Step into Summer

Summer is here with warm weather, outdoor activities and our favorite summer shoes.  Frequently, foot pain or problems with the feet are a direct result of the shoes that we choose, so these are a couple of tips to keep your feet safe in the summer:

·         The warm summer weather often encourages us to participate in new activities.  While outdoor athletic activities are a healthy pursuit, be careful when starting something new.  You should make sure that the shoes that you wear are appropriate for the particular sport or activity.  Overuse injuries are frequently seen in the foot and ankle when you try to do too much of one activity after a long winter.  Start slowly and increase your activity as you become stronger and your endurance increases.

·         Flip-flops rule at the pool!  Many patients ask whether flip-flops are safe to wear, and the answer is “yes and no”.  When protecting your feet from hot pavement at poolside, flip-flops are an excellent choice.  Flip-flops can actually help strengthen feet and are best worn on flat reliable surfaces.  When you head to the local amusement park for a day of walking or to the closest state park for an outdoor hike, leave the flip-flops at home.  Long periods of walking and extensive walking on uneven ground with flip-flops or any open back sandal can cause injury to the foot.

·         Stylish sandals and summertime shoes for men can offer minimal support and risk injury to the foot and ankle when worn for inappropriate activities.  While there is no harm to wearing these shoes to a casual barbeque or dinner party, you may cause injury to your foot if you decide to hop on a bike or participate in the unexpected softball game in this type of shoe.  Wearing your favorite summer dress shoes should be limited to activities that require a very low level of activity.

In summary, choose the shoe to match the activity.  Keep a pair of supportive athletic shoes and socks in the car so that you are ready for anything and have a great summer!

By: Sandra Klein, MD

I sprained my ankle last spring while I was running. The ankle doesn't really hurt anymore, but it keeps 'giving out." What should I do?

Foot and Ankle Surgeon, Jeremy McCormick, MD:

Ankle sprains are the most common foot and ankle injury in sports. Typically, sprains occur when inverts with an awkward step while running or jumping. As the foot rotates inward, the ligaments on the outside, or lateral aspect of the ankle, are stretched, causing swelling and pain. Most frequently, sprains will recover completely with rest, ice, compression, evaluation and early mobilization.

In less than 10% of cases, while ankle swelling and pain improves, the ankle continues to "give out" or feel unstable. Classically, this occurs when walking on uneven ground or when stepping off a curb. Repeated episodes of "giving out" is a condition called chronic ankle instability. Most frequently, this is a result of incomplete recovery from an acute ankle sprain that leaves the ankle with weakness and impaired postural control.

The initial treatment for chronic ankle instability is a program of structured rehabilitation with the help of a physical therapist. Exercises are aimed specially at strengthening the peroneal tendons which run on the outside aspect of the ankle. The regimen should also include use of a balance board or similar device to work on proprioception - awareness of the position of the foot and ankle in space. Improved proprioception helps the ankle react more quickly to stresses, preventing future sprains.

After 6-8 weeks of intensive therapy, if the ankle continues to feel unstable, one might be a candidate for surgery to reconstruct the injured ankle ligaments. At this point, an MRI is helpful to identify any underlying injury such as cartilage damage at the ankle or peroneal tendon tears. Complete recovery from surgery takes at least 3 months, but patients will typically be able to return to full activity without limitation, and, most importantly, without the sensation of their ankle "giving out."