Podiatrist Shares Stretching Tips for Exercise and Walking

 Stretching Tips for Exercise and Walking
When walking for exercise, it’s important to stretch before and after you walk. Follow the stretching techniques shown below and remember to stretch slowly, without bouncing. You only need to stretch far enough to feel your muscles elongating, not until you feel pain. Talk to your podiatrist, or call Dr. Kerch, if you have specific questions about your stretching routine.
1. Head Circles
Start with your ear near your right shoulder. Rotate your head around to the front, ending with your ear near the left shoulder. Roll your head back to the other side. Repeat 5-10 times.
2. Arm Circles
Lift arms out at your sides and make forward arm circles. Keep your palms facing in and your thumb pointed down. Make 20 forward circles with each arm. Then make backwards arm circles with your palm facing out, thumb pointed up. Make 20 backward circles with each arm.

3. Ankle Circles
While sitting or lying down, lift your right leg from the hip so that your thigh is about 1 inch off the ground/chair. Keeping your knee straight, rotate the foot at the ankle joint slowly in a circular motion. Make 10 circles with your ankle going clockwise and 10 going counterclockwise. Repeat with your left leg.
4. Hip Stretch
Stand up and take a step back with your right foot. Bend your left knee and shift your weight back to your right hip. Keep the right leg straight, bend forward more and reach further down your right leg. Hold for 20 seconds. Then repeat on the other side.
5. Side Reaches
Reach one arm over your head and to the side. Keep your hips steady and your shoulders straight to the side. Hold for 20 seconds and repeat on the other side.
6. Leg Curl (Quadriceps Stretch)
Stand straight up and if necessary, hold onto a wall for support. Bend your right foot behind you to your buttocks with your right hand. Keep standing up straight and push your knee gently back as far as you can comfortably go, keeping your heel in place. Hold for 20 seconds and repeat with your left foot and hand.

7. Wall Push (Calf Stretch)
Lean into a wall with your feet about 3-4 feet away from the wall, bracing yourself with your arms. Bend one knee and point it toward the wall. Keep your back leg straight with your foot flat, your head up and your toes pointed straight ahead. Keeping your back straight, move hips forward until you feel a stretch. Hold for 20 seconds and repeat with the other leg.
8. Achilles Stretch
From the calf stretch position, bend your knee back so your leg straightens, stretching the Achilles tendon. Keep your heel down and hold for 20 seconds. Repeat on the other side.

9. Triceps
Stretch your arms up over your head. Bend the right arm, pushing the right elbow back and down with your left hand. Hold for 20 seconds. Repeat on the other side.
10. Hip flexors, hamstrings and lower back
Bend your right leg forward until your knee is directly over your ankle. Rest your left knee on the ground. Keeping your right leg in place, lower your hips and slide your left leg back slightly, stretching as far as you are comfortable. Hold for 20 seconds and then repeat on the other side.

Don't underestimate the importance of stretching to prevent injury and to promote health.
Dr. Lotchie M. Kerch is accepting new patients in our Capital Hill location:

                                   1201 Pine St.

                                   Seattle, Wa 98101

Please call 206-786-0064 for an appointment with Dr. Lotchie Kerch

What is a Neuroma?

Neuromas
What is a Neuroma?

A neuroma is a painful condition, also referred to as a “pinched nerve” or a nerve tumor. It is a benign growth of nerve tissue frequently found between the third and fourth toes that brings on pain, a burning sensation, tingling, or numbness between the toes and in the ball of the foot.

The principal symptom associated with a neuroma is pain between the toes while walking. Those suffering from the condition often find relief by stopping their walk, taking off their shoe, and rubbing the affected area. At times, the patient will describe the pain as similar to having a stone in his or her shoe. The vast majority of people who develop neuromas are women.

Symptoms

•Pain in the forefoot and between the toes.
•Tingling and numbness in the ball of the foot.
•Swelling between the toes.
•Pain in the ball of the foot when weight is placed on it.

How Do You Get a Neuroma?

Although the exact cause for this condition is unclear, a number of factors can contribute to the formation of a neuroma.

Biomechanical deformities, such as a high-arched foot or a flat foot, can lead to the formation of a neuroma. These foot types bring on instability around the toe joints, leading to the development of the condition.

Trauma can cause damage to the nerve, resulting in inflammation or swelling of the nerve.

Improper footwear that causes the toes to be squeezed together is problematic. Avoid high-heeled shoes higher than two inches. Shoes at this height can increase pressure on the forefoot area.

Repeated stress, common to many occupations, can create or aggravate a neuroma.

What Can You Do for Relief?

Wear shoes with plenty of room for the toes to move, low heels, and laces or buckles that allow for width adjustment.

Wear shoes with thick, shock-absorbent soles and proper insoles that are designed to keep excessive pressure off of the foot.

High heels should be avoided whenever possible because they place undue strain on the forefoot and can contribute to a number of foot problems.

Resting the foot and massaging the affected area can temporarily alleviate neuroma pain. Use an ice pack to help to dull the pain and improve comfort.

For simple, undeveloped neuromas, a pair of thick-soled shoes with a wide toe box is often adequate treatment to relieve symptoms, allowing the condition to diminish on its own. For more severe conditions, however, podiatric medical treatment or surgery may be necessary to remove the tumor.

Use over-the-counter shoe pads. These pads can relieve pressure around the affected area.

Treatment by Your Podiatric Physician
Treatment options vary with the severity of each neuroma, and identifying the neuroma early in its development is important to avoid surgical correction. Podiatric medical care should be sought at the first sign of pain or discomfort; if left untreated, neuromas tend to get worse.

The primary goal of most early treatment regimens is to relieve pressure on areas where a neuroma develops. Your podiatric physician will examine and likely X-ray the affected area and suggest a treatment plan that best suits your individual case.

Padding and Taping: Special padding at the ball of the foot may change the abnormal foot function and relieve the symptoms caused by the neuroma.

Medication: Anti-inflammatory drugs and cortisone injections can be prescribed to ease acute pain and inflammation caused by the neuroma.

Orthotic Devices: Custom shoe inserts made by your podiatrist may be useful in controlling foot function. An orthotic device may reduce symptoms and prevent the worsening of the condition.

Surgical Options: When early treatments fail and the neuroma progresses past the threshold for such options, podiatric surgery may become necessary. The procedure, which removes the inflamed and enlarged nerve, can usually be conducted on an outpatient basis, with a recovery time that is often just a few weeks. Your podiatric physician will thoroughly describe the surgical procedures to be used and the results you can expect. Any pain following surgery is easily managed with medications prescribed by your podiatrist.

Your Feet Aren’t Supposed to Hurt

Remember that foot pain is not normal, and any disruption in foot function limits your freedom and mobility. It is important to schedule an appointment with your podiatrist at the first sign of pain or discomfort in your feet, and follow proper maintenance guidelines to ensure their proper health for the rest of your life. The advice in this pamphlet should not be used as a substitute for a consultation or evaluation by a podiatric physician.

Neuroma Tips

•Wear shoes with plenty of room for the toes to move, low heels, and laces or buckles that allow for width adjustment. "Your 2 Feet" carries a diverse variety of these shoes for you to view.
•Wear shoes with thick, shock-absorbent soles and proper insoles that are designed to keep excessive pressure off of the foot. Choose from 5 different types of insoles/arch supports including custom made orthoses fabricated by Dr. Kerch.
•High heels should be avoided whenever possible because they place undue strain on the forefoot and can contribute to a number of foot problems.
•Resting the foot and massaging the affected area can temporarily alleviate neuroma pain. Use an ice pack to help to dull the pain and improve comfort.
•For simple, undeveloped neuromas, a pair of thick-soled shoes with a wide toe box is often adequate treatment to relieve symptoms, allowing the condition to diminish on its own. For more severe conditions, however, podiatric medical treatment or surgery may be necessary to remove the tumor.
•Use over-the-counter shoe pads. These pads can relieve pressure around the affected area. A specially designed metatarsal pad carried at "Your 2 Feet" can assist in relieving neuroma pain.

Diabetic Self-Exam and Dr. Kerch Starts Your Process for Medicare Shoe Reimbursement Program

Foot Care For Diabetics
A regular self-exam will show indications for further follow-up:

1. Balance. A good test for balance involves standing on one foot, with your arms out to the side and your eyes closed. If you are less than 30 years old, you should be able to balance for 15 seconds, 30-40 years old for 12 seconds, 40-50 years old for 10 seconds and over 50 years old for seven seconds. This can be improved with exercises.

2. Circulation. Look at the color of your toes. Are they red, pink, purple or blue? Press down on the nail of your big toe until the color blanches. Now let go and allow the blood flow to return to your toe. The return of normal color should take 2-5 seconds in a person with average circulation.
At Your 2 Feet you can choose from the Jobst styles of support stockings. Support stockings are to be put on first thing in the morning so the compression will help pump the circulation back to your heart all day long. If you have haven't tried Jobst support hose yet, they are different than other brands of support hose.

3. Flexibility. How flexible are your toes? Try to pick up a marble or a small dish towel. To test your ankle flexibility, hang your heel off of a stair. Now let the heel go below the level of the stair. If this causes pain, stop the test. If your heel goes below the level of the stair without causing strain in your calf, that is a goof sign. If there is some strain, this can be improved with flexibility exercises.

4.Pain. There should be no pain in the average foot.

5. Sensation. Take a pencil eraser and lightly run it on the top, bottom and both sides of your feet. The sensation should feel equal in all quadrants. It may tickle on the bottom of the feet. That is normal. The last paragraph outlines how Dr. Kerch works with Your 2 Feet in fitting you with the proper diabetic footwear.

6. Skin. Check your skin for calluses, blisters or areas of irritation. Stand next to your shoes. Are they shaped like your feet or are they causing areas of constriction that may result in calluses, blisters or irritation? Put your hand inside your shoe. Are there seams, tacks or rough places in the shoe that correspond to the areas of irritation, calluses or blisters on your feet?

The following items may result in burns and you should NOT be using:
A. Hot tap water or super-heated water from the "Insta hot" faucet used on towels which are wrapped in additional layers of towels, chucks, or blankets.

B. Towels, rice packs or anything else heated in the microwave that is intended for food (temperature limit is not controlled; it’s also a fire risk).

C. A disposable latex glove filled with hot tap water. Even if mixed with cold tap water, the glove can burst and spill on the patient causing a burn.

7. If you have diabetes, keep educated about proper foot care and check your feet daily.
You should have an annual foot examination by a podiatrist or other health care professional.

Conveniently Dr. Kerch, ABPS certified and FACFS member is accepting new patients. Due to her experience treating diabetic complications over the years, she is very invested in early diagnoses, prevention and treatment. Beginning with conservative care, she can begin the process of enrolling you in the Medicare Shoe Reimbursement Program. Since Dr. Kerch's Clinic is located behind the Your 2 Feet Pain Relief Shoe and Product Store (A-Z), you will have easy access to a vast array of qualified shoes to choose from.