a re-useable adhesive to the surface of the flip flop has produced another popular variation. The idea is that the foot sticks to the surface and eliminates the clawing. The only thing is the adhesive will not last very long if worn wet or when dirt covers the surface and probably not the easiest  item to pack away. Maybe this version may no longer produce the familiar flip-flop noise !

Get bitten by Crocs


Perhaps not the dangerous animal but the popular rubber type sandal. It seems that many find this a comfortable colourful alternative to everyday footwear. Mothers have reported that kids wearing Crocs on an escalator have almost seen their ‘baby’ crocks pulled off their feet as they get pulled in to the machinery, thankfully just part of the shoe not the foot.  As I have personally witnessed a child’s shoe getting caught at the top of an escalator and there was no misbehaviour by the child, any loose fitting footwear is potentially dangerous. Crocs might also be banned in some schools (dangerous when running around) but they have now been targeted by hospital administrators. Their crime is that the material they are made of is not anti static and can cause wild but perhaps not dangerous malfunctions in delicate equipment, there is also a potential to cause an explosion. Certainly not something that anyone would like to happen. The Crocs have been a favourite of some nursing staff but Health and Safety concerns may have something to say –the holes in the Crocs might very well be an ideal entry point for the dropped contaminated syringe or perhaps any form of, let’s say, organic matter that might find its way to your footwear, not very hygienic. So everyone has a favourite story about their Crocs–helped my sore feet?, very dangerous?, a fashion faux-pas?, very comfy?, what’s your thoughts ?

Summer time feet

cool feet 

As the weather warms up it’s time to think how to keep the feet comfortably cool. Wearing sandals instead of closed in shoes seems obvious but the inner sole of the sandal can make a difference to the way you feel. A good quality inner sole made of leather will help absorb perspiration, but the opposite is the plastic one that will sweat the feet all day. Even some expensive sandals seem to have plastic inner soles and this contributes to that horrible sticking feeling when using them. Manufacturers have thought up some clever ideas to help combat this sticky sweaty situation, one is a towelling type of insole that can be washed or exchanged for a new one. Other alternatives to help keep comfortable are based on sprays or cooling gels. Some gels can be sticky if applied too thickly but Ice Gel a cooling foot gel for hot feet is a helpful product and a spray containing cooling Menthol and Triclosan for its deodorant properties called Akileine Red, hot foot spray helps. Even the least expensive methods such as using a cool foot bath or a simple application of surgical spirit dabbed between the toes can make you feel much more comfortable.

Keep clean at the Gym

When joining a gym the first thing that happens is the induction. Learning to use the exercise equipment safely is important for your health and safety and prevents injury. Something though that doesn’t come in to mind much or is never mentioned are the hidden problems like bacteria covered equipment, stale sweat exercise mats and fungal infected floors. A good gym that recognises that many people use equipment in various states of cleanliness will provide some form of antibacterial sprays and paper towels to wipe down the equipment. If you use an exercise bike or tread mill this will provide a moment of time just to look around to see how often the equipment is cleaned. This is an exercise that may surprise you !

Although few in gyms pick up the Community-Acquired MRSA, it can trigger a lethal type of pneumonia which infects vulnerable individuals causing boils and sores, joint infections and and at worst septicaemia via open cuts and abrasions. Some clubs that issue towels to members have through incomplete or inadequate washing also passed on this bug. So take your own towel is an answer here.

Good precautions are; wipe down the equipment with the sprays provided and if none are available find out why and wear flip flops in the gym around changing areas and most certainly in showers. Another consideration is the anti bacterial Silvatec soap which kills 99.9% bacteria and produces a protective layer over the skin protecting you from harmful bacteria.

More about High Heels

high heel shoes

It would appear that the fashion for high heels is certainly not abating. Medical staff at Ninewells Hospital in Dundee report 20 new cases a month for surgical intervention. Fashion conscious ladies are simply just hobbling their way to future problems and the inevitable foot surgery. High fashion plus the fact that the shoes are worn so often and not kept just for those special occasions are contributing to bunions, neuromas and curly bent toes to name but a few. The biomechanically unsound shoes cause the ball of the foot, the metatarsal area, to be really uncomfortable. To improve comfort manufacturers have incorporated gel heels and ball of foot cushions plus soft leather uppers in to their styles and some designers advocate shoes no higher that 10cm (4ins) in their ranges. Improve comfort in your existing footwear with Invisigel ultra fine gel insoles http://www.yourfootcare.com/html/silicone_insoles_.html and ball of foot cushions http://www.yourfootcare.com/html/ball_of_foot.html

Ancient feet

cavemanIt would seem that squeezing feet in to shoes is not a new thing. A recent study in the US looked at the 40,000 year old structure of the human foot found in a cave in China. When the feet were examined for shape and bone density they showed an amazing similarity to the feet of todays shoe wearers. The early toe bones might not have had the likes of narrow footwear and high heels to deal with but as civilisation progressed skills such as shoe making using animal skins became evident from the types of tools found on archaeological digs. It was often considered that the Romans had the first footwear made from a separate upper and sole but the discovery of the ‘Iceman’ in 1991, a 5,300 year old frozen mummy found by hikers near the Austrian Italian border, also showed a remarkable degree of sophistication. The Iceman’s shoes were in an advanced stage of disintegration when found but careful examination revealed a shoe made in one piece leather with a form of straps to hold the shoe on and grass stuffed in for heat retention.The shoe itself being recently considered the possible upper portion of a snowshoe.

Dry Pro

dry pro

Several weeks ago during Diabetic Week I was reminded by a patient that it’s an important point for our profession of Podiatry to recall how difficult it can be to care for foot dressings at home. The patient is sent home to return in a few days with sometimes information like “keep it dry”, “hang your foot out of the bath” or even “just wrap a poly bag around your foot”. Not only can dressings be bulky and warm they can also make life difficult when doing those normal everyday things like washing and bathing. In the Yourfootcare forum Fred asked the question “I have my foot wound dressed three times a week (I burnt it). I find having a shower difficult with plastic bags on my foot, and it leaks!  
Help !! is there anything to help my problem, I have seen things that look like a big plastic bag”. 

There are several different products on the market to help patients like Fred. Many of the products look like modified polythene bags and can be quite slippy to use in baths or showers or they can only be described as ‘showerproof’ rather than for full immersion in water. Dry Pro ( Xero Products LLC)is a latex product that is quite superior to the modified plastic bag variety. The Dry Pro dressing and cast protector has a small valve on the side which when sqeezed repeatedly removes all the air making a vacuum around the foot and dressing to allow total immersion in water. There is also a clever non slip base that can make the patient feel more secure in the shower or bath. Quality of life is often discussed by professionals in relation to health care, this is one product that allows patients to return to a normal activity that we all take for granted like bathing whilst their foot wound heals. 

Children’s footwear

ClassroomSome of the interesting questions on our foot forum concern children’s footwear. The following question illustrates one of the problems. “My children are made to take their school shoes off as soon as they arrive at school, they then put plimsoles on . I have spoken to the teacher but to no avail. I have seen plimsoles that are too small on childrens feet -doesnt this do damage in the long run this kind of rule”?

My answer on the forum was “I think it’s important to press the school on this issue again. Many parents do spend a great deal of money on properly fitted school shoes only to find they are worn going to school and finally going home at the end of the day. In the largest part of the school day the children wear gym shoes/plimsoles/sandshoes probably to keep the school clean or perhaps keep noise down. The problem arises when this type of footwear becomes too small and this is not noticed until a parents night or end of term because the gym shoes are normally left at school.  Unfortunately growing feet can be easily damaged by short tight shoes of any kind thus destroying your efforts when buying well fitted footwear. It would perhaps help if you could speak to the head teacher as not everyone is aware of the health aspects or maybe thinks the point through. This issue is quite common and was recently discussed in current UK Podiatry literature”.

Plimsole/GymshoeThis is just part of the story and parents should remember plimsoles worn all the time can make the feet hot, sweaty and really moist making the skin prone to bacterial and fungal infections. Ordinary shoes really do support the feet considerably better than plimsoles which are so lightweight and flimsy they can damage the growing foot. So check those gym shoes often, at least every few months and look after those tiny feet.