The prolonged cold spell got me thinking about chilblains.When I was a child we all seemed to get chilblains. I’m sure it was due to being out on the farm in wellingtons during the cold damp weather. This belief was reinforced by my review of the subject this week, where I also saw that ‘childhood chilblains' is not rare as I thought, even today. I always felt coming indoors and giving our toes a good toasting to the fire had an influence. I have also noticed, through domiciliary work, that anyone still living with only a fireplace for heating will usually have chilblains only on the side which is facing the fire. What are Chilblains? Chilblains, (also called pernio or perniosis) are localised, tender, inflammatory, red, often itchy lesions, which may become blistered or ulcerated, caused by continued exposure to cold. In more severe cases the skin can break and sores or blisters can develop. They usually heal after a few weeks especially if exposure to cold is avoided.More commonly seen in children, women and persons with low body mass index, with a genetic link. I don’t see very many cases in my podiatry/chiropody clinic but I usually find it is secondary to circulation problems, often with very cold feet. So it follows that if you are prone to the condition you should try to avoid cold feet, have your circulation assessed and take exercise to help improve the blood flow. Sometimes medication called Nifedipine is necessary to open up the blood vessels. www.seamusmcnally.ie

Here's a few thoughts for your new year resolutions. You know the one, about getting more exercise and fresh air. See more at www.seamusmcnally.ie Walking the walk Protect toes from blisters and toenails from bruises by wearing proper-fitting footwear. Make sure boots/shoes are a good fit. Footwear too loose, allowing foot to move around in the shoe can cause as many complications as too tight. Keep nails short. Select material for socks that wick away moisture and protect from the cold. Shoes or boots? I wear shoes on low level walking and boots for the hills. However many enthusiasts will argue that good hiking or trail shoes are the business for hills too. Condition shoes/boots before setting out on a hike. If you are going off the beaten track, know the hiking route and options for accessing medical assistance. Carry basic first aid like padding or gel dressings for blisters. Add items such as bandages and wraps, to help immediately protect and stabilize injured feet and ankles. I am focusing on the lower limbs here, and areas that apply to low level walks. However if you are going hill walking make sure to research other areas such as communication (e.g. charged phone),navigation ( I use a Garmin E-Trex touch 25 which is also designed for cycling), survival bag, spare nutrition etc. If you have a history of pains or discomfort in the lower limbs during or after exercise it is well worth making an appointment with the Foot Specialist (that’s me) for an assessment. It can be amazing how simple interventions can greatly enhance your comfort. Finally do get out in the open air. Cut your cloth to your measure when starting off, and set realistic goals. All exercise should be progressive, so try to gradually increase the time and distance. But even if you don’t greatly increase the amount, remember, the latest research shows that even a modest amount of regular exercise can greatly increase wellbeing and life expectancy.

Try these healthy cookies over the Christmas, and make them part of your new year resolution to maximise your nutritional choices to help avoid cancer. www.seamusmcnally.ie

A little seasonal joke . Www.seamusmcnally.ie

Foot on the pedal. I cycled the Portuguese Cosatal Camino in September of this year. All the preparation got me thinking of how much thought the average casual cyclist puts into how they fit their bike. ‘Bike Fit’ has long been a serious consideration for professional riders. In more recent years it has become popular with casual riders as well. It is an art and a science. Since the first Penny-Farthing rattled along the road we have the same three points of contact with the bicycle; the saddle pedals and handlebars. It is important that the cyclist is positioned correctly by virtue of a proper bicycle set-up. Therefore the important assessment areas are: • Saddle height (and forward/ back adjustment) • Crank length (the standard is fine for most leisure cyclists) • Position of foot on pedal • Upper body position. There are a varied number of cycling pursuits, and an equal number of bike types: • Road bikes • Mountain bikes • Hybrid (mixes the two above) • Touring The type and level of activity will partly dictate optimal bike position. However the basic considerations are the same for all cyclists. As a podiatrist I am mainly interested in the lower limb and pedal contact, but the overall bike fit will govern how the power is transmitted to the pedal. If you are having pains that you think are related to cycling, give me a call. Better again if your New Year resolution is to take up cycling have your ‘bike fit’ checked. And don’t forget to bring along your bike. www.seamusmcnally.ie

You watch Aidan O’Shea or Kieran Donaghy leap high in the air to catch a ball. Do you ever wonder how they land squarely on their feet (mostly), without regularly smashing an ankle? Or have you wondered how you can touch your nose or strum a guitar with your eyes closed? We are all familiar with the five senses (I.e. sight, smell, taste, touch and hearing) but there is another type of sense, often referred to as the ‘sixth sense’ which we don’t hear or think about very much. Proprioception is the name of this lesser known ‘sense’. It is the part of the nervous system that tells us where our body parts (eg foot, ankle) are in space at any given time. It is so tied up with general movement that we overlook its subtle influence. It is often only when we lose this sense that we become aware of its importance. This is common with injuries such as ankle sprains. It is also why we find it easy to ‘turn’ on the same ankle again on return to active sport. We often fail to retrain our lost proprioception faculty. For example with ankle injuries the ‘wobble board’ is a good retraining device. The irregular, erratic movements created while balancing on the board help to recreate proprioceptive pathways. There is some evidence that using taping techniques over the injured ankle can help in the relay of signals during the recovery phase. We are using proprioceptive retraining exercises to help the athlete get the proprioceptive impulses back under our unconscious control. Then you can focus on what to actually do with the ball. But proprioception is not only for athletes. It is important for everybody, especially as we get older, to engage in simple exercises to maintain this marvellous sixth sense.Visit www.seamusmcnally.ie

I find this link reflects my own nutritional lifestyle. Check it out. Is it yours? Thanks for sharing Paul.

Just a word of thanks to all of you who have visited and liked my page. My website is www.seamusmcnally.ie; It has useful articles and you can contact me or even book an appointment from there.

Those of us not lucky enough to get an All-Ireland ticket to watch Mayo, will be glued to the television, for the duration of the match. That's exciting, but what about sitting watching too much TV? This extract from a study of prolonged sitting in front of the box gives important food for thought. It was carried in Medscape. "Those who may be tempted to binge watch the latest episodes of "Game of Thrones" may want to reconsider: A new study suggests time spent watching television is significantly related to subsequent risk for limited mobility among older adults. In a longitudinal, prospective study involving more than 130,000 people, there was no significant association between sedentary behavior and the risk of walking disability among participants who exercised at least 7 hours a week, lead author Loretta DiPietro, PhD, MPH, and colleagues report in an article published online August 30 in the Journal of Gerontology: Series A. However, time watching television was associated with a dose-dependent increase in risk, regardless of the level of overall physical activity. "TV viewing is a very potent risk factor for disability in older age," Dr DiPietro, chair of the Department of Exercise and Nutrition Sciences at the Milken Institute School of Public Health, George Washington University, Washington, DC, said in a press release about the study. "Sitting and watching TV for long periods (especially in the evening) has got to be one of the most dangerous things that older people can do because they are much more susceptible to the damages of physical inactivity." www.seamusmcnally.ie

Another good reason to watch our weight. www.seamusmcnally.ie

'Surge of Kidney Failure Deaths Blamed on Heat Exposure.'' Interesting headline from a Medscape article. Medical specialists now believe that 'a lethal epidemic of chronic kidney disease' has a strong link to working in intense heat, made worse by lack of hydration. In Central America it is estimated that upwards of 20,000 men, working in sugar cane plantations, have died of kidney failure. Many of you, like ourselves, have young relatives doing the travel/ work thing, so might be no harm to advise them of the potential danger.