Managing Chilblains

Chilblains are a relatively prevalent problem when the weather is cooler. These are a painful and itchy reaction of the small arteries in the toes to the changes in temperature. They cause a painful red lesion, which later turns into a dark blue color when they become chronic. They have recently been receiving some extra publicity from the media on account of them being more common in those infected with coronovirus, being given the label, COVID toes.

Chilblains are a seasonal problem and appear in all areas in which the climate will get cold enough to result in the reaction in the skin. An episode of PodChatLive had a deep dive into condition of chilblains:

The obvious way to deal with chilblains is to prevent these by keeping the feet warm. If a chilblain does develop then it ought to be kept warm and be covered to stop the skin from breaking down. There are numerous chilblain creams that can be used to help to encourage the blood flow.

Can flip flops have enough arch support?

Do they have enough arch support built in so that they can support the foot? Can they be used instead of foot orthotics? Even thousgh foot orthotics do work really well at helping people with foot orthotics, they do need to be worn in shoes. Not everyone wants to wear shoes all the time, so if they need foot orthotics, are the arch supporting flip flops any good as an alternative? A lot of people are asking.

Yes, they definitly can be a help adjunct to foot orthotics, but not always an alternative to them. They can support the arch somewhat, but that may be not enough for particular individuals. The amount of support that the arch supporting flip flops come with is usually a low to average amount and its the same size for everyone. If it does help someone, then it would be by chance and not design. If you use foot orthotics in your shoes, then using these as well when you are not wearing shoes is a good option.

Can flip flops have enough arch support?

For example, if your have a mild problem, then mild or average supports may be all you need.

When I was in Australia, I came across the Archies brand which is providing very popular with podiatrists there. I have not yet seen an equivalent brand in San Francisco, so will eagerly await options.

What to do about Sever’s Disease

Sever’s disease is a very common problem in children and early teenagers that are still growing. The proper term for Sever’s disease is calcaneal apophysitis and probably should be used, but we are for now sticking to the common name. It is an excessive use type injury of the growth plate at the back of the heel bone. This is a self-limiting problem, in that the teenager will always grow out of it when growth and development in the bone stops, usually about the mid-teenage years. The common and typical symptom are pain at the back and sides of the heel bone, especially after taking part in sport. What exactly causes it is not totally clear, but it is an overuse injury as it is more common in children who are more active.

One of the better discussions on this condition is this video interview on Calcaneal apophysitis (Sever’s disease) from PodChatLive interviewing an expert on this:

The treatment of Sever’s disease is not that difficult and is simply a matter of managing the loads that the child puts on the heel bone and the lifestyle, and their expectations, perhaps with heel pads and just waiting for the natural history of the condition to takes its course. Children are notorious for not listening when instructed to reduce their loads, so this does have to be done with the parent’s involvement and some negotiation