Barefoot running has increased in popularity in recent years. In fact, Dr. Segler recently lectured at a medical conference on the topic of barefoot running trends. Part of the appeal in barefoot running technique is to increase your efficiency by using more natural running biomechanics in order to hone your running form.

The American Podiatric Medical Association has a position statement declaring that barefoot running is an unsafe activity and is not recommended by podiatrists. Of course not all podiatrist agree with this position. I happen to be one of those dissenting physicians.

Toenail fungus is common among runners. In fact all fungal infections are common among runners. Particularly athlete's foot. Athlete's foot is nothing more than a fungus infection of the skin on the foot. A toenail fungus infection is actually caused by the same organism that causes athlete’s foot.

When you run your feet sweat, moisture collects in your shoes and the ideal environment for fungal growth is created. If you run on back-to-back days the problem is compounded because your running shoes never completely dry out.

If you happen to develop a case of athlete's foot, the fungus is growing between the layers of the skin. As the skin peels it sheds fungal spores into your shoes. These spores of course are the seeds from which fungus grows.

If you are running, doing hill repeats or some other strenuous workout, and you repeatedly bumped the toes and the end of of the toenail on the inside of the running shoe, the fungal spores can get between the toenail and the underlying nail bed. The fungal spores begin to grow and develop into a fungal toenail infection.

However when you run barefoot, you not have any risk of bumping the toenails repeatedly against an inside of a running shoe that is ripe with fungus. So in that respect, running barefoot is actually much lower risk for developing a toenail fungus infection as compared to running with running shoes.

The risk is mainly related to the potential for fungal spores to collect in your shoes and then have trauma where those spores are actually in contact with the toenail in such a way that they can become embedded in or underneath the toenail and start to grow. If you are wearing minimalist running shoes such as the Vibram Five Fingers without socks the risk of developing one of these toenail infections actually increases significantly. 

If you start to notice discoloration such as white or yellowish spots where the toenail seems to be changing and getting thicker it could be a fungal toenail infection. Treating these infections is not really a big deal. Our podiatrist can actually bring a laser to your home or office in order to directly kill the fungus and help your toenails returned to their normal clear and healthy state.  For more information on discount toenail fungus laser treatment and laser toenail fungus removal treatment visit http://www.lasertoenailhouston.com/

Dr. Christopher Segler, DPM is Board Certified, American Board of Podiatric Medicine.  He believes the best podiatry practice combines cutting edge technology with the old-school convenience of house calls. He makes podiatry house calls for young active adults who want to get rid of their funky toenails as quickly as possibly. He brings the laser to homes and offices throughout the Houston Metro including Downtown Houston, the Houston Heights and  Sugar Land, Texas.  If you have a question about fungal toenail laser treatment, you can reach him directly at  713-489-7674.

If you are a runner with Achilles tendon pain and swelling that just won't go away, you should know about Platelet Rich Plasma (PRP). PRP is a new treatment alternative to surgery. It is one of the best treatment options for runners with chronic tendinitis. 

The procedure is simple and not time consuming and can be performed at your home. Call 713-489-7674 today and schedule an appointment. 

Dr. Christopher Segler, D.P.M. is board certified, American Board of Podiatric Medicine. His practice is limited to  runners, triathletes and active young adults who want to stay active. He travels often to accommodate patients with complicated injuries in San Francisco, Houston, and Hawaii. He also provides remote consultations via Skype for injured expat patients living abroad who need expert advice, but cannot readily access a true foot and ankle expert while overseas. If you have a question about a complicated foot or ankle injury that just isn't getting better, you can reach him directly at  713-489-7674. 

Dear MyRunningDoc, 

I have been ramping up my mileage as part of my marathon training. My foot has been sore and aching when I run. Someone told me that stress fractures don't normally show up on an x-ray until they start healing. If this is true, is there really any point to getting an x-ray if I think I did get a stress fracture from running too much?  


Adam J.
Houston, TX

Answer:
Great question!  This is a question I often hear from runners in San Francisco and Houston. Most runners are busy and don't wont to waste their time going to a podiatry office getting an x-ray of their foot unless they really think the x-ray will change what they need to do to get the foot to stop aching and  heal. (And of course, get back to running and training). But when you suspect a stress fracture, there are good reasons to get an xray.

3 reasons to get an x-ray of your foot if you think that you have a stress fracture.

The 1st reason to get an xray of your foot is to make sure that the metatarsal has not actually cracked all the way through the bone or broken into pieces. 

The 2nd reason is to confirm that the metatarsal, if it is broken, is still in a good position that will heal correctly. If the bone is moved out of place after it has broken that it will not heal correctly and will result in what doctors call a “malunion.” When the metatarsal bone heals in an abnormal position it will alter the way that forces are distributed across the ball of the foot. An unnatural distribution of forces across the ball of the foot will put other metatarsals at risk of problems later. It can also increase the chances of nerve compression that can lead to a neuroma. 

The 3rd reason to get an xray of your foot when you suspect you have a stress fracture is for peace of mind. Having an x-ray confirms that the bone is not actually broken and will not likely get worse if you are walking on the foot as it heals. A fracture walking boot is made to protect a stress fracture and allow you to walk while the bone heals.  if you have had an xray of the foot and confirmed that the bone is not completely broken, and you suspect that it is just a stress fracture, then you can treat it as such and feel confident you’re not going to make things significantly worse if you walk on the foot while protected in a fracture walking boot.

Dr. Christopher Segler, D.P.M. is board certified, American Board of Podiatric Medicine. His practice is limited to  runners, triathletes and active young adults who want to stay active. He travels often to accommodate patients with complicated injuries in San Francisco, Houston, and Hawaii. He also provides remote consultations via Skype for injured expat patients living abroad who need expert advice, but cannot readily access a true foot and ankle expert while overseas. If you have a question about a complicated foot or ankle injury that just isn't getting better, you can reach him directly at  713-489-7674.