My Blog

May 15, 2017
Category: shoes
Tags: podiatrist   podiatry   high heels   Foot Care   Shoes  

For years, high heels have the stigma of being bad for the feet, but women are still drawn to them. If you are one of those who cannot, or wouldn’t, say ‘no’ to stylish but uncomfortable footwear, this article is for you.



You might think that this is a bit of an odd relationship between women and their feet. Many women spend a lot of time pampering their feet with lotions, foot soaks, and pedicures, among others. Though there are other issues that may be the factors, the kind of shoes that are worn are definitely related to foot problems experienced by women.


High Heels and the Dynamics of Human Walking

Researchers have found that high heels increase bone-on-bone forces in the knee joint significantly, explaining the higher incidence of osteoarthritis in the knee joint in women as compared with men.


In 2015, a published study in the Journal of Orthopedic Research also found that there are changes to knee kinetics and kinematics while walking in high heels that might contribute to increased risk of osteoarthritis in women. The risk also increased with extra weight and additional heel height. According to another study, the extra stress placed on the knees while wearing high heels also increases the risk of knee osteoarthritis and joint degeneration.


Other studies suggested that the use of high-heeled shoes might alter the natural position of the foot-ankle complex, and thereby, produces a chain reaction of effects (mostly negative) that travels up the lower limb and goes at least as far as the spine.


Generally, the higher the heels you are wearing, the more stress it places on your knee joints. However, even shoes today that have moderately high heels can still significantly increase knee torques that can contribute to the development and progression of knee osteoarthritis.


Foot Problems Related to High Heels

According to the American Osteopathic Association (AOA), high heels are not just one of the major factors leading to foot problems in women; one-third of wearers suffer from permanent problems because of long-term use. The extended wearing of high heels and continuous bending of toes into an unnatural position can cause a range of foot ailments, from ingrown toenails to irreversible damage to leg tendons. High heels have also been linked to injured or overworked leg muscles, plantar fasciitis, osteoarthritis of the knee and low back pain.



Healthier Ways to Wear High Heels

The general idea is: the less you wear high heels, the better. It does not matter if the heel is a wedge or a stiletto, both wide- and narrow-heeled shoes increase pressure on the knees in places where degenerative joint changes occur. If you do wear high heels, it is best to reserve them for occasions that do not involve extended periods of standing and walking. 

May 10, 2017


The heel is the largest bone in the foot. If you injure or overuse your heel, you might experience heel pain and the pain can range from mild to disabling.


Common Causes of Heel Pain

There are a number of cases that are associated with the overuse of the heel bone. You can strain your heel by wearing shoes that do not fit, being overweight, or by pounding your feet on hard surfaces. Strains like these can irritate the heel’s bones, tendons, or muscles.


Other common causes of heel pain include the following foot conditions:


Heel Spurs

This foot condition develops when the lining that covers the heel is stretched continuously. When this happens, pieces of the lining might break off. Heel spurs typically develop in people who frequently jog or run like athletes as well as in people who are obese.


Excessive Pronation

This is a condition wherein the foot rolls inward, towards the arch, and the tendons and ligaments at the back of the heel are stretched too much. This might occur when injuries to the hips, back, or knees change the way one walks.


Plantar Fasciitis

This foot condition develops when the tendinous tissue that connects the heel to the ball of the foot becomes inflamed. It can also occur in athletes who frequently jog or run. Wearing shoes that do not fit properly can also lead to plantar fasciitis.


Achilles Tendinitis

This foot condition can result from inflammation of the Achilles tendon – the tendon which runs along the back of the heel. This foot condition is common in people who have active lifestyles, professional athletes, as well as frequent dancers.


When to Contact Sheldon H. Nadal, DPM

If you develop heel pain, you can first try some remedies such as resting to ease your symptoms. If, however, your heel pain does not get better in two to three weeks’ time, you should make an appointment with Sheldon H. Nadal, DPM.


Call him if:

  • The pain is severe and starts suddenly.
  • You have redness and/or swelling in your heel.
  • Walking becomes too difficult because of the heel pain.


How the Pain can be Healed

You can try some of these home methods to ease your discomfort should you develop heel pain:

  • Rest as much as you can.
  • Apply ice to the affected heel for 10 to 15 minutes. Do this twice a day.
  • Wear shoes that fit you properly.
  • Wear a special device such as a night splint that stretches the foot as you sleep.
  • Use shoe inserts or heel lifts to reduce pain.

If the aforementioned home care strategies do not ease your pain, you need to see Sheldon H. Nadal, DPM at the soonest possible time. 

April 24, 2017
Category: Foot Care
Tags: podiatrist   podiatry   Foot Care   diabetes   foot doctor  

It is common in people who have diabetes to have foot problems. If you have diabetes, you might have heard that there is a possibility to lose a leg, toe or foot. Fortunately, you can lower your chances of having foot problems related to diabetes by taking care of your feet on a daily basis. You can also keep your feet healthy by managing your blood sugar.


There are two problems caused by diabetes that can affect your feet:


Diabetic Neuropathy

This happens when uncontrolled diabetes damages your nerves. If you have damaged nerves in your feet and legs, there is a possibility that you do not feel heat, cold, or pain – this is called ‘sensory diabetic neuropathy’. If you do not feel that something is wrong with your foot, the cut or sore could get worse and become infected over time. The muscles of the foot might not function properly. This can also cause the foot to not align properly or create too much pressure in one area. Foot ulcers can also occur due to nerve damage and peripheral vascular disease.


Peripheral Vascular Disease

Diabetes affects the blood flow. Without good blood flow, a sore or a cut takes a longer time to heal. Poor blood flow in one’s arms and legs is called ‘peripheral vascular disease’. It is a circulation disorder that can affect blood vessels away from the heart. If you have an infection that does not heal because of poor blood flow, you could become at risk for developing ulcers or gangrene – death of tissue due to lack of blood.


What can you do to keep your feet healthy?

It is important to have a healthcare team at this time to make a diabetes self-care plan. This plan will include an action plan to manage your diabetes. A foot care plan is also essential and Sheldon H. Nadal, DPM can definitely help you create the best one for you.


Check Your Feet Every Day

You might be having foot problems, but there is a possibility that you are feeling no pain in your feet. Checking your feet on a daily basis can help you spot any problems early before they get worse. Each evening, when you take off your shoes, make it a point to check your feet and the areas between the toes. If you have trouble bending over to check your feet, you can use a mirror to see them, or you can also ask someone else to look at your feet.


Look for problems such as:

  • Sores, cuts, or red spots
  • Ingrown toenails
  • Swelling or fluid-filled blisters
  • Corns or calluses
  • Plantar warts
  • Warm spots
  • Athlete’s foot


For any foot problems that you want to discuss more thoroughly, set up an appointment with Sheldon H. Nadal, DPM today. 

April 21, 2017

When the tissue at the base of your big toe swells up, bunions occur, forming a large bump on the side of your foot. This foot condition can cause intense foot pain and eventually, it may lead to arthritis. There are ‘special foot exercises’ that can relieve the symptoms of bunions. Although these exercises will not get rid of the bunion, they can help increase the foot’s flexibility.


Benefits of Special Foot Exercises for Bunions

Non-surgical strategies, like physical therapy exercises, can help slow the progression of bunions. Foot exercises for bunions help keep the joint between the big toe and the rest of the foot mobile, strengthening the muscles that control the big toe and maintaining flexibility.


Here are some exercises that might benefit people with bunions:


Toe Stretches

Stretching out your toes help keep them limber and offset the pain. To do this, point your toes straight ahead for 5 seconds and curl them under for another 5 seconds. Repeat this for 10 times. This exercise can also be beneficial if you have hammertoes in addition to a bunion.


Toe Flexing and Contracting

This exercise is also recommended and to do this, you should press your toes against a hard surface such as a wall, to stretch and flex them. Hold the position for 10 seconds and repeat for three to four times. Next, flex your toes in the opposite direction, and hold that position for 10 seconds. Repeat again for three to four times.


Stretching the Big Toe

This exercise requires your fingers. Use your fingers to pull the big toe gently over into proper alignment. Hold the toe in this position for 10 seconds and repeat for three to four times.


Resistance Exercises

Resistance exercises are also great for the big toe. This can be done by wrapping a towel or belt around the big toe. Pull the big toe towards you while simultaneously pushing forward, against the towel or belt, with your big toe.


Towel Curls

You can also help strengthen your toes by spreading out a small towel on the floor. Curl your toes around it then pull it toward you – repeat this for five times. Gripping objects with your toes like this can definitely help keep your foot flexible.


Ball Roll

This can be done with the help of a golf ball. You will massage the bottom of your foot with the golf ball and this can be done sitting down. Roll the ball around under your foot for two minutes. This exercise helps relieve foot strain and cramping.


These exercises can be done ideally in the morning and at night. If you need help dealing with bunions, set up an appointment with Sheldon H. Nadal, DPM. 

Plantar fasciitis is one of the most common causes of heel pain. To be more specific, plantar fasciitis means that your plantar fascia is inflamed. 



Your plantar fascia, like a ligament, is a strong band of tissue that stretches from your heel (calcaneum) to your middle foot bones. It also supports the arch of your foot and acts as a shock-absorber in your foot.


What causes plantar fasciitis?

Repeated small injuries to the fascia that may or may not come with inflammation are thought to be the cause of plantar fasciitis. The injury is usually near the area where the plantar fascia attaches to the heel bone. There are situations wherein you are more likely to injure your plantar fascia:


  • If you have recently started exercising on a different surface – running on the road instead of a track.
  • If you are on your feet for prolonged periods of time.
  • If you do a lot of walking, running and/or standing.
  • If you are overweight – this puts extra strain on your heel.
  • If you have been wearing shoes with poor arch support or cushioning.
  • If there is sudden stretching or overuse of your sole.
  • If you have a tight Achilles tendon – this affects your ability to flex your ankle and make you prone to damaging your plantar fascia.

Plantar fasciitis might be confused with ‘Policeman’s heel’ but the two are different. Policeman’s heel is plantar calcaneal bursitis – inflammation of the sac of fluid under the heel bone. This foot condition is not as common as plantar fasciitis.


How common is plantar fasciitis?

This foot condition is common. Around 1 in 10 people will develop this foot problem at some point in their life. It is most common in people aged 40 to 60 years. However, it can still occur at any age. It is also twice as common in women as it is in men as well as in athletes.


What are the symptoms of plantar fasciitis?

The main symptom of this foot problem is pain that can be anywhere on the underside of your heel. However, one spot is found as the main source of pain commonly. It is often about 4cm forward from your heel, and it might be tender to touch.


The pain is often worst upon getting up in the morning when you take your first steps or when you take long periods of rest where no weight is placed on your foot. Gentle exercises might ease things a little as the day goes by. However, being on your feet for a long time or a long walk often makes the pain worse. Resting your foot, on the other hand, usually, eases the pain. 

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