Archive for September, 2014

We Offer Custom Functional Orthotics

September 22nd, 2014 by Dr.Chang

Orthotics are commonly suggested aides to recovery and injury prevention. Orthotic shoe inserts control the motion between the forefoot and the rear foot, evenly distributing the weight and pressure exerted on the foot. They reduce excessive motion that may occur in certain feet, they can act as a binding force that absorbs strain as pressure is exerted on them, and they can accommodate and cushion painful or injured areas. “While not everyone needs orthotics,” Dr. Murray notes, “they are a highly successful conservative treatment strategy for certain types of feet and foot conditions.” For problems ranging from structural deformities, such as bunions, to conditions such as posterior tibial tendonitis, orthotics are an economic way to both treat pain and prevent further injuries.orthotic pic reduced

Through their forty years of combined experience in working with Charlottesvillian feet, Dr. Murray and Dr. Chang have found resounding success in prescribing and fitting orthotics to fit a variety of foot types and injuries. The process for getting orthotics takes some time, primarily because Dr. Murray and Dr. Chang want to make sure that orthotics are right for the health of your feet.

If you suspect that you need orthotics or if you have foot pain, a first visit will include a foot examination, as well as an examination of your shoes. That’s right, bring your shoes to your appointment. The reason being is that the number one cause of foot pain and related injuries is worn out shoes. “Shoes are just not made to be worn forever,” comments Charlottesville shoe guru, Mark Lorenzoni of Ragged Mountain Running. Lorenzoni, a veteran runner and long-time shoe salesman, argues that you should be just as wary of your daily shoes as you are of your athletic shoes. Shoes should be sized properly in regard to the width of the different parts of your foot as well as your gait, your arch, and any propensities your foot may have to pronate. Shoes support your foot by guiding its motion.

If you did not consider which shoes are best for your individual feet, or if you wore out your shoes and kept using them, you may be experiencing a host of problems. Shoes that are too loose can cause blisters or problems with your Achilles tendon; shoes that are too tight could cause plantar fasciitis or aggravate bunions and bursitis; shoes too wide could cause problems in the ankle of people who pronate, and shoes too tight could cause ankle pain in a supinator. So if you come in telling Dr. Chang and Dr. Murray that you have kept working out in over-worn or ill-fitted shoes, they may just send you back to Lorenzoni’s shop. There, a number of trained shoe experts will conduct a gait analysis and draw on their years of expertise in the industry to match your feet to the proper shoe. And a time-saving strategy may be just trying new shoes and replacing your shoes every 200-400 miles, according to the chart below. The good news is that purchasing new shoes is often a complete solution to burgeoning foot pain! The shoe mileage chart below, created by the family at Ragged Mountain Running Shop, can help you sort out when to replace your shoes.

Shoe Mileage Chart

Over half the injuries runners and walkers experience can be directly attributed to “worn out shoes”. Worn out refers to the midsole (engine) of the shoe, which is the most important component of an athletic shoe. Don’t use the outsole/tread wear as a way of determining how much life is left in your shoes! This midsole component generally lasts about 375-450 miles of athletic use. Cut that mileage rating in half if you choose in addition to use your shoes for anything other than your running or walking exercise (i.e. “wearing around”). Here is a sample mileage chart to determine how often you might need to replace your exercise shoes.

Exercise miles/week5 miles/week10 miles/week15 miles/week

20 miles/week

25 miles/week

30 miles/week

35 miles/week

40 miles/week

50 miles/week

When to replace shoesEvery 18 months-two yearsEvery 10 months-1 yearEvery 6-9 months

Every 5-7 months

Every 4-6 months

Every 3-4 months

Every 3 months

Every 2.5-3 months

Every 2-2.5 months

*Created by the family at Ragged Mountain Running Shop*

New shoes, however, may not solve all your foot pain. If you still feel pain after you try out your spiffy new, well-fit shoes, it is time to visit your Charlottesville podiatrist. To get closer to the root of your foot pain problem, Dr. Murray and Dr. Chang are likely to suggest that you wear an over-the-counter shoe insert for a couple of weeks. These inserts cost between $35 and $60, and test whether your foot needs a little extra support or more specific support from an orthotic. If pain still occurs, upon the next visit Dr. Murray, Dr. Chang and their staff will assist you with taping your foot. The tape, in addition to the over-the-counter shoe inserts, will help to redistribute weight throughout the whole foot, binding it in a way similar to an orthotic to test whether a pair of custom-made orthotics will help you. Orthotics last about 5 years (depending on use), they lessen the likelihood of injuries, reduce doctors visits, and relieve pain.

The prescription for your orthotics will depend on your foot type, your condition or injury, and the intended purpose of the orthotic. To this effect, there are different kinds of orthotics. Orthotics are mainly grouped into two categories: functional and accommodative. Functional orthotics correct for excessive motion of the foot, preventing pain during ambulation. Accommodative orthotics are used to distribute weight away from a painful or injured area. Dr. Murray and Dr. Chang will scan your foot and write a customized prescription for your orthotics to fit your orthotics’ purpose and your intended activities. They will consider materials used, the rigidity of the device, and the shape of the heel or head to ensure you go home with the right product.

The process to begin wearing orthotics is gradual. It takes 2-3 weeks to work up to wearing an orthotic full time since the adjustments they make with your foot function could cause initial soreness or pain in the feet, ankles, knees or hips. It takes several months before athletes can run in orthotics comfortably. Be attentive to any pain that may surface in the initial weeks, as adjustments to your orthotics are free under a six-month warranty with the lab that makes them.

IMG_1762But it all comes back to shoes. Truth be told, orthotics are only as good as the shoes in which they are inserted. Make sure that your footwear is foot-friendly and accommodates orthotics. It is important to recognize that worn out shoes will negate the work of the orthotic. Note that not all shoes are made to accommodate orthotics, no matter the brand, style, or cost. Consult your podiatrist or local shoe store for more information on which shoes are compatible with orthotic devices. Although one pair of orthotics can be used in multiple pairs of shoes, most patients purchase multiple pairs of orthitcs to fit a variety of shoes.

As sand and dirt can abrade them, reducing their functional period, wash your orthotics every two weeks with mild soap and lukewarm water, letting them dry overnight before reinserting them. If you find that your orthotics squeak, remove them from your shoes and sprinkle talcum or baby powder on them, which should prevent the squeaking.

Your orthotics will work to restore your gait, posture, and to prevent a host of injuries that could be caused by your foot condition. Orthotics are affordable and last for years, and prevent a host of conditions, from runner’s knee to lower back pain. They are a highly effective, cost efficient, non-invasive, and all-around successful treatment technique. Orthotics are only helpful when used, so Dr. Murray and Dr. Chang suggest that you wear orthotics continually to reduce pain and to improve your posture and alignment.

Click here for a free book offer.

 
Blue Ridge Foot and Ankle Clinic
 
887 A Rio East Court Charlottesville, VA 22901
434-979-8116
 
417 South Magnolia AveWaynesboro, VA 22980
540-949-5150
 
Blue Ridge Foot and Ankle Clinic has been a part of the Waynesboro and Charlottesville communities for over 20 years. Podiatrists Dr. Kevin Murray and Dr. Stewart Chang offer services in sports podiatry, foot and ankle problems and diabetic foot care. Our friendly, accommodating team of Certified Podiatric Medical Assistants look forward to welcoming you to our practice.
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What is Morton’s Neuroma?

September 19th, 2014 by Dr.Chang

 A neuroma is a growth or thickening in the nerve tissue due to compression or irritation of the nerve. While neuromas can develop in different parts of the body, they are most commonly found in the feet between the third and fourth metatarsals and called Morton’s Neuroma, or intermetatarsal neuromas. Populations who wear restrictive shoes, or have foot abnormalities such as bunions, hammertoes, flat feet, or more flexible feet, are at a higher risk of developing this type of nerve damage. If you suffer from Morton’s neuroma, you probably already know this by the instant relief from the burning and aching toe pain once you take off your shoes. That’s because the width of your shoes often aggravate an already irritated nerve.

Neuromas have a variety of symptoms that vary from pain to tingling, burning or numbness, and even feeling as if something is inside the ball of the foot. Symptoms often have a gradual onset, first only flaming up when wearing shoes with a tight toe box or while engaging in activities that stress the ball of the foot. Initially, symptoms can be relieved by removing a constricting shoe, massaging the tender area, and by avoiding aggravating activities. However, as time passes, symptoms will get progressively worse. If untreated, neuromas can lead to permanent nerve damage, so consult your podiatrist early about your neuroma.

Treatment and prevention vary. First, make sure you have the proper shoes for your feet! Your podiatrist may suggest special padding techniques to relieve the pressure from the affected area. Additionally, icing, using over the counter or custom made orthotics, modifying activities that aggravate the injury, taking NSAIDs, or even cortisone injections can help. In more severe cases, surgery will be a viable option to remove the neuroma altogether.

Click here for a free book offer.

 
Blue Ridge Foot and Ankle Clinic
 
887 A Rio East Court Charlottesville, VA 22901
434-979-8116
 
417 South Magnolia AveWaynesboro, VA 22980
540-949-5150
 
Blue Ridge Foot and Ankle Clinic has been a part of the Waynesboro and Charlottesville communities for over 20 years. Podiatrists Dr. Kevin Murray and Dr. Stewart Chang offer services in sports podiatry, foot and ankle problems and diabetic foot care. Our friendly, accommodating team of Certified Podiatric Medical Assistants look forward to welcoming you to our practice.
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Where To Buy Shoes

September 15th, 2014 by Dr.Chang

We recommend the following stores when shopping for your next pair of shoes. There are many shoes that meet Dr. Murray’s and Dr. Chang’s specifications. These stores will take the time to fit you with the shoe that works best for your activities and needs. In general we recommend shoes with removable insoles, firm heel counter, torsional stability, and good cushion.

Click on picture to view Store websites and top selling shoes from each store.

540-943-1461

434-293-3367

540-885-3200

434-995-5669

 

540-564-2668

540-433-6323

434-977-4400

434-245-0208

Lexington 540-464-4453 Harrisonburg 540-434-9900

Click here for a free book offer.

 
Blue Ridge Foot and Ankle Clinic
 
887 A Rio East Court Charlottesville, VA 22901
434-979-8116
 
417 South Magnolia AveWaynesboro, VA 22980
540-949-5150
 
Blue Ridge Foot and Ankle Clinic has been a part of the Waynesboro and Charlottesville communities for over 20 years. Podiatrists Dr. Kevin Murray and Dr. Stewart Chang offer services in sports podiatry, foot and ankle problems and diabetic foot care. Our friendly, accommodating team of Certified Podiatric Medical Assistants look forward to welcoming you to our practice.
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sm100-logo-400

Blue Ridge Foot and Ankle Clinic’s employee, Mark Smith, had a strong showing at the Shenandoah Mountain 100 mountain bike race this past Sunday (watch). This was Mark’s first attempt at a 100 mile mountain bike race.  Racing for the Charlottesville Racing club/Blue Ridge Cyclery p/b Reynolds GM Subaru, he completed the course in 8 hours and 39 minutes, placing him 35th out of over 500 competitors.

“I’ve been wanting to compete in this race for a couple years now, but injuries kept me from participating”, says Mark.  Finally injury free, Mark was able to get a last minute entry to the race. Mark admits, “I have not been this nervous about an event in a very long time. All my friends and fellow competitors were giving me advice and it was making me more and more nervous.” Once on the starting line, the familiarity of racing calmed his nerves and the race was on. “100 miles of fun!” Yeah um, maybe for you Mark.

“All joking aside, this was a very hard race that tested every aspect of my biking skills. I didn’t want to get stuck in traffic, so I went out fast, too fast. 45 miles in, I had a hard time communicating with the volunteers at aid station 3. Luckily the volunteers were on the top of their game and just took care of me: food, drink, and a shove off in the right direction.”

Mark ran into hard times before reaching aid station 4 around 60 miles. A bad headache caused him to slow and have a hard time keeping his bike on the trail. Disappointment set in as he sat at aid station 4  with a cold wet cloth dripping water over his head and watching other racers ride by. “I was dizzy and in a lot of pain. I even contemplated dropping out.” After 10-15 minutes, Mark decided to just get on his bike and pedal slowly to the finish, well at least try to.

Approximately, 10 miles later Mark’s headache started to dissipate and he started to feel much better. “I couldn’t believe it. I couldn’t explain it. It was like my body did a complete 180.” For the last 30 miles, Mark, “put the hammer down”. Fellow riders warned him about the difficult climbs still remaining, but why slow down when you feel this good. “I felt great and was climbing stronger than I had all day. Maybe it’s the strength I developed on my back to back 100 miles to Georgia or with my teammate Barry Pugh.”

First 100 mile mountain bike race completed. When asked if he will do it again next year, Mark had this to say. “YES! I not only learned a lesson about staying in the race and finishing, I also had a blast. The whole weekend was fantastic. Chris Scott of Shenandoah Mountain Touring and all of the really helpful volunteers made this event one of my all time favorites. The trails were so much fun and at times extremely challenging. The climbs were long and hard. The competition was crazy good. Yes, these are the things I enjoy about racing. I love pushing myself and can’t wait till next year.  Oh, tell Dr. Chang the custom carbon orthotics he made for my cycling shoes did great. I had no foot pain whatsoever.”

Great job Mark.  See race results here, SM100.

Follow up note: 
Mark’s calves became very sore and tight a couple days after this race. Dr. Stewart Chang treated his calves with Extracorporeal pulse activation treatment (EPAT) Wednesday. We are happy to report, Mark’s calves were immediately better and he is back on the bike.
Athletes who need to stay consistent with their training should consider EPAT. Read about EPAT on this site or call us today. 

Click here for a free book offer.

 

Blue Ridge Foot and Ankle Clinic
 
887 A Rio East Court Charlottesville, VA 22901
434-979-8116
 
417 South Magnolia AveWaynesboro, VA 22980
540-949-5150
 
Blue Ridge Foot and Ankle Clinic has been a part of the Waynesboro and Charlottesville communities for over 20 years. Podiatrists Dr. Kevin Murray and Dr. Stewart Chang offer services in sports podiatry, foot and ankle problems and diabetic foot care. Our friendly, accommodating team of Certified Podiatric Medical Assistants look forward to welcoming you to our practice.
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