Prevent Foot Problems When Walking

Americans are on the go. According to a NSGA Survey, 71 million American adults are exercise walkers, making walking the top sport in the United States. Taking steps daily to improve health will help with America's obesity epidemic. Sixty five percent of Americans are overweight, which is linked to diabetes, heart disease, arthritis and some types of cancer. Walking an extra 2000 steps a day is equivalent to walking a distance of 1 mile and to burning 100 calories. Burning an extra 100 calories a day is equivalent to losing about 10 pounds in a year.

The American Podiatric Medical Association teamed with Prevention Magazine to name the "12 Best Walking Cities in the U.S." The cities were examined based on their crime rate, air quality, mass transit, historic sites, museums, parks and gyms. The top 12 cities were San Francisco, San Diego, Honolulu, Washington, DC, San Antonio, El Paso, St. Louis, Madison, Chicago, Philadelphia, New York and New Jersey.

National campaigns, health practitioners and even major corporations are encouraging Americans to walk more. Unfortunately, many sedentary individuals who start walking programs quickly develop foot problems. Almost sixty million Americans have foot problems and many develop them after beginning a new exercise routine. A foot injury can take weeks, even months to heal and many will gain more weight during this healing period. Preventing these problems through education will keep Americans walking.

1. Buy a shoe made for walking. Make sure the shoe has enough stability and support. If you can fold the shoe in half, it is too flexible. Make sure the shoe has enough room at the toes and is fitted well at the heel.

2. Start on flat surfaces. Do not start a walking program walking on hills or stairs.

3. Start with a short distance. Stick with that distance for a week. If you are pain free and injury free, increase the distance the following week.

4. Start with an easy pace. Increase your pace gradually.

5. Choose soft surfaces. Walking on a track or a trail will decrease the impact on your feet and legs. Cement can be a particularly hard surface to walk on.

6. Limit your time on the treadmill. Treadmills can contribute to the development of foot problems. Start with the treadmill flat and at a slow pace. Slowly increase your pace each week. Increase the incline after you have reached a comfortable pace.

7. Stop if you feel foot or ankle pain. Don't try to walk through the pain.

8. Examine your feet. Look areas of rub or irritation the first few weeks of your walking program and then again after trying new shoes or socks. Moleskin can be placed on areas of irritation to help decrease friction. Do not use bandaids on these areas.

9. Consider wearing orthotics. Individuals with flat feet may need inserts for their shoes. When buying inserts, look for sport othotics, as opposed to cushioned insoles. A more rigid insert will offer more support. Custom orthotics can be made by a podiatrist if necessary.

10. Avoid cotton socks. Synthetic socks decrease friction, prevent excess rubbing and don't absorb moisture. Your local running store or sports store should carry a variety of new high-tech socks for walking.

Consult your podiatrist if you start to develop pain when walking, or consider a visit before embarking on your new walking program.

By Christine Dobrowolski

Treating Neuromas - Ten Tips

A neuroma is an inflamed nerve. In the foot, the most common place for a neuroma is between the third and fourth toes. The main nerve to your foot originates in the spine and travels down the back of the leg to the bottom of the foot and out to the toes. When the nerve becomes irritated, electrical or burning pain shoots out to the toes when walking. The second, third and fourth toes can become numb. There can be a sensation of walking on a lamp cord or a lump. Removing the shoe and massaging the ball of the foot can bring relief.

To help decrease the pain, try the following tips:

1. Rest. Every step you take aggravates the nerve. Decreasing the time on your feet will help decrease the inflammation. If you walk for exercise, try biking or swimming instead.

2. Avoid activities that aggravate the pain. Squatting, walking or running hills, climbing up and down stairs and carrying heavy items will increase the stress through the ball of the foot and irritate the nerve. Taking the stress off the nerve will help decrease the irritation, decrease the inflammation and accelerate healing.

3. Wear low-heel shoes. Any shoe (cowboy boots or high heeled dress shoes) will place excessive pressure on the ball of the foot. Keep the heel height below 1 inch.

4. Wear shoes with a wide toe box. If the toes are cramped together, this places pressure on the nerve, worsening the irritation. Your toes should have enough room to "wiggle".

5. Wear rigid shoes. Wearing flexible shoes increases the force placed through the ball of the foot. A rigid shoe with a rocker sole will decrease the pressure on the nerve.

6. Ice your foot. Placing ice of the ball of the foot for 20 minutes once or twice a day will decrease pain and inflammation.

7. Use contrast soaks. Start with 5 minutes of heat, then apply 5 minutes of ice, then switch back to heat and alternate for 20-30 minutes. Contrasting between hot and cold will help decrease the inflammation around the nerve.

8. Place a neuroma pad in your shoe. A neuroma pad (similar to a metatarsal pad) can be placed in the shoe, under the ball of the foot. The pad lifts up the bones in the foot to help decrease the pressure on the nerve. The pad should be placed behind the ball of the foot.

9. Slip inserts into your shoe. Make sure the insert you buy is an orthotic. The device should be semi-rigid to help control motion in the foot. These can be bought at your local running shop or sports store.

10. See your podiatrist. If the pain persists after taking these steps, make an appointment with your podiatrist.

By Christine Dobrowolski

Signs of Suicide : Learn What They are and How to Deal with Them

The true numbers are probably much higher because many suicides are reported as accidents or illnesses. Suicides are usually the result of a complex combination of emotional, social, and biological factors. For that reason, learning about the warning signs of suicide can be difficult yet so important.

Warning Signs of Suicide:

Feelings of helplessness and hopelessness
Extreme withdrawal from friends, family, and usual activities
Talking about suicide or "ending it all"
Self-destructive or risk-taking behavior
Giving away favorite possessions
Sudden changes in mood or behavior
Increased use of alcohol or drugs
dentification with someone who has committed suicide
Preoccupation with thoughts of death
Previous suicide attempt(s)

How to Help Someone Showing Signs of Suicide

Know the warning signs!

Most suicidal people give clues about their feelings. Don't be afraid to ask someone you are worried about if he or she is thinking of taking his or her own life. You cannot make someone suicidal by asking a direct, caring question about the warning signs of suicide you may have identified. Tell your loved one that you are worried and give specific reasons why. Stress that he or she is very important to you and to other people. Encourage that person to get help through a psychiatrist, social worker, clergy member, or other mental health professionals.

How to Deal with Signs of Suicide:

Stay Calm. Don't overreact.

Express Concern. Take your friend or family member seriously. Explain why you are worried. Be specific.

Listen Attentively. Maintain eye contact.

Ask Direct Questions. It is important to find out if your friend has a specific plan for suicide.

Acknowledge Feelings. Do not be judgmental. Don't take it personally if you can't help your friend "cheer up".

Reassure. Stress that suicide is a permanent solution to temporary problems. Remind your friend that there is always hope, and things can and will get better.

Don't Promise Confidentiality. You may need to consult others, or talk to your friend's doctor about the signs of suicide you have identified. Take Action, Involve Others.

Don't attempt to handle this alone. Consult others who are trained to help and deal with warning signs of suicide.



By Charles E. Donovan

Another Cold Sore! Why Me?

An estimated 85 million Americans have acquired the herpes simplex (cold sore) virus. And the majority had received the virus before the age of 3.

Not such a big surprise when you realize how many loving Uncles, Aunts and nephew just can't resist that cute little Kissy Kissy baby. Which is exactly how the Herpes Simplex virus is passed along. That innocent little hug and kiss is all it takes to inject a lifetime of the Herpes Simplex virus.

Generally a cold sore will run from 5 to 15 days in its various stages. They will range from a tiny split to an enormous sized seeping scab.

If the virus has gained strong immunities against your antibodies then you will be prone to repeated outbreaks.

Unlike the sexually transmitted Herpes virus there is little to worry about with the Herpes Simplex virus other than an occasional lip sore that can grow to the size of a watermelon and cause every living being to stare at you like you have a 12 inch nose growing out the side of your face.

So the first question to pop into your mind might be, "is there a cure"? No. The herpes simplex virus is very versatile and can adapt to just about anything you can throw at it. It will adapt and become stronger with each form of treatment.

Which brings us to question two. "Is there any particular remedy that has proven to stop or control cold sore outbreaks". Accepting the fact that what was just said in the proceeding paragraph the answer would be yes and no.

Because most immune changes of the virus are minor it leaves it open to possible treatments by various antibiotics and many natural remedies which can temporarily halt an outbreak. However, again the virus will quickly adapt to many of these treatments making them useless on the next outbreak.

So, yes some treatments will work on most outbreaks but there will definitely be a stage of herpes simplex virus immune syndrome that will eventually make most all present day treatments ineffective. Simply meaning the more you try to treat the outbreaks with various medications the sooner you will reach the stage where no treatment will help.

You must also keep in mind that your present overall health conditions and other variables may temporarily slow or stop a remedy from working. So it may not always be the virus but your present health condition that blocks any remedy from working. So, what is your solution for cold sore outbreaks?

If you have the simple small split type sore just let it run the course. Your body will develop antibodies to overpower the virus outbreak which will help keep new outbreaks from happening so repeatedly.

However if you have the major Mt Saint Helen's size outbreak then you can try the various medications and treatments in hopes that you will hit the right one.

A rule of thumb would be not to use remedies that you have recently used in the past simply because of the likelihood that the virus has already become immune to it.


By Dan Adams

"Ooohhh? my aching knee!!!" Insider Secrets on How You Can Get Relief Quickly and Easily!

When your knee hurts, getting relief is all that's on your mind. Getting the right relief, though, depends on knowing what's wrong. The correct diagnosis will lead to the correct treatment.

Know Your Knee!

The knee is the largest joint in the body. It's also one of the most complicated. The knee joint is made up of four bones that are connected by muscles, ligaments, and tendons. The femur (large thigh bone) interacts with the two shin bones, the tibia (the larger one) located towards the inside and the fibula (the smaller one) located towards the outside. Where the femur meets the tibia is termed the joint line. The patella, (the knee cap) is the bone that sits in the front of the knee. It slides up and down in a groove in the lower part of the femur (the femoral groove) as the knee bends and straightens.

Ligaments are the strong rope-like structures that help connect bones and provide stability. In the knee, there are four major ligaments. On the inner (medial) aspect of the knee is the medial collateral ligament (MCL) and on the outer (lateral) aspect of the knee is the lateral collateral ligament (LCL). The other two main ligaments are found in the center of the knee. These ligaments are called the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL). They are called cruciate ligaments because the ACL crosses in front of the PCL. Other smaller ligaments help hold the patella in place in the center of the femoral groove.

Two structures called menisci sit between the femur and the tibia. These structures act as cushions or shock absorbers. They also help provide stability for the knee. The menisci are made of a tough material called fibrocartilage. There is a medial meniscus and a lateral meniscus. When either meniscus is damaged it is called a "torn cartilage".

There is another type of cartilage in the knee called hyaline cartilage. This cartilage is a smooth shiny material that covers the bones in the knee joint. In the knee, hyaline cartilage covers the ends of the femur, the femoral groove, the top of the tibia and the underside of the patella. Hyaline cartilage allows the knee bones to move easily as the knee bends and straightens.

Tendons connect muscles to bone. The large quadriceps muscles on the front of the thigh attach to the top of the patella via the quadriceps tendon. This tendon inserts on the patella and then continues down to form the rope-like patellar tendon. The patellar tendon in turn, attaches to the front of the tibia. The hamstring muscles on the back of the thigh attach to the tibia at the back of the knee. The quadriceps muscles are the muscles that straighten the knee. The hamstring muscles are the main muscles that bend the knee.

Bursae are small fluid filled sacs that decrease the friction between two tissues. Bursae also protect bony structures. There are many different bursae around the knee but the ones that are most important are the prepatellar bursa in front of the knee cap, the infrapatellar bursa just below the kneecap, the anserine bursa, just below the joint line and to the inner side of the tibia, and the semimembranous bursa in the back of the knee. Normally, a bursa has very little fluid in it but if it becomes irritated it can fill with fluid and become very large.

Is it bursitis... or tendonitis...or arthritis?

Tendonitis generally affects either the quadriceps tendon or patellar tendon. Repetitive jumping or trauma may set off tendonitis. The pain is felt in the front of the knee and there is tenderness as well as swelling involving the tendon. With patellar tendonitis, the infrapatellar bursa will often be inflamed also. Treatment involves rest, ice, and anti-inflammatory medication. Injections are rarely used. Physical therapy with ultrasound and iontopheresis may help.

Bursitis pain is common. The prepatellar bursa may become inflamed particularly in patients who spend a lot of time on their knees (carpet layers). The bursa will become swollen. The major concern here is to make sure the bursa is not infected. The bursa should be aspirated (fluid withdrawn by needle) by a specialist. The fluid should be cultured. If there is no infection, the bursitis may be treated with anti-jnflammatory medicines, ice, and physical therapy. Knee pads should be worn to prevent a recurrence once the initial bursitis is cleared up.

Anserine bursitis often occurs in overweight people who also have osteoarthritis of the knee. Pain and some swelling is noted in the anserine bursa. Treatment consists of steroid injection, ice, physical therapy, and weight loss.

The semimembranous bursa can be affected when a patient has fluid in the knee (a knee effusion). The fluid will push backwards and the bursa will become filled with fluid and cause a sensation of fullness and tightness in the back of the knee. This is called a Baker's cyst. If the bursa ruptures, the fluid will dissect down into the calf. The danger here is that it may look like a blood clot in the calf. A venogram and ultrasound test will help differentiate a ruptured Baker's cyst from a blood clot. The Baker's cyst is treated with aspiration of the fluid from the knee along with steroid injection, ice, and elevation of the leg.

Knock out knee arthritis... simple steps you can take! Younger people who have pain in the front of the knee have what is called patellofemoral syndrome (PFS). Two major conditions cause PFS. The first is chondromalacia patella. This is a condition where the cartilage on the underside of the knee cap softens and is particularly common in young women. Another cause of pain behind the knee cap in younger people may be a patella that doesn't track normally in the femoral groove. For both chondromalacia as well as a poorly tracking patella, special exercises, taping, and anti-inflammatory medicines may be helpful. If the patellar tracking becomes a significant problem despite conservative measures, surgery is need.

While many types of arthritis may affect the knee, osteoarthritis is the most common. Osteoarthritis usually affects the joint between the femur and tibia in the medial (inner) compartment of the knee. Osteoarthritis may also involve the joint between the femur and tibia on the outer side of the knee as well as the joint between the femur and patella. Why osteoarthritis develops is still being scrutinized carefully. It seems to consist of a complex interaction of genetics, mechanical factors, and immune system involvement. The immune system attacks the joint through a combination of degradative enzymes and inflammatory chemical messengers called cytokines.

Patients will sometimes feel a sensation of rubbing or grinding. The knee will become stiff if the patient sits for any length of time. With local inflammation, the patient may experience pain at night and get relief from sleeping with a pillow between the knees. Occasionally, locking and clicking may be noticed. Patients with osteoarthritis may also tear the fibrocartilage cushions (menisci) in the knee more easily than people without osteoarthritis.

So how is the arthritis treated? An obvious place to start is weight reduction for patients who carry around too many pounds.

Strengthening exercises for the knee are also useful for many people. These should be done under the supervision of a physician or physical therapist.

Other therapies include ice, anti inflammatory medicines, and occasionally steroid injections. Glucosamine and chondroitin supplements may be helpful. A word of caution... make sure the preparation you buy is pure and contains what the label says it does. The supplement industry is unregulated... so buyer beware!

Injections of the knee with viscosupplements - lubricants- are particularly useful for many patients. Special braces may help to unload the part of the joint that is affected.

Arthroscopic techniques may be beneficial in special circumstances. Occasionally, a surgical procedure called an osteotomy, where a wedge of bone is removed from the tibia to "even things out," may be recommended. Joint replacement surgery is required for end stage knee arthritis.

Research is being done to develop medicines that will slow down the rate of cartilage loss. Targets for these new therapies include the destructive enzymes and/or cytokines that degrade cartilage. It is hoped that by inhibiting these enzymes and cytokines and by boosting the ability of cartilage to repair itself, that therapies designed to actually reverse osteoarthritis may be created. These are referred to as disease-modifying osteoarthritis drugs or "DMOADs." Genetic markers may identify high risk patients who need more aggressive therapies.

Newer compounds that are injected into the knee and provide healing as well as lubrication are also being developed. And finally, less invasive surgical techniques are also being looked at. Recent technological advances in "mini" knee replacement look very promising.

By Dr. Wei

Irritable Bowel Syndrome: Simple Self-Help Tips

If you have been diagnosed with irritable bowel syndrome (IBS), you will know how difficult it is to treat. Doctors can be dismissive of IBS symptoms such as diarrhea, constipation and bloating, and when treatment is offered it may only help for a short while before the distressing symptoms return.

Sufferers often find that they have to deal with the symptoms themselves, through self-help methods and supplements, rather than by using conventional medicines. However, this does not mean that there is no hope of improvement. By sharing their experiences, sufferers can learn a lot about what really helps to ease IBS.

All the self-help tips in this article have come from IBS sufferers who have found a way to control their irritable bowels. Before trying any form of self-help, please make sure that you have your doctor's approval, and do check that anything you try will not interfere with any medication you are taking.

Calcium tablets

Linda, who suffers from severe diarrhea, says: "What has helped me for more than two years is calcium carbonate, an over-the-counter supplement. I take three tablets a day, one at each meal. The most success has come from using any formula of calcium supplement that is like Caltrate 600 Plus with vitamin D and minerals. The only side effect is at the beginning of taking the calcium you may have some gas or indigestion, but this usually goes away after taking a regular dose for a few days."

If you suffer from constipation rather than diarrhea, you could try magnesium supplements instead, as these can have a slight laxative effect.

Digestive enzymes and probiotics

Kim, who also suffers from bad diarrhea, says: "I tried taking digestive enzymes with acidophilus and found significant relief within three days. I am not afraid to eat now, but find that I still cannot eat very much refined sugar or high fibre vegetables. I have also added a cup or two per day of peppermint and chamomile tea. When I do have an episode it occurs late in the day and by the next morning I am feeling back to normal."

Looking at your diet

Laura describes how a close examination of her diet helped her IBS: "I was placed on every kind of medication, and sometimes they worked in the short term, sometimes they didn't work at all. The doctor finally suggested trying to alter my diet in cycles, and we discovered that eating meat was my problem. I became a vegetarian and no longer have constant problems. Sometimes I even go years without any pain at all. It's worth all the effort you put into it when you finally feel better."

Mina also found that dietary change helped control her symptoms, alongside traditional medication: "I've made a number of changes to my diet. I've eliminated milk and mostly any dairy, fried foods, sugar for the most part, pop, alcohol, potato chips, spicy food, rice, pasta and bread. Most recently I'm eliminating flour. But my best friend for the last couple of years has been Imodium Quick Dissolve tablets. I don't ever leave home without them. I just have to make sure I don't overdo it. If I ever become immune to the wonder drug I am gonna be a real mess!"

Flaxseed

Watching your diet is sometimes not enough to completely control the symptoms, and natural or herbal supplements can help, as Marion discovered: "After about six months of a horrendously restrictive diet (ultra low-fat vegan with no raw veggies or fruit except banana) and a lot of Metamucil, I managed to get it sort of under control. But if I deviated from the diet, the chronic diarrhea would come back. Someone I met told me that she had helped her IBS by taking a tablespoon of freshly ground flaxseed with a glass of water or juice every morning.

I thought it was another crackpot cure, but eventually I decided to try it. She had told me that pre-ground flaxseed didn't work because flax seed starts to oxidize as soon as you grind it and that whole flax seeds are no good either, because they cannot be digested properly. After years of IBS, in about two weeks it just went away. I cannot believe that I now have perfectly normal, regular bowel movements."

Fiber, water and yoga

Pam, who struggles with constipation, has developed a combination of things which work for her: "I drink Metamucil (psyllium fibre) every day and try to relax, pray or meditate, even do a little yoga. The more I make myself relax and take time to de-stress the better I can manage my problem. I know time for yourself is very hard to come by sometimes but I have to if I'm going to manage this. I try to drink at least three bottles of water a day. This is also hard sometimes but I have to take care of me the best I can. I also take a mild anti-depressant. This has helped a bunch in my stress department and in turn has helped my IBS."

Stress and IBS

Daniel believes that his symptoms are related to his emotions and stress: "I thought that when I was stuck on the toilet, experiencing the most severe cramps, thinking I was about to pass out from the pain, feeling like I was about to throw up, I was the only one. I'm still trying to work it out but I believe it has a lot to do with my psychological state. I say this because although I don't get too stressed out at any one moment, I do have general worries about money and life. I tend to find when I'm not worrying about these things I don't get the pain as much, if at all.

It's easier said than done of course, I can't just stop worrying about money or my future, but being aware of these things seems to help - being optimistic and knowing that everything is only temporary. I have been taking Colpermin (peppermint capsules) as a preventative which often helps and for a while I took painkillers which I think helped."

Soluble versus insoluble fiber

Some nutritionists believe that IBS sufferers' intestines react differently to soluble and insoluble fiber, and this has been Stu's experience: "After trying all kinds of drugs and healthy eating, my pains were still there. I found by accident that it wasn't so much what I ate but whether I ate it on a full stomach or not. My failsafe is pasta on an empty stomach, I get no reaction - it is soluble fibre that settles the colon apparently. I quickly searched on the internet for recipes high in soluble fibre and I have improved.

Most significantly though I am on no medication and this puts me in control of the IBS, not the other way around. I think this is important as stress certainly can trigger the symptoms off. I don't avoid insoluble fibre as it is essential for the body, but I recommend that you eat it on a full stomach."

By Sophie Lee

A Very Medical Miracle

Madeline Mann once weighed less can a can of soda making her the tiniest surviving newborn known to medicine. Next week, she enters high school as something even more exrtaordinary- a honor student who likes to play violin and Rollerblade.

"Her survival wasn't the miracle; her development was." says Dr. Jonathan Muraskas of Loyola University Hospital in Maywood, Ill. She was Born 27 weeks into her mothers pregnancy, she weighed just 9.9 ounces, less than any surviving baby in medical history. Just 10 inches long, smaller than a football. She rested easily in the nurses hand.

Madeline, now 15, weighing 61 pounds and measuring 4 feet 7 has no major medical problems.