A Sore Big Toe
Q When I walk or run, I get a stiff, achy feeling in the base of my big toe. The pain is intermittent when I’m not walking. What could it be?
A Depending on the location of the pain, any number of issues could be the culprit. Some of them include bunions, tendonitis, arthritis, intrinsic foot muscle strain, or even inflammation of the capsule that holds the sesmoids, the little bones under the ball of the foot, in place.
Your description makes me think it could be inflammation in the joint or in the tendon. An ice bath for your feet would be a good idea, especially post-walk. Dip your feet in a tub of ice water for 10 minutes or less. Then stretch your feet and toes. This should help to decrease the pain and swelling. Think about picking up some arch support insoles that maintain your foot arch and provide some cushion to lessen the impact. Check the wear pattern on your shoes to make sure you are walking evenly and not missing the toe-off portion of your gait on the injured side.
As with most injuries, if the pain is so great that it affects your gait or causes you to limp, seek professional help. Frequently people get irritation of the big toe and the ball of the foot because they are not pushing off their big toe at the end of their stride. Instead they walk or run off the ball of their foot.
Sometimes the cuboid — a bone in your foot — can lock up and not provide vital information to your body during your gait cycle, thus affecting the mid-stance to toe-off portion of your gait. This limits push-off with the big toe and will eventually cause an abnormal wear pattern on your shoes and soreness in the big toe. Having the cuboid bone adjusted and an ultrasound-stim combo performed on the sore area will help decrease the symptoms.
Placing a cuboid post under the bone or wearing orthotics with a cuboid post will transfer weight from the outside of the foot to the big toe, preventing a reoccurrence. As with any disorder, proper diagnosis is key to a successful treatment.
— Jacob May
Gestational Diabetes
Q What changes in lifestyle and diet should I make if I have gestational diabetes?
A Gestational diabetes is when a pregnant woman can no longer produce or use insulin appropriately, so glucose (or sugar) stays in the bloodstream instead of entering the cells where it is used for energy. The condition is usually found with either a blood test or a routine oral glucose tolerance test. Depending on severity, some women can make diet changes, but others will need insulin shots. I am assuming your doctor recommended watching your diet so here are some basic guidelines.
1) Try eating healthy foods every two hours, or three small-to-moderate meals with two to four snacks per day. Make sure these meals are high in protein and fiber, and focus on complex carbohydrates versus simple carbohydrates. High complex carbohydrate foods include whole grains such as brown rice, millet, barley, and quinoa, while simple carbs include bread, cereal, chips and crackers, and white rice.
2) Avoid foods high in sugar. This not only includes desserts and hard candy, but fruit juices, milk, soda (even sugar-free), and many processed foods. When in doubt, read the label.
3) Track the glycemic index of the foods you are eating: The glycemic index ranks carbohydrates according to their effect on our blood glucose levels. Low glycemic carbs produce smaller fluctuations in our blood glucose and insulin levels. To learn more, visit www.glycemicindex.com or the American Diabetes
Association website, www.diabetes.org.
4) It is not a good idea to start a strenuous exercise program if you have gestational diabetes. However, walking, low-impact aerobics, swimming, and yoga are excellent for improving the health of you and your baby while lowering blood glucose levels.
I would also like to note that women with gestational diabetes have a higher risk of developing type 2 diabetes after pregnancy, so there is even more reason to make these dietary changes and start exercising now.
— Lindsey Nelson
Prenatal Vitamins
Q What should I look for in my prenatal vitamins?
A New research is showing how important prenatal vitamins are to the brain development of the baby as well as the health of the mother. Ideally you should start taking these vitamins before conception. It’s important to read the label, because some brands offer only the minimum, rather than maximum, levels of nutrients. Choose one that contains the following:
Folic acid, 1000 micrograms/day, and choline, 200 mg (milligrams)/day, have been shown to prevent neural tube defects. At 600 mg/day, EPA delivers essential fatty acids, and DHA, at 500 mg/day, has been shown to improve the baby’s cognitive development and decrease postpartum depression in the mother. Vitamin D3, 500 IU/day, is critical, as deficiencies might impact brain development in the baby. Calcium, 400 mg/day, and magnesium, 300 mg/day, help protect the mother’s bones and can help prevent pre-eclampsia. Chromium, 200 mg/day, helps control the mother’s blood sugar, and look for the following B vitamins: B12, 120 mg/day; B6, 20 mg/day, and B5, also known as pantothenic acid, 20 mg/day. Include antioxidants such as selenium, 200 mg/day; vitamin C,
500 mg/day; vitamin E, 100 IU/day, and zinc, 25 mg/day.
Follow directions to ensure proper dosage, and remember that vitamins are a complement to a good diet and exercise program, not a replacement.
— Arianna Staruch
This Issue’s Experts
Jacob May, DC, brings careful thought and analytical thinking blended with a holistic approach to medicine and can be reached at 503-279-0205 or jacob@clearh2o.org.
Lindsey Nelson, ND, is a naturopathic primary care physician and can be reached at 503-279-0205 or lindsey@clearh2o.org.
Jacob May, DC, brings careful thought and analytical thinking blended with a holistic approach to medicine and can be reached
at 503-279-0205 or jacob@clearh2o.orglindsey@clearh2o.org |
