Dr. Rock Positano

Hospital For Special Surgery

When it comes to the best of the best foot doctors, Rock G. Positano is a legend, to say the least. He’s on staff at the Hospital for Special Surgery on the Upper East Side, where he’s the founder and director of the Non-surgical Foot and Ankle Service and the Heel Pain Center. Dr. Positano, or Rock as he’s famously known, runs a booming practice where people with foot issues of all manners clamor to get in.

No wonder —he’s written a dozen books about various foot issues and treated Joe DiMaggio for years. Read his “Dinner with DiMaggio” to get more scoop on their close friendship. We live in the same neighborhood, and I’ve seen him around for as long as I’ve lived here- every time we chat, Dr. Positano tells me something fascinating and valuable as it relates to feet.

Now, comes his travel fix. “Your feet never go on vacation. They are constantly working and never on holiday,” was his latest bit of wisdom. “The best travel insurance is healthy feet.”

According to Dr. Positano, a painful foot can ruin a $40,000 vacation even before it starts, so why aren’t people more proactive when it comes to protecting the “Michelin tires” of the body?

“People often ignore and underestimate how important the feet are, especially when going on vacations that often require a tremendous amount of walking and standing, climbing hills, and uneven terrain,” he says. “What baffles me is the patient who comes to see us at our center at HSS, complaining of foot and ankle pain, the week or even the day before they are leaving on their voyage.”

“Favorite trips that involve climbing Mt. Kilimanjaro, walking on a glacier, walking the trail (el Camino), or navigating difficult waters are challenging enough. But trying to tackle these trips with a bum foot astounds and confounds us as healers,” he says. “Not only is it stupid for obvious reasons, but it is also downright dangerous. Patients who have door and ankle pain usually have balance issues, and dangerous falls are part of the potential repertoire.”

Dr. Positano adds that vacations where you need to walk in dangerous and choppy water have their own set of dangers.

His guide for healthy vacation feet follows:

Do
If you have an upcoming trip that requires copious walking and standing, endurance, and stamina, get a foot exam, especially if you have a history of musculoskeletal injury, such as heel, Achilles, metatarsal, and ankle issues.

Don’t

Google it. “Patients reading Google are also potentially in a dangerous predicament. Google is an unbelievable knowledge resource, but that’s only the case when a doctor has already evaluated an injury and has a diagnosis. Self-diagnosis is not only dangerous but can be very costly as the traveler is often confined to a hotel room, terrace, or poolside while others are swimming, jet skiing, etc.”

The Hazards You Need to Watch for On Every Type of Getaway

Hiking trips with altitude and mountain climbing: The foot naturally swells at higher altitudes, so shoes and boots get tighter. This causes tendons, muscles, and ligaments to overwork, resulting in pain.

Walking trips sans hills: Heel and Achilles overwork because they’re not accustomed to the rapid increase in mileage, which can mean plantar fasciitis and Achilles tendon issues. Skin issues such as painful blisters can also develop from the repetitive motion.

Cycling trips: Heel, Achilles, and calf strains are very common. These may also affect the knee and hip.

Water trips: Stepping on a foreign body, such as glass or shells, can be painful and debilitating. Stepping on a sea urchin is particularly painful because the creature’s spines have toxins that can cause inflammatory reactions. You need to wear aqua shoes for any water activity.

Also, keep in mind that running on the beach is very dangerous, especially is you have a history of Achilles problems.

Gout: This is a vacation foot killer and can result from overindulging in alcohol and rich foods such as beef, pork, lamb, shrimp, and lobster. Gout pain in the big toe and the area underneath renders you incapable of doing any walking at all, but even sitting down can be painful. Plan ahead by limiting to richer foods, as we all tend to overindulge when we’re traveling, and drink plenty of water. Dehydration concentrates uric acid, which is a culprit for gout.

DVT: Long trips put you at risk for DVT because you’re sedentary on long flights, which can cause this potentially fatal condition.

Ingrown toenail and infection. Wearing ill-fitting shoes and sudden increases in mileage can lead to the big toe becoming infected. Ouch! Make sure your nails are cut before you take that flight.

Prevent Feet Vacation Woes
Get an evaluation before your trip. If you have never had a foot issue, have your feet checked a month before. If you have, go six weeks in advance.

Bring shoes with a wider toe box to accommodate swelling that occurs with increased walking, activity, and altitude.

Your Packing List:
Telfa bandages are great for blisters.

Domeboro soaks are great for nail infections and irritated skin.

Ice packs are great for the end of the day, after prolonged walking and standing.

Aspirin ( if you’re not allergic or on blood thinners) is a good safety precaution before long flights to prevent DVT.

MalleoTrain foot and ankle sleeve braces for heel, Achilles, and ankle pain.