PHOTO BY DANIEL LIPPITT

Taking A Pounding

Your feet do a lot of work,
and may need extra care as
spring approaches.

RUTHAN BRODSKY SPECIAL TO THE JEWISH NEWS

Dr. Kaczander removes a
patient's ingrown toenail.

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hh, my feet are killing me!"
You and three-quarters of the
American population who have foot
problems have probably said these
words at one time or another.
With spring in the air and the extended
daylight hours, the numbers of people who
develop foot problems tends to increase.
It's not surprising that the foot is prone
to problems. It's a very complex structure
of 26 bones, 33 joints, and a network of ten-
dons, muscles and ligaments.
What's more, it withstands incredible
stress over the course of an average day,
and a whole lot more stress when summer
activities such as outdoor tennis, golf, run-
ning, biking and hiking are in full swing.
And medical conditions such as diabetes,
poor circulation, arthritis and obesity can
cause or worsen foot problems.
'When the weather changes, I'll start
putting in my 30 miles of running a week,"
says Sheri Warner of West Bloomfield. "I
have three children — ages 7, 4 and 1 —
and running has helped me get back into
shape and condition.
"I admit it, I tend to overdo the running
during those first warm weeks, and some-
times my knees or shins start hurting. But
I'm fortunate because I'm relatively young
and usually recover quickly from strains
and sprains."
Bruce Kaczander, D.P.M., with offices
in Southfield and Novi, says that the first
weeks of warm weather bring in a number
of patients with newly acquired foot injuries

and with foot problems that worsened.
"Patients don't understand they need to
gradually prepare their feet as well as their
bodies for the more strenuous activities in
the spring and summer," says Dr. Kaczan-
der. "Doing too much and too soon after be-
ing sedentary during the winter, and then
not properly stretching, usually results in
an over-use injury, particularly if you're
over 40.
"A tremendous amount of pressure is put
on the feet while exercising. The cumula-
tive impact of a 150-pound jogger running
three miles is more than 150 tons on each
foot. Besides, even without exercising, foot
problems can cause pain in the knees, hips
and lower back."
Dr. Kaczander believes that the body re-
quires preparation for golf, tennis or bik-
ing, and the feet also need preseasonal
conditioning. The traditional advice is 15
minutes of walking for a few days before
you begin a running program and then
gradually increasing to longer distances
and more time.
Or it may mean hitting tennis balls for
15 minutes on an outdoor tennis court be-
fore you play so that your feet get accus-
tomed to the surface and you develop a feel
for the outdoor conditions.
"A lot of my patients come in with stress
fractures in the spring, many of which could
be prevented," says Dr. Kaczander. "Oth-
ers complain of severe heel pain, which is
usually traced to faulty biomechanics such
as placing too much stress on the heel bone.

ter also decreases the risk of sprains as well
as muscle strains when beginning summer
activities. A pair of orthotics can also help
correct excess supination or over-pronation
by fitting into shoes and controlling foot po-
sition.
"My second piece of advice is to break
these new shoes in slowly, at first wearing
them around the house for an hour or so
each day before you begin any rigorous ac-
tivity wearing them."
Dr. Kaczander explains that parents
need to be particularly careful when it
comes to finding the right athletic shoes for
their children because less-protective equip-
ment is available for children.
"For example, the heel counter on a
child's soccer shoe is usually not rigid
enough for the quick changes of direction
made while running. What's more, less em-
phasis is placed on conditioning in children,
especially flexibility. Stretching is impor-
tant for children, especially in early ado-
lescence when muscles, tendons, ligaments
and bones grow rapidly."
Most athletic shoes are designed to adapt
to the contours of the feet. If corns, callus-
es or ingrown toenails develop from shoes
that pinch, it's time to toss those shoes and
get another pair.

Or the stress could be from a bruise in-
curred while walking or jumping on a hard
surface like a tennis court or from poorly
made or worn shoes.
"Heel spurs, or bony growths on the un-
derside forepart of the heel bone, form and
they can be very painful when inflamed."
The old sneakers in your closet aren't go-
ing to work! According to Dr. Kaczander, a
good athletic shoe is the first line of defense
for any athletic activity. Major shoe com-
panies have designed special shoes for spe-
cific activities. Sometimes, purchasing one
can get fairly complicated with the high-
tech treatments and the myriad of choic-
es for different activities.
Keep in mind above all else that what
POUNDING page 76
shoe you wear depends on
you — not every shoe
works for every foot.
"My major piece of ad-
vice for a shoe is to get one
with a stiff heel counter for
stability," says Dr. Kaczan-
der. 'That's what keeps the
foot from twisting too
much which can cause leg
muscles and tendons to
ache and tear. Wearing
shoes that fit well and pro-
vide support to the ankles
helps prevent both knee
and ankle sprains.
"Developing and main-
taining good muscle tone
and flexibility in the win- Improper trimming or shoes can cause an ingrown toenail.

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