Humans are on their feet most of their life. So why wouldn’t you want a proper pair of shoes?

Specifically, look for footwear that’s wide enough to prevent two common toe issues: bunions and hammer toe.

Marc Leonard, DPM, an OSF HealthCare podiatrist, sees these ailments frequently but stresses they are treatable without surgery when caught early.

Bunion

A bunion is when bones move out of place to form a bump on the toe joint, drawing the toe inward. Bunions are mostly seen on big toe, but they can happen on the pinky toe, too. This is called a bunionette or tailor’s bunion. Dr. Leonard says bunions are often caused by joint hypermobility, and they can also be genetic.

If pain from a bunion is not impacting your daily life, getting wider shoes or using a splint may do the trick. When the discomfort becomes intolerable, a doctor will discuss surgery.

“We make a cut in that bone, bring it over back into alignment and put some screws in,” Dr. Leonard explains. “Then we protect the area during post-operative course.”

The surgery is outpatient, and you typically can walk out of the doctor’s office. But beyond daily household activities, you should be off your feet for a month.

“We find the more people rest and elevate the foot, the better they feel. There’s less swelling and less potential for complications,” Dr. Leonard says.

Six to eight weeks after surgery, the person can resume exercise.

Hammer toe

Hammer toe is when a toe (usually one other than the big toe) contracts up, resembling a hammer.

“They make very prominent knuckles that can rub in the shoe and get red, irritated and sore,” Dr. Leonard describes.

Like bunions, splints and wider shoes are a short-term treatment, and outpatient surgery is possible for more severe cases.

“We remove some of the bone which allows the toe to reduce the contracture. Then, typically, we stabilize it in that new position with a wire for four weeks,” Dr. Leonard says. “Then that wire comes out. The toe should be more stable, straighter and hopefully not rub and cause the same pain it did prior to surgery.”

Recovery time is like bunion surgery but may be a little quicker.

 Finding footwear

The common link between bunions and hammer toe? A big step toward prevention is picking the right footwear.

“Cheapest is not best,” is an understatement, Dr. Leonard says.

“Things I recommend avoiding: flip flops, lighter weight canvas shoes or shoes that just don’t give you a lot of support,” Dr. Leonard adds. “Instead, I recommend a good, sturdy walking shoe. If you have to do a sandal or flip flop, get something that’s well-made with good arch support.”

Avoid wearing high heels all the time, Dr. Leonard also advises. You can also try an orthotic device, or a shoe insert to give you more support. Over the counter orthotics are just fine, Dr. Leonard says, but a podiatrist might recommend taking a mold of your foot to make a custom insert.

Learn more

Learn more about foot care on the OSF HealthCare website.

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Stand up for your feet

Find the right foot for summer foot health

When watching a basketball game on television, you may hear coaches and announcers say the star player is missing time with a hernia.

A sports hernia is different than a hernia suffered in everyday life, says Raman Kumar, MD, a colorectal surgeon and general surgeon at OSF HealthCare. But each should be taken seriously.

Hernia

Dr. Kumar says a hernia is when an internal organ or piece of fat goes through a hole in the abdominal wall. The most common type – around 80%  – is an inguinal hernia, when a part of the intestine pushes through the abdominal wall in the lower belly (also called the groin). Anyone can get a hernia, even newborns. But Dr. Kumar says they are seen more in older men. Symptoms include a bulge or swelling in the abdominal area and pain when moving.

“A lot of chronic heavy lifting,” can cause hernias, Dr. Kumar says. “Other things weaken the abdominal wall such as diabetes and smoking. Being obese causes a lot of weight hanging down on the abdominal wall. If you’ve had surgery in the past, that’s also a risk factor.”

So be mindful when lifting objects, Dr. Kumar advises. Lift with your knees, not your back, and don’t try to lift heavy items. Get a cart or a partner to help. Eat healthy and exercise to avoid obesity and diabetes. Avoid alcohol and cigarettes.

Dr. Kumar says an exterior wrap known as a hernia belt or abdominal binder can be a short-term solution. But surgery is often the endgame.

“If you have a hole or defect, it needs to be closed,” Dr. Kumar says. “The reason we fix hernias is because we don’t want a loop of intestine or bowel to get into the hernia, twist off and die.”

That would make a person very sick and possibly threaten their life, Dr. Kumar says.

Sports hernia

Dr. Kumar says a sports hernia is a muscle tear in the groin area. They’re seen in athletes due to all the twisting, turning and bending that comes with competition.

“Stretch before you do any type of activity. Work and develop your core muscles, including your abdominal and hip muscles.” Dr. Kumar says. “If the muscles are strong, they are less likely to tear.”

Athletes who complain of groin pain should immediately leave the competition and get checked out by a trainer or doctor. Resting and icing the groin will help, but a combination of medication, physical therapy or surgery will likely be needed to fully heal.

Be proactive

If you have symptoms of a hernia or sports hernia, see a health care provider right away.

“Nine times out of 10, we can determine you have a hernia just based on a physical exam,” Dr. Kumar says.

But for more complicated cases, your doctor may order an ultrasound or CT scan. Then, the provider will develop a treatment plan.

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Hernias: More common than you think

Whether you’re a competitive athlete or a casual runner, repetitive use of your legs (especially long distances like a 1600 meter run at a track event) can bring pain, swelling, tenderness or soreness along the shin bone (the tibia). The medical term is medial tibial stress syndrome.

“It’s usually because they’re increasing the frequency or intensity of their workouts,” Delaney says. Changing surfaces can also play a role. Delaney says she’s seen shin splints in football players who run on soft grass transitioning to basketball season and a hard court.

Diagnosis and treatment

Delaney says health care providers might take an X-ray or a CT scan to determine the extent of your injury. From there, the advice is typically to rest and ease back into competition.

“If you’re in a high impact sport, alternate days and do low impact work like pool workouts or getting on a stationary bike,” Delaney suggests.

Icing the leg can also help. A trick, Delaney says, is to freeze some water in a paper cup and tear away some of the cup so you have exposed ice. Then, massage your leg with the ice block.

“It gets a lot deeper into the soft tissue as opposed to just putting a cold pack on the leg,” Delaney says.

Delaney says rushing back into competition could cause the shin splint to progress to a stress fracture, or a tiny crack in the bone. That could mean an extended time on the sideline.

Prevention

Talk to any orthopedic provider, and you’ll be told the right footwear goes a long way to prevent injuries. Delaney agrees. She says to talk to an expert, like an athletic trainer, to find the right shoe for you. Flashy and expensive isn’t always best.

“Foot mechanics play a role,” Delaney adds. “Do you have flat feet? People with no arch support in their feet typically get shin splints. It’s a hard impact as opposed to having an arch to absorb the shock.” If this is the case, you might need a shoe insert (also called an orthotic or insole).

Get on a workout plan to strengthen your midsection and legs, and stretch before and after running. Delaney also says you can try leg compression sleeves. These can help prevent swelling and muscle fatigue and increase blood flow.

Learn more

Read more about how to keep your body in top shape on the OSF HealthCare website.

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Spring allergies will be here soon. If you’re suffering from a runny or congested nose, watery or itchy eyes or sneezing, it’s tempting to grab the first medicine that catches your eye at the pharmacy or rifle through the bathroom drawer for some pills you’re hanging on to.

Not so fast, says Maddy Draper, APRN, a health care provider at OSF OnCall. She says it’s important to know what to take and when in order to avoid side effects that can be serious.

What to take

Draper says an antihistamine like Astepro, Zyrtec, Allegra or Benadryl is a typical first line of defense.

“There are also decongestants for severe nasal congestion or sinus pain and pressure,” Draper adds. Sudafed is a well-known decongestant.

If a more severe case brings symptoms like face swelling or wheezing, Draper says treatment could be a steroid like Flonase or prednisone.

For more chronic (in other words, long term) allergy cases, the U.S. Food and Drug Administration says a provider may recommend immunotherapy to build up a tolerance. This could be an injection or a tablet under the tongue.

Misuse

It may not seem like over the counter allergy medications are ripe for misuse, but it can happen.

Draper says antihistamines, especially Benadryl, can make you drowsy. If you take too much or take it at the wrong time, you could, for example, find yourself sleepy behind the wheel. Or your attentiveness at work or school could suffer.

On the flip side, Draper says Sudafed can make you jittery, irritable or cause heart palpitations (the feeling of an irregular heartbeat). This could be a big issue, she says, for people with a heart condition.

“We want to avoid nasal sprays for people with nasal trauma. Things like a deviated septum or nasal sores,” Draper adds. “Putting something up the nose could cause further tissue damage.”

Draper says to take medication as directed by your provider. Or if it’s over the counter, follow the label instructions. She says these medications typically take a couple days to start working. So don’t be tempted to take an extra dose if you’re not seeing relief right away.

Think of the children! (and seniors)

Children and seniors may be more impacted by the side effects of allergy medications. An older adult who takes Benadryl, for example, may be drowsy to the point that they fall and suffer a serious injury.

So, Draper says providers will typically start with an antihistamine that doesn’t make you super drowsy. She says Zyrtec is approved for ages six months and up, and that’s often where providers will start.

“Any antihistamine label is going to tell you to consult your provider for use under the age of two,” Draper says. “So you’ll need to be seen by a provider or your pediatrician.” This could be a virtual visit or a message to your provider in your patient portal.

Plan ahead

Draper says knowing your allergy triggers and acting accordingly is key to avoiding unpleasant symptoms. For example, you know grass clippings will cause an allergic reaction, but you have no choice but to mow the lawn.

“Primary care providers and allergists typically recommend starting the medication prior to exposure,” Draper explains. “If you know you’re going to be outside on that windy, dry day to mow, start the antihistamine a couple days prior so it can fully take effect.”

If you can’t get a handle on a known allergy, or if you have unexpected allergy symptoms, Draper says it’s never a bad idea to go to an urgent care.

Or if you find yourself looking for an over the counter medication option: “Just ask the pharmacist,” Draper suggests. “They’ll give you recommendations.

“There’s usually a specific aisle for allergies,” she adds. “Find the right antihistamine. Flonase is another big one we see people use.”

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Shingles.

It’s a word that stings just coming out of your mouth. And it’s certainly an illness you want to avoid.

There are time-tested treatments for the disease that’s associated with chickenpox – namely an effective vaccine. But new research from the University of Pennsylvania and New York University (NYU) gives hope to people who have suffered eye complications from shingles.

“It’s promising,” says Fred Burke, MD, an emergency medicine physician who provides care at OSF HealthCare.

Shingles basics

Dr. Burke says shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. Chickenpox is common in children, who typically suffer from a blistering rash for four to seven days.

“That virus will lie dormant in the nerve cells of the body. For some unknown reason, it gets activated later in life,” causing shingles, Dr. Burke says. “Generally, that’s in people 50 and over. You’ll get a localized blistering rash. It’s painful. It can last for three to five weeks. We treat it with antiviral medication.”

Catching the disease early is key.

“If the rash has already crusted over, the antiviral medication won’t be effective,” Dr. Burke says. “You can treat the pain, but you have to just ride it out.”

You’re not contagious at that point, Dr. Burke says, but you’ll want to rest.

Aside from older adults, people with a compromised immune system – for example, someone with cancer or a transplanted organ – are at a higher risk for shingles. The disease spreads through the air – like when you cough on someone – or by direct contact.

In some cases, the pain from shingles can linger for months or years, Dr. Burke says. It’s called neuropathic pain, and there’s medicine available for that too. Meningitis and facial paralysis are other shingles complications.

Shingles can also impact the eyes, causing redness, swelling, itching and impaired vision. This is called herpes zoster ophthalmicus (HZO).

“We treat that with antiviral medication. We consult an ophthalmologist because the person may also need steroids,” Dr. Burke says. “It’s good to treat this quickly because it can lead to vision loss.”

Treating eye complications

That’s where the new research comes in.

Elisabeth J. Cohen, MD, a professor of ophthalmology at NYU, did the study after she was impacted by shingles-related vision loss. The research looked at the antiviral treatment valacyclovir, which is typically short term.

“The researchers showed that using valacyclovir for a year can decrease the risk of new or worsening eye disease by 26 percent at 18 months after initiating treatment. Patients treated with valacyclovir also were 30 percent less likely than those not receiving the treatment to have multiple HZO flare-ups at a year or a year-and-a-half later,” a news release announcing the research results says.

“I was very, very impressed,” Dr. Burke says after reading the results.

Importance of vaccines

Like any new research, more study is needed of long-term use of valacyclovir. In the meantime, Dr. Burke says vaccines for chickenpox and shingles are 90% effective.

The United States Centers for Disease Control and Prevention says children under 13 should get two doses of the chickenpox vaccine – one at 12 to 15 months and the other at four to six years. People 13 and older who never got chickenpox or the vaccine should also get two doses 28 days apart.

But be warned: Dr. Burke says if you don’t get chickenpox as a child, you can still get shingles as an adult.

“It’s the same virus,” that’s associated with both ailments, he says. “So if you catch it from someone [as an adult], you’ll probably get chickenpox first. And you could get shingles later.”

Meanwhile, Dr. Burke says the two-shot shingles vaccine is for healthy people 50 and older and people 19 and older who are immunocompromised.

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One in 1,000 Americans are affected by secondary lymphedema. It’s a chronic disease when there’s an increased collection of lymphatic fluid in the body that causes swelling. Those with cancer are known to develop lymphedema, which can lead to skin and tissue changes, according to the National Institutes of Health.

Sometimes those with lymphedema can inherit the disease, known as primary lymphedema, which is much rarer. You can be born with lymphedema, develop it during puberty, or later.

There’s no cure for lymphedema. It’s a disease, and one like diabetes that you have to manage through treatment. Treva Haney, a supervisor in Rehabilitation Services at OSF HealthCare, says her team works through different treatment plans with patients to meet their specific needs.

“Usually the plan of attack for treating lymphedema is complete congestive therapy,” Treva says. “This involves compression bandaging and a special, lymphatic massage.”

Along with the massage and bandaging, the plan can include manual lymph drainage, which – like it sounds – is a specialized form of manual therapy used to stimulate the lymph system and promote drainage.

Haney says exercise is a great way to get lymph fluid moving from the part of the body where it has collected.

“We have therapists who will use some of the equipment to get people moving and exercising. We teach the patients how to do the self-massage and how to do the bandages. As we get that limb better under control, we can recommend compression garments that they can wear,” Treva says.

Haney says some patients her clinic works with are former cancer patients.

“Our lymph system just builds up and you can get a big arm. We see that a lot with ladies who get breast cancer treatments,” Haney says. “They have axillary nodes or armpit nodes removed as part of their treatment and then their arm will swell. We occasionally see it in the legs from other pelvic cancers.”

“Stay active, stay mobile!” Is the advice Haney has for those looking to prevent lymphedema.

“If you can maintain a healthy and active lifestyle, that can decrease your risk for lymphedema,” Haney says.

People should see an occupational therapist or physical therapist if they’ve been diagnosed with lymphedema or have swelling due to a post-surgery or post-traumatic injury. You’ll need a referral from your physician to set up an initial evaluation.

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