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When you are in a hot environment and your body becomes overheated, your blood vessels dilate in an effort to try to cool you off. This puts more strain on your circulatory system, however, as it has to work harder to transport blood back to your heart. This reduces your body’s ability to deal with the usual force of gravity, and your fluids are pulled down into the vessels in your ankles and feet, where they collect and then seep into the surrounding tissue. This causes your lower extremities to swell. Research has shown that heat edema can lead to swelling for periods of several days.

While this condition is not harmful, in some cases it can produce pain and irritation, and the affected skin might appear unsightly – puffy, shiny, and red. The swelling will recede when one returns to an environment that has a normal temperature, but it can be quite unpleasant while it is ongoing. If the swelling doesn’t go away within a few days, one should consult a physician in case there are other underlying health issues causing it (diabetes is one condition that can present with swelling in the feet).

Other factors that exacerbate foot swelling

While foot swelling – otherwise known as heat edema – is the body’s natural biological response to being in a hot environment, there are preventable factors that can intensify the problem. One is an excess of salt in one’s diet, which can lead to an imbalance in the body’s natural salt-to-water ratio: the body will retain water in an effort to compensate.

Sitting or standing for extended periods of time can also contribute to this problem. Moving the extremities helps the circulatory system to pump blood upwards; remaining sedentary makes it more difficult for the body to fight the force of gravity.

Other factors which can worsen heat edema include pregnancy, as pregnant women have a natural increase in body weight, which taxes the circulatory system more than usual, and introduces an excess of bodily fluids into the mother’s system. Swelling in the lower extremities is commonplace in any pregnant woman, and heat only increases the chances of this happening. Increasing age is another; our circulation weakens as time goes on, which in turn increases the chances of fluid pooling.

How to reduce and treat heat edema

While staying out of excessively hot temperatures is the best way to prevent heat edema, this obviously isn’t always possible. Drinking plenty of fluids (8-10 glasses of pure water per day) and maintaining a normal sodium intake are simple ways to try to avoid the condition. One should also be sure to avoid remaining stationary for too long and to get regular exercise, even if it’s just walking, especially during the cooler periods of the day; swimming is an especially good remedy. Also be sure to wear loose-fitting footwear and clothing.

But if heat edema happens despite these precautions, there are ways to deal with it. One is to keep your feet elevated, which aids your heart’s ability to pump fluids out of your feet and lower legs. This should be done several times per day for at least half an hour. When sleeping, you should keep a pillow under your feet to aid the process as well. Certain foods also serve as diuretics and help the circulation by getting rid of excess fluids through urination. These include asparagus, beetroot, green beans, leafy greens, lemons, onions, pineapple, pumpkin, and green beans.

Another treatment is to simply getting out of the heat, such as by avoiding direct sunlight, using fans, or going to an air-conditioned area. There are also cooling foot sprays that can help to relieve the strain. Don’t use excessively hot water when washing, either.

Massaging your feet and ankles can also bring relief, especially while using essential oils. Magnesium – taken in doses of 200 milligrams twice per day – can likewise help a great deal. While magnesium tablets are available, it can also be ingested naturally in certain foods, including avocados, bananas, dark chocolate, fish, kale, nuts, seeds, and spinach.

Lastly, horse chestnut extracts in gels, such as Venagel, can both provide relief and promote the reduction of heat edema once it has occurred, facilitating healing. A small amount of such gels should be massaged into the affected skin 2-3 times per day in an upwards motion, which promotes circulation.

Best footwear for swollen feet

When all else fails, however, there are several types of footwear that have been designed to accommodate changes in the feet when swelling is experienced. Clarks Breeze Sea Flip Flop is one that has been evaluated by consumers as being especially suitable for dealing with heat edema.  Others that have been rated highly include Cole Haan Zerogrand Stitchlite, Crocs Classic Clog, and Skechers GOwalk 5.

While heat edema is an unfortunate risk during hot weather, it is something that can be easily treated without seeking professional help.

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Pros:

One of our absolute must-haves in any shoe is a good, solid base, and Birkenstocks pass this test with flying colors! The foot bed is made out of cork, which provides great cushion and support. We actually provide custom orthotics in our office made out of the exact same material! This material molds to your feet and provides enough stability to make Birks ultra-comfortable- no wonder they’re so popular!

The solid cork bed is also thick enough that it provides ample stability. If you perform our signature twist test, Birks are rocks solid. They have some slight give to allow for comfort (nobody wants to feel like they’re walking on a block of wood), but other than that these shoes are just about as stable as they can be, especially for a sandal!

Cons: 

Although Birks have one of the best foot beds out of any sandal, there are definitely some features that cause problems. The biggest problem we have with Birkenstocks? You guess it: no ankle strap! Having a thick, secure ankle strap is the most important feature of any sandal. When there’s no ankle stability, your toes are forced to curl and grip the front of the shoe which can lead to hammertoes, plantar fasciitis, and a ton of other unwanted foot problems. 

If you can find a style of Birkenstocks with a solid ankle strap that will keep your foot locked in place, they can be a great option for lounging around the house, wearing out to the pool, or any other low-impact activity. Even with a sturdy strap, we would NOT recommend wearing these for a long period of time or for any intense activities, such as going on a walk or going to the grocery. In the long run, they just won’t do great things for your feet.

Key Takeaways:

Even though Birks have a great cork base that provides lots of cushion and comfort, we only recommend wearing these shoes if you can find a style with a solid ankle strap to keep your foot locked in. Even then, be sure to restrict when, where, and how often you wear them. Birks (as long as you find the right style) are a great sometimes sandal, NOT an everyday shoe!

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Pedicures Aren’t Just for Women

There’s no difference between a pedicure for a man and one for a woman aside from a pretty pop of color. Who in society said that pedicures and manicures are for females only? Whoever that person may be, they are oh so very wrong. Pedicures are a part of good foot hygiene and cleanliness should speak to both women and men. 

Not only do you get a relaxing foot massage, but you also get the soles of your feet pampered as well. In that sole pampering, your tech (who should be carefully chosen), will inspect the health of your feet.  Some professionals do not recommend that diabetics get their feet taken care of in a salon or day spa. It is only right that we think we can assume that every spa is sanitary, but everyone’s definition of clean is not the same. 

Nicks and cuts in the feet can create a prime breeding ground for bacteria and the germs from numerous other people can creep and crawl, making infection inevitable. 

So, let’s run down what should be done if we’re going to get those toes dancing in a salon or a spa. 

They May Not Like it, But You Tell Them like It Is

If you prefer to go to a salon or day spa to have your pedicure, you need to scout for a spa and a tech that will give you the best service for the safety and security of a diabetic. 

The first step is to make a list of day spas you think you may want to go to. Call each one. Ask if they have a tech that has experience performing pedicures on patients who are diabetics. If the answer is no, kindly pass to the next establishment on your list. 

Once you find a tech who has experience with diabetics, be sure to make it clear that for your health and wellness you must see the foot bowl get sanitized, it cannot be sanitized before you arrive. 

If Your A1C is in the Green Zone It’s a Go!

It is of utmost importance to discuss that diabetics can’t get pedicures any time they please. If your glucose is not well-controlled, we need to postpone the Pedi. If your toenails require trimming, make an appointment with your podiatrist to get it done in a way that you know will be safe. This is especially true if you have neuropathy. 

If the tech gouges too deeply into your nail bed, files the edges of the toenail down too deep, or grinds calluses down to the tissue, a dangerous ground is being laid. This may sound extreme but it occurs. A pedicure can, with just a nick, leave you with a chronic wound needing management by a wound care specialist. 

When Infection Sets In From a Pedicure

One of the biggest points needed to be understood, learned, memorized, and made into a mantra for everybody, not just diabetics, is that a pedicure is in no way, shape, or form a substitute treatment for ingrown toenails and fungal infections. Repeat it with me “A pedicure is not a substitute treatment for ingrown toenails and fungal infections”. 

There are several types of infections that can be contracted during a pedicure. A nasty fungal infection sits at the top of the list. If you see a tech touch one person’s feet then go to touch another person’s feet without either changing gloves and/or washing hands there is a chance that fungus could have been spread between those two clients. It is up to you to be an observer and speak out if you see something that does not seem right.

Let’s talk Staph. A microscopic nick in your skin can let Staph in. Staph, Hepatitis B and C, Plantar Warts, and a multitude of pathogens can get into your body to wreak havoc on more systems than just your feet. Mycobacterium fortuitum is caused by the spread of the microbe nontuberculous mycobacterium. This is a common infection caused by pedicures. Painful sores develop that initially look like small spider bites, but develop into boils. The boils continue to grow until they are pus-filled. 

In a healthy person, this infection can take multiple rounds of broad-spectrum antibiotics to administer full treatment. If a diabetic gets it, it can result in horrific consequences such as cellulitis, sepsis, gangrene, or even amputation. The unfortunate reality for diabetics that a pedicure can end with a critical outcome if proper protocol is not followed. 

Steps for a Safe Salon Pedicure

When it comes time to get your feet taken care of, the first thing you need to do is check yourself. Not your feet, your glucose. What are your sugars looking like? If your glucose is controlled enough for a Pedi, then check your feet. Do you have any nicks, cuts, or open sores? If you do then you need to call your podiatrist rather than your pedicurist.

Do not shave your legs 48 hours before your Pedi-appointment. Shaving can leave micro-cuts in your flesh that you did not see or feel when they occurred but are big enough to leave you prone to infections. 

It cannot be stressed enough how important it is that the salon you go to must be impeccably clean. Bring your personal nail kit to every appointment and take it home with you when you leave. Be sure that the tech who does your pedicure knows that your toenails are not to be cut or filed in a curved shape. This is not an aesthetic choice, this is a medical requirement. 

Remember to advise your tech that under no circumstances are your cuticles to be trimmed.  Additionally, if pumice stone is used it should be used gently. Pumice stones can leave microscopic tears in the feet and create a risk for infection. 

When you make your appointments ask if you can have a standing appointment of being the first available appointment of the day. 

I Need My Doctor

If you are worried about your safety getting a pedicure in the salon, have the pedicure done by your podiatrist or check into having someone come into your home is trained from a medical standpoint and will not endanger the health of your feet.

If you have a loved one that lives in a skilled nursing facility, check to see if they have CNAs that will do pedicures. Get your loved one their own set of nail kit tools. If your beloved one is a lady, buy her favorite color of nail polish so that she has her supplies.

Heidi West is a medical writer that writes about healthcare and technology in the medical industry with a focus on wound care.

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A solid pair of tennis shoes should absolutely be a staple in everybody’s closet! When Dr. Freels isn’t in the office, she LIVES in her Brooks Ghost 12s. Tennis shoes offer so much more support than any other type of shoe, there is just absolutely no comparison (especially when you have a solid pair of custom orthotics to go with them). Since “athleisure” has become the latest fashion trend, wearing tennis shoes all day every day is easier than ever!

Back to the Basics: What do I need?

Ideally, we recommend that you have at least two pairs of tennis shoes: one pair for exercise and one pair for every day, especially if they are your go-to shoe! The shoe you pick for your exercising, running and other high-impact, high-sweat activities should be your MOST supportive pair. Your feet are under the most stress during these activities, so that’s when they need the most support. Here are some key features to look for when you go shopping:

• Lots of cushion
• Supportive heel
• Does it pass the twist test?
• Arch support
• Breathability

Pro Tip: Whenever you invest in solid exercise shoes we also recommend that you purchase socks that are made of breathable, moisture-wicking material. When swear and moisture build up in your socks and shoes, it can lead to more serious foot conditions like athlete’s foot or fungus, so wearing the right socks will save you a lot of time, money, and discomfort. These Thorlo socks are a great option!

Your other pair of tennis shoes should be your go-to for everyday activities, like grocery shopping, running errands, travelling, etc. This pair should still be supportive, but it’s okay to sacrifice some function for fashion! Now, this definitely doesn’t mean throwing the entire checklist out the window, but if the cushion in your everyday shoe leaves a little something to be desired, it’s not the end of the world. This is another reason that orthotics are such a great investment- they instantly upgrade any shoe and make them custom to your needs!

How often do I need to buy new tennis shoes?

How often you replace your tennis shoes depends on a few different factors, like how often you exercise and how intense your workouts are. Typically, your high-impact exercise shoes should be replaced pretty frequently, anywhere between every 6-8 months. Obviously, those people who run 7 miles a day are going to put more wear and tear on their shoes than somebody who goes on a leisurely walk a few times a week. 

Your everyday shoes don’t need to be replaced as often, probably once a year. This also depends on how much you wear them and the types of activities you do! If you wear your tennis shoes all day every day, you will go through them much more quickly than somebody who only wears them to the grocery once a week.

How do I know if I need new shoes?

Having a general timeline of when you should buy new tennis shoes is great, but there are also a few key things you should keep an eye out for to monitor the life of your shoes. 

Monitoring the treads on your shoes is crucial. If the treads are worn down and have lost their grip, this is probably a good sign that it’s time to replace them! You should also pay attention to the wear and tear pattern. If the treads are worn unevenly (i.e. they are worn down more on the outside than the inside, or only worn down in the heel) then this could be indicative of gait issues. Essentially, your weight and impact are not being distributed evenly through your foot. If this is the case, we recommend that you make an appointment with your local podiatrist.

We also recommend that you do our signature twist test periodically to double check the stability of your shoes as they age. If you notice that they are significantly more flexible than they used to be, this is a good indication of significant wear and tear!

We know that buying tennis shoes can get expensive, but caring for your feet is one of the best investments you can make! If you make the best choices now, your wallet and your feet will thank you later.

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Even though pedicures can be great for your foot health, they have the potential to cause some serious issues if not done properly. Here are our top three tips for getting a SAFE pedicure this summer!

1. Skip the cheese grater

One of the best things about getting a pedicure is walking out of the salon with baby smooth feet, but the cheese grater style tool that they use to file off dead skin is actually pretty dangerous. It can easily cut your feet if it touches the wrong spot, which is especially problematic if you have diabetes or neuropathy. Even though they are probably sanitized well, this type of tool can also harbor lots of bacteria and spread issues like Athlete’s Foot, fungus, etc. Because of this, we recommend that you avoid this tool altogether and opt for the buffing tool instead. It will still shave down your dead skin and make your feet feel smooth, but without slicing your foot wide open!

2. Keep your polish on for a week… max!

We know this might seem a little bit extreme, but giving your nails time to breathe is essential to their health! We’re all guilty of leaving nail polish on for weeks at a time, but constantly covering the nail traps bacteria and often leads to fungus and other nail issues. We also recommend using the Doctors Remedy Nail Polish that we offer over the counter in our office! Its natural ingredients include tea tree oil, cactus extract, and vitamin C, which combat fungus and strengthen nails. They also come in every color of the rainbow so you can always find your perfect color!

3. Bring your own tools

Bringing your own tools to your pedicure is a great way to minimize the spread of germs at the salon! Even though most salons are great about sanitizing their tools, you can never be too careful. You can get pedicure tool sets from Ulta, Target, or even Amazon that include nail clippers, cuticle trimmers, and buffing tools. This is the perfect way to ensure that your tools are clean and cared for properly!

Pedicures can be great for your feet, you just have to make sure that they’re done properly and safely. These three tips will help keep your feet happy and healthy all summer long! 

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As summer is approaching and the world is slowly making its way out of quarantine, we’re also beginning our transition from slippers and house shoes and back in to everyday footwear. Although we recommend that you stay away from the classic flip flop, we understand that avoiding sandals altogether throughout the summer is not a realistic option for everyone. For those of you out there who love a good summertime sandal, we’ve created a basic guide for buying podiatrist approved shoes without sacrificing summer fashion.

Why should I avoid flip flops?

Although it can be a hard pill to swallow, we insist that our patients completely avoid flip flops at all costs. Why? First, flip flops just don’t offer enough support, stability, or protection for your feet. Most flips flops have a thin sole, which means it’s pretty easy for foreign objects like nails, sticks and other general debris to puncture clean through your feet. This can lead to open wounds, infections, and other potentially dangerous conditions that can be painful and time-consuming to treat. Because flip flops only have two (usually thin) straps, they leave your entire foot exposed, creating ample opportunity injuries and trauma. The absence of a sturdy toe strap and ankle strap also forces your toes to grip the front of the shoe in order to keep your foot in place. This gripping motion tends to cause hammertoes and blisters, both of which can be absolutely detrimental to your foot health.

What features should I look for when I’m sandal shopping?

Even though flip flops are a no-go, there are tons of sandals on the market that are podiatrist approved! These sandals from Vionic are a great example. Why do these check all of our boxes? We’ll break it down so you can see exactly what to look for on your next shoe shopping spree.

A Stable Base:

If you’ve ever spent any time on our website or social media, you know that one of our favorite ways to evaluate the stability of a shoe is by doing the “twist test”. You simply pick up the shoe and twist it around as much as possible. Ideally, the shoe should hold its shape- the more it twists and folds, the less stability it provides. Shoes with thicker soles also tend to be more stable, so if you’re shopping online, this is a great way to visually evaluate stability and support!

Cushion & Arch Support:

Just like with running shoes, finding a sandal with sufficient cushion and arch support is incredibly important. This will help provide stability for your feet while also keeping them comfortable. Having these two features, especially, can help prevent tons of common foot problems, from stress fractures to general foot pain. Finding sandals with arch support can sometimes be challenging, but Vionic typically has some great options!

Toe Strap AND Ankle Strap:

Finally, finding a sandal with sturdy toe straps and ankle straps is probably the most important criteria. Having thick straps that align with the ball of your foot as well as wrap around your ankle will help keep your feet locked in place. This will also help prevent your toes from having to curl and grip like they do in traditional flip flops, keeping your feet healthy and relaxed.

We know that giving up flip flops completely might be challenging, but sticking to these guidelines will pay off in the long run by keeping your feet happy and healthy!

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Warm weather finally rolling in means it’s time for those long-awaited beach trips we look forward to all year round. But, just because you’re going on vacation doesn’t mean you can take a break from caring for your feet! Those beautiful destinations still have the potential to cause some serious foot pain if you’re not careful. How can you protect your feet at the beach? Here are our provider’s top three tips for keeping your feet happy and healthy, no matter your vacation spot!

Dr. Freels: Wear your tennis shoes as long as you can

Dr. Freels always recommends that you wear tennis shoes as much as possible! She usually wears hers while walking to the beach and then switches to sandals once she reaches the sand. Although we typically suggest staying away from flip flops, anything is better than going completely barefoot! It’s especially important to protect your feet during those heavy weight bearing times so you can get away with wearing your less supportive, lighter weight options for a reasonable amount of time.  

Dr. Carter: Put sunscreen on your feet

Sunburns can make or break your vacation. We’ve all been that person who doesn’t apply enough sunscreen the first day and then suffers the consequences for the rest of vacation. Even the most dedicated sun screeners miss a spot now and then! 

Even though it can be easy to forget, applying sunscreen to the top of your feet is SO important. If you’ve ever burnt the top of your feet (we know we have) you know how excruciatingly painful it can be. A severe burn can lead to infection if not treated properly, not to mention, it makes wearing shoes really difficult! All it takes is a quick spray (and reapplication, of course) to keep your feet burn-free.

Dr. Barko: Don’t go for a beach walk barefoot

If you’re travelling to the beach, chances are, you’re spending your vacation kicking back on the sand soaking up some vitamin C. If you’re anything like us, you love taking long walks up and down the beach while taking in the view, but extensive walks while barefoot can really do a number on your feet.

When you’re walking on sand, you’re walking on a soft and unstable surface. This causes your feet and body to work harder than if you were walking on the pavement or level ground. It’s easy for your feet to become inflamed after taking a gentle stroll on the beach, so if you plan on taking a nice long walk, be sure you wear a supportive shoe. We know it’s tempting to go barefoot and feel the sand between your toes, but your feet will thank you in the long run!

Although protecting your feet might seem like a hassle in the moment, your feet will definitely thank you later. Following these three easy tips will make a huge difference in your foot health, giving you the freedom to enjoy your well-deserved vacation!

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