"Summer Foot" and Flip Flop Pain

I just had a friend text me and ask a very familiar question for this time of year. “Ian, my feet and shins are killing me. What can it be?” After a couple of questions back and forth trying to E-heal my friend, I simply asked how old her shoes were that she was walking in. She texted me back, “I don’t know, 3 months? Why does that matter?” I went on to explain how footwear can affect someone with a lot of walking if they get old, but her shoes were well within the realm of normal. After a little bit of a pause, she texted back again. “Um, I haven’t worn those in about a month, I’ve been wearing flats, and flip-flops to walk in.” Ta-Da, we figured out the root of the problem.

I know, I know, it’s summer time and we have all been waiting months to free our feet from the confines of shoes. Those perfect little flats that go great with that outfit. Those flip-flops that are so easy to slip on. Those bedazzled sandals that are just killer when you go out. I get it...but your feet don’t. I have started to evaluate more and more “summer foot” (that’s my phrase, not medical at all) in the clinic lately because of the nice weather. So what is summer foot and how do you fix it?

Summer foot is any pain in the foot associated with wearing horrible footwear. Some people get plantar fascitis, some get ankle pain, some get toe and bunion pain. No matter where the pain is, it is all from the same root cause - poorly supportive footwear that leads to bad alignment of the foot and ankle, and pain. You might be thinking, “Ian, not everyone gets summer foot though – why is that?” Well, not everyone has the same type of foot. Some people have a normal arch (they are the lucky ones) which allows them to wear unsupportive footwear without an issue. If you are like most of us though you have either too low of an arch (pronated) or too high of an arch (supinated).

If you have too low of an arch you will get more benefit from strengthening your foot and hip. Try these exercises:

They will help to strengthen your foot, and hip, and give you a little more arch support when you wear those summer shoes.

If you have too high of an arch, you aren’t as lucky as your low arch counterpart. A high arch means you have a very stiff bony structure. Although that is how you are built, you will still get some benefit from stretching your ankle and hip. Try these stretches to loosen your muscles and take some pressure off your arch:

 

 

The best way to make your feet feel better in the summer months is to wear those flats and flip-flops sporadically. If you do find yourself wearing them more than you should and your feet start to bother you, try the exercises. Hopefully they help you get through the nice weather with a pain free flip-flop tan.

Making Time for Physical Therapy

Let’s face it, nobody has enough time anymore. It’s the number one reason that we hear from our patients as to why it takes them so long to get started on a rehabilitation program. Once people do start on a program, they finally commit to getting better. The thing that makes us crazy, though, is when people throw all of their hard work away by not sticking with their program once they are discharged. Why do patients fall off the wagon once they are done with treatment? Time, not enough time.

We’re here to offer some solutions for people who are looking to stay on top of their program and stay pain-free especially during this busy holiday season.

1. You don't have to do every single exercise, every single day.

Rehabbing from an injury is a huge commitment. You usually have to go to PT 1-2x/week for about an hour per visit. When you are not at PT you have "homework" that you are supposed to do at least once per day. It all starts to add up. Patients think that once they are discharged they need to keep up with the pace of doing everything once a day. Add that to everything else that people have to do during the day and it starts to get overwhelming

We always try to educate our patients that rehabilitating is different from maintaining. When a patient is rehabilitating, they are working on correcting whatever strength, flexibility, or motor pattern issues that are leading to their pain. It takes more repetitions to make those changes, and that’s why we usually ask the patient to perform their program daily. 

Once they make those changes and are now pain free, the patient transitions to the maintenance phase. During the maintenance phase patients only have to perform the exercises 1-2 times/week. What a relief! Think of all that extra time you will have on your hands. 1-2 times/week is all that is needed to maintain that new strength and flexibility you have worked so hard to obtain. 

2. You don’t have to do all the exercises at once. 

Most patients’ rehabilitation "homework" consists of at least 5-6 exercises that you are supposed to do multiple repetitions of. That can add up to a lot of time in one sitting. Instead of trying to carve out a block of time to perform the whole program you can do each exercise at least once per day. If you have a free couple of minutes, do one of the exercises. If your program consists of some exercises that have you lying down you have two opportunities during the day where you start and end in that position (yes, we’re talking about sleeping, people!). Take a little extra time to do those exercises when you are already in the starting position. That way you can get to the whole program throughout the day, rather than feeling like you need "extra" time to perform the whole thing at once. 

3. You probably don't have to do every exercise on your program for the rest of your life. 

If you feel like your program is really extensive by the end of your rehabilitation, you are probably correct. If you truly feel like you can't do every exercise then be honest with your therapist. We always try to work our programs around what the patient is willing to commit to. Sometimes that is only two exercises. If that is all you can commit to, it just means you have commitment issues and that’s fine (…or is it?). In all seriousness, we would rather give someone a couple of exercises that will highlight the biggest areas of dysfunction vs. a program that is aimed at fixing everything that they won't stick to.

4. Pain sucks, so why would you want it to come back?

It drives us CRAZY when patients come back with the same injury. This drives us up a wall because the typical answer as to why their pain returned is because they didn't stick with the program. It’s like failing a test that you have the answers to. 

One of the best ways that we've found to keep people on track is setting a schedule. Set reminders on your phone, place sticky notes around your house, whatever reminders you need to stick to the schedule. That will give you the best opportunity to stay on track and live pain free!