Season 3 Episode 2 Transcript 

Producer Voice Over: [00:00:00] Welcome to Nice Legs with Dr. Kamran. The podcast dedicated to exploring all there is to know about leg health. In this episode, Dr. Kamran Guzi sits down with his friend and colleague, Dr. Robert O’Malley, a highly regarded podiatrist and sought after lecturer. Over the years, Dr. O’Malley’s helped countless patients overcome foot challenges, ranging from plantar fasciitis to heel spurs, to complex sports injuries and chronic conditions.

And together in this episode, they’ll cover common questions and insights you need to know as they dive into the powerful connection between foot health and overall leg health. And now here’s Dr. Kamran.

Dr. Kamran: Hi, this is Dr. Kamran Zi, doing another episode of, a Nice Living by Dr. Kamran, except this is going to be Nice Legs by Dr.

Kamran. So it’s our first episode of NICE Legs. By Dr. Kamran, since we’re talking about legs, I thought it was very appropriate to start off with foot because foot is the very foundation of the leg. And, so we would like to talk [00:01:00] about feet and then move on to ankles and legs. Et cetera. For our first episodes, I’m extremely lucky to have a very good friend of mine, an excellent podiatrist, Dr.

Robert O’Malley, who was kind enough to join us, for our first episode. So, Dr. O’Malley, Thank you very much for joining us today. I know you’re a board certified podiatrist. You’ve been doing this for a long time. You are my doctor. You are pretty much everybody. doctors. So could you please tell us a little bit about yourself and, and then we go on to some of the questions that patients might have, but after you sort of give us some basic fundamental knowledge and, expertise about, feet and why they’re so important.

Dr. O’Malley: Thanks so much for having me. My name is Dr. Robert O’Malley, but my patients just call me Bob. and I’ve been practicing podiatry in Wilmington, North Carolina for about 25 to 30 years. I grew up in, New York, then I did my residency in Houston, Texas, and [00:02:00] I’ve been practicing Wilmington, North Carolina for the last 20 to 30 years.

And, I just love it here in Wilmington, North Carolina, and I’m happy to answer anybody’s questions.

Dr. Kamran: Thank you so much. I appreciate it. I’m going to start off by the function of the foot. So why is the foot so important when it comes to your leg health?

Dr. O’Malley: Just like anything, you need a strong foundation, whether it’s a house, you need a strong foundation of a house or a car, and that’s what’s so important about the foot.

And the foot has to act anatomically correct, so your UL or you walk in a more efficient manner to prevent injuries. So there’s so many things that are related to the foot that, if you just have common sense and wear the appropriate shoes and the appropriate training, you can walk more efficiently and you prevent injuries.

Dr. Kamran: That’s, that’s [00:03:00] wonderful. In fact, I remember a few years ago, we went to, British Open and I could hardly walk because I’d actually managed to partially tear a tendon on the outside of my foot because. I put so much pressure on that tendon eventually wore up, and, thank God I didn’t need surgery.

I just got into the proper shoes, which held my arch. And honestly, I haven’t, I haven’t needed surgery for that. So, again, goes to show how important it is to, even if in the beginning when you’re young, your feet are doing fine, you’re, it’s like your tires on your car, right? you, you wear some tires if, if they’re not aligned properly.

So having said that, there’s all kinds of variation of the food, right? God has not made all of us identical. So could you kindly talk about some of the anatomical variation of the feet, and what are the most common ones that you encounter?

Dr. O’Malley: Yeah, there’s, there’s so many different structures of the foot where people have flat feet.

Some people have a high arch, but I think the most important thing is that as long as you’re walking around and you don’t have [00:04:00] significant pain in your feet, that’s what’s most important. And then when you’re, when you’re playing sports or you’re just walking around daily life, you have to have the appropriate sugar gear or ankle support so you don’t have those injuries.

Like so many times people have. Inserts or they have sneakers, but they don’t have any support of their ankle. Well, if you don’t support the ankle and the ankle’s off, well the foot’s gonna be off and vice versa. So it’s so imperative that you have a good foundation and it’s. Even when my daughter runs cross country, I can look from across the track and I could tell, certain people don’t have the appropriate shoe gear or they don’t have the appropriate muscle tone where certain muscles are too tight and they need to stretch certain muscles.

People also need to cross train a lot more. So many people are doing the same activities, but if you look at baseball players, when you pitch for the World Series, you don’t pitch game one and then pitch game two. You gotta rest your shoulder and you gotta do other [00:05:00] activities, So it’s just so you don’t keep getting these overuse injuries.

So if you don’t have the appropriate shoe gear and you don’t walk appropriately, you’re gonna ultimately get an overuse injury. And you could get it from via just walking in the grocery store or walking on the beach or just walking on vacation with your family. 

Dr. Kamran: Well, that’s, that’s, fantastic. So the real problem is unfortunately, we don’t even know we have a problem because it is our own feet.

We’ve been looking all our life, and we don’t know if we have a high arch or large arch, or if we have flat feet. So, at what stage do you think an average person should say, you know what, I really need to have my feet evaluated. Maybe I should see a podiatrist because I don’t want to go on later on in life and have issues.

I mean, a lot of this callous formation, the way our toes start getting, I mean, I was raised in England and I’m a. Big guy, just in case you hadn’t noticed already. And they don’t have size 14 E in England. So I was, [00:06:00] I grew up in London wearing very tight shoes and my toes are horrible and I had, I didn’t know, I didn’t know I have wide feet versus flat feet.

So, that’s What stage do you suggest? People have got to start, questioning may, maybe I should see a podiatrist, get my foot evaluated. Or, what can they do to know that there is something wrong with their feet? And what do they need to, like, your daughter is a runner. She’s lucky to have a father who’s, who’s a podiatrist.

And you notice the problem immediately. But what happens to the average person who doesn’t have that luxury?

Dr. O’Malley: Well, like I tell my patients, the most important thing is your body. You know, when you’re tired, you know, when you have to sleep, so if you’re walking around and your feet are hurting you, you have to look for another cause, whether it’s shoes or cross training.

But you have to know your body and you can just it’s pretty easy to look at your feet and see if your feet are a lot more abnormal than your brother’s feet or your friend’s feet. I mean, if your feet are not symmetrical, everything in life should be [00:07:00] symmetrical.

If you’re not. If your ears are off, they’re not symmetrical. Everything in life is symmetrical, and if it’s not symmetrical and your feet hurt, there’s a problem. So a lot of it’s just you need to listen to your body or with people coming in the office and they say, my foot’s hurting and my foot’s swollen.

Then I have to start thinking, well, maybe they injured a tendon, maybe they injured a nerve, maybe they injured, a bone because their body’s telling ’em that their foot hurts. It’s swollen, so it’s like a car. If you’re driving your car and the engine light goes on, you need to pull over. If you’re walking around and your foot’s hurting, you need to stop and reassess what’s going on and why you might be having that problem.

Whether it’s a sport that you’re playing or it’s your shoes or it’s just you have an abnormality of your foot.

Dr. Kamran: So bottom line is God gave us those. Nerve fibers for a reason and exactly not to ignore them. So if the alarm goes off your, if your hurting thing, get it checked, if you find out your, your feet are, you got flat feet, [00:08:00] it’s different than anybody else’s, then, try to get a consult at cc a podiatrist, you know, one time say, listen, is this normal and what can I do about it?

That’s basically what, what you’re suggesting is that, right? 

Dr. O’Malley: It’s like when people come into my office and they say, I think I may have an infected toe. I was like, well, why do you say that? And they say, ’cause it’s red, hot and swollen. It’s like your fingers. Your fingers are all symmetrical and they look the same.

If one finger is red, it might be infected. If one toe is red, hot, swollen, and is pus well, you don’t have to be a podiatrist or a surgeon to realize there’s an abnormality and you gotta get it addressed.

Dr. Kamran: Great. So now that we’re just talking about toes, let’s just start out with a toe. So some of the questions I’ve had patients have been asking me, to ask you is, how do you cut your toenails?

Dr. O’Malley: I think the most important thing is you have to start off with a clean toe. So I tell my patients what you should do is you should rinse off your instruments with soap and water, and then you should rinse off your [00:09:00] toe with soap and water, like take a shower. Then you trim your nails and then you put some antibiotic cream on, and then you put a clean sock on.

If your toothbrush falls on the ground, you’re not gonna pick it up and brush your teeth. But so many people trim their nails with dirty instruments, and then they wonder why they get an infection. Because when you take a shower, all the dirt from your hair goes to your body. So it’s pretty likely that your foot is pretty dirty and your trim in a dirty foot unless you rinse off your foot.

So if you have a dirty foot with. Instruments aren’t sterile, you have a much higher chance of getting an infection. So that is the foremost key, is to use clean instruments and not cut into the skin.

Dr. Kamran: Of course, if you’re diabetic or you’re already prone to infections, you should be even even more careful.

Right. and then

Dr. O’Malley: Exactly. And then the diabetics, when I see the diabetics, it’s a multidisciplinary approach and they need to see someone like yourself to make sure they have adequate circulation. So if they get a cut on their toe, they don’t [00:10:00] lose their toe with their leg.

Dr. Kamran: So do you think if you’re a diabetic, you probably should just see a podiatrist at least once a year just to keep an eye on it?

Or do you think they should continue? Some people say they don’t, some diabetics say they only go to the podiatrist to trim their toenail. The rest of them are doing it on their own. So I guess the question for you is, if, if you’re a diabetic, do you think you should see a podiatrist to help them, clip their toenail or do you think they should do it on their own?

Well, I

Dr. O’Malley: think you should see your internist. On a more regular basis and get your okay and your diabetes under good control, and you should be seeing a vascular doctor, and you should be seeing a podiatrist just to make sure that you don’t have neuropathy or numbness of your feet. I mean, you just have to get a baseline, just like you go to a dentist to get your teeth cleaned, to get ’em checked.

You should be seeing your internist, your vascular surgeon, your podiatrist, your eye surgeon on a regular basis. I mean, you wanna be preventive as opposed to go to someone when there’s a problem.

Dr. Kamran: So with the [00:11:00] diabetes, I mean the recommendation was, my mother was diabetic, my son is juvenile DBE diabetes, and I, I dealt with diabetes.

when part of my residency program, and there’s one thing we always suggested that they come on a regular basis, they eye check, obviously they have their hemoglobin one C checked, but they had to have a podiatrist to check them at least once a year too. Make sure they’re heading in the right direction.

Teach them how to cut. Because when you’re diabetic and you already got what we call microvascular disease, because small vessels get disease and they get the infection very easily, and you go, you cut your nails wrong, cut into your toe, or you get groin toenail, you could easily end up losing your toes or even the whole foot isn’t that correct?

Yeah. I think

Dr. O’Malley: another thing that’s important is to say is, the American Diabetes Association makes recommendations like to see a podiatrist. But it’s also important to see a podiatrist. So the podiatrist examines your foot and says, you know what? You’d be a good candidate for. Custom inner soles or Medicare, a lot of times will pay for custom orthotics or diabetic [00:12:00] shoes.

And the reason why they do that, it prevents amputations of the lower extremity. So if you could see a podiatrist and they can recommend that you go to a catharsis and they can fit you for diabetic inner soles and diabetic shoes, and it can prevent you from having an ulcer or a cut on your foot.

Dr. Kamran: That’s really important.

So if you’re a diabetic, please follow the rules, which means you have your eye exam, have your foot exam, make sure your circulation is examined. So, well that is great. Now, on top of that, if, if you find that you also got flat feet or you’ve got club feet or whatever, then you’re gonna get a callous.

And I’ve seen a lot of those patients, when the callous comes infected in a diabetic patient, which comes to your insole and make sure your. You know, your shoes fit properly, then obviously that’s, that’s very important.

Dr. O’Malley: If I could add something, I always tell patients when I was younger, my parents used to have me rake the yard and I would get calluses, and the reason why I got calluses on my hands is because I didn’t wear gloves.

Well, that’s how the feet are. If you’re getting callouses, obviously you don’t have enough protection and your [00:13:00] body’s trying to tell you need more protection, whether it’s socks or inner souls or sneakers. So if you’re having a pathology, you gotta stop and think while you’re having that pathology.

Dr. Kamran: That’s great. I’m just gonna ask you some very basic questions if you don’t mind. So, we talked about flat feet. So, how do you know you have flat feet and what do you do about it?

Dr. O’Malley: I would say, you have flat feet when a lot of times your arch or the inside of your foot turns inward.

Okay. When you’re walking on the beach, it looks like your feet are really flat. You could see your whole foot, where if you have a high arch, you see. Essentially heel and the metatarsals. When you walk on the beach, it looks like a “C” shaped, and I always tell my patients, the best time to buy shoes is at the end of the day.

After you’ve been walking around the whole day and your feet are tired, go in and get fitted for a pair of shoes. Err on shoes that are a little longer and a little wider because you could always put inserts in there. And you should also err on shoes that are deep, so you can slide your foot in there.

[00:14:00] Because I see so many patients, their shoes are too tight, and then they try to put on an inner sole. And then the top of the foot hits or the toes hit and they get ulcers because their shoes don’t fit. And as we get older, our feet get longer and wider. So many people wear the same shoes that they were in high school, but my body’s changed over the last 30 years and their feet have changed also.

So they need to be fitted for shoes, and that’s getting harder now than ever before because you don’t see as many places taking their time at fitting people for shoes.

Dr. Kamran: So when somebody goes to buy a shoe, better not worry too much about how beautiful it looks, but make sure it is the right size shoe.

And in England, you don’t have the luxury you have here. you get only one size fits all. But now in America you can get wide, extra wide, narrow. What are your recommendations? You think the average person should probably at least go to a place where they can tell you what kind of feet you have?

Exactly. Is it two E, one E? Could you kind of expand on that? Send my

Dr. O’Malley: patients, I send [00:15:00] all my patients to, like who have problems with their feet. I start off with a good place in town that takes their time. They fit them for shoes, they try a good pair of shoes, and it’s really important if you’re gonna play like say pickleball, you need to be wearing tennis shoes and not running shoes because if you wear running shoes, you could twist your ankle.

So you need to be fitted for someone who knows the difference. Of shoes and they’ll fit you accordingly. And then if your shoes feel good, then you’re, then you’re okay. If not, then you start wearing inner soles and you try different inner soles and see which inner soles feel good and give you the support you need and the comfort you need.

And it’s, if you have a really good person, they can watch you walk and they can see if that shoe’s most appropriate.

Dr. Kamran: Is there any. without mentioning anybody’s name, are some inner soles better than others? or do you think they’re all about the same?

Dr. O’Malley: Now? There’s some inner souls are better than others, but, you know, I always recommend with my [00:16:00] patients, my parents had eight kids, is to starting with reasonable ones.

You can get a good, you know, inner sole for $30 or $40. I mean, there’s, and you, and there’s other places that say they make, you know, like. Almost like custom inner souls, but they’re really not. So you can get a good inner soul, pretty reasonably, and you can get a good sneaker at a reasonable cost also.

Dr. Kamran: So, how would they know this inner soul is the best for them?

Dr. O’Malley: It’s comfort. It’s just like if you put, like, I have these glasses from the Dollar store, but they work. I mean, if you put on sneakers and you put on inner soles, they should feel comfortable. And when you walk, when you walk, you should be walking off your first metatarsal head. So if you walk off the side of your foot, you’re gonna get pain on the outside of your foot.

So when you walk, you should be feeling like you’re walking efficiently. And just like when you’re a little kid, you put on shoes and you think you can run faster. You can’t really run any faster, but they’re comfortable. [00:17:00]

Dr. Kamran: That’s very important because again, the same thing. Let the body talk to you if your foot hurts.

One thing I’m really shocked about, to be honest with you, is people say, well, my feet hurt because I’m working on concrete floors all the time. Although it was gold, it would be. Different or it was, I don’t know. I think it’s just your foot. I don’t think it’s the ground. Is that important? I understand. If it’s uneven ground, could you explain that to me?

Do you think the actual, whether it makes a difference if it’s concrete or wood or, or something else?

Dr. O’Malley: concrete definitely puts more stress on people’s feet, but you also have to cross train. I mean, you can’t run every day of the week. So people really should be working and then they should be changing their shoes.

They should have one pair of shoes for Monday, a different fair for Tuesday. But when they go home, they should be biking. They should be swimming, they should be stretching. They shouldn’t just go home and walk every day and just only do his walk. They should cross train. They do their same repetitive trauma, and a lot of times people don’t replace their shoes [00:18:00] frequently enough.

I mean, just like your car, if you’re driving your car more frequently, you have to replace the tires and the oil more frequently. Well, you have to do the same thing with your shoes.

Dr. Kamran: Do you think? an average shoe? I mean, some people, my father used to do that. He loved, tailormade shoes made of leather, and then he would wear them for the next 50 years if he could.

Do you think shoes are something that need to be changed every six months or a year, or, or, yes, definitely. I think the

Dr. O’Malley: The quality of the shoes isn’t as good as it used to be. Just like a lot of appliances don’t last 20, 30 years, I don’t think the quality is there in the shoes as like they used to be.

Probably so I think you have to replace them more frequently.

Dr. Kamran: Fantastic. Well that’s really great to know. Now, very briefly, if your feet are not taken care of properly, in other words, a line of force as we basically do in physics, right, what other joints can it damage over time?

Dr. O’Malley: It affects, it could [00:19:00] affect the ankle joint, it can affect the knees, it can affect your back.

And that’s why I’m a big advocate of like a lot of my patients, I put almost in high top sneakers or like hiking boots because it keeps the ankle straight. And if, and if you look in the army, a lot of times you’re in army boots ’cause it supports the ankle. So if the ankle supported and you have good inner soles, it helps defeat.

But if your ankle is off, it throws off everything else.

Dr. Kamran: Now, something which is relatively rare, but not too rare in the army is when they have stress fractures of their feet. Yes. I mean, that’s obviously extreme. I mean, you’re, they’re walking so much till eventually the bone just breaks. Could you tell us a little bit about that?

Dr. O’Malley: I see stress fractures frequently, and I usually see it of the metatarsals, like the second metatarsal. It’s in the front of the foot and it’s, a lot of times it’s people in the military, but it’s also, a lot of times I’ll see it in women who wear high heels because they’re putting a lot of pressure in their forefoot and they just walk a lot, you know, during the day.

I mean, if you, you could imagine if [00:20:00] you have a heel, you’re gonna put a lot more pressure on your forefoot than if you have a running sneaker where you hit on your, on your heel and then propose to your forefoot.

Dr. Kamran: So, two questions here is one, do you think ladies are more prone to having foot problem than men because they wear higher shoes?

Dr. O’Malley: Definitely.

Dr. Kamran: And do you think High Hill shoes are bad for you? I probably shouldn’t be asking that, but, ladies are not gonna stop wearing them because of whatever reason. But how, what, what way do you think could harm them? And how do you suggest, should they wear them every day?

At least give them several, a break every other day. What do you think about high heel shoes?

Dr. O’Malley: I, I don’t like high heel shoes. I always tell people, if you wanna, if someone gave you a million dollars to run a marathon, I guarantee you wouldn’t wear high heel shoes. I mean, you can choose to wear whatever they want, but if they ask for my honest, educated opinion, I don’t think they’re a good idea.

Dr. Kamran: What about high heel shoes and, ACHI? Okay. Actually not necessarily high heel shoes. What about Achilles tenders? Some people just tear their Achilles stand. And is there any [00:21:00] particular shoe which could hurt your Achilles standard? I know that there’s some people just prone to. Tear ulu tendon. That’s by the way, for, for our audience, that’s a tendon, behind your angle and, is connected to your calf muscles.

And then of course, over time, that tendon can wear down and just snap. And believe me, it is not a nice thing to happen. Invariably, Dr. Malick can tell you, they, they’re convinced somebody to kick them in the back of the foot because it hurts so bad, so much, and then they can’t lift the foot up anymore.

And that’s when you know, you totally ally send it and you don’t necessarily totally. Tear either. Some people have partial tear. We do a lot of ultrasounds in our office. We see that. But, is there, I think some people are just prone to it. They do. Don’t you agree with that? Genetic, it also,

Dr. O’Malley: it has to do with is, they’re, they’re too tight.

Your achilles tendons too tight. Your hamstrings are too tight. And that’s why you have to really stretch your Achilles and, that’s why physical therapy’s so great. Like, if I see someone who’s achilles tendonitis. I’m always sending ’em to physical therapy and then I’m getting them things [00:22:00] to stretch their Achilles, whether it’s a night splint, and that’s really, really important.

And you see Achilles tendon, Achilles center, injuries a lot with like people who propose, whether you’re playing football or tennis where you’re pushing off, but you don’t see any achilles tendon ruptures really in swimmers. And that’s why I keep telling people they really need to cross train a lot.

They really need to do things like yoga and Pilates and in more of a holistic approach.

Dr. Kamran: So I know you go to the gym a lot, Bob, becauseyou know, we spend a lot of time there together, butI’m horrible in the stretching. Do you think we should never exercise

withoutstretching?

Dr. O’Malley: just look at the athletes. The athletes are always stretching, if it’s at any kind of big game, they always get there an hour early to stretch. And so if these professional athletes are stretching, well then you and I should be stretching a lot more, but I don’t stretch nearly enough. And if you lookas We get older, a lot of people fall andand it leads to horrible disabilities. And that’s why I send so many of my patients to physical therapy for stretching and for [00:23:00] gait training. I mean, it’sdevastating how many people are stiff. And when you’re little, if you go skiing, tend not to fall, ’cause you’re more flexible, we can all benefit from stretching.

Dr. Kamran: So that’s extremely important. Even young people, particularly, or older people as you’re suggesting, well, plantar fasciitis. Everybody loves to ask you about that, I’m sure. So what is plantar fasciitis and how do you diagnose it and how do you know you’ve got it?

Dr. O’Malley: Plantar fasciitis is it’s kind of controversial.

Some people say it’s inflammation plantar fascia. Some people say it’s scar tissue along the plantar fascia. Like so many things, it’s an overuse injury. It’s very common in runners. I see it a lot with people walking barefoot on the beach because they’re walking barefoot on the beach and they’re enjoying their vacation and they just are walking along the beach.

And what happens is say they have a high arch or flat arch, flat foot. They put tremendous strain in the plantar fascia, and as a result it really hurts. And so how I always address that is two components. When I see someone who has any kind of pain, I’m like, the first thing you have to do is address the inflammation, [00:24:00] whether you do cold water, stick your foot in cold water or try various creams.

And then after that, you go after the root cause. You wear a good pair of sneakers, a good pair of inner souls, you stretch, you cross train. It’s a combination of both. Too many people just think it’s taking pills or just trying inner souls. It’s a combination of both.

Dr. Kamran: Actually one of my nurses was telling me on the TikTok that people are spraying lidocaine on their feet because of pain, which I was horrified.

First of all, Xylocaine can cause an allergy and it can absorb your body and slow your heart down. In fact, I know somebody. Died a few years ago. They were just having hair removal, but they covered themselves with Xylocaine about an hour before they went to have the hair removed.

And, the heart has slowed down and actually the lady died from it. So, Xylocaine, it is not exactly a benign thing, but I don’t think you would recommend spraying Xylocaine on your feet. Right?

Dr. O’Malley: I guess it could be worse, it could have a headache and put it on their head. I don’t know. I don’t know this.

Certain [00:25:00] things defy logic to me.

Dr. Kamran: Okay. Plantar fasciitis. I was actually a friend of mine, I was in England, played a lot of like baseball, but not, not exactly, but he would stop his foot, he would put, stop the ball with his, with his heel. And, he was actually a professor of mathematics.

A guy was very smart, and he said, I’ve got a hali spare and I got a hali spare because I sub my, the ball with my, with my. with my heel. And then they would operate on those things. They would literally go and take that heel, spare out. And it took years before we found out that was actually calcium deposit in your plantar fascia, which goes to show how dumb things we’ve done in the past in, in medicine and medicines.

Like everything else is evolving. We are learning from our own mistakes. But would you say Helios spares are just basically a kind of some form of chronic plantar fasciitis?

Dr. O’Malley: And I tell people to live with it. if it’s not broken, don’t fix it. So, find so many times when people have plantar fasciitis and heel spur, say on [00:26:00] the right foot, if you took an x-ray of the left foot, they probably have a heel spur in the left foot.

It’s not the heel spur that’s causing the problem, it’s just the inflammation, the pain. And I’m also a big advocate of night splints because what happens when you sleep, your foot’s plantar flexes. and that’s why plantar fasciitis hurts so much in the morning. So I always tell people. Just before you get up in the morning, make sure you stretch your Achilles or get a nice stretch, or take warm baths and stretch or go to the steam room and stretch.

A lot of it’s we’re too tight.

Dr. Kamran: Do you think it’s a good idea to, for example, get into a sauna and then stretch? Or does it really matter?

Dr. O’Malley: I think stretching is key, whether you do it in the sun or after a sauna. I think it’s really important, and I’m a big advocate of cold therapy too.

If my back hurts and I go swimming in a pool and it’s cold, it helps my back.

Dr. Kamran: Again, that’s been a controversy in medicine, right? Is cold better for you or warm is better for you? So some people say ice pack, some say warmth. So my thought was they all cause what we call vaso dilatation, right?

[00:27:00] It opens up your vessel. So if you put an ice on something and you take the ice off, the whole thing gets pink because nowThe blood vessels open up in reaction to it. You put heat on it, it does the same thing. Am I correct in making that assumption, or do you like I think

Dr. O’Malley: It’s also, like when people say it hurts when they put ice on it, I always say cool, like if I stick my hand in a bucket of cold water, that’s different than if it’s has ice in it.

I mean, it’s, like if something hurts, like you have an acute pain, I think it’s cool. Things are probably better, say you’re for your plantar fascia as opposed to sticking your foot in a bucket of ice.

Dr. Kamran: Definitely you would not put heat on the bottom of your foot if you apply the fasciitis.

Dr. O’Malley: I think heat is good for stretching. Like if you take a warm bath and stretch your calves, I think that’s good. Like if my heel hurts, I’d get in a warm bath and stretch, and then afterwards I would stick my foot in a cool bucket of water to get rid of the inflammation.

Dr. Kamran: What about the injections for plantar fasciitis?

I know you guys inject the steroids and that kind of thing. [00:28:00] What are your thoughts about that?

Dr. O’Malley: I try different things first, and I leave it up to the patient and I always tell, like, even my daughter, her body’s her body. And so how I always work is I educate patients and I give them options, and then they choose what they wanna do.

But, I think a lot of times we give people steroid injections without going after the root of the cause, where they just need to rest their foot.

Dr. Kamran: These are, again, thank you so much. They’re wonderful. These are just the questions that I’ve had for a long time and I’m sure our audience will have more questions to ask.

So, two things. one is, I was wondering if you would be kind enough at some stage probably to join us, for. Episode two. If, over time we have patients who, an audience is gonna send us some questions, have more questions about what we talked about, I would really appreciate that.

I also know you’re extremely busy and I’m just so thankful that you gave us this one episode. The Future No Id by honor. Yeah, that would be awesome. And you are, of course, here in Wilmington, North Carolina, and I know it’s [00:29:00] extremely hard to make an appointment, but usually if they, if they need to see you, they can just, you work with Emerge Ortho now.

Dr. O’Malley: Correct. Exactly. Emerge Ortho. 

Dr. Kamran: So they just call and they can ask if they could make an appointment and see you again. Thank you so much. I really appreciate it. 

Dr. O’Malley: God bless you. Have a great day. Alright sir, take care.

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