So go ahead and step out in your favorite flip-flops for summertime strolls and parties. (P.S. Be sure to protect your feet with sunscreen.) Then, step into well-cushioned shoes when walking on concrete or pavement and exercising to dodge painful problems, say Mount Sinai School of Medicine Orthopaedic doctors who treat an influx of flip flop injuries each summer. Here’s why!

Flip-flops offer limited support.

1. People grip and hold flip-flops in place with their toes. Result: This motion changes the way you walk and can stress the toes, ankles, legs, hips, and back.
2. Flat and flimsy shoe beds provide inadequate foot support for all-day wear. Result: Arch pain, plantar fasciitis, and nerve issues.
3. Lack of shock absorption. Result: Pain in feet, legs, hips, and back.

Flip-flops offer limited coverage.

1. Few people understand or think of the foot as a place where skin cancer can arise. Result: Foot melanoma can be deadly. Mount Sinai Podiatrist Dr. Bryan Markinson reports a sharp rise in foot melanoma among his patients. Alert to sandal wearers: Remember to apply sunscreen to your feet!
2. Flip-flops leave toes and nails uncovered and unprotected. Result: Broken toes and toenails.
3. Feet can roll off the shoe. Result: Cuts and infections.

Mount Sinai’s Leni and Peter W. May Department of Orthopaedics specializes in surgery of the foot and ankle, knee, hip, hand, elbow, shoulder, and spine; total joint replacement for knee, hip, foot, ankle, and shoulder; microvascular surgery; cancer surgery; and minimally invasive surgery.

Flip-Flops For Summer Fun The Saturday Evening Post

1. Consider a supportive insert. UGGs are super-comfortable for many, but a lack of arch support and loose fit can sometimes cause tendonitis and heel pain.

2. Always wear socks. Bare, damp feet are prime targets for fungus and other infections.

3. Treat the outside of the boots with a product that repels stains and water. Follow product instructions carefully.

4. Treat the liner and interior of boots with anti-fungal spray once monthly.

5. Inspect the boot’s liner yearly and replace if badly worn, stained, or dirty.

6. Inspect the boot’s outer soles and heels after the cold weather season. If excessive wear is evident, look for a new pair at winter-clearance sales.

Do’s and Don’ts for UGG Boots The Saturday Evening Post

For the nearly 50,000 Americans seeking relief each 
year for debilitating bone-on-bone ankle pain and disability, there’s good news. Recent advances in arguably the 
most intriguing area of orthopedic surgery—total ankle replacement—are making strides in restoring mobility and quality of life to patients.

Today, four total ankle replacements are used in the U.S.: the Agility, the Inbone, the Salto Talaris Anatomic Ankle, and the Scandinavian Total Ankle Replacement (STAR).

“The technology is light years ahead of where it was a decade ago,” says Dr. Robert Anderson, an orthopedic surgeon in Charlotte, North Carolina, who performed more than 40 Inbone procedures in the past two years and is part of a design team working on a second-generation device.

Hi-tech artificial ankles provide a new alternative to surgery, which permanently fuses worn-out joints. That procedure reduces ankle pain but often limits mobility, causes a limp, and can lead to arthritis in nearby foot joints. An estimated 25,000 Americans underwent ankle fusions in 2009; others considered even more drastic measures.

Reasons for needing an ankle replacement include wear-and-tear over time, accidents, sports injuries, and bone diseases that lead to severe and life-limiting arthritis.

Four years ago, Jeanne St. John’s ankle problems led her to the brink of a difficult decision.

“I was born with deformed ankles and, eventually, was 
so immobilized by arthritis that I considered a double amputation,” recalls St. John, who lives in Oregon. “Then a friend heard about the Inbone. It’s been life-changing for me.”

As with hip and knee replacements, the history of total ankles dates back to the 1970s. Healthy ankles can withstand 1.5 times one’s body weight while walking, but early devices didn’t hold up. Then, Dr. Mark Reiley—who performed St. John’s surgeries in the San Francisco Bay Area—devised a new way to replace the complex joint.

“Dr. Reiley took the proven technology of knee replacements and basically flipped it upside down to be used in the ankle,” Dr. Anderson describes. “The device, now called the Inbone, has very good mechanical advantages and can be used for primary replacements, as well as revisions of failed or previously placed devices. We believe it will be successful 
for a long time.”

Orthopedic surgeons select the specific ankle replacements depending on patient age, anatomy, bone quality, and goals. Long-term success rates on Inbone are not yet available; European data show that 85 percent of modified Salto and STAR devices are functioning well after 10 years.

But Jeanne St. John, now age 67, prefers to focus on how far her new ankles take her.

“I think in terms of steps rather than years,” she says. “I save my steps for selected activities and for travel. Some of my friends are slowing down, but I have this ‘reverse aging’ thing going on, and I’m so thankful.”

Good News for Bad Ankles The Saturday Evening Post

My husband’s feet smell terrible. He has calluses and uses foot creams after his daily shower. He changes socks and shoes every day. Is there anything we can do to cure this awful problem? We are anxiously awaiting your reply.

Smelly Feet: What to Do The Saturday Evening Post

Jeannine

Michigan
Post contributing editor and dermatology expert Dr. C. William Hanke replies:

“Your husband’s symptoms are most commonly associated with a type of eczema called dyshidrotic eczema that results from lack of moisture in the skin caused by seasonal changes to cold, dry temperature, frequent skin washing, and indoor heating which decreases skin moisture.

“Treatment includes minimal use of soap, applying over the-counter emollients (ointments are better than creams and lotions which are water-based) and, when severe, the use of prescription strength topical steroids. Early diagnosis and treatment is important to prevent the development of open foot sores that may progress to chronic wounds.

“Dyshidrotic eczema is also called pompholyx, a term that derives from cheiropompholyx meaning ‘hand and bubble’ in Greek. Patients typically present with itchy bumps that progress to water blisters on the sides of the hands and feet in a near symmetric distribution.”

Skin Problem Could Be Eczema The Saturday Evening Post

About 75 percent of the nearly 800,000 surgeries performed for bunions and the other most common foot problems are caused by poorly fitting shoes, according to the American Orthopedic Foot & Ankle Society.

Consumers can prevent painful feet by simply buying shoes that fit. Ron Harris, director of product logistics at Munro & Company, offers the following tips.

1. Start by having both feet measured. Some people’s feet change sizes as they age, have children, gain or lose weight, or change physical activities.
2. Because most people have one foot larger than the other, be sure you pick a shoe that fits your larger foot comfortably. You can always add an insert or pad to the shoe for the smaller foot.
   Shoe sizes are not universally standardized. “Different brands and different styles within a brand will fit differently,” Harris says. “A shoe labeled 8 ½ may fit like an 8 or may fit like a 9.” The half-size of a shoe is only one-sixth of an inch.
3. Even with a company like Munro that makes 75 different sizes per style to ensure the right fit, the same woman may wear different sizes in different styles because of the shape of her foot.
   “Most of our customers can wear all of our shoes in the same size, but not all of our customers can,” Harris says. If someone has a high instep, for example, she may have to wear a different size for a low-cut pump than she would for a boot.
4. Select shoes that conform to the shape of your foot. You can still wear a pump that fits comfortably, as long as you don’t try to squeeze your toes into the point. The widest part of your foot should fit into the widest part of the shoe. “You’re going to have to have some room at the end.”
5. That half-inch space between the end of your toes and the shoe isn’t just for kids. Harris says everyone should have up to half an inch between their longest toe and the end of the shoe.
6. Slippage is good—just not too much. As we walk, our feet have to have room to bend within the shoes. If you don’t have enough room, you’ll get blisters or “pump bumps,” calcium deposits caused from chronic irritation or rubbing. “If you cannot pull your heel out of a shoe while standing, the shoe is probably too short or narrow.”
7. The shoe should feel comfortable when you walk around the store. If it hurts in the store, it’ll hurt when you wear it.
8. Try to recreate the conditions under which you’ll be wearing the shoes. If you’re the kind of person who is on your feet all day, your feet swell as the day goes on. So it’s best to try on shoes in the evening.
9. If you wear orthotics, take them with you for your fitting. “The slightest difference from the insert or insole can have a drastic effect on the fit of your shoes,” he says. Orthotics affect the size and fit of a shoe, so if you buy shoes without seeing how they fit with the orthotics, “it could completely defeat the purpose of the orthotics.”
10. Try on shoes with the same type or weight of socks you’ll be wearing with the shoe. For example, don’t wear trouser socks to try on dress shoes if you’ll be wearing the shoes with nylons. And don’t wear nylons to try on athletic shoes. “They need to fit in the same environment in which you need the shoes,” he says.

And to get the most life out of your shoes, Harris advises never to never wear the same shoes two days in a row, so they can dry out naturally.

Find the Perfect Shoe The Saturday Evening Post