If you are standing outside in the cold for too long these days, chances are your toes might feel numb. But there are many more reasons why legs and feet can feel numb and tingly. The medical terminology for numbness and tingling is called "paresthesias". One of the most common causes of paresthesias in the lower extremities is nerve impingement. It is important to understand that the nerves supplying the feet arise from the lower back region. Any time there is an impingement or back injury, foot and leg numbness is common. Neuromas (inflammation of the nerves) in the foot can  cause "an electric shock type" sensation in the toes and cause numbness in the toes when in shoes. Another common cause of paresthesias is diabetes-most commonly termed diabetic neuropathy.

One of the major reasons why it is important for diabetic patients to see podiatrists every few months is so that we can test your sensation and make sure there are no cuts or scrapes that can lead to serious infections. Poor circulation can lead to cold feet but also numbness. Raynaud's disease is seen more commonly in the winter months and patients frequently come in complaining of "not being able to feel their toes". Some of the other less common causes of paresthesias in the lower limb can be vitamin deficiency, autoimmune diseases such as thyroiditis and Celiac's disease, pregnancy, kidney disease and infections such as Lyme disease and shingles. If you are experiencing paresthesias in the lower extremities, make an appointment with the foot specialists at Advanced Podiatry and we can work together to figure out the cause. We work well with other specialists such as neurologists to find the best treatments for our patients.

Trends are everywhere in the clothing and shoe business. Within the last 7-10 years, the newest trend in shoes is the minimalist movement. Shoes are lighter, thinner and smaller and every brand, store and cobbler is on board. Within the workout community, sneakers have been one of the main targets for the minimalist shift. The vibram five finger shoes were huge when they first came out and I remember seeing them everywhere. Books were published touting the efficiency and better form associated with "barefoot running" or "natural running" attributed to the professional Kenyan and south African runners. 

But, the real question is, is this the best thing for training? I see many patients in the office who have tried to make the switch, but end up injuring themselves. To run in a minimalist shoe, the running form has to shift from a heel strike, to a forefoot strike. For many people, this will take significant time and training to properly perform. A newer athlete will likely not have the proper muscle tone or form to adequately execute higher intensity workouts, and this can lead to injury. As I tell patients, every foot is different, so by seeing a sports medicine specialist, he or she can tell you how to properly train and condition your body while suggesting appropriate foot wear to allow for less stress on your joints. As your running pattern changes, most people can then begin to transition to lighter shoes. Remember loyal readers: listen to your body. It will tell you if you are pushing too hard, too fast, or too long.