Circulation & Your Feet

ImageThe human circulatory system is made up of a pump (your heart) and a delivery system (your blood vessels) for transporting blood throughout your body. The two types of circulation in your body are called systemic circulation and pulmonary circulation. Your systemic circulation is responsible for bringing fresh, oxygen-rich blood to all your body’s tissues and organs, while your pulmonary circulation is responsible for carrying oxygen-depleted blood from your heart to your lungs. Systemic circulation is controlled by the left side of your heart, pulmonary circulation by the right.

Though two distinct cycles make up your circulatory system, both cycles operate simultaneously. Blood fills your heart chambers and is pumped to your lungs and the rest of your body (organs, tissues, extremities) by your right and left ventricles, respectively. For the average person, this process repeats about 72 times per minute, though great differences exist between people based on fitness level and activity status. Certain medications and health conditions can also affect the efficiency and capacity of your circulatory system.

Circulation is an important issue, especially as it pertains to your extremities. Blood flow to the points in your body farthest away from your heart, including your feet and toes, can become compromised for various reasons, which in turn affects tissue health in these areas. In extreme cases, prolonged insufficient blood flow to your extremities may cause tissue death and lead to amputation of your affected body part. Some of the most common circulatory problems that may affect your feet and toes include Raynaud’s, peripheral arterial disease, and diabetes.

Raynaud’s is a health problem involving the spontaneous narrowing of blood vessels in your fingers and toes. This condition causes temporary skin discoloration in involved areas along with pain and discomfort, in many cases. Peripheral arterial disease (PAD) is a health problem in which plaque—a combination of calcium, fibrous tissue, fat, and cholesterol—accumulates in the arteries that deliver blood to your head, organs, and limbs. Plaque can harden your arteries over time and decrease the diameter of your blood vessels, which reduces the amount of blood reaching certain parts of your body, including your feet.

Diabetes is a chronic, or lifelong, condition in which your body is unable to maintain proper blood sugar levels. Foot problems are among the most common health concerns diabetics face. Several types of diabetes exist, yet they all may cause similar changes in your feet. Prolonged elevated blood sugar levels may lead to a serious health complication known as neuropathy—nerve damage or dysfunction. The nerves in your feet perform many important functions, and they may be particularly susceptible to diabetes-related damage.

Blood vessels run alongside nerves in many parts of your body, including your feet. In your foot, these structures travel together between your metatarsal bones—the long bones in your midfoot. Both the nerves and the blood vessels branch at the base of your toes before sending oxygen-rich blood to your toe tissues. Enabling natural toe splay is vitally important in ensuring optimal circulation and nerve function in your forefoot and toes. Most conventional shoes possess toe box taper, a design feature that compresses your metatarsal bones and squeezes the bundles of nerves and blood vessels that lie between. Correct Toes, our toe-spacing product, helps improve blood flow and nerve health in this part of your foot by opening up nerve and blood vessel channels and reducing the effects of pinch forces associated with prolonged conventional footwear use. Correct Toes can be used in combination with wide toe box shoes, while barefoot, or in wide slippers for this purpose too.

Please note that while many shoes may call themselves wide, they’re often widest at the ball of your foot, not the ends of your toes. It’s important to use Correct Toes in footwear that is widest at the ends of the toes. A shoe that possesses toe box taper is the opposite of natural foot shape. Please also note that smoking is one of the principle underlying causes of many circulatory issues, including reduced peripheral circulation. Smoking boosts your risk for atherosclerosis and peripheral arterial disease, and several ingredients in tobacco cause narrowing of your blood vessels, which increases your chances of a blockage, and therefore a heart attack or stroke.

Check out this informative video in which Dr. Ray McClanahan explains how footwear and toe splay affect foot and toe circulation:


Love Your Feet!

Feet with heartValentine’s Day is fast approaching, and because February has Valentine’s Day, and because Valentine’s Day is all about love, we thought it would be a great month to encourage you to love your feet! Loving your feet means appreciating their incredible and brilliant design and caring for them in a way that supports and encourages their long-term health. Understanding the numerous structures and unique architecture of your feet can help you better appreciate the amazing work your feet accomplish every day. A loving approach, in line with nature’s intentions, can keep you on your feet and out of your healthcare provider’s office, enjoying the activities you’re most passionate about.

The Virtues of Feet

Your feet help carry you around, it’s true, but the virtues of your feet go far beyond simple locomotion. Your feet allow you to run, stand, jump, dance, and climb, and they support your body weight—all without complaint, as long as you respect their natural, brilliant design. Your feet are the foundation of your entire body and musculoskeletal system. Your feet affect the alignment of every other joint in your body, from your knees and hips up through your spine to your skull. Feet are, of course, critical to the gait cycle and help you navigate terrain ranging from dirt to concrete to grass. A healthy foot—a foot in which the toes are splayed and the widest part of the foot is at the ends of the toes—naturally resists excessive pronation, or a rolling inward of the foot and ankle, which helps prevent common lower extremity problems.

An Anatomical Wonder

Your feet are anatomical wonders! They contain 25 percent of the bones in your body, possess between 100,000 to 200,000 nerve endings for sensation, tactile feedback, and movement, and are covered by skin that’s adaptable to various surfaces and protects you from infection. Your feet also possess three unique arches to help bear your body weight, and even the bones in your toes have an arch-shaped design to help manage the stress and strain of walking, standing, and other bipedal activities. Your foot and toe bones are held together by several key ligaments, and the long tendons of your foot and toe flexor and extensor muscles perform an intricate dance to balance the forces acting on your feet and toes. Most of us, however, don’t even think of our feet until something goes wrong. We at Correct Toes and Northwest Foot & Ankle think it’s important to remember that your feet are worthy of love both in times of health and in times of distress.

Ways to Love Your Feet

Showing your feet some love is easy, though it does take time and dedication to keep your feet and toes in top form. Using Correct Toes in combination with a shoe that is widest at the ends of the toes is one of the best ways to love your feet, as Correct Toes helps restore proper toe alignment, helps support your principle foot arch, and helps treat or prevent numerous common foot and toe ailments. The Correct Toes toe-spacing appliance enhances circulation, promotes balance, helps properly distribute weight, and minimizes ball of foot pain, too. Correct Toes are like “cupid’s arrow” for your feet: They show love by respecting each individual toe as well as nature’s brilliant—and intended—design (i.e., a foot with ample toe splay). Wearing foot-healthy footwear is another excellent way to show your feet some love. Healthy shoes possess no heel elevation or toe spring, have a sufficiently wide toe box to allow for toe splay, and possess a flexible sole, and they allow your foot to function like a bare foot inside your shoe.

Other great ways to love your feet include receiving professional massage, acupuncture, reflexology, or chiropractic treatments. Each one of these health disciplines has something unique to offer when it comes to foot health. Having a partner or friend massage your feet (and offering them the same in return) is a great way to love both your feet and a loved one. Ball-rolling exercises can feel great and are another excellent way to show your feet some love, as is performing key stretching exercises, including the toe extensor stretch and the bunion stretch.

Make foot health a priority this February, and show your feet some love!

Corns and Calluses

CallusCorns and calluses are common skin problems that are characterized by a buildup of hard, thick skin, usually on your feet. Corns and calluses are particularly common on your toes, and they are caused by prolonged pressure or friction on your skin. Though not life-threatening health problems, corns and calluses may cause pain and disability when the buildup of skin gets too thick or causes pressure on sensitive parts of your foot. Thick, hard skin can occur on any part of your foot.

Condition Information

A corn is thickened skin on the top or sides of your toes, while a callus is thickened skin on the soles of your feet. The skin thickening that characterizes these feet problems is a protective reaction by your body to avoid painful blisters. Corns that manifest on the tops or ends of your toes are called heloma durum (hard corns), and corns that develop between your toes are called heloma molle (soft corns).

Common locations for hard corns on your toes include your first toe joint, or proximal interphalangeal joint, and the ends of your toes. Soft corns may develop between any of your toes and are caused by shoes that pinch your forefoot. Soft corns are seen more often in people who wear shoes with tapering toe boxes. Tapering toe boxes force the normal roundness of your forefoot into an unnatural triangular shape.

The skin beneath your metatarsal heads is among the most common locations for calluses. Calluses may also form around and/or under your heel. In rare instances, calluses may form in your foot arch. Arch calluses are usually associated with extreme foot deformities.

Causes and Symptoms

Pressure from shoes or the ground on your feet is the most common reason that hard, thick skin develops. Factors that may contribute to this health problem include:

  • Ill-fitting shoes or socks
  • Sock bunching or socks that possess seams near your toes
  • Prolonged physical labor
  • Certain athletic events that place significant stress on your feet

Common signs and symptoms associated with corns and calluses include:

  • Areas of thick and hardened skin
  • Flaky and dry skin
  • Waxy skin
  • A hardened, elevated skin bump
  • Pain or tenderness under your skin


Obtaining and using appropriate shoes along with manual therapies that reduce your skin thickening are among the most common and effective conservative strategies for treating your corns and calluses. Consider using a pumice stone to reduce your corns or calluses after your feet have been bathed or soaked. Over-the-counter acid plasters are also helpful in treating your corns and calluses, although they should be used with extreme caution, as they contain acid that is capable of damaging normal tissue surrounding your corns or calluses.

You should avoid using acid plasters if you have diabetes, nerve-related conditions, and/or poor circulation because you may be unable to feel the acid damaging your skin.

See your podiatrist for treatment if manual reduction of your skin thickening and a proper shoe fit have not resolved your problem.

Dr. Ray McClanahan, DPM, NW Foot & Ankle

Correct Toes Testimonial

5x7 outdoor femaleWe always love hearing feedback from our customers and patients about their journey towards natural foot health!  Below is Nancy’s Correct Toes testimonial.

“When your feet hurt, your whole body doesn’t function correctly! In May of 2012, I somehow hurt my right foot. I went to my regular podiatrist to have him check it out. He x-rayed the toe area to see what could be causing my severe discomfort. The x-ray did not reveal anything. But because there was severe pain at the joint between my big toe and the second toe, he administered cortisone shot to the affected area. That shot did provide me with comfort until July.

I decided to visit Dr. Michael Cocco, my chiropractor and acupuncturist.
When I walked into the examining room, I noticed Dr. Cocco had  rubberized devices between his bare feet. It was a set of your Corrected Toes! He suggested I might benefit from them and explained how they work. He directed me to your website where I watched all the videos and ordered my own set of Corrected Toes!

It is now January and I am pain free.  I can’t thank you enough for developing this product. I never want to have to have surgery on my feet.
Yet, I was at my wit’s end with the pain I was experiencing when this problem first occurred.

I love the toe stretches you suggest in your latest video release. They are so helpful!”

~If Correct Toes have helped bring your feet from hurting to healthy let us know.  We want to hear your story, see your pictures, celebrate your success!

A New Year’s Resolution? A Natural Foot Health Solution!

ImageNew Year’s has come and gone, but the important work of 2013 has only just begun. This year, consider making lasting foot health your new year’s resolution! Attention and time given to natural foot health concepts and activities can yield profound foot health benefits, both for foot injury prevention and improved quality of life. Caring for your feet and allowing them to function the way nature intended can keep you pain-free and performing those activities you love most. In most cases, the answer to long-term natural foot health is simple and involves removing the impediments to optimal foot functioning and remaining disciplined in your natural foot care routine. Here are a few simple and effective ways to care for your feet this new year and beyond:

Wear Healthy Shoes as Much as Possible

Resolve to wear only healthy shoes as much as possible in 2013. This simple strategy will help you treat or prevent some of the most common foot, toe, and lower extremity problems, including bunions, hammertoes, plantar fasciosis, interdigital neuromas, and ingrown toenails. Healthy shoes allow your feet and toes to function the way nature intended; that is, with toes splayed and heel and forefoot on a level plane. Healthy shoes are shoes that don’t get in the way of your feet or alter your gait in any way. Using healthy shoes is especially important for weight-bearing activities, including weight-bearing activities in both casual and athletic situations. Wearing conventional footwear (with its many injurious design features) for running and walking can accelerate toe deformities and lead to chronic foot and toe problems.

Resolve to Make Wise Footwear Purchases

To ensure natural foot health in the new year, make your next footwear purchase one that incorporates all the desired design features we typically look for in shoes. Key design features to consider when shopping for new footwear are degree of heel elevation and toe spring, toe box width, and sole flexibility. An ideal shoe has no heel elevation or toe spring, only a completely flat sole from heel to toe. This flat platform allows your principle foot arch to act as it is supposed to and helps enable natural arch support. A sufficiently wide toe box is widest at the ends of your toes and allows your toes to splay optimally when standing, walking, or running. A shoe with a flexible sole improves your tactile sensation of the ground and helps strengthen your intrinsic, or internal, foot muscles. You should be able to easily fold the shoe in half or twist its sole with little restriction.

Wear Correct Toes Every Day

Wearing your Correct Toes every day is an excellent way to achieve lasting foot and toe health in 2013. Correct Toes creates space between your toes and realigns your toes to their normal anatomical position. In this optimal position, your toes are free to perform as they were intended, and you are less likely to experience the foot and toe problems that plague so many shod, or shoe-wearing, individuals. It’s important to transition into Correct Toes use slowly, as it can take some time for your foot to adapt to this new toe orientation. It’s also important that you use your Correct Toes in shoes that possess sufficiently wide toe boxes. You can use your Correct Toes on your bare feet, over toe socks, or within conventional socks. Some people use Correct Toes as a night splint to help treat bunions and other foot and toe problems.

Perform Relevant Foot Stretches Regularly

Certain foot stretches can enhance your foot health, especially if you perform them on a regular basis, according to your healthcare practitioner’s instructions. We find several foot and toe stretches particularly helpful, including the toe extensor stretch. This stretch helps lengthen tight toe extensor muscles and tendons. Tight toe extensors can cause a variety of foot and toe problems, and the toe extensor stretch helps balance the pull of toe extensor and flexor tendons on your toes. Other helpful foot stretches or exercises include the bunion stretch and the hacky sack grab exercise, both of which can be easily performed at home.

Be Active & SMART!

Being physically active in 2013 is an excellent way to ensure natural foot health, especially if you choose to be active in footwear that allows you to incorporate Correct Toes and respects nature’s brilliant foot design. We encourage you to select an activity that you find truly enjoyable to help put your feet and toes to good use. We also encourage you to set fitness goals that are SMART—Specific, Measurable, Attainable, Realistic, and Time-Bound (e.g., “I want to be able to run 5 miles in 40 minutes by May 15.”). A SMART approach to fitness or health goals keeps you engaged in the process of health attainment, and it ensures that you experience frequent successes to keep you motivated.

Resolve to make natural foot health a priority in 2013. Visit our website to learn more about the strategies to do just this. May 2013 bring you all lasting foot and toe health!


sesamoidboneIrritation, imbalance, or fracture of two small bones—sesamoids—near your big toe is a forefoot problem that may cause pain in some individuals. These two sesamoid bones, located on the underside of your foot, directly below your first metatarsal bone, are approximately the size of corn kernels and act like pulleys. Your sesamoid bones function like a kneecap—another type of sesamoid bone—for your big toe joint.

Your sesamoid bones provide a smooth surface over which your toe flexor tendons slide, and they improve the ability of these tendons to transfer force from your lower leg muscles to the proximal phalynx, or bone, of your big toe. The sesamoid bones under the base of your big toe also help bear some of your body weight, reducing the stress on other forefoot structures. Sesamoid bones, like the other bones in your body, can break, and the tendons that pass over these structures can cause soft tissue irritation and inflammation. Sesamoiditis is most commonly seen in runners, baseball catchers, and ballet dancers.

Condition Information

Special grooves on the bottom of your first metatarsal bone—the long, thin bone that connects your ankle bones to your big toe—accommodate your sesamoid bones. Your sesamoid bones may move out of their special grooves and begin wearing away cartilage and bone if you have flat feet, flexible feet, or bunions, or if your feet have undergone some of the various anatomical changes that can result from long-term conventional footwear use. Feet that are imbalanced or too flexible may place excessive pressure on your sesamoid bones and cause them to fracture.

Sesamoiditis may cause you to limp or walk on the outside aspect of your foot to help remove pressure from your painful involved area. Gait changes are a problematic compensation for this health problem, as they may cause pain and disability in one of your other joints, such as your knee, hip, or low back joints or some other part of your foot. You should always seek treatment as soon as possible if you suspect you have sesamoiditis.

Causes and Symptoms

Sesamoiditis is an overuse injury that involves chronic, or long-term, inflammation of your sesamoid bones and the tendons that act on these bones. In most cases, a sudden and excessive upward bending force on your big toe causes sesamoiditis, although wearing high heels and experiencing certain types of foot trauma may also contribute to your sesamoiditis.

Conventional footwear plays an important role in aggravating your sesamoids and their surrounding structures. Shoes with tapered toe boxes and toe spring can cause the sesamoids to become dislocated, causing dysfunction. (Click here for a video demonstration of this phenomenon). When your hallux, or big toe, is properly aligned with your first metatarsal bone, your sesamoids are also properly aligned and function as they’re intended to.

Sesamoiditis commonly involves a dull pain under your big toe joint that fails to resolve over time. Sesamoiditis-related pain is usually intermittent, or comes and goes, and may be worse when wearing certain shoes or participating in certain activities.

Some of the most common signs and symptoms associated with sesamoiditis include:

  • Pain focused under your big toe, on the ball of your foot
  • Pain in your affected area that develops gradually
  • Swelling and bruising
  • Impaired ability to bend or straighten your big toe


Injured or inflamed sesamoid bones can be difficult to heal, as you put almost continuous pressure on these structures every time you stand or walk. Conservative care methods may be helpful in resolving your sesamoiditis. Conservative treatment techniques include:

  • Shoe therapy: Footwear that allows proper toe splay can help. For footwear suggestions, see our list of recommended shoes. Toe splay can be enabled with our toe spacing device, Correct Toes.
  • Immobilization: Your affected foot may be placed in a cast or removable walking cast to help rest your injured or irritated tissues. Crutches can help reduce the amount of force on your sesamoids.
  • Taping or strapping: Your involved toe may be taped or strapped to help reduce tension on your sesamoid bones.
  • Padding: A special pad may be placed inside your shoe to help cushion your sesamoid bones. A metatarsal pad helps return the fat pad in the ball of your foot to a place where it will protect your sesamoids.
  • Physical therapy (PT): PT is an important treatment measure for this health problem, especially following immobilization. Range-of-motion exercises and ultrasound therapy are among the most commonly used PT modalities for this health purpose.

Anti-inflammatory medication, cortisone injections, and certain types of surgery are more aggressive treatment measures for treating your sesamoiditis and may be necessary in some individuals. Your doctor may recommend surgery, including sesamoid bone removal, if conservative care measures fail to resolve your health problem.

-Dr. Ray McClanahan, DPM, NW Foot & Ankle