Injury and Repair?

It appears injury and repair are the yin and yang of healing. Injury may be necessary for nerve regeneration to occur, at least in mice. Talk about neural learning! So injuries (from a neurological perspective) may be a good thing!  Perhaps this is why acupuncture, dry needling and intramuscular therapy work so well for these conditions. ( Watch for a Live Gait Guys course in dry needling and intramuscular stimulation this fall in Chicago and Denver!)    

A protein abbreviated DLK (which stands for dual leucine zipper kinase) apparently is necessary to activate nerve regeneration after an injury.    

“DLK is a key molecule linking an injury to the nerve’s response to that injury, allowing the nerve to regenerate,” says Aaron DiAntonio, MD, PhD, professor of developmental biology. “How does an injured nerve know that it is injured? How does it take that information and turn on a regenerative program and regrow connections? And why does only the peripheral nervous system respond this way, while the central nervous system does not? We think DLK is part of the answer.”    

Most injuries have a neurological component, whether it be the inflammatory process, a change in muscle tone or activity, the perception of pain or proprioceptive abnormality. If this mechanism is not triggered, the nervous system may not heal. This may provide clues as to why nerve injuries heal so slowly or are less responsive. Learning more about this protein may provide clues and answers to this commonly encountered dilemma.    

The original paper was published in Neuron and a nice summary can be found here.    

The Gait Guys: sorting out the literature and giving you the latest information so you can make more informed clinical decisions.

The Coffee Walkers: Why coffee should come in a sippy cup. A tangent article on gait concepts.

The Coffee Walkers. It sounds like some creepy Steven King inspired blog post today (reminds us of the Tommy Knockers). However, the truth of the matter is that this is a gait blog post on walking.

Why is it so hard to walk with a cup of “joe” or a coffee mug of anything liquid for that matter ? It is all about physics and wave frequency.

In a neat little article written by Natalie Wolchover for CNBC.com she says,

“New research shows that "the properties of mugs, legs and liquid conspire to cause spills, most often at some point between your seventh and tenth step. So says a pair of fluid physicists at the University of California at Santa Barbara.”

This is a physics problem actually. It is one of frequencies to be precise. Apparently the human stride has almost exactly the right frequency and amplitude to drive the natural oscillations of a liquid when it is in a classic shaped and sized coffee mug. The frequency of the liquid sloshing to and fro in your mug has the same frequency as your gait. So, when you are walking with your mug-of-Joe there is an additive effect of the two frequencies and apparently the more steps that are taken the effect eventually summates until the lip of the mug is exceeded. Stopping or slowing down once the ride is underway and the summation effect is changed, but not necessarily reversed. A sudden change in the frequency, such as you suddenly stopping, slowing or speeding up, can abruptly change the effect on the mug however the fluid within the vessel is not changed at the same rate and thus it can breach the edge of the mug.

According Wolchover, of one of the linked articles,

“Coffee drinkers often attempt to walk quickly with their cups, as if they might manage to reach their destination before their sloshing java waves reach a critical height. This method is scientifically flawed. It turns out that the faster you walk, the closer your gait comes to the natural sloshing frequency of coffee. To avoid driving the oscillations that lead to a spillage, walk slowly.” The other valid suggestions were to watch the mug and to accelerate slowly.

We take the easier route. Maybe we are smarter, maybe lazier, and maybe just tired of always analyzing things … . . we choose a container with a damn lid. Can you say “Einstein-ian” ? We don’t like coffee sloshing on our clothes or rugs.

Shawn and Ivo ………… jacked up on Joe.  Get you never thought we would be able to turn coffee-talk into a gait article huh ?  And you thought we would run out of gait stuff to talk about !

Article links that provided the inspiration for today’s post, and that we referenced.

http://esciencenews.com/articles/2012/06/04/rhythmic.firing.nerve.cells.involved.bodys.movements

http://www.msnbc.msn.com/id/47364282/ns/technology_and_science-science/#.T-OZQXBPH4g

* remember: by clicking on the YOUTUBE logo in the lower right you will be immediately linked to a larger viewing screen on youtube.

This is a video case of a triathlete who presented with left calf pain and right quadriceps leg pain after months of training. In the video we discuss altered ankle rocker (dorsiflexion), lower crossed syndrome, altered arm swing patterning, unilateral quadriceps tightness and several other functional gait pathologies with this case.

Neuromechanics weekly: proprioceptive clues in Children’s Gait.

We can learn a lot about gait from watching our children walk. An immature nervous system is very similar to one which is compensating meaning cheating around a more proper and desirable movement pattern; we often resort to a more primitive state when challenges beyond our ability are presented. This is very common when we lose some aspect of proprioception, particularly from some peripheral joint or muscle, which in turn, leads to a loss of cerebellar input (and thus cerebellar function). Remember, the cerebellum is a temporal pattern generating center so a loss of cerebellar sensory input leads to poor pattern generation output. Watch this clip several times and then try and note each of the following:

• wide based gait; this is because proprioception is still developing (joint and muscle mechanoreceptors and of course, the spino cerebellar pathways and motor cortex)
• increased progression angle of the feet: this again is to try and retain stability. External rotation allows them to access a greater portion of the glute max and the frontal plane (engaging an additional plane is always more stable).
• shortened step length; this keeps the center of gravity close to the body and makes corrections for errors that much easier (remember our myelopathy case from last week ? LINK.  This immature DEVELOPING system is very much like a mature system that is REGRESSING.  This is a paramount learning point !)
• decreased speed of movement; this allows more time to process proprioceptive clues, creating accuracy of motion

Remember that Crosby, Still, Nash and young song “Teach Your Children”? It is more like, “teach your parents”…

Proprioceptive clues are an important aspect of gait analysis, in both the young and old, especially since we tend to revert back to an earlier phase of development when we have an injury or dysfunction.

Ivo and Shawn. Still bald, still good looking, with intact cerebellums and neocortices : )

Biomechanist challenges idea that forefoot strike pattern reduces runners’ injury rate→

Cites lack of conclusive evidence

By Jordana Bieze Foster

http://www.lowerextremityreview.com/issues/may/biomechanist-challenges-idea-that-forefoot-strike-pattern-reduces-runners-injury-rate

“UMass researchers have demonstrated that, although forefoot strikers do not experience a vertical ground reaction force “impact peak,” they do experience impacts during running, albeit at lower frequencies than rearfoot strikers. This research, presented last summer at the American College of Sports Medicine meeting in Denver, suggests that because those lower frequencies are attenuated by muscle tissues, while higher frequencies are attenuated by bone, forefoot strikers may actually face a higher risk of muscle injury than rearfoot strikers.

Claims that loading rate is significantly lower in forefoot strikers than rearfoot strikers also may not be entirely accurate, Hamill said. He cited research from Iowa State University, scheduled to be presented in August at the annual meeting of the American Society of Biomechanics, suggesting that when natural forefoot strikers switch to a rearfoot strike pattern, their loading rate actually decreases.

Research, most notably the oft-cited Harvard study published in Nature in 2010, have found higher magnitudes of ground reaction force in rearfoot strikers than in forefoot strikers. However, Hamill noted, the heel is a much less delicate structure than the forefoot and therefore may be better suited to absorb higher forces.”

Dear Dr. Lieberman : Some vital facts on forefoot running are not being discussed.→

A clay pot sitting in the sun will always be a clay pot. It has to go through the white heat of the furnace to become porcelain. -Mildred Wite Stouven.

Today’s blog article is likely to bring flames to our feet, but we are not afraid of the heat.  At the very least we will settle for the heat this article may bring so that our work can get the recognition we feel it deserves and so the truth can be brought to light for the good of all mankind.

“Forefoot strike causes less impact force on the body,” says co-author Daniel Lieberman, Ph.D., a professor of human evolutionary biology at Harvard and scribe of a popular barefoot running manifesto in 2010. “People forget that running is a skill, and if you don’t run properly, you’ll get injured.”

Amen to that; we have been saying that for years before this all became popular talk …

We recently read this article in Men’s Health, yet another one supportive of minimalism running. And once again some of the most important facts are being left out. We just cannot sit here and watch the inaccuracies of minimalism and forefoot running continue to root themselves without policing. So, let us once again set foot into the raging battle.

According to the article (LINK) Sturtz says, “Landing on your forefoot, the way humans have run for thousands of years, produces almost zero impact on joints and bones, according to Lieberman’s 2010 study. But 75 percent of us now land heel first—cushioned running shoes made that possible (and comfortable)—which slams up to 3 times the body’s weight in impact force on your knees and legs.”

Our question is, “ Why is no one paying attention to foot types?” In every lecture we do, to clinicians or everyday runners, about “forefoot type” variants (valgus and varus to be precise) we comment that this is something that should be talked about during Running Form Clinics where forefoot landing is promoted. 

“… forefoot running is not the whole answer to injury prevention, just a component”, says Lieberman. “This is not a simple solution to a complex problem—you can’t change one thing and have everything be fine. You can still forefoot strike with poor form.”

And we would add to that quote that “you can get a resultant compensatory running form if you forefoot strike with a forefoot varus or forefoot valgus”. Not everyone has that pristine neutral forefoot bipod architecture that the internet articles are assuming exists in everyone, and thus there is no way that everyone has fully competent pristine forefoot biomechanics that will not eventually trigger injury. This is a fact, not our opinion. 

Dr Lieberman then goes on to say: “ If it ain’t broke, don’t fix it.”

We respectfully disagree. We do this on a daily basis (as do many of you).  If the check engine light on your dashboard is flashing at you every day for a week you would be remiss not to consider the repercussions.  “The car ain’t broken… YET” is a more precise comment. You would be wise not to go on a long distance car trip knowing this fact.  Translating this to forefoot load/strike running, ignoring a potential injury because of flawed forefoot anatomy and biomechanics is a recipe for injury.  Just because it isn’t broken YET doesn’t mean ignoring the issues will make them go away or make you immune. A few hundred or thousand miles on a forefoot variant can be an issue clinically and injury wise.

Just because the body isn’t broken YET doesn’t mean it cannot work better and prevent a problem down the road. Dr Lieberman then goes on to quote, “Remember, almost every distance runner gets injured".  Why is he batting from both sides of the plate here? If “Landing on your forefoot, the way humans have run for thousands of years, produces almost zero impact on joints and bones”, according to Lieberman’s 2010 study then why would he go on to say “Almost every distance runner gets injured”?  There has to be a reason !  Forefoot running is either the answer or it isn’t.  Our valid and ignored proposal above, and our repeated comments throughout our 500+ blog posts on this topic on foot types, is a valid answer to his injury assumption.  It is quite possible that these inevitable injuries occur because people take the advice of “if it ain’t broken, don’t fix it”.  It is also most likely that ignorance of the deeper facts is bliss for most people. .Had they spent the time to find out about their forefoot type and learn to modify subtle biomechanical flaws of forefoot loading strategies of their foot type, perhaps we wouldn’t hear “Remember, almost every distance runner gets injured".   Maybe that is why you SHOULD look into fixing things that are not YET broken and at the very least learn about foot types, particularly which one you have and the potential risks it exposes you to. Our blog here has done this in depth over the last year. 

“An ounce of prevention is worth a pound of cure” -Benjamin Franklin.  Anyone is medicine knows this is true (or should).

We prefer midfoot strike when possible, for many reasons but mainly because it takes into account a tripod contact loading response.  A tripod load is more stable than a rear foot unipod load and more stable than a forefoot bipod load, particularly when there are rear or forefoot variants (rearfoot valgus, rearfoot varus, forefoot valgus, forefoot varus) from the pristine normal that is always assumed in many articles.   A tripod loading response (midfoot strike) can dampen some of the mechanical flaws of either heel or forefoot strike patterns and of the foot type variants that are the norm, not the exception.

We see this stuff everyday in our practices. We are the guys that get the injury cases that are driven by the inaccuracies, or better put “overlooked facts”, of articles on the internet. To be fair, we have also written a fair number of articles for magazines and we know how they can get so chopped down that truth, honesty and full disclosure can be lost for the sake of publication limitations. None the less, our strong opinion, this article could have been far more complete had it talked about the issues we have brought to light here.  We love and respect the work of Lieberman and his colleagues.  He and his colleagues have done a huge service to the runners of the world and we have learned from them. Learning is a lifelong journey for us all and we just think that there is a huge information gap that is being missed and we feel it is time that the runners of the world hear the whole truth. We believe our work is filling that gap.

“First they ignore you, then they laugh at you, then they fight you, then you win.”

- Mahatma Gandhi

For the past year, we have been feeling a bit like Gandhi must have felt. We realize that some of our work is complicated, difficult to understand, and tough to digest. We know we are laughed at by some who prefer to seek the safety of ignorance. And yes, despite 600 blog posts on these very topics (yes, we have one of the most informative blogs and YouTube Channels on the web for runners and athletes looking for answers) we feel somewhat ignored. None the less, we continue to stick our necks out far and long to set the record straight to make sure that everyone knows the facts they deserve to know.   We hope you will forward, link, Facebook and tweet the hell out of our blog post today, for the good of every runner and athlete you know and for the whole of mankind.  We are in this for the long haul. Stick and stones … .       - Drs. Shawn and Ivo …  The Gait Guys

here is the article that spurred our post:

http://news.menshealth.com/fix-your-running-form/2012/01/24/

Clearing that long leg….

Even MORE on short legs…

We remember from last week, and the week before, there at least SIX common compensations for a short leg.

We recounted them and spoke about leaning to the side of the short leg last time. Here are the others, in case you need a reminder:

•  pronation of the longer side, supination of the shorter
• circumduction of the longer leg around the shorter
•  hip hike on long leg side (seen as contraction of hip abductors, obliques and quadratus  lumborum on short leg side)
• excessive ankle plantar flexion on short side
•  excessive knee bend on the long leg side

Lets look at “circumduction" of the longer extremity. Swinging the longer leg out and around helps to create clearance for the longer leg.  It makes no difference if the leg is functionally or structurally short, the body still needs a strategy to move around the asymmetry. This can sometimes occur with one of the other compensations, but we usually see it by itself.

This compensation often occurs with a pelvic dip on the same side, due to weakness of the gluteus medius complex.

Watch the above video (which we slowed down for you) that we captured on “the Gait Cam” a few times to see what we are talking about. This person has a left short leg and has a pelvic drift during stance phase to that side . We slowed it down so it is easier to see.

Remember here is that what you are seeing is the compensation, not necessarily the problem. When one leg is shorter, something must be done to get the longer leg through swing phase.

Circumduction….Tautological gait…Increasing your gait vocabulary on a daily basis..

Ivo and Shawn.

A brief story by Ack Simon Dedman:

A lecturer at a university is giving a pre-exam lecture on time management. On his desk is a bag of sand, a bag of pebbles, some big rocks and bucket. He asks for a volunteer to put all three grades of stone into the bucket, and a keen student duly steps up to carry out the task, starting with the sand, then the pebbles, then the rocks, which do not all fit in the bucket.

“The is an analogy of poor time management,” trills the lecturer, “If you’d have put the rocks in first, then the pebbles, then the sand, all three would have fit. This is much like time management, in that by completing your biggest tasks first, you leave room to complete your medium tasks, then your smaller ones. By completing your smallest tasks first you spend so much time on them you leave yourself unable to complete either medium of large tasks satisfactorily. Let me show you..”

And the lecturer re-fills the bucket, big rocks first, then pebbles, then sand, shaking the bucket between each so that everything fits.

“But Sir,” says one student, slouched at the back of the theatre, “You’ve forgotten one thing..”

At which the student approaches the bucket, produces a can of lager, opens it and pours into the bucket. “No matter how busy you are,” quips the student with a smile, “There’s always time for a quick beer.”

One of our goals is to make you think outside the box to solve clinical problems, and to fill your “bucket”. We also hope you have a good time while doing it : )

The Gait Guys

What is driving our patterned movements such as gait and running ?→

ScienceDaily (June 3, 2012) — A new finding that motor cortex is a dynamic pattern generator upends existing theory with broad implications for neuroscience.

Maybe it is actually easier to understand than we thought. A new paper presents some compelling evidence that the motor cortex, rather than being command central, is more like a part of the machine, sending rhythmic signals down the spinal cord to orchestrate movement. 

“The electrical signal that drives a given movement is therefore an amalgam – a summation – of the rhythms of all the motor neurons firing at a given moment.”

This is of course monitored (and modified) by one of our best friends, the cerebellum.

Check it out here: http://www.sciencedaily.com/releases/2012/06/120603191720.htm#.T8yrhOzhvGk.facebook

Ivo and Shawn…Geeky….Cool….Hey, geeky is the new cool. Don’t laugh, you a re a geek as well if you are reading this post : )

Welcome to Friday. Today we have a particularly gruesome post (literally). This was inspired by an NCIS episode we saw, sometime in the 8th season.

Zombies are a peculiar lot. Not wanting to limit our analysis to the living, we have begun to examine the undead.

In this clip (there are many available), we note that a common characteristic seems to be partial paralysis of an lower and/or upper extremity, along with the peculiar behavior of keeping their upper extremities in a flexed posture, similar to a stroke. They also seem to have an exaggerated gag reflex and difficulty with phonation (talking).  We believe this is a neurological phenomenon, based on the fact that the only way to truly kill a zombie is to kill their brain.

Have a great Friday!

Ivo and Shawn

Foot maturation in children is reached by 5 years old

source article: http://www.ncbi.nlm.nih.gov/pubmed/21257173

Gait development begins early! Start good mechanics in your kids! “Based on these results, it would appear that foot maturation during gait is fully achieved at 5 years”

Foot mechanics during the first six years of Independent Walking J Biomech. 2011 Jan 21. [Epub ahead of print]

“the MP joint biomechanical parameters were similar between children (older than 2 years) and adults, hinting at a quick maturation of this joint mechanics. The ankle joint parameters and the GRFs (except for the frontal plane) showed an adult-like pattern in 5-year-old children. Some ankle joint parameters, such as the joint power and the 3D angle α(M.ω) still evolved significantly until 3.5 years. Based on these results, it would appear that foot maturation during gait is fully achieved at 5 years.”

Retail Focus: The Midsole

The Midsole is the area sandwiched between the out sole and the upper (or vamp, as we have learned).

The two jobs of the midsole are to provide some degree of shock absorption as well as torsional rigidity to a shoe.

Midsole material (usually EVA or similar material) is very important, as it will accommodate to the load imposed on it from the person and their body weight. It serves as the intermediary for load transfer between the ground and the person. 

Softer density material in the heel of the shoe serves to soften the forces acting at heel strike (hopefully NOT when running) and “feels” good for impact and shock absorption. We know from studies we (and you) have read (and posts we have posted) that this is largely perception, as softer midsole materails generally INCREASE impact forces.

The stiffer or denser the midsole material, the more motion control it will provide. This is one of many “motion control features” put into shoes.  Some shoes have two different density foams (called dual density midsoles (see pictures above)), to provide a more graduated resistance. The midsole is softer on its lateral aspect, to absorb force and decrease the velocity of pronation during heel strike and midstance (ie. it keeps you supinated a bit longer), with a firmer material medially that protects against overpronation as you come through mid stance and go through toe off.

Air is an excellent shock absorber, however it does not deform, it displaces. This creates an unstable surface for the foot, promoting ankle injuries. It is great for tires, but we feel does not have a place in shoes. Can you think of any shoes that have Air in the midsole? We can, we have all heard that brilliant marketing campaign.  Foam and gel seem to be much better as they transduce the force and dissipate it.

What’s the bottom line? Materials determine the flex and to some degree, the shock absorbing characteristics of the shoe. More rigid midsoles provide more motion control, less rigid ones less. Not everyone can go into minimalist shoes, and not all need control. But we all need educated.

Want to know more? Take our soon to be released course “Proper Shoe Selection” or better yet, our entire shoe fit course, so you too can be a Shoe Jedi!

Shoe Jedi Masters….The Gait Guys

Make sure you visit our Youtube channel: The Gait Guys, or follow us on Facebook and Twitter

Video Gait Case: It is Neuromechanics Wednesday.

* Remember: you can always click on the YOUTUBE logo in the bottom right corner of the video to be hyperlinked to a blown up version of the video on youtube.  Just remember to read what we have written here as well. 

Here we present a video case of a client with advancing spinal myelopathy with characteristics of Trendelenburg gait pathology. Be patient with the first few slides, we have to set up and teach about the important issues regarding the topic and case otherwise some folks will get lost.  There is much to this case. There is evidence of balance issues (dorsal column disease), limb circumduction, 5 point turning strategy (abnormal), pathologic arm swing changes and a few other issues to observe. If you are looking for a great gait case that covers several layers, this is a good one. Be sure to check our our blog, youtube channel and website for other great videos and teaching cases.

Lean on me…

More on short legs…

We remember from last week, there are several common compensations for a short leg.

We recounted six common adaptations and spoke about pronation of the longer side, and supination of the shorter side last time. Here are the others, in case you need a reminder:

•  lean of torso to the short leg side
• circumduction of the longer leg around the shorter
•  hip hike on long leg side (seen as contraction of hip abductors, obliques and quadratus  lumborum on short leg side)
• excessive ankle plantar flexion on short side
•  excessive knee bend on the long leg side

Lets look at “The lean”. Leaning to the short side helps to create clearance for the longer leg. The lean in essence helps to lift the pelvis on the swing side by using a shift body mass to the stance leg, similar to in a Trendelenburg gait. It makes no difference if the leg is functionally or structurally short, the body still needs a strategy to move around the asymmetry. The lean can often be mistaken for a weak gluteus medius on the side they are leaning to (which would look very similar). Sometimes, the two can occur concurrently as well. 

Often with “the lean” there will be an increased arm swing on the opposite side to “help” pull the long leg through , while creating a counter balance effect.

Watch the above video several times to see what we are talking about. This person has a left short leg and leans to that side. We slowed it down so it is easier to see.

Again, the thing to remember here is that what you are seeing is the compensation, not necessarily the problem. When one leg is shorter, something must be done to get the longer leg through swing phase.

Short legs and compensations. There not just for breakfast anymore.

Ivo and Shawn. Two guys with two short legs… ; )

Education’s purpose is to replace an empty mind with an open one.

Malcolm S. Forbes

More on children's foot maturation.

source article: http://www.ncbi.nlm.nih.gov/pubmed/21244647

Watch what you put on your kids feet! encourage them to go barefoot early or use a minimal support type shoe (like Robeez or similar with a soft leather sole)
“Shoes affect the gait of children. With shoes, children walk faster by taking longer steps with greater ankle and knee motion and increased tibialis anterior activity. Shoes reduce foot motion and increase the support phases of the gait cycle. During running, shoes reduce swing phase leg speed, attenuate some shock and encourage a rearfoot strike pattern”.

Effect of childrens shoes on gait: a systematic review and meta analysis J Foot Ankle Res. 2011 Jan 18;4:3.

A fun little video for all you foot fanatics out there!

Have a great Weekend.

Ivo and Shawn

OK, Friday Follies are upon us. Here’s a not so funny one. Funny Gait May Cause Back Pain. Gee, imagine that! : )

We don’t necessarily agree with the Journal of the American Podiatric Association that orthotics are the answer, but the we like the premise.

Have a great Friday!

Ivo and Shawn

photo from: http://www.fatfiction.co.uk/society/funny-walks-of-the-20th-century/

Is that dry skin on your feet ? Lotions not working ? It is a yeast infection !

How many times will you smash your forehead into a wall before you realize that the bleeding suggests it might not be a good idea to continue ?

Similarly, how many times are you going to put lotion on your feet, or pumice off the dry skin and callouses before you ask “maybe this isn’t dry skin after all !” ?

Do your feet have something similar as to what is seen in the photo above ? Do your heels look like this ? Do they have the deep fissured cracks ? Do you have similar powdery white appearing stuff on your feet ? Are lotions not taking care of all this “apparently dry” skin ?

Candida albicans is a yeast that lives in harmony in and on our body until something throws off the delicate balance, causing the fungus to proliferate wildly. When Candida is allowed to build up in the body, over time a wide variety of severe symptoms can occur. Without proper treatment, the yeast overgrowth can be extremely dangerous.

Candida buildup in any one place in or on the body indicates that a balancing act is off when it comes to normal body system regulation. Candida overgrowth can cause cognitive problems, genitourinary, gastrointestinal, allergic and even (as we see here) dermatological problems. The skin is the body’s largest organ and it is also susceptible to problems.

Sometimes referred to as Athletes foot, in this case a fungus, it spreads easily through contact. Exposure to the fungus does not guarantee its growth and conditions must be right for the fungus to spread. Athletes foot is a fungal infection of the skin of the feet, which can also involve reactions by the feet and skin to toxins produced by candida/fungus overgrowth.

• Red and/or pale skin.
• Mild to intense itchiness, mostly in between the toes.
• Burning and inflammation.
• Cracked or blistered skin.
• Skin patches and scaling of the skin.
• Skin fissures (small cracks).
• Toenails may become affected as athlete’s foot progresses causing thick yellowish nails that are malformed, thickened and crumbly, called onychomycosis.
• Fingernails can also become affected just like toenails.

Fungus on the feet can also develop into or enable other opportunistic issues such as calluses, corns, warts, and horny growths, or keratotic tissue (hardened horny growths or build-up). Active growth of the fungus is also supported by nutrients contained in such horny growths.

Now do not dismiss this apparently benign problem. We have had patients experience bleeding from these deep fissures and cracking and we even had one client have one of these bleeding fissures get infected with Staph Aureus and almost lose their entire leg from the “flesh eating bacteria”. So we do not take this apparently benign infection lightly and we suggest you not either.

Find a doctor that will properly diagnose the problem and then look deeper for signs and symptoms that indicate where in the body the imbalance is located. We have found it is usually a GI (gastrointestinal) tract problem, one of dysbiosis (normal flora imbalance) in the bowels.

Yeast and fungal infection, they are definitely not just for athletes alone.  If you have it, it is in all of your shoes, on your shower floor, and anywhere it can harbor growth. But do not freak out. Just take care of the problem and move on. It is a mere several weeks to months to remedy. Just get the right solution for the job.  When it comes to yeast we suggest 2% miconazole cream (yes, vaginal yeast cream) be trialed, but it isn’t a fix if that is not the problem.  See someone who knows. Sadly the yeast problem is missed by most in the field, we have no idea why but it is.

Shawn and Ivo…….not just your regular foot geeks. 

Read more: Signs & Symptoms of Candida Buildup in the Human Body | eHow.com http://www.ehow.com/list_5929515_signs-candida-buildup-human-body.html#ixzz1voZ6mLOw