Shabbat of Sanctity Dirshu’s 20th Anniversary International Convention

Past Articles:
THIS MONTH DR. JACQUES DOUECK INTERVIEWS NOTED PODIATRIST, DR. JEFFREY KNOBEL. HEEL SPURS, PAINFUL FEET, AND INGROWN TOENAILS



What is the main cause of heel pain?

Our feet are created with arches. Just as bridges and buildings are designed with arches to be able to support great weight, our feet were created with arches to support our body weight. When the arch starts to collapse, pressure on the ligament on the bottom of the foot causes pain. This is called plantar fasciitis. This ligament is designed to absorb the high amount of strain we place on our feet but, sometimes, too much pressure damages or tears the tissues.

 

Many people are told they have heel spurs. Isn’t that the cause of their pain?

Although many people with plantar fasciitis do have heel spurs, spurs are not the cause of plantar fasciitis pain. One out of ten people have heel spurs, but only one out of twenty people with heel spurs have foot pain. Because the spur is not the cause of plantar fasciitis, the pain can be treated without removing the spur.

 

What is the best prevention for heel pain?

Wearing shoes that have good support. Since 80% of foot surgery is performed on women, they are the ones who really have to follow these guidelines. Flats are like slippers and are the worst type of shoe, since they have no arch support. When going to a function, you can “cheat” and wear fashionable shoes, but otherwise you should wear “sensible shoes” that are more closed and supportive. Laced shoes and sneakers are best.

 

If I already have foot problems, will wearing the right shoes help me to avoid surgery?

Yes. Especially for men, using custom arch inserts and donning the right shoes can help avoid the need for surgery. We always try to avoid surgery here. However, the answer is not always as simple as shoes and inserts. If the deformity is such that the proper shoes are not enough, surgery really can improve your quality of life. There’s no reason to suffer with the pain when surgery can remedy it.

 

What is the cause of ingrown toenails?

While it is important to cut the toenails straight and not too short, the most common cause is shoes that are too short, or that fit too tightly and compress the toes together.

 

What is the cause of and treatment for nail fungus?

Excessive moisture in the shoes is the main cause of nail fungus. That is why it’s important, to wear different shoes every day, which gives your shoes a chance to dry out. Nail fungus is usually treated very effectively with Lamisil, an oral antifungal. Topical creams do not usually work for nail fungus. In some cases, the fungus can be killed in one visit with a laser.

 

Why is a plantar wart so difficult to treat?

Warts are caused by viruses. Since the skin on the bottom of your foot is three times thicker than regular skin, when you get a wart on the bottom of your foot it goes into the skin three times deeper. Administering a combination of very strong acids and scraping the foot helps to treat it. If that is not enough, the wart needs to be surgically removed.

 

Why do diabetics need to visit the foot doctor regularly?

Many parts of the body are affected by diabetes. The feet are the farthest from the heart with the poorest circulation, so the breakdown is worse. Add to that neuropathy, which causes a lack of sensation and damage. Bunions, hammertoes and other problems will cause the skin to break down, causing severe infections to develop with no pain.