Transcript: Foot Health | Jan 14, 2002

(music plays)

A title appears inside the shape of a house: More to Life. Words spin against a red and orange background: Health, Family, Home, Money, Fitness, Life. Fast clips show images related to the previous concepts, such as a dollar bill, a wheat field, and strands of DNA.

In animation, the title appears inside the shape of a house: "More to life."

Then, Mary Ito sits in a studio with textured yellow walls and the logo of the show in the background, which reads "More to life."

Mary is in her late thirties, with short black hair and bangs. She's wearing a printed black shirt, a black vest and a pendant necklace.

She says HELLO. I'M MARY ITO. WELCOME TO "MORE TO LIFE." WELL, WE'RE GOING TO PUT OUR FOOT FORWARD TODAY. WE HAVE JUST THE GUEST TO HELP DO THAT. DR. GLENN COPELAND IS A TORONTO PODIATRIST AND THE AUTHOR OF "THE FOOT HEALER." IF YOU WANT TO KNOW THE LATEST ABOUT FOOT CARE FROM SHOCK WAVE TREATMENTS TO TEFLON SOCKS, CALL US TODAY.

A caption reads "416-484-2727. 1-888-411-1234."
Then, it changes to "moretolife@tvo.org"

Glenn is in his fifties, clean-shaven and balding. He's wearing a black suit, white shirt and gray checkered tie.
A picture of his book appears briefly on screen. The cover features a drawing of a human foot showing the different layers, including the skin, muscles and bones.

Mary continues HELLO, DR. COPE RAN. WELCOME.

Glenn says THANK YOU VERY MUCH FOR HAVING ME.

Mary says WE'RE NERVOUS WITH YOUR TIMING HERE. JUST GETTING HERE IN THE NICK OF TIME. I THOUGHT YOU HAD WALKED ALL THE WAY.

Glenn says WELL, I WAS GOING TO. TRAFFIC WAS TERRIBLE. SO I APOLOGIZE. BUT I HAVE NEVER MISSED. I'VE COME CLOSE, BUT NEVER MISSED.

Mary says YOU KNOW, JUDGE FROM YOUR SHOES, IT LOOKS LIKE YOU COULD HAVE WALK. THEY LOOK VERY COMFORTABLE.

Glenn says VERY, VERY COMFORTABLE. THE FASHION INDUSTRY HAS BEGUN TO THE SQUARE TOE.

Mary says AND I'M WEARING SQUARE TOES AS WELL. WE SHOULD GO TO SQUARE TOES.

Glenn says THE FOOT IS NOT POINTED AND COMES ACROSS AND SO THE SQUARE TOE REALLY ALLOWS THE FRONT OF THE FOOT TO HAVE ENOUGH ROOM SO YOU'RE WEARING SENSIBLE SHOES.

Mary says I PUT THEM ON JUST FOR YOU TODAY. OKAY. I WANTED TO TALK FIRST OF ALL THERE WAS A RECENT REPORT IN THE NEW ENGLAND JOURNAL OF MEDICINE, VERY PRESTIGIOUS MEDICAL JOURNAL. AND IT TALKED ABOUT AN OUTBREAK OF SOMETHING CALLED HOT FOOT SYNDROME. THIS WAS, UM, WITH CHILDREN IN A PUBLIC WADING POOLE IN ALBERTA. CAN YOU TALK ABOUT THAT?

The caption changes to "Doctor Glenn Copeland. Podiatrist."

Glenn says IT WAS AN INFECTION, AN INFECTION WHERE, UM, WHERE BECAUSE IT WASN'T PROPERLY CHLORINATED FROM WHAT I UNDERSTAND, YOU DON'T KILL ALL OF THE BACKER TOIA AND SO THE INFECTION HAS A GREAT POINT OF INDUSTRY IN THE-- ENTRY IN THE FOOT. BECAUSE THE FOOT IS CRACKED AND KIDS RUN AROUND THE POOL. AND IT GIVES THE KIDS AN INFECTED FOOT, IF YOU WILL. AND IT FEELS VERY HOT. IT'S SWOLLEN. IT'S RED AND IT'S LIKE ANY OTHER INFECTION. AND SO IT'S VERY IMPORTANT THAT THESE KIDS GET TREATED VERY QUICKLY. BECAUSE IT'S A VERY AGGRESSIVE, UM, YOU KNOW, BACTERIA THAT WILL DO SOME DAMAGE.

Mary says OH. SO THERE COULD BE LONG-TERM DAMAGE.

Glenn says OH, YEAH.

Mary says IF LEFT UNTREATED?

Glenn says IF LEFT TOO LONG UNTREATED. IT'S A VERY, VERY NASTY BACTERIA. IN FACT, IT'S ONE OF THE ONES THAT YOU SEE AFTER A RETURN VICTIM-- AFTER A BURN VICTIM, FOR INSTANCE, HAS EXPOSED TO THE BURN. THE BACTERIA IS VERY OPPORTUNIST OPPORTUNISTISM CT WILL GET ON THE BURN SITE AND CREATE A LOT OF PROBLEMS WITH HEALING.

Mary says NOW, QUHON WOULD THIS PROBLEM DID-- PROBLEM BE IN ONTARIO?

Glenn says IT'S HARD TO KNOW. BECAUSE AS THE NEW ENGLAND JOURNAL SAID IT'S ONE OF THE FIRST REPORTED CASES OF-- BUT, YOU KNOW, THAT'S NOT THAT EVERYBODY WHO GOT BURNING FEET ALL OF A SUDDEN HAVE THIS BACTERIA, BECAUSE IT'S A VERY COMMON COMPLAINT.

Mary says HAVE YOU SEEN IT?

Glenn says I HAVE NEVER EVER SEEN A CASE THAT WAS DIAGNOSED AS THE BACTERIA HOT FOOT SYNDROME. I HAVE SEEN INFECTIONS OF THE FOOT. AND QUITE FRANKLY PROBABLY THEY WOULD HAVE BEEN HOT FOOT, HAD, YOU KNOW, BEEN GIVEN THAT NAME BY THEN. BUT IT'S A COMMON KIND OF THING. YOU SEE PROBABLY-- I GET FOUR OR FIVE CASE AS YEAR OF THE INFECTION OF THE FOOT. AND, UM, AND WHERE IT'S BEEN EXPOSED TO SOME KIND OF A TRAUMA LIKE THAT. YOU KNOW, BECAUSE KIDS RUN ON THE BOOM POOLE AND, UM, AND POOL IS PERFECTLY FLAT. YOU KNOW , WHEN THEY PAINT IT, THE PAINT IS NOT PERFECTLY-- SO WHAT HAPPENS THIS-- THEY IRRITATE THE BOTTOM OF THE FOOT. KIDS WILL SAY I WAS RUNNING AND PLAYING FOOTBALL ON THE POOL AND THEY REALLY GET THE BAD CUTS AND IT GIVES THE BACTERIA, IF IT'S NOT PROPERLY CHLORINATED. THAT'S THE BOTTOM LINE. EVEN FOR KIDS AT HOME. POOH HAVE POOLS IN THE HOME AND BUILDINGS MAK SURE THAT THEY'RE TAKING GOOD CARE OF IT.

Mary says WE'RE IN THE WINTER MONTHS NOW. I'M JUST WONDERING IF YOU CAN TALK ABOUT SOME OF THE COMMON FOOT PROBLEMS ASSOCIATED WITH WINTER.

Glenn says RIGHT. A LOT OF IT IS BOOTS. A LOT OF IT IS THAT THE FOOT DONE GET TO SEE SUNLIGHT. YOU KNOW, AS SOON AS APRIL COME AROUND IN TORONTO, PEOPLE PUT THE SANDALS ON GO BAREFOOT IN THE SAN DAAL AND THERE'S A LOT OF SUNLIGHT. SUNLIGHT DESTROYS FUNGUS AND THE FUNGUS DOESN'T LIKE SUNLIGHT.

Mary says IT'S ALMOST LIKE OUR FEET ARE HIBER NAIGT. I REMEMBER THE FIRST FEELING WHEN YOU UNCOVER THEM AND YOU GO OUT, THEY FEEL FRAGILE AND TENDER.

Glenn says YOU PUT THE SOCKS ON AND THEN YOU HAVE A SHOWER AND PUT THE SOCKS ON AND REALLY UNTIL YOU GO TO BED, THE SOCKS DOAN COME OFF AND THE SHOE, FOR THE MOST PART, ONCE YOU LEAVE THE HOUSE, DON'T OFF. AND ONCE YOU COME HOME, YOU WEAR SLIPPERS AND SOCKS. PEOPLE RUN INTO THESE ISSUES THAT THE FOOT DONE GET TO BREATHE PROPERLY AND FUNGUS IS A HUGE PROBLEM IN THE WINTER.

Mary says ARE WE WENT-- ARE WE MEANT TO GO AROUND LIKE BARE FEET. WE DON'T HAVE HOBBITS AND ARE WE MEANT TO GO AROUND BAREFOOT.

Glenn says NO, BECAUSE TODAY WITH THE CONCRETE AND CEMENT, WE NEED THE SUPPORT AND PROTECTION AND PEOPLE SAY WALK THE WAY WE WERE INTENDED, AND I-- THE GREAT CARTOON I USE WHERE YOU HAVE A BEAR WALKING ON ALL FOURS. BUT THE FACT IS WE'RE SUPPOSED TO WEAR SHOES. BUT PEOPLE DON'T DRY, YOU KNOW BETWEEN THEIR TOES PROPERLY AFTER A SHOWER. THEY PUT THE BOOT ON AND THEY'RE IN THE BOOT ALL DAY LONG. CONSTRUCTION PEOPLE. KIDS IN SCHOOL. IT'S COMMON THAT WHEN WE WERE KIDS WE HAD A PAIR OF SHOES AT SCHOOL AND TAKE THE BOOTS OFF. TODAY, IT'S COMMON, ESPECIALLY WITH YOUNG TEENAGE GIRLS THAT THEY WEAR THESE BOOTS AND PUT ON AT 7 OR 8 IN THE MORNING AND IN THEM RIGHT THROUGH UNTIL THE END OF THE DAY SO THE FOOT NEVER, EVER HAS A CHANCE. THEY'RE REALLY A WINTER BOOT. SO IT DOESN'T BREATHE PROPERLY.

Mary says SO YOU SAY, OKAY, FUNGUS IS ONE OF THE BIG GUYS. MAKE SURE YOUR FEET ARE PROPERLY DRIED BEFORE PUT THEM...

Glenn says ABSOLUTELY. A LITTLE BIT OF A BABY POWDER IN BETWEEN THE TOES. BECAUSE IT HELPS TO ABSORB THE MOISTURE. STUFF LIKE THAT. THE OTHER THING WE SEE IS FROSTBITE. I MEAN, IT IS BIG. PEOPLE DON'T REALIZE THAT YOU SEE SO MUCH FROSTBITE TODAY. KIDS ARE OUTSIDE, YOU KNOW, THE ONES THAT ARE SO ACTIVE. SNOWBOARDING, SKIING, SKATING, UM, TOBOGANNING AND THEY'RE OUT THERE, AND THANKFULLY THIS YEAR, DIN HAVE THE ENOUGH TEMPERATURES YET BUT ONCE THE TEMPERATURES ARE 10 BELOW ON THE CELSIUS SCALE AND 5 BELOW, THAT'S THE TIME WHEN YOU GET CONCERN WHEN A KID'S OUT WITH FOUR OR FIVE HOURS WITH IMPROPER BOOTS AND SHOES AND IMPROPER SOCK AND THEY RUN INTO PROBLEMS WITH FROSTBITE.

Mary says YOU COULD SEE THAT HE HAPPEN BECAUSE THEY'RE COVERED AND IT'S NOT LIKE YOU CAN SEE WHAT'S GOING ON. WHAT SIGNS ARE YOU LOOKING FOR, THOUGH?

Glenn says BASICALLY WHEN THEY START TO FEEL PAIN IN THE FOOT WHEN THE FOOT REALLY IS COLD. YOU KNOW, PEOPLE TODAY HAVE TO START, YOU KNOW, GETTING BACK INTO TUNE ON THEIR BODY WITH THE SKI SLOPES. HAVE COME OUT NOW WITH SKI HEATERS. YOU CAN PUT HEAT NECESSARY YOUR SKI BOOTS AND...

Mary says THAT'S FOR ME.

Glenn says IT'S GREAT. PEOPLE WHO WANT TO SKI, ESPECIALLY IN NORTHERN ONTARIO, NORTHERN QUEBEC, UM, WHERE THE TEMPERATURES ARE REALLY COLD, THIS TIME OF YEAR, .UM, THEY PUT THESE-- THESE HEAT NECESSARY AND SO THAT THE FEET DON'T GET COLD. YOU ARE PREVENTING A LOT OF EARLY FROSTBITE.

Mary says OKAY. LET'S JUST REMIND YOUR VIEWERS IN CASE YOU JUST TUNED IN, WE'RE TALKING ABOUT YOUR FEET TODAY. ANY FOOT PROBLEMS THAT YOU MAY HAVE, WHETHER THEY'RE CALLUS, UM, BUNIONS, ANYTHING AT ALL. PLEASE US TODAY. DR. COPELAND WILL ANSWER YOUR QUESTIONS E THE NUMBER TO CALL IS...

The phone numbers and email reappear briefly.

Mary says AND WE'VE GOT THE FIRST CALLER ON THE LINE. LISA FROM AJAX. HI.

The Caller says HI.

Mary says GOOD.

The Caller says MY SON IS SEVEN. IT LOOKS LIKE SOMETHING LIKE A PLANTER'S WART FROM WHAT I'VE BEEN TOLD ON THE BOTTOM OF THE FOOT. I WONDER IF THIS IS SOMETHING I SHOULD TAKE HIM TO A DOCTOR FOR? OR WHETHER WE CAN TREAT IT WITH PHARMACY STUFF.

Glenn says SURE. THE FIRG THING IS TO MAKE SURE IT'S THE RIGHT DIAGNOSIS BECAUSE SOMETIMES PEOPLE LOOK AT A CALLUS AND CALL IT A PLANTER'S WART. BUT LET'S ASSUME THE DIAGNOSIS IS RIGHT. PLANTER'S WART, THE PLANTER IS JUST IN THE BOTTOM OF THE FOOT. IT'S A PLANNER SURFACE AND PEOPLE THINK IS IT A WART OR A PLANTER'S WART. IF IT'S ON BOTTOM OF THE FOOT, IT'S A PLANNER'S WART. THAT'S ALL IT MEANS A WART IS A VIRUS. CAN HAPPEN ON YOUR HAN OR ANYWHERE ON YOUR SKIN. SO THE-- THE-- THE ONE ON THE BOTTOM OF THE FOOT ARE PAINFUL BECAUSE YOU WALK ON THEM. THE-- SO THE POOR LITTLE FELLOW FEELS LIKE HE'S WALKING ON A STONE. SO IF, IN FACT, IT IS A WART, WHICH IS A VIRUS AS OPPOSED TO A CALLUS WHICH IS CAUSED FROM PRESSURE, I WOULD START REALLY WITH OFF THE SHELF KIND OF PRODUCTION. THEY MAKE TODAY A LOT OF THE CELL ACID AIDES. I THINK-- I DON'T WANT TO USE BRAND NAMES BUT A LOT OF THE DRUGSTORES CARRY THE BAND AIDS WITH BARNEY AND THIS LITTLE KID'S STUFF WITH AND THEY'RE IMPREGNATED WITH THE CELL AS AND I HAD PUT IT-- AND PUT IT RIGHT ON AND CHANGE IT EVERY DAY. I WOULD START WITH THAT. IF AFTER A COUPLE OF WEEKS DONE LOOK TO GET BETTER, HEAD OFF TO THE LOCAL PODIATRIST AND DOUBLE CHECK WITH THE DIAGNOSIS, NUMBER ONE, AND, UM, AND IMMEDIATELY WERE YOU-- EVEN BEFORE YOU START TREATMENT, COULD WANT TO GET A DIAGNOSIS. BUT A LOT OF-- LOT OF THE COUNTER-- OVER COUNTER STUFF YOU CAN USE. AND IF THEY'RE NOT WORKING, DOAN KEEP GOING. BECAUSE ACID IS AS AND I HAD IT WILL BURN.

Mary says HOW DO YOU GET THE PLANTSER'S WART.

Glenn says IT'S VIRUS. FEELING IS YOU GET A OR AN OPENING IN THE SKIN ON THE BOTTOM OF THE FOOT AND VIRUS IS PARENTHESIS, IT WILL IN.

Mary says IS THAT WHY IT'S ENCOURAGED WHEN YOU GO TO LET'S SAY A GYM OR A POOL THAT-- THAT YOU...

Glenn says SANDALS.

Mary says RIGHT.

Glenn says SHOWER SANDALS. FOR THAT AND FUNGUS. ANY KIND OF BLOOD SUPPLY THAT ALLOWS THE VIRUS OR THE BACTERIA OR THE, UM, OR THE FUNGUS TO GROW CREATES THE ISSUE F YOU'RE NOT EXPOSED BY IT TO-- BY WEARING A SHOWER SAN DAAL, IT'S BETTER FOR YOU.

Mary says LET'S TAKE ANOTHER CALL HERE. OWEN ON THE LINE FROM BRANTFORD. HELLO.

The Caller says GOOD AFTERNOON. I'M INQUIRING IF THERE'S ANY ADVANCES IN THE TREATMENT OF NEUROPATHY DUE TO DIABETES. YOUR COMNT ON THAT, PLEASE.

Glenn says SURE. UM, NEUROPATHY IS A VERY COMMON DISTURBANCE OF DIABETICS. WHAT IT IS IS IT'S AN BE FLAMATION OF THE NERVES AS A CONSEQUENCE OF THE DIE BEETTIC CONDITION. UM, THAT A LOT OF DIFFERENT THEORIES AS TO WHAT REALLY CAUSES IT. THE MOST COMMON ONE TODAY THAT-- THAT I THINK MOST PEOPLE SUBSCRIBE TO IS THE FACT THAT BECAUSE OF THE HIGH SUGAR LEVELS IN THE BLOOD, AND POOR CONTROL OF THE SUGAR LEVELS, THAT THE BODY TRIES TO CONVERT THE-- THE GLUCOSE TO SOMETHING IT CAN STORE AND SO THE BELIEF IS THAT IT ACTUALLY CONVERTS IT TO SORBITOL, WHICH IS ANOTHER KIND OF SUGAR. NOW, THE PROBLEM WITH CONVERTING TO SORBITOL IS WE DON'T HAVE AN ENZYME THAT CONVERTS IS BACK TO GLUCOSE. SO THE FEELING IS THAT THE SORBIT. O L INTERFERES WITH THE NERVE OF THE FOOT. REMEMBER, THE FOOT IS THE FARTHEST FROM THE HEART. SO THAT ANYTHING THAT WILL HAPPEN IS WHERE THE BLOOD PRESSURE'S THE LEAST, WHICH IS IN THE FOOT. THAT'S WHY THE BLOOD TENDS TO POOL THERE. THAT'S WHY YOU GET KIND OF CONVERSION HAPPENING AND YOU GET THIS NEUROPATHY. BUT A LOT OF THE PHARMACEUTICAL COMPANIES ARE WORKING ON WHAT'S AVAILABLE IN REGARDS TO TRYING TO TREAT NEUROPATHY. THERE'S DIFFERENT STUDIES GOING ON RIGHT NOW BY DIFFERENT DRUG COMPANIES TO TRY AND REVERSE THIS KIND OF PROBLEM. IT'S A VERY UNCOMFORTABLE SENSATION FOR A DIABETIC. THEY FEEL PINS AND NEEDLES AND A BURNING SENSE SAGS IN THE FOOT. IT'S SOMETHING THAT-- THAT DOESN'T ALLOW THEM TO SLEEP WELL. IT REALLY INTERFERES WITH A LOT OF THEIR LIFE. UM, AND AGAIN, TO-- ANYBODY WITH THE CONDITION, SPEAK TO YOUR BETTIC SPECIALIST. MAY BE SOMETHING COMING DOWN THE TUBE NOW. MAYBE EXPERIMENTAL DRUGS THAT YOU COULD GET INTO A PROGRAM. BUT IT IS-- IT IS SOMETHING THAT'S A HUGE ISSUE DIABETICS, ESPECIALLY SOMEONE WHO'S NOT WELL CONTROLLED.

Mary says RIGHT. NOW IN YOUR CLINIC, YOU HAVE A CLINIC OUTSIDE OF MOWN SINAI .HOSPITAL, WHAT PERCENTAGE OF YOUR PATIENTS WOULD BE DIABETIC?

Glenn says THERE IT'S A SPORTS MEDICINE CLINIC AND WE DON'T SEE ANY. BUT THE AVERAGE PODIATRIST, HE HE OR HER WOULD SEE 25 percent. COULD BE THAT HIGH. AND SOME PODIATRISTS SPECIALIZE IN DEBITTIC OR WOUND CARE. THERE'S A GREAT ONE AT WOMEN'S COLLEGE HOSPITAL, THERE'S TOPNOTCH DERMATOLOGY PEOPLE INVOLVED DIABETIC FOOT CARE.

Mary says THIS CALLER WAS ASKING ABOUT PRODUCTION. I HAVE HEARD ONE AND I WANT YOU TO TALK ABOUT IT... ABOUT IT. IT'S A TEFLON SOCK.

Glenn says WHAT HAPPENED A NUMBER OF YEARS AGO, WITH THE DIABETIC, THEY TEND TO BREAK DOWN. SKIN ON THE BOTTOM OF THE FOOT, BECAUSE OF BAD CIRCULATION, YOU AND MAY GET A CALLUS ON BOTTOM FOOT IT, LAYS DOWN THICKER TISSUE. UNFORTUNATELY THE DIABETIC, BECAUSE THEY DON'T GET THE OXYGEN DOESN'T DO THAT, THEY BREAK DOWN SO THAT UNNEATH A VERY THIN CALLUS, YOU FIND AN OPEN SORE BECAUSE THE-- THE OXYGEN DOESN'T ALLOW THE TISSUE TO HEEL. SO, UM, SO WHAT, UM... I BELIEVE, AND I HOPE I'M USING THE RIGHT COMPANY HERE, DUPONT CAME OUT THAT, MAKES TEFLON CAME OUT WITH AN IDEA THAT IF WE CAN PREEN BLISTER FORMATION, THAT YOU CAN PRESENT THIS-- PREVENT THIS KIND OF ULCER FROM STARTING AND CAME OUT WITH THE TEFLON SOCK AND IT'S BEEN AN INTERESTING PROGRESS. I KNOW THEY'VE DONE STUDIES AND PROVED TO BE VERY SUCCESSFUL IN PREENING ANY KIND OF RUBBING WITH THIS KIND OF SOCK. SO I'M NOT SURE WHERE-- YOU KNOW, WHERE AT IN THE MARKETING PROGRAM. BUT AGAIN, THINGS LIKE THAT, SHOES, UM, THERE'S SHOES TODAY, VERY WIDE AND COMFORTABLE SHOES FOR THE DIABETIC. UM, THERE'S NEW TECHNOLOGY FOR, FOR USING, UM, TO MARKOV, IF A DEBIT TECH IS GETTING ABNORMAL PRESSURE ON THE BOTTOM OF THE FOOT. SO BY LOOKING AT A COMPUTER EVALUATION OF THE WEIGHT...

Mary says SENSORS WOULD TELL.

Glenn says WHERE THAT ABNORMAL PRESSURE MAY BE. ONE OF THE THINGS THAT WE CAN HOPEFULLY DO IS PREEN THE ULCER FROM EVER HAPPENING ON BOTTOM OF THE FOOT. BY OFF LOADING THE PRESSURE. RIGHT SHOE AND SOCKS. THERE'S A THE LOVE THINGS. BUT RIGHT NOW, IT'S ESTIMATED THERE'S 10 MILLION DIABETICS DIAGNOSED IN NORTH AMERICA AND ANOTHER 10 MILLION UNDIAGNOSED. IT'S A HUGE ISSUE WHEN YOU LOOK ABOUT 20 MILLION KNOWN AND UNKNOWN DIABETICS RIGHT NOW. IT'S A BIG, BIG ISSUE. HUGE.

Mary says OKAY. LET'S GO TO BE-- TO AN E MAIL NOW. I'VE GOT AN INTERESTING QUESTION FOR YOU HERE. THIS PERSON WRITES...

Mary reads from a laptop computer and says
I HAVE FASCIITIS BRUCHITIS IN MY HEEL AND I'M IN AGONY MOST OF THE TIME. I WORE ORTHODI CS TWO YEARS AGO AND HAD COURT SON SHOTS THREE YEARS AGO AND THEY WERE VERY TEMPORARY. SHOULD I GIVE UP.

Glenn says THEY SAY NOBODY DIES OF BAD FEET AND ONLY BAD HEARTS, FROM NOT WALKING. ANSWER IS NEVER GIVE UP YOUR WALKING. OKAY? THAT'S A VERY CLEAR AND CONCISE ANSWER. YOU KNOW, PEOPLE GET VERYER CONCERN. I THINK IT'S-- IT'S A VERY GOOD QUESTION BECAUSE PEOPLE OF-- HAVE A PEACE OF MINUTE ISSUE. IF I KEEP WALKING, WILL I DESTROY MY FEET? UM, IF YOU DON'T KEEP WALKING AND YOU BECOME A COUCH POTATO, YOU WILL DESTROY YOUR HEALTH AND YOUR HEART. SO THERE IS THERE IS NO TRADE OFF. YOU HAVE TO KEEP GOING, UM, AND-- NOW, TO TAKEN WHAT FASCIITIS... IT'S IMPORTANT SO SAY IT'S SIMPLY WHERE THE MUSCLE, MAJOR TENDON ON THE FOOT TEARS AWAY FROM THE HEEL BONE. IT'S VERY, VERY PAINFUL THING SOCIETY EVERY MORNING, AND WILL GET OUT OF BED AND IT RIPS AGAIN AND VERY SORRY FOR MOST OF THE DAY AND SIT DOWN FOR TWO HOURS AND GO TO STAND UP, AND TEAR IT AWAY AGAIN. IF YOU TAKE AN X-RAY, THERE'S PROBABLY A SMALL SPUR PARENTHESIS. SO IT REALLY IS A MAJOR ISSUE E NOW, THERE'S A NUMBER OF THINGS THAT CAN BE DONE. NUMBER ONE, SURE YOU'RE IN THE RIGHT ORTHODIC AND SEEK OUT THE HELP OF A GOOD PODISM ATRIST THAT CAN WORK WITH YOU AND SEE WHAT HE GOES ON AND YOU CAN ABSOLUTELY SEE, UM PODIATRIST AND THAT YOU CAN-- THAT CAN WORK WITH YOU AND SEE WHAT GOES ON. AND YOU CAN ABSOLUTELY SEE WHAT GOES ON. AND THERE'S A NEW MACHINE OUT THERE THAT'S VERY HIGH INTENSITY ULTRA TOWN. STARTED ABOUT EDGE-- BY PEOPLE THAT BELIEVED WHEN WE BOMBARD KIDNEY STONES AND BREAK THEM UP THAT YOU CAN BOMBARD IF YOU WILL, THE PLANTER FACHIA AND VIRTUALLY A PAIN TREATMENT TWO OR THREE TREATMENTS AND, UM, AND WHAT-- FROM WHAT I UNDERSTAND, THE SUCCESS RATE IS ANYWHERE BETWEEN 60-75 percent SO IT'S VERY HIGH. UM, AND IN CASES JUST LIKE THIS, WHERE YOU'VE HAD EVERYTHING AND NOTHING'S WORKED, AND SO THERE ARE THOSE THAT-- POTENTIAL KIND OF ISSUES. BUT PLANTER FASCIITIS S FOR THE MOST PART, ENOUGH ORTHODI CS AND GOOD MEDICATION AND A GOOD STRETCHING PROGRAM, GENERALLY SPEAKING, 90-95 percent SUCCESS.

Mary says SOMETHING THAT PUZZLES ME BECAUSE SHE PROBABLY GETS UP EVERY MORNING AND TEARS IT AGAIN.

Glenn says EXACTLY.

Mary says WELL, IF YOU SAY YOU SHOULD KEEP ON WALKING, AROUND YOU GOING TO KEEP ON RETEARING IT?

Glenn says THE WHOLE THING IS IF YOU KEEP THE SHOES BESIDE THE BED WITH THE ORTHOTICS IN SO-- TO GET UP IN THE MORNING YOU DON'T GET THAT INITIALLY TEAR. IF IF THERE'S A SECRET TO IT, THAT'S IT. PUT THE SHOE BESIDE THE BED. DON'T STEP DOWN IN THE MORNING OR IN THE MIDDLE OF THE NIGHT WITHOUT THE SHOE...

Mary says TAKE-- PUT THE SHOE-IN BEFORE YOU PUT THE FOOT ON THE GROUND.

Glenn says ABSOLUTELY THAT STOPS THE TEAR. THE SECOND PART OF THE QUESTION IF THEY KEEP WALKING, WILL THEY GET MORE TEARING? YES. BUT THE BODY WILL GRADUALLY TRY TO HEAL AT THE, MORE THAN IT TEARS. EXACTLY. SAME THING AS WEIGHT LIFTING. YOU KNOW, YOU-- YOU END UP LIFTING AND THEN YOU TEAR THE MUSCLE AND AS IT REPAIRS THE MUSCLE GETS BIGGER. WELL, THIS IS-- THIS LIGAMENT, IF YOU WILL, IF YOU CAN BEAR THROUGH IT, AND DO THE STRETCHING AND DO THE ORTHODI CS AND DO THE MEDICATION, HOPEFULLY IT STRETCHES ENOUGH AND YOU STOP THE ABNORMAL MOTION OF THE FOOT, WHICH ISL ROLLING, WI CAUSES THE TEARING.

Mary says OKAY. MAKES SENSE. DAVID ON THE LINE FROM BELLEVILLE. HELLO.

The Caller says HELLO.

Mary says HI.

The Caller says GOOD AFTERNOON. THANK YOU FOR TAKING MY CALL. I WAS BORN WITH SPINA BIFIDA, BUT MOST OF IT IS JUST CLUB FOOT I CAN'T MOVE MY ANKLE BECAUSE WHEN I WAS BORN, HALF OF-- HALF OF THE BONES WERE REARRANGED AND PUT BACK INTO SEMI-NORMAL POSITION AND ALL OF THAT. AND VERY HARD ARCH. I WAS TOLD AFTER PUBERTY THAT I SHOULD GO SEE, UM, SOMEONE TO SEE EVERYTHING IS OKAY AND-- AND, UM, AND I WAS WONDERING IF I SHOULD DO THAT? AND IF I DON'T, UM, ARE THERE THINGS JUST TO KIND OF BE AWARE OF?

Glenn says UM, VERY GOOD QUESTION. FIRST OFF, WHAT A CLUB FOOT IS INSTEAD OF THE FOOT SITTING LIKE THIS, THE CHILD'S BORN WITH THE FOOT ALL TURN IN, SO THE TOES AND THE FOOT IS TURN IN. AND THE GOOD NEWS FOR THIS YOUNG GENTLEMAN IS THAT HE'S HAD THE SURGERY TO CORRECT THAT VERY EARLY ON. AND-- AND SOME OF THAT EARLY SURGERY, WHICH, UM, WHICH AS A CANADIAN AND TORONTO, I'M PROUD OF, WAS DONE IN SICK CHILDREN'S HOP IN TORONTO AND SOME OF THE EARLY STUFF THEY DID HAS BEEN USED AROUND THE WORLD TO-- TO, UM, TO OPERATE ON CLUB FEET. UM, AND TO ANSWER YOUR QUESTION, YES, YOU SHOULD DEFINITELY GET AND GO AND GET CHECKED BY A PODIATRIST OR SOMEBODY WHO DOES KNOW, UM, THE RAM IF I CANS OF CLUB FOOT SURGERY. BECAUSE IT'S VERY-- IT'S A VERY EXTENSIVE SURGERY. YOU'RE ARRANGING AS YOU SAID THE BONES, BUT IN ESSENCE YOU'RE DOING TENDON TRANSFERS AND MAYBE BREAKING BONE, WHAT WE ALL AN OSTEOTOMY TO RESET THE FOOT. ALTHOUGH THE FOOT MAY NEVER BE PERFECT, BUT-- IT'S OBVIOUSLY FUNCTIONAL AND OBVIOUSLY WORKING WELL BUT YOU WANT TO MAKE SURE YOU'RE GETTING THE OPTI M UM USE OUT OF IT AND MAY MEAN CERTAIN SHOES OR ORTHOTICS. IN SOME CASES, THERE COULD BE MORE SURGERY THAT COULD BE DONE TO GIF YOU BETTER FOOT FUNCTION. THERE'S A WHOLE GROUP IN THE US-- U.S. OF ORTHOP DFMT IC SURGEONS, FOOT AND ANKLE SURGEONS THAT SPECIALIZE IN THIS. THERE'S 1900 OF THEM TRAINED AND FOOT AND ANKLE ORTHOPEDISM C. THEY ONLY DO, MOST OF IT, REAR FOOT SURGERY. AND, UM, AND SO...

Mary says IT'S REAR FOOTED AT THAT EVEN.

Glenn says WELL, REAR FOOT'S MORE EXTENSIVE SURGERY BECAUSE YOU DEAL WITH THE ANKLE AND ET CETERA. WITH PODIATRY, WE DO MOST OF THE WORK ON THE FRONT OF THE FOOT. THE ORTHOPEDIC, FOOT AND ANKLE SURGEON WOULD DO A LOT OF THIS KIND OF WORK.

Mary says IT'S HARD TO REMEMBER WHO DOES WHAT. MAYBE YOU CAN EXPLAIN QUICKLY WHAT IS A PODIATRIST AND A PODIATRIST.

Glenn says ORTHOPEDIC DOES FOUR YEARS OF MEDICAL SCHOOL AND THEN TWO YEARS AND THEN A FOOT OR ANKLE SURGEON DOES FOUR MORE YEARS OF THAT. AND PODIATRY FOUR YEARS AND THEN PODIATRY SCHOOL AND THEN THREE YEARS OF.
MAYBE SURGERY. AND...

Mary says BUT THE BIG DIFFERENCE IS THAT IF YOU'RE A PODIATRIST THAT, MEANS YOU WEREN'T TRAINED HERE BUT IN THE U.S.

Glenn says EXACTLY. YOU CAN BE TRAINED IN BRITAIN. THEY'RE USING THE TERM PODIATRY OVER THERE AS WELL. HERE, SO IF YOU'RE TRAIN IN THE U.S., YOU'RE A PODIATRIST. I'M A CANADIAN WHO WENT TO SCHOOL THERE. WE HAVE A PROGRAM IN TORONTO, THREE OR FOUR-YEAR PROGRAM HERE NOW, AND I BELIEVE IT WAS, UM, ORIGINALLY THROUGH-- I THINK IT'S THROUGH THE MICHNER INSTITUTE NOW. THEY TRAIN, UM, CANADIAN-TRAIN, UM, COROPISM DIST THAT HAVE THE SAME TRAINING AS PODIATRISTS BUT DON'T DO SURGICAL TRAINING. I THINK THAT'S THE DIFFERENCE. I'M NOT SURE OF THAT. A LOT OF THEM DIABETIC FOOT CARE AND EVERYTHING BASICALLY UP TO THE SURGICAL LEVEL.

Mary says AND YOU GET THE DESIGNATION OF DOCTOR IN THE U.S.

Glenn says ACTUALLY IN, CANADA, UM, DOCTOR-- WE HAVE A DEGREE OF PODIATRIC MEDICINE AND THE COR COROPIDIST HAVE A DEGREE IN-- IN DOROCHOPIDYN NORTH AMERICA, THIS TERM DOCTOR IS AN INTERESTING TITLE, BECAUSE IN B.C. I THINK THE PODIATRISTS ARE ALLOWED TO USE THE TITLE AND IN ONTARIO, I'M NOT SURE THAT WE ARE. ONLY BECAUSE IT-- YOU'RE DENOTING THAT YOU MAY BE A MEDICAL DOCTOR, WHERE YOU'RE A PODITRIST AND YOU'RE NOT. SO, UM, SO IN ONTARIO, I DON'T BELIEVE THAT YOU LEGALLY ARE ALLOWED TO USE DESIGNATION. WHERE AS IN THE EAST, UM, AND...

Mary says OKAY, GLENN.

Glenn says IT GOES ON. THE LEGISLATION CHANGES ALL THE TIME. SO I DON'T WANT TO MISLEAD ANYBODY. AND THEN IN THE U.S., NO, ABSOLUTELY THE TITLE DOCTOR IS ACCEPTABLE. SINCE I SPENT HALF OF MY LIFE DOWN THERE, IT'S-- IT'S VERY INTERESTING TO SEE THE LEGISLATION AS IT'S WORK OUT.

Mary says WHAT ABOUT THE FINAL CATEGORY OF PIDORTHIST.

Glenn says CERTIFIED PIDORTHIST, I BELIEVE, I'M NOT NEAR ANYWHERE GOOD ON THIS, BUT THEY'RE PEOPLE THAT ARE TRAINED SHOE FITTING AND, UM, AND TRAINED IN-- IN, UM, IN ORTHODISM CS AND, UM, AND I BELIEVE THIS-- THAT TO BE CERTIFIED, THEY HAVE TO WRITE SOME KIND OF EXAM, BUT-- BUT DON IF THERE'S ANY COURSES IN CANADA.

Mary says WE DOAN SEEISM DO DOTHISTS HERE?

Glenn says I'M NOT SURE. I KNOW THERE'S A PROGRAM IN CHICAGO. AND...

Mary says SO WE DON'T SEE PIDORTHITS HERE?

Glenn says I DON'T KNOW. I KNOW THERE'S A COURSE IN CHICAGO.

Mary says OKAY. NOW TO ANOTHER CALLER.

The Caller says I'M CALLING IN ABOUT MY TOENAILS, AND A LARGE-- THE LARGE ONE AND I WENT TO A SKIN SPECIALIST TO SEE TO MY TOENAILS. IT'S STRAIGHT AND A LITTLE BLACK. AND THE DOCTOR SAID IT'S FUNG US AND RECOMMENDED THAT-- TO GIVE ME THE CREAM AND I APPLY IT FOR THREE MONTH. BUT ONE OF THE SIDE EFFECTS IS THAT IT WOULD BE FOR MY LIVER. I HAD A GALLSTONE PROBLEM OR SOMETHING LIKE THAT. AND IT HAD A BAD EFFECT ON THE LIVER, BASICALLY, AND I COULDN'T TAKE THE MEDICATION BECAUSE OF THAT.

Glenn says NOW, THIS WAS A PILL. NOT THE CREAM.

The Caller says NO, IT WAS A CREAM. AND-- NO, I'M SORRY, IT WAS A PILL. NOT A CREAM. I'M SORRY. IT WAS A PILL. HE GAVE ME THE PILL AND I COULDN'T TAKE IT BECAUSE IT WOULD BE MORE BAD ON THE LIVER AND THAT'S WHY HE-- AND IT LOOKS AWFUL AND I NEVER WEAR SANDALS BECAUSE OF THAT.

Glenn says RIGHT. FIRST OFF, FUNGUS IS COMMON. IT PROBABLY I WOULD GUESTIMATE THAT 45 percent OF PEOPLE OVER 45 HAVE A TOENAIL FUNGUS.

Mary says WHAT PREDISPOSES TO YOU?

Glenn says PRESSURE. BLEEDING UNDERNEATH THE NAIL AND THE FUNGUS ATTACKS IT AND GOES TO WORK ON IT. OKAY?

Mary says IT'S NOT-- WHAT I'M GETTING AT IT IS THAT WINTER CONDITIONS WILL PROMOTE IT. BUT IS IT SOMETHING TO DO WITH THE PERSON THEMSELVES AND THEIR FEET?

Glenn says NO.

Mary says THEIR BODY CHEMISTRY.

Glenn says THERE IS. CERTAIN PEOPLE ARE VERY PRONE TO ATHLETE'S FEET FUNGUS. NO WHEART YOU-- MATTER WHAT YOU---- AND OTHER PEOPLE WALK AROUND BAREFOOT THROUGH THE SHOWERS AND NEVER GET IT. SO THERE'S ABSOLUTELY PRE-DISTO IT AND WE DON'T KNOW WHAT THAT IS. WITH HE REALLY DON'T KNOW. BUT WITH THE TOENAIL FUNGUS, IF YOU'VE INJURED THE TOENAIL, DANCE WITH SOMEBODY AND HE OR SHE INJURIES YOUR FOOT OR HORSEBACK RIDING AND THE HORSE STEPS ON THE FOOT, ANYTHING THAT DAMAGES THE FOOT ALLOWS THE BLEEDING AND ONCE THE BLEEDING IS UNDERNEATH, IT'S IN A GREAT ENVIRONMENT FOR THE FUNGUS. THIS POOR LADY HAS GOT THAT CONDITION AND NOW THE FUNGUS HAS TURNED BLACK AND LOOKS-- ASSUMING THAT THE DIAGNOSIS IS CORRECT IN THIS CASE, UM, THERE ARE TWO WAYS OF GOING. ONE IS THE PILL. UM, AND THERE'S A COUPLE OF PILLS OUT THERE NOW. UM, FOR TOENAIL FUNGUS. BUT AS THIS LADY SAID, AND I'M GLAD SHE CALLED, BECAUSE IT DOES CREATE, IT DOES CREATE A CERTAIN, UM, SYSTEMISM C PROBLEM. IN THIS CASE, THERE IS A LIVER PROBLEM. AND IT COULD ALSO BE A BOWEL PROBLEM SO, YOU KNOW, PEOPLE THINK THAT EVERY DRUG, AND THIS IS SOMETHING THAT I ALWAYS ADVISE MY OWN PATIENTS, ARE YOU PREPARED TO TAKE THE RISK OF THE DRUG TO FIX A TOENAIL FUNGUS, OKAY? AND, UM, I KNOW OF ONE PATIENT WHO ENDED UP WITH A SEVERE REACTION. WHICH IS VERY UNUSUAL. ONE IN PROBABLY, UM, 1.8 MILLION. BUT IF IT'S THAT ONE CHANCE THAT YOU MIGHT BE THE ONE WHO HAS THAT DRUG REACTION, UM, YOU KNOW, ARE YOU REALLY PREPARED TO TAKE THE-- THE MEDICATION AND TAKE THAT RISK? SO MY SUGGESTION IS ALWAYS TRY THE ANTI FUNGAL CREAMS FIRST. THE SAME PEOPLE WHO MAKE THE PILL, DO MAKE A CREAM FORM SO THAT'S WHERE I WOULD TELL YOU TO GO WITH IT. GO WITH THE CREAM FORM ON TOENAIL. BECAUSE THE ABSORPTION IS VIRTUALLY ZERO. I'VE NEVER EVER HAD ANYBODY WHO EVER HAD ANY KIND OF SYSTEMIC PROBLEM FROM THE CREAM. THE WORST PART IS THAT YOU COULD BE A L LERGIC TO IT, WHICH IS VERY UNLIKELY, OR IT MIGHT JUST NOT WORK. BUT THE SIDE EFFECTS ARE VIRTUALLY ZERO.

Mary says DO PEOPLE WHO GET A FUNGAL INFECTION TENDS TO KEEP GETTING THEM?

Glenn says YEAH, THEY DO. AGAIN, PREDISPOSED AND, UM, AND, YOU KNOW, THE TOENAIL FUNGUS IS-- IS UNSIGHTLY. MOSTLY FOR A WOMAN. GUYS COME IN, UM, I DON'T CARE. AND ESPECIALLY GUYS-- I MEAN, GUYS WHO ARE ACTIVE ALL HAVE IT. IF THEY'VE BEEN PLAYING BASEBALL AND BASKETBALL, BECAUSE THEY'RE ALWAYS STEPPING ON EACH OTHER'S TOES SO, YOU KNOW, YOU SEE SOMEBODY ACTIVE THEIR WHOLE LIVE AND 40 YEARS OLD THEY HAVE ONE OR TWO TOENAILS. WOMEN WHO RUN. YOU KNOW, THAT HE E THEY'LL DOME IN AND SAY MY TOENAIL'S BLACK AND WE CALL THE BADGE OF COURAGE BECAUSE IF THEY'RE DOING MARATHONS OR RUNNING 10 K'S, THEY'LL GET BACK NAILS. OKAY?

Mary says OKAY. LET'S LOOK ANOTHER E-MAIL HERE. THIS WRITES AND SAYS...

Mary reads from the laptop and says I'M IN MY MID-40'S AND I HAVE FLAT FEET. I'M WEARING ORTHOTICS TO CORRECT THE PROBLEM BUT ARE ENCOURAGED TO DO EXERCISES WITH A PHYSICAL THERAPYIST. AND FROM A BOOK I READ. WILL EXERCISES IMPROVE MY ARCHES O-- OR ARE THEY A WASTE HE HAVE TIME?

Glenn says YOU PICK ON THE PHYSICAL THERAPYIST. CERTAIN PHYSICAL THERAPYISTS HAVE ALWAYS BELIEVED AND THEY'RE EXCEPTIONALLY WELL TRAIN AND A GREAT GO-- GROUP OF PEOPLE AS WELL. BUT SOME BELIEVE AND IT'S MORE THE ENGLISH TRAINING THAT YOU CAN STRENGTHEN THE ARCH AND STOP THE FOOT FROM PRONATING. IFED INVOLVED PERSONALLY IN A STUDY FOUR YEARS AGO IN THE US IN THE U.S. WE TRIED THAT. AND BECAUSE OF THE COMPUTER WE COULD SEE HOW MUCH OF A ROLL THERE WAS. WE DID HE THE PRE-EXERCISE TRAINING PROGRAM AND GAVE THEM OVER TO THE-- TO THE PHYSICAL THERAPY WHO DID THE TRAINING, UM, AND UNFORTUNATELY, AH, WE ONLY DID, UM, VERY SMALL, SEVEN OR EIGHT PATIENTS, AND NONE OF THEM HAD APPRECIABLE CHANGE IN THE WAY THEY PRONATED SO IS IT A WASTE OF TIME? I BONE SAY IT'S A WASTE OF TIME BECAUSE I BELIEVE THAT STRENGTHENING AND STRETCHING THE FOOT IS ALWAYS A GOOD IDEA. DO I PERSONALLY BELIEVE THAT YOU CAN, YOU KNOW, REVERSE OR UNDO SOME OF THE PRONATION BY DOING IT, I HAVEN'T SEEN ANYTHING TO INDICATE THAT IN ANY BONA FIDE STUDY YET. SO, YOU KNOW, NOTHING OR YOU'RE STRETCHING OR STRENGTHENING IS EVER A WASTE OF TIME. BUT, UM, BUT I DOUBT YOU'RE GOING TO GET RID OF YOUR PRONATION PROBLEM. THE ANALOGY I USE IS LIKE YOU NEED READING GLASSES. NOW, OKAY, SOME PEOPLE DO BELIEVE THAT YOU CAN STRENGTH EN YOUR EYES TO THE POINT THAT YOU MIGHT NOT NEED THEM AND THERE'S A STUDY GOING ON WITH CONTACT LESS THANS AROUND THAT. BUT I HAVE YET TO SEE ANY BONA FIDE PAPER THAT SAYS.

Mary says THAT YOU'RE UNDOING THE PRONATION OR ABNORMAL PRONATION. OKAY. NOW TO KAREN ON THE LINE. HI. DO YOU HAVE A QUESTION.

The Caller says YES, I HAVE A BUNION ON BOTH OF MY FEET AND I HAVE AN APPOINTMENT WITH A DOCTOR TO SEE ABOUT HAVING THEM OPERATED ON. BUT I'VE ALSO HEARD THAT THERE'S SUPPOSEDLY, UM, A LASER TYPE OF OPERATION THAT-- THAT CAN BE DONE ON BUNIONS AND I'M JUST WONDERING WHAT YOU KNOW ABOUT THAT AND IF, INDEED, IT IS DONE, WHERE?

Glenn says SURE. THERE'S A LOT OF GREAT NEW SURGERY BEING DONE, UM, BY, UM, BY, UM, PODIATRISTS ON BUNIONS SURGERIES.

Mary says WHAT ARE BUNIONS.

Glenn says IT'S WHERE THE BIG TOE JOINT DEFORMIATES. THEY THINK IT'S LIKE A CALLUS. BUT IT'S NOT. IT'S A BONEY DEFORMITY.

Mary says ARE YOU BORN WITH THAT?

Glenn says NO, YOU'RE BORN WITH THE ABNORMAL ROLL OR PRONATION. YOU WALK YOURSELF INTO A BUNION. SHOES PLAY A BIT OF A PROBLEM. IF YOU ABNORMALLY ROLL AND YOU'LL END UP WITH THAT. AND SO THE THING IS FOR THE PATIENT TO BE IF YOU WILL A CONSUMER. BECAUSE THERE'S NOTHING LIKE AN EMERGENCY BUNION-LECTOMY. YOU WANT TO FIT THE SHOES BETTER AND GET RID OF THE PAIN IN THE JOINT. AND THERE'S DIFFERENT WAYS OF DOING IT. SOME OF THE MORE STANDARD METHODS ARE, UM, ARE WITH-- WHERE YOU GO INTO THE HOSPITAL AND SURGICALLY BONE IS EITHER, YOU SHAVED OFF AND IT CAN BE BROKEN AND REMOVED. UM, AND-- AND IN-- IN PODIATRIST'S CASE, AND SOME ORTHOPEDIC SRNLS ARE DOING THE SAME THING, THEY MAKE A VERY SMALL INSIGNIFICANCE AND USING THE RIGHT INSTRUMENTATION, AND DOING THAT NOW FOR BACK SURGERY.

Mary says PIN-HOLE SURGERY?

Glenn says EXACTLY. PODIATRISTS LED THE WAY IN THIS SURGERY NOW OVER THE PAST 15, 20 YEARS. IT'S BEING DONE IN TORONTO. THERE'S THREE OR FOUR PODIATRISTS THAT DO THIS AND THEY DO A WONDERFUL JOB. GENERAL, THEY'VE BEEN TRAINED IN THIS PARTICULAR PROCEDURE. AGAIN, YOU KNOW, CALL THE ONTARIO PODIATRY ASSOCIATION AND GET THE NAMES THESE THREE FOUR GUYS THAT DO IT. I'M NOT ONE OF THEM. I'M MORE ON THE MECHANIC APPLE SPORTS MEDICINE SIDE. BUT THERE ARE-- THEY DO A GREAT JOB.

Mary says WITH SO MANY OF THESE PROBLEMS, WE ALWAYS GO BACK TO BAD SHOES. TIGHT SHOES. POOR...

Glenn says EXACTLY.

Mary says DON'T WE? WHAT'S THE PERFECT SHOE. DESCRIBE IT TO ME?

Glenn says A PERFECT SHOE, WIDE, OKAY? WIDE, UM, SOMETHING THAT IS VERY FLEXIBLE. OKAY? FLEXIBLE IS VERY IMPORTANT, BECAUSE YOU WANT THE FOOT TO BE ABLE TO GO THROUGH ITS RANGE OF MOTION. SEE, THE FOOT HAS TWO MAJOR FUNGS. ONE, WHEN IT HITS THE GROUND, IT'S GOT TO BE A MOBILE ADAPTER AND IT'S GOT TO ADAPT TO THE SURFACE. THE FOOT DOESN'T KNOW WHETHER YOU'RE GOING ROCK CLIMBING OR PLAYING TENNIS OR GOING TO THE STUDIO. IT ONLY KNOWS IT'S GOT TO BE A MOBILE ADAPTER AND. THEN TO PUSH-OFF, IT'S GOT TO BECOME A RIGID LEVER TO PUSH FORWARD.

Mary says DOES ANY SHOE HAVE COMPBAIL?

Glenn says SOME SHOE. ESPECIALLY THE GOOD RUNNING SHOES DO-- DO AN EXCEPTIONAL JOB AT HELPING THE FOOT DO THOSE THINGS. BROOKS IS ONE OF THEM. JUST AN OUTSTANDING JOB. UM, AND-- AND, YOU KNOW, SOME OF THE EARLY STUFF THAT THEY DID, WAY BACK IN THE '70'S, ALLOWED THE FOOT TO BECOME A MOBILE ADAPTER EARLY. AND THEN BECOME A RIGID LEVER. SUM, SOCKENEY IS ANOTHER GOOD ONE. I HAVE NO ALLEGIANCE TO ANY PARTICULAR SHOE COMPANY. BUT THEY TEND TO LEAD INTO THAT. UM, AND NEW BALANCE, IT COME INTO WIDS SO THAT-- IT'S THE FIRST RUNNING SHOE COMPANY THAT HAS WIDS, ALL RIGHT? UM, AND-- BUT, YOU KNOW, EVERY SHOE HAS ITS OWN UPS AND DOWNS. UM, THE MOTION CONTROL PEOPLE, UM, WHERE YOU WANT TO PREVENT TOO MUCH ABNORMAL ROLL, UM, THE RUNNING SHOE SO IF YOU SAY WHAT IS A PERFECT SHOE, A GOOD RUNNING SHOE. A GOOD RUNNING SHOE.

Mary says BUT YOU DID SAY, THOUGH, THAT BECAUSE WE HAVE DIFFERENT SURFACES AND THERE WOULD BE DIFFERENT PURPOSES TO HOW WE'RE WALK ING.

Glenn says ABSOLUTELY F YOU SAID TO ME THAT WE'RE GOING ROCK CLIMBING AND YOU GET A GREAT BOOT.

Mary says I DON'T SEE HOW ONE SHOE...

Glenn says THERE SIN.

Mary says THERE SIN, RIGHT?

Glenn says IN FACT, THE RUNNING SHOE SHOW COMING UP, CALLED THE SUPER SHOW, THEY'LL UNFOLD MAYBE 4 ,000 OR 5,000 OF NEW STYLES OF ATHLETIC SHOES. NEW STYLES THAT DOESN'T INCLUDE THE 20,000 OR 30,000 FROM LAST YEAR. SO IT'S IMPOSSIBLE CONSUMER TO KNOW.

Mary says THIS BOTHERS ME. BECAUSE IT JUSTIFIES THE NEED FOR ALL OF THESE DIFFERENT RUNNING SHOES.

Glenn says YOU KNOW WHAT? THE AVERAGE PERSON TODAY, THE AVERAGE JOCK OR JOCKETTE GOES IN AND IF YOU LOOK THEIR CLOSET YOU'LL SEE 20 KIND OF ATHLETIC SHOES AND IT'S CRAZY. THERE'S SUCH A THING AS A CROSS TRAINER. BUT NOT GREAT FOR A THE LOVE RUNNING. OR TENNIS OR PLAYING A THE LOVE TENNIS. BUT IF YOU'RE DABBLEING IN A LITTLE BIT OF EVERYTHING, IT'S FINE, ALL RIGHT? WE JUST DEVELOPED ONE-- ONE OF THE THINGS I DO IS WORK WITH MAJOR LEAGUE BASEBALL WITH THE UMPIRES AND WE JUST DEVELOPED AN ON SHOE-- AN ON-FIELD SHOE, STRICTLY FOR THEM TO WEAR WHEN THEY'RE ON THE FIELD. OKAY? NOW, THEY WEAR SOMETHING BEHIND THE PLATE THAT'S DIFFERENT BECAUSE IT'S GOT TO BE MUCH MORE PROTECTIVE, ALL RIGHT? BUT BECAUSE THEY'RE STANDING IN ONE SPOT FOR SO LONG DURING A GAME AND NOT MOVING AS MUCH AND WATCHING A FIRST-BASE UMPIRE, FOR INSTANCE, WE HAVE TO DEVELOP A WHOLE NEW SHOE FOR THEM.

Mary says IF I GIVE YOU A SIMPLE EXAMPLE, THEN, YOU HAVE SOMEBODY, SHE WORKS OUT, AND SHE ALSO PLAYS TENNIS AND SHE GOES FOR WALKS. HOW MANY DIFFERENT RUNNING SHOES...

Glenn says PROBABLY THREE. PROBABLY HAVE TENNIS SHOES, BECAUSE TENNIS SHOES ARE NOT GREAT-- YOU CAN USE IT FOR WALKING BUT NOT GREAT FOR WALKING. WOULD HAVE THE TENNIS SHOE AND THEN WOULD HAVE, UM, YOU SAID JUST WALKING. ONE THING I WILL SAY IS THAT A WALKING-- YOU KNOW, A LOT OF COMPANIES CALL THEM WALKING SHOES. A GOOD RUNNING SHOE IS BETTER FOR WALKING THAN A WALKING SHOE IS. BUT A LOT OF-- THE REASON I CAME OUT WITH, IN BACK ABOUT 125 YEARS AGO, PEOPLE DIN-- 15 YEARS AGO, OLDER PEOPLE DIDN'T WANT TO WEAR RUNNING SHOES. THEY SAID I WON'T WEAR RUNNING SHOES AND I'LL WEAR A WALKING SHOE. IT'S THE SAME KIND OF IDEA. RUBBER SOLE AND BETTER MOTION CONTROL AND FLEXIBLE AND CAME OUT WITH THE WALKING SHOE. BUT A RUNNING SHOE IS BETTER FOR RUBBINGING-- WALKING. NOT A TENNIS SHOE, IN THE A CROSS TRAINER, NOT ONE FOR WEIGHT LIFGST OR SQUASH, BUT A GOOD RUNNING SHOE IS BETTER FOR WALKING THAN A WALKING SHOE IS FOR WALKING.

Mary says A SHOE FOR WEIGHT LIFTING, TOO.

Glenn says OH, GOOD-- OH, GOD, YEAH AND BOXING. BOXING IS THE NEW ONE.

Mary says OH, MY...

Glenn says IT GOES ON AND ON AND ON. IT REALLY DOES DOES AND, UM, YOU KNOW, I THINK OUR GENERATION IS A GENERATION OF THE ULTIMATE CONSUMER F IT'S OUT THERE, WE'LL BUY IT.

Mary says YEAH. HERE'S ANOTHER THING AS WELL, UM, I MEAN A LOT OF WOMEN LIKE HEELS.

Glenn says RIGHT.

Mary says IS THERE A PERFECT HEIGHT AT WHICH OUR BODIES SHOULD BE AT? OR A PERFECT HEEL I GUESS IS WHAT I'M SAYING?

Glenn says PERFECT HEEL HEIGHT? ONE OF THE-- IN ONE OF THE FIRST BOOKS I WROTE, WE DID A TREMENDOUS A.M. OF RESEARCH ON THIS. IT'S ONE OF THE FUN NEST STORIES-- NOBODY HAS DONE A STUDY. FIRST PERSON WE CAME CROSS THAT DID A STUDY ON THIS WAS JULIUS CAESAR AND THE REASON WAS SAYING HOW MUCH HIS COULD MARCH SO HE FOUND IT WAS AN INCH AND THREE QUARTERS, SEEMED TO BE THE OPTIM YUM FOR HIS TROOPS TO MARCH FURTHER AND FURTHER AS THEY WERE TAKING OVER THE WORLD.

Mary says WHAT DO YOU SAY?

Glenn says I AGREE-- I SEEM TO FIND THAT-- THAT AN INCH AND THREE QUARTERS.

Mary says SEE. NOW MOST PEOPLE WOULD THINK FLAT. BUT FLAT IS NOT GOOD.

Glenn says FLAT IS NOT GOOD. FLAT IS NOD GOOD. FLAT IS NOT GOOD BECAUSE THEN THE HEEL'S SITTING HITTING THE GROUND AND WHAT HAPPENS IN THAT PARTICULAR CASE THAT IS CORRECT-- IS THAT YOU'RE TRYING TO DO MORE SHOCK ABSORPTION OF-- THAN IT'S CAPABLE OF DOING AND THE ACHILLES TENDON STRETCHES A LITTLE BIT TOO MUCH WHEN IT'S PERFECTLY FLAT.

Mary says YOU NEED A LITTLE BIT OF HEEL AND HE SAID AN INCH AND THREE QUARTERS.

Glenn says HIS INVESTIGATION WAS AN INCH AND THREE QUARTERS.

Mary says BUT WOULD MOST MEN'S SHOES FALL IN THAT CATEGORY?

Glenn says ROUGHLY SPEAKING.

Mary says THEY WOULD?

Glenn says MEN, WE HAVEN'T BEEN FORCED BY MEN TO-- TO WEAR THE FASHIONABLE CRAZY SHOES, ALL RIGHT? MOST MEN WILL ACCEPT, YOU KNOW, I'M PUTTING ON MY SHOES AND I'M GOING OUT. OKAY? WOMEN, NO WAY. WE FORCED WOMEN TO ACCEPT THE FACT THAT YOU'RE GOING TO WEAR A THREE-INCH HEEL BECAUSE IT GIVES A BETTER SHAPE TO THE LEG LEG.

Mary says LONGER AND...

Glenn says ONE OF THE THINGS I SAID IT'S THAT WAY FOR GETTING EVEN WITH THAT GARDEN OF EDEN TRIP WITH THE APPLE. BUT I DON'T KNOW WHY DESIGNERS AND WHY WOMEN FALL AUTHORIZE THIS. BECAUSE THERE'S PROBABLY THE MOST SINGLE DAMAGING, UM, THING THAT WE WEAR, UM, AS-- AS A WOMAN WOULD BE THE HIGHER HEEL. FOR THE LOW BACK.

Mary says YOU DID SAY IT RIGHT THERE, YOU SAID THAT YOUR LEG LOOKS BETTER. ANYTHING THAT-- WHERE WE LOOK BETTER, WE'LL FOLLOW.

Glenn says ABSOLUTELY. AND YOU KNOW WHAT? THAT'S A GREAT MARKETING TOOL TODAY. YOU KNOW, I MEAN, FOR WOMEN'S SHOES, IF YOU-- ANY FASHION MAGAZINE, I NEVER SAW ANYBODY THAT SAYS COMFORTABLE TO WEAR. IF IT'S-- THERE'S NO-- GUYS LOVE IT. BEAUTIFUL-LOOKING LEG AND COME THE 48 COLOURS. BUT NEVER DOES IT SAY COMFORTABLE OR MECHANICALLY PROPER.

Mary says OKAY. LET'S TAKE ONE MORE CALL HERE. WE HAVE BRENDA ON THE LINE FROM BRAMPTON. HI, BRENDA.

The Caller says HI MY QUESTION IS I'M PRONE TO SEVERE FOOT CRAMPS MORE SO IN THE WINTER AND MORE SO IN THE EVENING. AND WAKES ME UP AT NIGHT. CAN I BE PRO ACTIVE TOWARDS IT? AND WHAT CAUSE STOP SIGN?

Glenn says THAT'S A GOOD QUESTION. A FEW THINGS. NUMBER ONE, USED TO BE THOUGHT THAT LOW POTASSIUM OR CALCIUM. BUT FOR THE MOST PART IN MY PARTICULAR PRACTICE, I FIND THAT MAYBE 95 percent OF THESE PEOPLE HAVE A MECHANICAL PROBLEM IN THAT WHAT HAPPENS IS THAT WITH THE WAY THEY WALK, AND THE FACT THAT THEY OVER PRO NATURE, UM, THAT THEY'RE TRAINING ALL DAY-- PRONATE, UM, THAT THEY'RE STRAINING ALL DAY LONG.

Mary says WHAT'S OVER PRONATE.

Glenn says THE FOOT ROLLS AND ROLLS OVER TO THE BIG-TOE SIDE. YOU'RE ROLLING IN A LITTLE BIT TOO MUCH. SO WHAT HAPPENS IS THAT THAT HE STRAIN ALL DAY LONG. EVERY STEP TAKE THEY'RE STRAINING AND WHEN THEY FINALLY GET BACK INTO BED AT NIGHT THE MUSCLES RETRACT AND IT-- DO YOU HAVE TO GO-- JUMP OUT OF BED AND SORT OF DANCE IN THE MIDDLE OF THE NIGHT?

Mary says OR PUT MY FEET IN COLD WATER.

Glenn says I WOULD DEFINITELY, DEFINITELY, DEFINITELY START WITH A PODIATRIST ON THIS AND FIND OUT IF IT'S A MECHANICAL FOOT FALL. BECAUSE THE VAST IMAGINE-- THERE'S THE ODD ONE THAT MAY BE RELATE TODAY CIRCULATION OR THE ODD ONE THAT'S RELATE TODAY-- WE USED TO USE QUI-- QUANIDE USED-- QUANIDE USED TO BREAK THE CRAMP. BUT MOST OF THESE POOR PEOPLE HAVE A MECHANICAL PROBLEM AND ONE OF THE EASIEST WAYS TO-- YOU CAN FIND OUT IF IT'S MECHANICAL GO OFF OUT RUNNING SHOE STORE AND BUY AN ARCH SUPPORT AND PUT IT IN THE SHOE. FIND OUT IF THE CRAMPS GET LESS AND LESS. MAY NOT GET ANY-- YOU MAY NOT GET RID OF THEM COMPLETELY BUT GET SOME RELIEF. FOR 25 OR 30 dollars YOU MAY FIND OUT THAT I HAVE A MECHANICAL PROBLEM AND GET OFF TO THE PODIATRIST.

Mary says ANOTHER THING WITH WINTER, JUST BECAUSE OUR FEET ARE IN BOOTS AND SHOES SO MUCH WE GET SMELLY FEET.

Glenn says ABSOLUTELY.

Mary says NOW, WHAT ABOUT PEOPLE WHO-- WHO HAVE SMELLY FEET ALL THE TIME? WHAT DO YOU-- DO YOU SAY TO THEM?

Glenn says IT'S AN ISSUE. IT'S AN ISSUE.

Mary says YEAH.

Glenn says THE BIGGEST ISSUE IS THAT AGAIN, UM, PEOPLE HAVE-- HAVE A WAY OF PRE--- PRE-EXPIRING IN THEIR BODIES. SOME ON THE FOREHEAD AND SOME UNDER THE ARM AND SOME BE-- SOME ON THE FEET. AND WHEN IT BREAKS IN CONTACT WITH THE BACTERIA, THE BACTERIA BREAKS IT DOWN AND THAT'S WHERE THE SMELL COMES IN. THERE'S FOOT DEODORANTS AND ANTI PERSPIRANTS AND WEARING DIFFERENT SHOES. AND IF YOU TAKE THAT SHOE OFF AT NIGHT AND THEN GIVE IT A DAY SO, YOU NOT-- NOT EVERY WEARING THE SAME SHOE TWO DAYS IN A ROW. FOR SOMEBODY WHO REALLY HAS A PROBLEM.

Mary says OKAY.

Glenn says OKAY.

Mary says HOW SEVERE THIS GET? WHAT...

Glenn says IT'S VERY IN SOME CASES. IN SOME CASES IT CAN BE TO THE KIND OF THING THAT THE PATIENT IS, UM, IS COMPLETELY DEMORALIZED BY IT. I'VE SEEN PATIENTS WHERE THEY WON'T TAKE THEIR SHOES OFF, UM, THEY BONE, UM, UM, I HAD ONE PATIENT WHO REFUSED TO DATE, UM, AND, UM, A GUY WHO JUST WAS SO EMBARRASSED BY THE-- BY THE ODOUR AND HE JUST REFUSED TO EVER TAKE HIS SHOES OFF AND FELT THE ONLY WAY AROUND THIS AFTER TRYING EVERYTHING HE DID WAS, UM, WAS THAT HE JUST WOULD NEVER DATE AGAIN. IT WAS VERY TRAUMATIC. VERY, VERY TRAUMATIC. SO, UM, SO IT'S SOMETHING WHERE PEOPLE BECOME SO TRAUMATIZED BY IT. THESE CASES, YOU KNOW, YOU CAN SMELL THEM IN THE WORK PLACE. AND IT, UM, YOU KNOW, THESE POOR PEOPLE, THERE'S REALLY NO GREAT ANSWER, UM, AND THEY...

Mary says WHAT ABOUT SURGERY? I HAVE HEARD OF SURGERY. TO STOP...

Glenn says YEAH, THERE IS A SURGERY, UM, WHERE THEY-- THEY CUT ONE-- ONE OF THE MAJOR NERVES TO STOP CIRCULATION-- NOT CIRCULATION, BUT PER-- BUT PRES PERSPIRATION. I SOMEBODY THAT WENT THROUGH THIS. IT WASN'T THE SWEAT FROM THE HAND BUT WITH THE-- NOT FROM THE SWEAT OF THE FEET BUT FROM THE HANDS. AND THEY DIED IN THE SURGERY. AND THEY CUT A NERVE, WHICH IS A MAJOR NERVE FOR THE BODY AND CONTROLS OTHER FUNCTIONS. SO IT'S NOT SOMETHING THAT I WOULD RECOMMEND. AGAIN, SPEAK TO YOUR FAMILY DOCTOR IF IT'S THAT BIG OF AN ISSUE. AND, UM, AND, YOU KNOW IF IT DOES MAKE THAT MUCH OF AN ISSUE AROUND YOUR LIFE, YOU MIGHT WANT TO, YOU KNOW, CONSIDER TALKING TO YOUR FAMILY DOCTOR AND GETTING, UM, SOME IDEA FROM THE FAMILY DOCTOR. BUT, YOU KNOW, TRY EVERYTHING FIRST. GET TO THE PODIATRIST AND FIND OUT WHAT'S AVAILABLE ON THE MARKET AND FIND OUT WHAT SHOES ARE AVAILABLE AND WHAT ANTI PERSPIRANTS AND THERE'S SOMETHING THAT'S AVAILABLE THAT WILL STOP YOU FROM PRE-ENTIREING AND YOU PUT IT ON EVERY TWO DAYS BUT THE FOOT DRYS OUT SO MUCH AND-- THAT THE FOOT STARTS TO CRACK AND THEN...

Mary says NOW YOU HAVE A NEW PROBLEM.

Glenn says NOW YOU HAVE A WHOLE NEW PROBLEM.

Mary says BUT YOU'RE SAYING ON THE WHOLE THAT ALL OF THOSE PRODUCT AND...

Glenn says THEY DO WORK.

Mary says THEY DO WORK.

Glenn says 98 percent OF THE TIME, OKAY? CHANGING THE SHOE AND CHANGING THE SOCK. STAYING OUT OF SYNTHETIC SOCKS. NO NYLONS. COTTONS.

Mary says SO COTTONS, AND, UM , WHAT ABOUT-- I DID HEAR ABOUT THIS SOCK THAT WAS ON THE MARKET. SUPPOSED TO BE AN ANTI SMELL-- AND I THINK IT HAD SILVER IN IT.

Glenn says THE ONES THAT I KNOW HAD CHARCOAL. BUT IT MAY BE SILVER, TOO. ALL OF THESE DIFFERENT IDEAS OUT THERE. AND AGAIN, UM, THE ONE THING THE INTERNET DOES ALLOW IS BE-- IS A LOT OF GOOD AND BAD INFORMATION. BUT THERE'S SOME GOOD INFORMATION ON THERE. YOU MIGHT WANT TO GET ON THERE AND FIND OUT ABOUT THE SOCKS, THERE'S A WHOLE, UM, WHOLE THING AROUND SOCKS TODAY AND HOW TO-- IT PROTECTS THE FOOT AND, UM, AND SO THE ONE THAT I'VE HEARD OF IT HAD SOME CHARCOAL IN IT. BUT IT WAS DIFFICULT, UM, AND DIDN'T STAND UP ALL THAT WELL AND WAS STILL EXPERIMENTAL.

Mary says OKAY. UM, LET'S TAKE ANOTHER CALL. KEVIN'S ON THE LINE. HI.

The Caller says HI, MARY. HOW ARE YOU TODAY?

Mary says FINE, THANKS.

The Caller says DR. COPE RAN. WHAT A PLEASURE IT IS LISTENING TO A KNOWLEDGEABLE AND PASSIONATE FOOT PERSON. IT'S GREAT. I'VE HAD LARGE FEET ALL MY LIFE. I HAVE A 15 TRIPLE E WIDTH FOOT AND BUYING SHOES HAS ALWAYS BEEN A BIT OF A NIGHTMARE. I'VE SORT OF BEEN STUCK WITH LARGE CONSTRUCTION BOOTS OR STEEL TOAD BOOTS BECAUSE OF THE-- I WORK IN THE INDUSTRY. I FOUND, AND I DO THIS FOR YEARS. IF I DOUBLE MY SOCKS, I WEAR TWO PAIR OF FAIRLY THICK COTTON OR WORK SOCKS, I FIND NOT ONLY MY FEET DACEY FRESH BY THE END OF THE DAY BUT A LOT MORE COMFORTABLE AND DRIER AND SUCH, BUT CAN YOU OVER CUSHION OR, UM, OR, YOU KNOW, OR-- I PUT AN LOT OF LINERS IN THE FOOT. CAN YOU OVER CUSHION THE FOOT. TOO MUCH PROTECTION?

Glenn says NO. THAT'S A VERY GOOD QUESTION. VERY GOOD QUESTION. YOU CAN TALK TO SHAQUILLE O'NEAL, AND HE'S A 22. BUT NO, YOU CANNOT OVER CUSHION FOOT. YOU KNOW, YOU-- IF YOU GOT WAY TOO MUCH CUSHION, THEN YOU WOULD BE OFF BALANCE BECAUSE IT WOULD BE LIKE WALKING ON A BALLOON AND YOU DOAN KNOW WHERE YOU'RE WALKING. BUT OBVIOUSLY THE KRUK BOOT IS A VERY SOLID BOOT. YOU SOLVED YOUR ISSUE BY PUTTING ON TWO PAIRS SOX. ONE OF THE STUDIES WE JUST CHATTED ABOUT IS MEASURING HOW MUCH OFF LOADING OF WEIGHT THAT YOU CAN GET-- YOU CAN GET FROM A SOCK AND IT CAN BE 25 percent OF REDISTRIBUTING WEIGHT. IF YOU PUT ON TWO THICK SOCKS, YOU KNOW, CHANCES ARE WITH AN IN SHOE DEVICE, EUROPE LOADING 20-25 percent SO MANY IN THIS CASE, YOU'RE DOING ALL THE RIGHT THINGS. WHAT I CAN SAY ON AIR IS THAT THERE'S A LOT OF SHOE COMPANIES NOW, BECAUSE GUYS ARE GETTING BIGGER AND BIGGER THAT DO CARRY THE 14, 15, 16, 17'S. NIKE IS BIG IN IT. NEW BALANCE IS BIG IN IT. UM, AND-- AND, UM, AND THERE'S, UM, THERE'S OFF CHUTES OF BOTH OF THOSE COMPANIES THAT MAKE PRODUCTS THAT GO UP TO 17 AND 18. SO YOU'RE NO LONGER STUCK TO THE SIZE 7 TO 13, UM, THERE ARE A NUMBER OF SHOE COMPANIES THAT MAKE VERY, VERY GOOD SHOES UP IN THE 15, 16, 17 RANGE. OKAY?

Mary says TODAY, I CAN'T GET OVER HOW SO MANY PEOPLE WEAR ORTHOTICS. MORE AND MORE PEOPLE WEAR ORTHOTICS WHO REALLY NEEDS THEM?

Glenn says THAT'S SUCH A GOOD QUESTION BECAUSE PEOPLE WILL SAY THAT, THAT IT'S THE SAME PERCENTAGE OF PEOPLE WHO WEAR CORRECTIVE LENSES. WHETHER IT'S GLASSES OR CONTACTS. CAN BE AS HIGH AS 50 BE-- 50-60 percent. AND I'M INVOLVED IN A STUDY NOW IN CHARLOTTE, NORTH CAROLINA WHERE WE'RE TRYING TO ASCERTAIN WHAT PART OF THE POPULATION REALLY HAVE A SIGNIFICANT FOOT PROBLEMS. SOME OF THE THINGS YOU SEE, A LOT OF OVER PRONATION. BUT A LOT OF PEOPLE HAVE NO PROBLEM. THEY CONFISCATE BEAUTIFULLY.

Mary says OH, SO JUST BECAUSE YOU HAVE IT, DONE MEAN THAT YOU NEED...

Glenn says EXACTLY. PEOPLE COME IN AND SAY THAT I KNOW THAT I OVER PRONATE AND I HAVE NO PROBLEMS. THERE'S SOMEBODY WHO HAS MINIMAL OVER PRONATION, UM, HAVE-- HAVE INCREDIBLE PROBLEMS. DO EXCEPTIONALLY WELL, UM, AND THE REAL ISSUE AROUND ORTHOTICS IS TO ALWAYS SEE SOMEBODY WHO'S LICENSEED AND IS OVERSEEING THE WELL BEING OF THE PATIENT WHO KNOWS ORTHOTICS, OKAY? THE ONES WHO-- THAT I KNOW WHO SPECIALIZE IN ORTHOTICS, PODIATRISTS WHO DO THE MAJORITY OF THE WORK ON FOOT BIO MECHANICS BUT CHIROPRACTORS DO SOMETHING IN THE HIP OR LOWER BACK AND FIND SOMETHING GOING ON IN THE FOOT AND THAT MAY BE CREATING A PROBLEM IN THE BACK AND THE CHIROPRACTORS ARE THE ONES TO SEE THERE. SOME PT, PHYSICAL THERAPYISTS WILL DO THE WORK. AND, UM, AND SO-- SO THAT'S WHERE IT WOULD ALWAYS START, WITH SOMEBODY LICENSED AND-- AND AND-OR THE FAMILY DOCTOR. BECAUSE THE FAMILY DOCTOR MAY SEE AN ISSUE WITH THE FOOT OR FAMILY LEG AND SOMETIMES YOU MAY SEE A DIABETIC COME IN AND THE FIRST SYMPTOM YOU SEE IS FOOT PAIN. THAT'S UNUSUAL. BUT THAT COULD BE IT. SO GOING TO A PODIATRIS. T, WE WOULD BE ABLE TO LOOK AT THAT AND SAY, GEE, THERE'S SOMETHING ELSE GOING ON HERE. IF THEY WENT TO THE FAMILY DOCTOR, THEY WOULD AT THAT STAGE BE ABLE OVERSEE THE DIABETIC CARE. OR SOMETHING ELSE MAY BE GOING ON. SO YOU'RE NEVER WRONG STARTING WITH YOUR FAMILY DOCTOR. YOU'RE NEVER WRONG, OKAY? THEY MAY TURN AND SAY SEE THE FOOT PERSON AND SEE WHAT WE GOT HERE.

Mary says BUT THAT'S INTERESTING. BECAUSE WHAT I'M GETTING FROM YOU IS THAT JUST BECAUSE YOU HAVE A CERTAIN CONDITION, WHETHER IT'S-- MAYBE IT'S OVER PRONATION DOESN'T NECESSARILY MEAN SOMETHING HAS TO BE DONE ABOUT IT.

Glenn says EXACTLY. YOU MAY BE OVER COMPENSATING. FOR. YOU CAN OVER DEPEND IT ALL THROUGH YOUR LIFE. YOU KNOW, I'LL ANSWER BY, BY A PATHOLOGY TEACHER OF MINE MANY YEARS AGO, I ASKED HIM, I SAID TO HIM IT MUNS AMAZE YOU WHAT PEOPLE DIE OF. HE SAID NO. WHAT REALLY AMAZES HIM IS WHAT PEOPLE LEARN TO LIVE WITH. IN-- IT'S TRUE WITH THE FOOT, YOU KNOW, PEOPLE MAY NOT, MAY NOT KNOW THEY HAVE A BIT OF A PRONATION PROBLEM AND MAY HAVE PAIN AND ALL OF A SUDDEN FIX THE FOOT AND THE BACK PAIN GOES AWAY AND THEY NEVER KNEW THEY HAD A FOOT PROBLEM. CONVERSELY IF THEY HAVE NO PROBLEM AND SAY, YOU KNOW, EXAMINE ME AND TELL ME I GOT AND WE SEE THAT THEY'RE OVERLY PRONATED AND NO SYMPTOMS AND THEY'RE RUNNING MARATHONS AND EVERYTHING, AND YOU WOULD BE FOOLISH TO TRY AND TREAT THAT PATIENT BECAUSE YOU'RE UNDOING THEIR OWN BODY'S COMPENSATION.

Mary says DOAN FIX THE WHEEL.

Glenn says EXACTLY. EXACTLY.

Mary says OKAY. LET'S TAKE ANOTHER CALL. WE HAVE CHERYL ON THE LINE. HI.

The Caller says HI. HOW ARE YOU BOTH TODAY?

Mary says FINE THANKS.

The Caller says I HAVE QUESTION REGARDING MORTON'S NEUROMA. I HAVE BEEN DIAGNOSED WITH IT. AND IT OCCURS ON AN INTERMITTENT BASIS AND BESIDES SURGERY, IS THERE SOMETHING ELSE I CAN DO WITH IT.

Glenn says WHEN A NEUROMA IS A PINCHED NERVE AND MORTON NEUROMA HAPPENS BETWEEN THE THIRD AND FOURTH TOE. IT'S A PINCHED NERVE BETWEEN THE THIRD AND FOURTH METATARSAL AND SEND A STRANGE SENSATION TO THE THIRD AND FOURTH TOE A BURNING, NUMBING ALMOST SOME PEOPLE DESCRIBE IT AS PUTTING A KNIFE IN MY FOOT KIND OF SENSATION AND IT'S BROUGHT ON A-- BY A NUMBER OF THINGS. NUMBER ONE IS A TIGHT SHOE. PRESSED ON THE SHOE AND BE A NORMAL MECHANICS. WHAT CAN BE DONE BY SURGERY. NUMBER ONE, SHOE FITTING IS VERY IMPORTANT. NUMBER TWO, GETTING A MECHANICAL EVALUATION AS TO WHAT IS ACTUALLY HAPPENING. BECAUSE THERE ARE CERTAIN ORTHOTICS THAT CAN BE MADE TO LIFT AND ACTUALLY SEPARATE THOSE TWO BONES TO ALLOW THAT NERVE TO MOVE FREELY SO MANY THAT YOU CAN ACTUALLY GET THE PRESSURE OFF THE NERVE. UM, A COMBINATION OF SHOE AND OR ORTHODIC IS VERY KEY AND COURT SON INJECTION AND OTHER INJECTIONS MIXED WITH THE COURT SON MAY BE A BENEFIT. AND SURGERY IS A LAST RESORT. MAJOR BEING THAT SURGERY SUCCESS IS HIGH. SOMEWHERE IN THE VICINITY OF 80-85 percent. BUT THE ONES WHERE IT DONE WORK, YOU GET A NEUROMA COMING BACK. WE CALL IT A STUMPED NEUROMA AND CAN GIVE YOU THE SAME SENSATION AND SOMETIMES YOU GET THAT THE TOE'S COMPLETELY NUMB AND ALMOST LIKE A PHANTOM KIND OF PAIN. LIKE YOU HAVE WITH AN AMPUTATION. SO I'VE HAD CASES, NOT A LOT BUT PROBABLY ONE IN 10 OR ONE IN 15 THAT WOULD PREFERRED THEY DIDN'T HAVE HAVE THE SRKL. SO SURGERY FOR NEUROMA IS A LAST RESORT. BECAUSE THE RISK-REWARD IS PRETTY HIGH ON THE REWARD SIDE. BECAUSE YOU-- IT CAN'T BE TOO MUCH WORSE OFF.

Mary says WE DIDN'T TALK THAT MUCH ABOUT CHILDREN. BUT I DID WANT TO BRING UP TO THE TODDLER WHO IS LEARNING HOW TO WALK. THE BABY WHO IS LEARNING HOW TO WALK. DO YOU BELIEF THAT THOSE CHILDREN SHOULD BE WEARING SHOES?

Glenn says I-- SHOES ARE THERE FOR PROTECTION. AND-- AND, UM, AND, YOU KNOW, THERE'S-- THERE'S THE, UM, THE SCHOOL OF THOUGHT THAT YOU PUT THE BOOTIES ON THEM, THE LEATHER THEY NEED, THEIR FOOT WILL GROW PROPERLY OR SUPPORTIVE UNLESS-- ENOUGH UNLESS YOU DO THAT. AND MY ANSWER IS THAT YOU-- WOULD YOU PUT GLASSES ON A CHILD SO THAT THEIR EYES DEVELOP PROPERLY. THE ANSWER IS NO. IN MY EARNS, YOU-- EXPERIENCE, YOU GET A GOOD RUNNING SHOE, YOU KNOW, FOR A CHILD JUST STARTING TO WALK. AND IT GIVES YOU BETTER TRACKS TRACKS-- TRACTION FOR THE BABY SO THEY'RE NOT SLIPPING ALL OVER THE PLACE, AND ESPECIALLY ON A WOOD FLOOR. THE RUNNING SHOE GIVES TREMENDOUS FLEXIBLE. WHERE AS A BOOT, YOU DON'T HAVE ANY FLEXIBLE. OR VERY LITTLE FLEXIBLE. UM, AND NUMBER THREE, YOU GET BETTER SHOCK ABSORPTION FOR THE BABY. AND THE RUBBER SOLE GRABS THE FLOOR BETTER SO THAT THEY HAVE BETTER BALANCE AND AGAIN, YOU KNOW, PEOPLE PUT THE-- THE SHOES ON MORE TO DRESS THE BABY UP. OKAY? AND THAT'S FINE. PUT THE LITTLE, YOU KNOW, LASSE BOOTIES. FINE. BUT WHEN THE BABY STARTS PULLING THEMSELVES UP AND WALKING AROUND THE TABLE, PUT ON A GOOD, YOU KNOW, BABY RUNNING SHOE.

Mary says OH, BABY...

Glenn says YOU DON'T HAVE TO GET BRAND NAME. BECAUSE EVERY-- THEY'RE GROWING EVERY THREE MONTH AND WHETHER THEY HAVE THAT INSIGNIA ON THE SIDE OR NOT IS REALLY INSIGNIFICANT.

Mary says OKAY. ONE MORE QUICK CALL HERE. IRMA ONLINE FROM KANATA.

The Caller says MY QUESTION IS THAT I HAVE A 4-YEAR-OLD AND I NOTICE THAT, UM, WHEN SHE WAS GROWING UP, HERE FEET WERE IN.

Glenn says TURN IN?

The Caller says YES. AND, UM, AND HER PEDIATRICIAN TOLD ME TO JUST LEAVE IT. THAT IT WOULD GO AWAY WHEN SHE GREW UP. WELL, ONE OF HER FEET STILL GOES IN.

Glenn says RIGHT.

The Caller says AND SHOULD I GET HELP FOR THAT?

Glenn says UM, AT 4 YEARS OLD-- AT 4 YEARS OLD, I WOULD ALWAYS RECOMMEND THAT YOU SEE A PODIATRIST TO SEE WHAT HAPPENED. THE OLD SCHOOL WAS THAT-- ESPECIALLY WITH FEET AND LEGS THAT CHILDREN ALWAYS OUT GROW IT AND MOST PODIATRIST'S OFFICE ARE FULL OF PEOPLE THAT NEVER OUT GREW IT. SO I WOULD DEFINITELY START, YOU KNOW, IF THE ONE SIDE HAD OUTGROWN IT, YOU KNOW, YOU WANT SOMEBODY TO AT LEAST JUST MONITOR IT TO MAKE SURE THAT THE FOOT IS GRADUALLY TURNING OUT. IN MANY CASES IT, DOES. BUT IN MANY CASES IT, DONE. IN THOSE CASES, YOU NEED A LITTLE HELP WITH THE RIGHT SCOOT WEAR. SOME ORTHOTICS AND SOMETHING THAT HELPS AS THE CHILD WALKS TO TURN THE FOOT OUT AGAIN SO-- SO THE AGE 4 OR 5 OR 6 IS A GREAT PLACE TO START. BECAUSE THE-- THEY'RE GOING THROUGH AT LOVE GROWTH. AN AWFUL LOT OF GROWTH.

Mary says UH-HUH. YOU MUST SEE A LOT OF PEOPLE WITH CALLUS. DO YOU NEED PROFESSIONAL HELP WITH IT. CAN YOU TREAT IT AT STPHEM?

Glenn says YOU CAN TREAT IT WITH MILD ACIDS TO TAKE IT OFF. PEDICURES. CALLUS ARE FORMED FROM THE OUTSIDE IN. IT'S ABNORMAL PRESSURE. LIKE, ALL OF A SUDDEN, THE BEGINNING OF THE SEASON YOU GO AND PLAY GOLF OR TENNIS, YOU GET CALLUS OBJECT HAND. THE SOLES OF THE FEET AND THE PALMS OF THE HAND FORM CAL TO US PROTECT THE UNDERLINED TISSUE SO IF YOU'RE GETTING A CALLUS, THERE'S A REASON FOR. USUALLY ABNORMAL WEIGHT DRXL ON THE FOOT SO AT LEAST GET AN OPINION AS TO WHAT YOU'RE DOING WRONG SO THAT HOPEFULLY YOU CAN PREVENT IT AND SO IT FROM EVER GROWING.

Mary says WITH WOMEN IT, COULD BE HEELS, COULDN'T IT? IF YOU ASK THEM TO GIVE THOSE UP...

Glenn says WON'T GIVE IT UP. BUT FOR SOMEBODY LIKE THAT WHO'S IN THE HIGH HEEL AND HAS A SMALL CALLUS, THEY CAN USE THE MOISTURIZING CREAMS. TRY AND STAY AWAY FROM BATHROOM SURGERY. BECAUSE YOU SEE THEM COME IN AND THEY HAVE THESE KNIVES NOW, AND, UM, AND UNIVERSAL THEY TAKE AWAY, YOU KNOW, HALF THE SKIN AND-- AND WRITING DOWN TO THE BONE. SO-- SO BE CAREFUL. VERY CAREFUL.

Mary says OKAY. THANK YOU SO MUCH FOR THE GREAT ADVICE, DR. COPE RAN. NOW, GLENN COPELAND IS A POD PODIATRIST WHO WORKS IN TORONTO AND THE AUTHOR OF "THE FOOT DOCTOR: LIFETIME RELIEF FOR YOUR ACHING FEET." THE NUMBER FOR THE SPORTS MEDICINE CLINIC AT MOWN SINAI IS...

A slate reads "Sports Medicine Clinic. 416-586-8536."

Mary continues AND DR. COPELAND ALSO HAS A WEBSITE AT....

A slate reads "Doctor Glenn Copeland, www.performanceorthotics.com."

Mary says And that's it for today's show. Thanks so much for watching, and please join me each weekday, Monday to Friday, for More to Life at 1 o'clock.

A slate reads "The advice given in the preceding program is of a general nature only. Viewers should consult their own medical professional for medical advice specific to their circumstances."

Watch: Foot Health