Veruccae

Most parents are unaware that veruccas, usually found on the soles of our feet, which are the blight of children who swim (as they’re often picked up on damp surfaces such as pool surrounds), are caused by the HPV virus.

Verucca is actually another name for ‘wart’ but commonly refers to the black-headed warts that affect our feet. The black head is actually a result of the way the wart pulls blood vessels up towards the surface.

Avoid catching them by:

• Wear flip-flops around the pool and changing room


• Don’t cut toenails too short

If your child has one: Don’t panic – most veruccas clear up of their own accord, although it can take anything up to two years.

The current medical advice is to treat veruccas only if they’re painful. See a podiatrist if they persist or are sore.

From www.supplefeet.com/products you can buy tea tree oil with lemon which is great in the early stages and for more active treatment moderate strength salycyclic acid preparations such as Duofilm and Occusal are recommended for At Home use.

Keeping them covered with a simple elastoplast also helps speed up the resoution of these.

How to Cut your toenails properly

A simple task you would think but as with all things there is a better way.

Best to avoid jagged, sharp edges and for this reason I was asked by the Daily Mail to write a short piece on how to cut your toenails!

My main advice is to follow the natural contour of the nail, ie not just straight across and more gently rounded. Use clippers, not scissors ( they slip) and no digging down the sides.

See a podiatrist for advice on thickened or difficult nails. We can painlessly pare them down for you. What you do not want is to creat the nasty ingrowing toenail pictured.

Use tea tree oil to keep the nails clean and olive oil is always great for adding moisture to the nail plate and gives a nice healthy shine.

BBC newsround

We were featured today on BBC newsround. A programme specifically for kids so we had wonky camera angles and fun "worse feet" stories. With my daughter's assistance we demonstrated flat feet in kids and various insoles to be used to help. the main message was that bad shoes equals bad feet!

Take a look at http://news.bbc.co.uk/cbbcnews/hi/newsid_8290000/newsid_8290100/8290117.stm

keystone effect

I am always reminded about the need to restore the arch.
We do it as Podiatrists in many different ways, usually with insoles or orthotics.
The real arch of the foot is across the middle and is known as the transverse arch. Get this right and the foot is a stable structure. Any problems here lead to hyper pronation and a tilting and rotating of the foot.
Hence the need to stabilise the arch with shoes, insoles or the Hyprocure or other arch procedures.

Buying shoes

Took my child to get a pair of shoes today and the

process was dreadful, she was measured one whole size different and told the shoes did not come in her size, but they do!

We went specifically to get a pair of Start rite lovely red patent shoes for my Dorothy aged 3.

We have had these before and love the style. Classic, good heel counter, well made and in a lovely colour. Her sister has them for school and my only request is that they extend the colours into the bigger sizes.

First stop John Lewis who despite no queues keep us waiting for half an hour. (Why?) Chap comes out and measures her on a Clarks gauge and declares that she is a size 8 and a 1/2 and that the requested shoes are not in stock as they finish that colour (not the style) at size 6 and a 1/2. Not true! We try another style of red patent but they are the last pair and the display shoe, ill fitting and not what we had set out for.

Next stop Russell & Bromley who did pay attention to the queue and the wait was brief. We were measured again, this time on a Start Rite gauge. The young shoe fitter tried the bigger gauge first ,too small, and then the baby gauge which is non-weightbearing. Dolly was declared to be a size 7 and a half! I decided not to ask why she had measured one whole size smaller than the last measurement and thought I would see how it panned out. I asked for the red Mary Jane patents, that were in the shop. The response; that was not possible as they started at 8 and a half!

I insisted on trying the 8 1/2 pair and they fitted well. However when I asked to recheck the sizing and this was duly done and then I agreed to buy the shoes. I was told I would be a "self fit" as I had not gone with her measurement! Apparently this means that any blisters or tripping up caused by the shoes would be my fault!

So in summary

I am invited to speak on womans hour about childrens shoes as a foot expert and am met with this ridiculous scenario when buying for my own child.

Two well known stores, one classic brand and so much mis-information. Actually the red colourway is available on the wonderful Start Rite website easily and simply in a size 9.

So much for getting them professionally fitted!

TUC & high heels

Celebrating the success at the TUC of the debate on the wearing of high heels in the workplace.

This started in 2007 when I was asked by the Soceity of Chiropodists & Podiatrists to address a Parliamentary select committee on feet. The topic I was asked to speak about was "working feet" so I thought about all the women I saw in my hospital near Heathrow airport and the trouble they had with their feet.

The first group, the clickety clacks as I christened them, were unable, by the set dress code, to wear anything other than heeled court shoes; if we as foot specialists needed to change their shoes, even marginally, with a strap or a buckle we could not. If their foot problem demanded a change of shoes the woman (always the woman) would be moved to a back office position or, worse, be unable to carry out her tasks and therefore lose her job.

So to see this culminate in todays high profile debate, widespread media coverage and an acceptance of the legitimate concerns of the female workforce is a real joy.

NB High heels are a huge topic but not the only one to affect women!

dangers of flip flops!

Having spent a day out at Legoland I had a horrid blister in between my toe! An injury inflicted by flip flops. Really good ones, Havanas, and super comfortable until they caused a blister!
Amazingly sore and a real lesson in foot pain. Rescued by a silicon tube from Supplefeet.

Thongs aka Flip flops

I have only just realised that the word used in Australia for flip flops is thongs! So there is this wonderful sentence in the article on wearing high heels ; "thongs and ballet pumps not being the best option for women" a quote from an eminent senior Australian podiatrist, Mr Brown. He and I were both quoted in the article in The Sydney Morning Herald.

I shall be very mindful of the word difference for the future!

Australian news!

The Sydney Morning Herald has run an article on high heels. They have picked up on an article I contributed to for the Daily Mail and have run with the headline "Heels not arch villains after all".
How amazing and as I have a best friend in Oz (Angela) I do hope she saw it!
Essentially I am quoted as saying that feet are more strongly placed in a high heel that holds the foot and allows it to arch... I agree!

Summer Feet

Summer Foot tips

It is a truth that great feet make cheap shoes look good.

Do remember to get a professional pedicure at the start of the season and then carry out your At-Home treatments on a weekly basis.

Do cut toenails straight across and use a buffer to bring them to a real shine. Our Supplefeet pedicurists start with a horizontal line of polish which really helps give a clean edge to your nail paint. And a lick of glitter paint for at-home pedicures really acts as a super top coat.

So armed with the Supplefeet mantra of scrub and moisturise feet I wish you a pleasant Summer break.

Preparing for Summer feet

Warmer days are an excuse to treat yourself to a sexy new pair of sandals and proudly show off your newly pedicured toes. But how do we keep our feet looking beautifully healthy and sun kissed all summer long?

It is a fact that feet get dirty, especially if you’ve been out walking, or out sight- seeing on holiday. So take some time to care for them and reap the benefits of happy and healthy feet.

At the end of the day wash your feet well; give them a good scrub and follow with a foot massage to your feet with foot cream. Keeping them elevated for 10 minutes helps take the stress of your circulatory system.

Be sure to keep your feet clean and well moisturised: dry, cracking, peeling and sore skin can be the signs of a fungal infection, such as athletes foot, so apply an antifungal medication as soon as it occurs. Don’t forget to apply sunscreen to your feet, especially the tops and in between the toes, 20 to 30 minutes before going outdoors. Then, in the summer months ensure you wear shoes a half size bigger than usual to accommodate any daytime puffiness. If sweaty feet are a problem use an effective anti-perspirant as a final flourish for lovely fresh feet.

As your feet are on display during the summer months, invest in a great pedicure and then maintain your toes at home in perfect condition.

ingrowing toenails

IGTN (ingrowing toenail surgery)
This is a painful condition that occurs when the nail starts to press into the fleshy part of the adjacent skin. It can easily become infected and needs a professional podiatry opinion and treatment.
Painless removal of the spicule of nail can be carried out and if needed a minor surgical procedure to prevent recurrence. This is called a partial nail avulsion with phenolisation.

I had my toenails corrrected in this manner many years ago and have never suffered since.

(for the full picture see my piece on Ingrowing toenails that I did with NHS videos that is available on You tube)

Any questions please do get in contact.

high heels revisited

It has been a real pleasure to put my high heels back on post operative the Hyprocure.
After about 5 weeks of wearing black K shoes with black trousers I am released and able to easily wear heels. Still sticking to moderate heels, about 2 inches, and discovering the trick of avoiding black shoes to make legs look longer.

Also enjoying wearing flat ballet pumps and comparing and contrasting the new foot with the old position.
Pain : Almost none; only experiencing occasional twinges into the foot that feel rather like an internal orthotic.

the road to recovery - The Hyprocure TM

Nearly two weeks have passed with the new foot.
It has been a real paradigm shift as the old unstable foot and all that accompanied it, disappears
I am driving, walking, stairs etc. As long as I have it wrapped up for security it is fine. I just must be mindful, as a set back is still possible.
Still it is a revelation and a delight.

I know there has been a huge shift for me in the way I assess feet and foot conditions. Many continue to dismiss this procedure with lots of words to undermine the effects. It is almost as though had I had buckets of post operative pain, lots of metalware in the foot, long operating time, that would have made it more acceptable! Of course better for who, and that is the heart of the matter.
I had to buy a comfortable, flat shoe, having not worn flats in years! Satisfyingly, I threw old flat lace ups away and am now in uber-unglamorous Clarks K shoe. Very comfortable and far more stable on the operated, non wobbly foot than the one now in waiting.

Day 6 post op Hyprocure

Day 6 post op the Hyprocure TM by Dr Graham and a whole new world of a non wobbly - albeit asymmetric- foot is opening up.
It will be 4 weeks before I can safely (ish) assume that fibrous adhesions have formed sufficiently to be less nervous of it, but so far so good. No pain. Able to walk up and down stairs and did a Mum stint around Asda, as you do, with a wrapped up foot and a sock on as unable
to put on a shoe that we (me , myself and I ) agree on.
The most difficult thing is what to wear. All old shoes are out, no need for orthotics and new shoes yet to be bought or worked out! Still too early for heels.
It may be wellies yet. Hunter of course.

My Flatfoot correction

I am officially the new owner of a new foot! My Supplefoot has a stent in place and I have a non wobbly, arched foot. The longterm problems of hyperpronation are resolved and I am delighted.

The operation was yesterday and I am in no pain. The surgery was fine, done under local anaesthesiae with barely any pain and my sub talar arthroeresis went well.
The implant used to transform my foot is the Hyprocure TM and we have amazing before and immediately after xray pictures.
The surprising find from the motion analysis tests was a rigid beam of a 4th metatarsal that has supported my feet despite all the flexibility around it.
By getting this hyper pronated foot corrected I have headed off a bunion later on, early hallux limitus, neuromas and capsulitis in the 2nd and 3rd metatarsal heads (seen moving around alarmingly!) no wonder I had shearing stress and paraesthesiae there. And that is just the front part of my foot!
It immediately feels like the arch has been restored(it has) and I guess it might be like having old fashioned (now discredited) electric current treatment to "strengthen arch muscles."

So despite having worn orthotics since podiatry college aged 19, the flat feet were not going to improve. They - there is still another one to do- deterioate over time and cause all sorts of conditions up and down the skeletal frame.

Thanks to Dr Graham, DPM for designing it, performing the surgery and looking after me!
He is a genius.

PS As soon as I can I shall share with you my pictures of my foot. In the meantime the image is of the stent in place, from the Gramedica website. For more info go to www.hyperpronation.com

Best wishes

Emma Supple

Communication

Supplefeet has just hosted a seminar on surgery. It was very good, although I say it myself! We had great feedback and there was a real engagement from the delegates. Thanks to Steve Kriss and Grahame Mann for their contributions, very valuable.
Judith facilitated it for us and was, as always, an inspiration. She looked at communication and pointed out that the average time given to a patient by the medical profession to explain their problem is 23 seconds! We did some exercises just to drive home the point that listening is essential. Many clinical histories are to be found in the story of the complaint and taking the time to hear the story is so important.
When I worked in Chicago for the great Lowell Weil, he was excellent at this. He had a great deal to teach on approaching patients and making a difference to their care.

So I am off to the States tomorrow to join a conference on flatfeet. My new intent, after today, is to listen more!

Athletes foot

How is your january going?

On the wagon,lots of exercise and an annoying itch in between your toes?

Seriously; Gyms and public swimming pools are notorious places to pick up foot fungal infections. So beware. It is something to do with the pH and lots to do with the plentiful barefeet around in a warm, damp environment.

If you suffer from this common skin infection then you are aware of how unpleasant it can be.

It is a fungal infection that sits in between the toes and gets very itchy and sore. It also has a tendency to be very smelly which can be distressing. As a fungus thrives in dark, moist areas. So athlete’s foot thrives in between your toes.

Treatment

As with most things, prevention is better than cure.
Keeping toes clean and dry is the best way to avoid infection.
Wearing flip flips or our Beech Sandals (http://www.supplefeet.com/) is very important whilst swimming or at the gym.

Management
Use an anti-fungal to eliminate the infection.

At Supplefeet we do not recommend using the talcs or creams as they can make the area being treated more moist and so the cycle of infection is not broken.

We recommend anti-fungal sprays if possible:
Grisol™ - an effective anti-fungal spray that is easy to apply.
Lamisil™ - cream or spray.

We do use the cream in the early stages if the skin is broken and sore, as the cream is soothing. However it is best to move onto the spray as soon as is feasible and keep that in your gym bag.

This is an uncomfortable condition that is easily rectified.

High heels

One thing that always seems to surprise our clients is that we are not averse to, and positively encourage, the use of high heels. The image of chiropodists is such that unless we extol the virtues of "traffic warden shoes" then we are not conforming to our image!


At Supplefeet we truly believe that along with a perfect heel height for all, there is lots of scope to continue to wear and enjoy high heels.


If you are walking up hill and dale everyday then you need a shoe that can accomodate all the mountain paths, steep climbs etc. Clearly this is not everyday occurence nowadays and so wearing a heel can actually enhance your natural foot arch and be more comfortable on hard flat surfaces.


Top tip: look for a heel that suits you (the Supple perfect heel height test) and sits under your true heel.

Men: Best to avoid too flat shoes also. The old fashioned brogue has a heel, the flat Converses do not.

Painful Nails

I am being pathetic about a bashed thumb nail. I caught it on a padlock today and it hurts! I can see the blood blister forming under the nail. It occured to me how super sore bashed up nails can be. When you get a blood blister under a nail it increases the pressure and is called a subungal haematoma. Common in marathon runners who need the nail pierced at the end of the race to alleviate the pressure. If you get it fast enough the blood can really spurt out! Otherwise the blood dries and the nail blackens and often falls off.

My poor thumb is nothing compared to that but it is always good to be reminded just how sore nails can be. If necessary we can numb the toe to sort out the nail properly.
So do as I did not; avoid hitting the nail if you can.

Dirty feet

Dirty Feet are a fact of life. If you walk barefoot or in sandals etc (which you should when you can) they will get dirty. Keeping the dirt on feet can be a precursor to callus and hard skin formation. Small bits of grit and grime being pushed into the skin on the ball of the foot act like irritants and cause hard skin to form over many years. So scrubbing feet is a crucial part of your everyday routine. As vital as cleaning your teeth.

I recommend proper nail brushes, even good pan scourers will do. We use a Heals pan scourer, very colourful but quite harsh. I know this as my daughters little friend used it to scrub off some eye make up! When I told her Mum she had used a pan scourer that was kept by the bath it explained why she had scrubbed off a layer of skin! So these things are not gentle.

The skin on your foot is 5 times thicker than anywhere else so scrub away the dirt. Don't rely on the shower soapy water just sloshing over your feet. Get scrubbing!

Chilblains.

What would you wear if you were standing waiting to witness the inauguration ? Warm boots of course, preferably with a lambswool lining and two pairs of thin thermal socks. Perfect.

However so many ladies go out with hats, gloves, warm coats and just a leather shoe and nylons on their feet!

When the weather gets cold we are more liable to get chilblains and if you get your toes super cold and then warm them up too fast, the resuilt is chilblains. Painful and itchy they are a result of the blood vessels contracting and rapidly expanding causing swelling and tenderness.

They are common in more senior folk but also very common in children. If you get them then keep your toes warm and dress the chilblains in a light covering of antiseptic cream and a light dressing if needed. Do not scratch them, it will only make them worse.

So please make sure your child has not only warm gloves but also warm shoes and socks on in these cold days.

We know this as lovely walks in the woods with our dog have been ruined by crying children with cold hands and feet becoming utterly miserable!

Shoes; the return of Docs.

My obsession with shoes is still really in its infancy; I still covet some of the fabulous names in shoe design and crucially construction. I have a large stack of magazines from over the years that are starting to take over, so I have been de-cluttering.

What is fascinating to me are the adverts for shoes. The language of describing these is changing so much but to include words such as fierce and gladitorial when discussing feet is new.

Shoes are not only higher but come with their own ad campaigns now. It was not always thus; I recall Bally, Ravel and much gentler shoe shops!

However I also was a Doc Marten girl. In my student days it was jeans cut at the knee , black tights and docs. So it is really heartening to see Doc martens come back into fashion and in such fabulous colours. I may have to get another pair!

Ugg Boots; My opinion

Ugg boots: love them or hate them they are an amazing success.
The woes of wearing them were discussed on GMTV yesterday as they have been making headline news as being bad for your feet.
That is not entirely fair.
They are a remarkably comfortable shoe and the quite expensive price tag has made them ultra fashionable. Kate Moss and Sienna seen wearing made them uber-trendy.
They are also a great antidote to the extreme high heels we are seeing at the moment which are clearly damaging to feet if worn for too long. It is little wonder that Uggs are a slipper for the feet.
And that is the downside, too flat and too unsupportive they can quickly become "down at heel." Sagging and Bagging and causing a shuffling style of walkng is not great. If your Ugg boots do bag & sag alarmingly then get a new pair (if beyond redemption) and put in an insole (try the interpods from Supplefeet). As they are so roomy it is usually no problem to get an insole in.

And there is more than one style of Ugg, so choose the pair for you.

As for causing athletes foot; hardly a fair accusation as they are made of super absorbent materials that wick away moisture so you are less likely to get a fungal infection wearing Uggs. However if do you have athletes foot, a hot, warm environment will not clear it up. You need to treat the infection with an anti-fungal cream or spray.
So wear and enjoy. All shoes in moderation!

Until the next time


Emma Supple

A look at the benefits of running

As the foot experts our aim is to get you walking pain free. We also work with you to get you running and as the London Marathon approaches again (Sat 26th April 2009) you may be taking part or using it as the impetus to get you moving.

It is natural to run. It is not simply a learnt skill, it is part of life itself. Running brings rewards beyond the triumph of the finishing line. I have never been a fast runner but running is part of our lives. We need to keep moving.
“We need to eat, to rest but we also need to run.”

Runners always say that if you run you will see a difference between your life with running and without it. With running, they say, you are productive and you give your brain the time and the chance to create new things.

I have been working at the first aid tents at the London marathon for many years; I remember when the race used to finish over Westminster Bridge. In those early years, the devastation on feet was astonishing. People wore dreadful shoes and were poorly prepared; it felt at times like working in a war zone. Huge blood blisters, feet torn to shreds, damaged toenails… all very painful.

One year I administered foot first aid at the half way mark as we used to live in the Isle of Dogs and the race passed by our house. I like to think I contributed to some people actually completing the race because of what we were able to do at mile 12!

Nowadays the first aid medical team is very well organised and comprises of physios, sport doctors and podiatrists. The runners themselves are so much better prepared and manage their own blisters etc themselves with dramatically better shoes and much more information and improved training schedules our role is much less now. One year it rained so hard that all the string knots on the kit bags had swollen up so I spent more time cutting open kit bags than treating feet!

Supplefeet reminder at this time of January Fitness!

Watch children who not only run everywhere but have a third movement which is skipping!

Tips for running and for training for the marathon

Taken from an interview in the Telegraph with Haile Gerbrselassies; World record Holder 2.04:26 Berlin 2007

Mind preparation is key
Let you win yourself first. Before you “win” the marathon or race, if you win within yourself first you can do whatever they want.

How?
First do enough training. Then believe in yourself and say “I can do it”. Tomorrow is my day. And then say: the person in front of me is just a human being as well.

Be committed
Go through the plan you have and say “I have to do it”. Tell your brain like some high official.
“Do It!”
“Come On,”
“I have to do it.”

“Always if you mentally win you can win physically.”

Supplefeet recommends Runners Need in Liverpool Street for your running shoes.

Do book a Video Gait Analysis with our Podiatrists at Supplefeet and we will analyse your running style and advise on any areas to be strengthened and recommend orthotics or insoles as necessary. This will help to avoid unnecessary sports injuries.

Choosing shoes in the January sales?

Choosing shoes in the January sales? Then don’t forget this heel-to-toe checklist for value, stability and fit.

1. Happy feet are usually dressed in softer, more pliable leather. It has memory and molds to the foot. Well made shoes also have flexible leather soles. A leather lining is best as it absorbs excess moisture and has enough “give” to allow the foot to swell slightly.
   
2. Invisible construction is important. The better crafted a shoe is the more seamless it should look with no visible glue or staples. Unfinished insides are not comfortable, no matter how cute on the outside.
   
3. Less weight often correlates with greater quality. Heavier shoes (other than work boots) signal bulkier, less refined components.
   
4. High heels can feel wobbly if they’re very thin at the top where they are attached to the sole. Wedges and chunkier heels are more stable because the weight is distributed over a wider area.
   
5. Buying too tight and hoping the fit will ease up over time- is the number one mistake people make. If a shoe pinches, no amount of stretching will make it comfortable.
   
6. Buying too high. We all have a perfect heel height. Check yours and match the heel height to that. Simply extend out your leg and see how your foot falls in relation to your leg. If it points down like a dancers foot then you can wear very high heels; 3-4 inches plus. If it is more at right angles then you are better off in flatties and in between the 1 to 2 inches is best.
   
7. Buying too short is also a no no as this is the way to bunched up toes and sore toenails. Watch too in sandals as the foot should sit squarely on the sole of the shoe and not spill over.
   
8. And finally, watch for that plumb line. Pay attention to where the heel sits on the shoe and avoid heels coming out at weird angles from the shoe. The best is for the heel to sit nicely under the seat of the heel.

"Defying the credit crunch in sky-high heels with price tags to match!"

Good luck in the sales.

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