Posts Tagged ‘orthotics’
Sunday, December 4th, 2011
With the arrival of winter, trendsetters are excited to see the styles that will be popular this season. Clothes are important, but do not forget about the bag! Whether you carry a luxury designer purse or a classy more affordable purse, one thing is clear – it better be big. From celebrities to college students, one of the most popular purse choices is the large tote. As purses get bigger, they also get heavier. Recently on his TV show, Dr. Oz weighed the bags of the women in his audience. One woman’s purse weighed almost 15 pounds! Can you imagine carrying a 15 pound bowling ball with you as you went about your daily activities? Well, this is what some women do every day. Inside of a typical heavy bag you may find an iPad, phone, book, wallet, magazine, extra shoes, lunch or snacks, toys for children, makeup, medication, and whatever else may fit. No doubt these women are well prepared, but their heavy purses may be causing health problems.
Weeks of carrying a 15 pound purse can cause shoulder pain, but the problem does not stop there. Most women like carrying their bag on a particular shoulder. If your bag is too heavy, you may find yourself walking with a lean to the right or to the left. Center of gravity is important in walking. If everyone were perfect, we would all walk with an equal amount of weight placed on both on each of our feet. No one is perfect and obesity, back problems and foot problems can cause you to place more weight on one side of your body. Because your center of gravity is thrown off, instead of walking with your feet straight, your feet may begin to turn inwards. This process is called pronation. Foot pronation can cause calluses, bunions, and a loss of the foot arch. Some people have feet that naturally turn inwards. Orthotics and foot surgery can help treat this problem. However, getting rid of a heavy purse is a simple thing you can do to stop your feet from pronating too much.
If you just can’t say goodbye to your large tote just yet, here are a few ideas to keep your feet feeling as good as possible.
1) Carry only what you NEED. Leave the heavy gadgets at home.
2) Wear comfortable shoes. A heavy bag and high heels are a bad combination and can increase
your risk of foot problems.
3) Try a tote with a strap that you can wear across your chest. These ‘cross body’ bags may be a
bit smaller, but they are better at equaling out your center of gravity between your feet.
The next time you have an appointment at Affiliated Foot & Ankle Center, LLP, ask your podiatrist about your center of gravity and how a heavy bag can be causing you foot problems. With locations at Howell, Edison, and Monroe, NJ, you are sure to find a podiatrist who can answer your questions and give you more advice on how to strengthen your center of balance. Your podiatrist may even give you advice on a smarter, but stylish bag to carry this season!
By: Varun (Ben) Gujral, DPM
Tags: Affiliated Foot and Ankle Center, Bunions, Dr. Oz, Dr. Varun (Ben) Gujral, Dr. Varun Gujral, edison, orthotics, stylish bag
Posted in General, Orthotics, Seasonal Foot Care | 1 Comment »
Wednesday, October 5th, 2011
This is the time of year where our children will get ready for school and hit the books while in school. Many of our children will participate in sports. The big sports this time of year are soccer, football, field hockey, cross country, and cheerleading. Many young men and women will transition from the summer of wearing flip flops to going right into engaging in the sport of their choice. The most common ailment from ages 9 until 14 is pediatric heel pain (aka Sever’s Disease, aka Calcaneal Apophysitis).
The correct term is Calcaneal Apophysitis and it is the inflammation of the ligament on the bottom of the foot known as the Plantar Fascia and also the growth known as the Calcaneal Apophysitis. These two anatomical structures became inflamed due to the lack of support of the arch. In addition to the lack of support, the pulling of the Achilles in conjunction of the pulling of the Calcaneal Apophysis will cause a moderate to severe ache while playing sports and with a first step after a period of rest. Infrequently, the pediatric patient can fracture the heel and this can prevent the patient in playing any sport.
Fortunately, this condition can be treated conservatively at Affiliated Foot and Ankle Cneter, LLP with locations in Howell, Edison, and Monroe, NJ. Patients will go through a thorough exam (medical, physical and biomechanical). Usually, I will watch the patient walk because walking can tell a lot about the patient such as the presence of a tight Achilles tendon as well as scoliosis. X-rays are taken in the office to make sure there are no fractures present.
Once the exam is performed, a treatment is put in place, which will include stretching, anti-inflammatories, orthotics and the use of a night splint. A night splint is an apparatus that is prescribed and dispensed by the doctor for the patient to use at night to provide a gentle stretch along the plantar fascial band on the bottom of the foot. An orthotic is a device that is placed in the shoe to provide a bed of support and to prevent the foot in engaging excessive flattening of the arch.
Calcaneal Apophysitis is treatable and responds to conservative treatment pretty quickly. With the treatment plan outlined above and children who participate in the treatment plan, these growing and active children will not miss a step in their junior sports career. If your child is experiencing any of these conditions we urge you to make an appointment by visiting our appointment request page or by calling us in Howell at 732-905-1110, Edison at 732-662-3050, and Monroe at 732-662-3050.
By: Dr. Jasen Langley, DPM
Tags: Affiliated Foot and Ankle Center, Dr. Jasen Langley, fractures, heel pain, howell, orthotics, pediatric foot care, sports injuries, sports medicine
Posted in Orthotics, Pediatric Foot Pain, Seasonal Foot Care | No Comments »
Wednesday, September 21st, 2011
If you have regular appointments at Affiliated Foot & Ankle Center, you probably already know about orthotics. Maybe you have even purchased orthotics. A foot orthotic is an insole placed into the shoe that helps control foot position. There are two main types of orthotics. A functional orthotic controls foot movement and helps a person walk in a way that best supports joints and muscles. An accommodative orthotic helps distribute foot pressure evenly over the bottom of the foot. Most patients use a functional orthotic. A functional orthotic can be useful for several problems such as flat feet or rolling the feet inward while walking (over pronation).
In the foot care aisle at your local drug store or grocery store, you may have seen readymade orthotics for sale. Does it really matter whether you buy store bought orthotics or custom orthotics from your podiatrist? Well, some people may be able to get away with wearing store bought orthotics for a period of time. However, when you think about the long term health of your feet, custom orthotics are the way to go! Store bought orthotics are made to fit many foot problems for a large variety of people. To be truly effective, an orthotic must be fitted for YOUR particular needs. Wearing an ill fitted orthotic is not only a waste of time, but it can also make your foot problems worse. Over time these problems can lead to leg, knee, hip, and even back problems. Store bought orthotics tend to not offer long lasting comfort. If you find yourself buying store bought orthotics every few months because of foot pain, it may be time to schedule an appointment at Affiliated Foot & Ankle Center, with locations in Howell, Edison, and Monroe, NJ. Your podiatrist will produce orthotics that fit only YOUR feet. The materials used will be those that are best suited for your walking and even running needs.
Everyone deserves special treatment! With a real custom orthotic that is exactly what you have. Yes, custom orthotics can be costly, but so can surgery from walking incorrectly over the years. Think of the orthotics as an investment and an investment in your health is one of the best choices you can make for yourself.
By: Dr. Alison DeWaters, DPM
Tags: Affiliated Foot and Ankle Center, Dr. Alison Dewaters, heel pain, howell, orthotics, Shoe Inserts
Posted in General, Orthotics | No Comments »
Friday, May 27th, 2011
If you are a regular reader of this blog, you already know that problems with the feet can lead to problems in the leg, thigh, lower back, and even the buttocks. The piriformis muscle is in the buttocks region. This muscle moves the thigh away from the body. A person can develop piriformis syndrome when the piriformis muscle irritates a large nerve in the buttocks region. This irritation causes pain in the buttocks, hips and groin. This pain can also extend to the thigh, leg, and foot. People with piriformis syndrome often have the following symptoms:
- Chronic pain in the buttocks
- Pain in the lower leg and foot that worsens with walking or squatting
- Lower back pain
- Pain when getting up from bed
- Pain when sitting
Piriformis syndrome is usually caused by direct injury to the piriformis muscle. But, the way you walk can also cause piriformis syndrome. Overpronation is when a person walks with their knees turned inwards. This is also known as being “knock-kneed”. Walking with the knees inward for long periods of time overworks the piriformis muscle and can lead to piriformis syndrome.
If symptoms of piriformis syndrome are related to how you walk, your podiatrist can help. At Affiliated Foot & Ankle Center, LLP, we can create custom orthotics for your feet that help you walk in a more natural form. We can also discuss proper stretching exercises that will help lessen the pain associated with piriformis syndrome and which shoes will best help to prevent pain. Affiliated Foot & Ankle Center, LLP has locations at Howell, Edison, and Monroe, New Jersey.
Do you think you have piriformis syndrome? A talk with your podiatrist is a step in the right direction for getting relief from pain. We will work closely with your primary doctor to treat you in the best way possible. In the meantime, here are four suggestions that can help prevent pain caused by piriformis syndrome:
· Always do a warm-up activity before and during any sport or activity.
· After physical activity, be sure to give your muscles time to rest and recover. Do not overwork your muscles.
· Focus on activities that strengthen and condition the hips, buttocks and lower back.
· Stretch! Muscles that are flexible are less prone to injury.
After a long winter, don’t let pain keep you from enjoying the summer. Now is the time to get the proper care so that you can get the most out of life!
By Dr. Alison DeWaters
Tags: Affiliated Foot and Ankle Center, Dr. Alison Dewaters, howell, lower back pain, orthotics, Piriformis Syndrome
Posted in General | No Comments »
Thursday, May 12th, 2011
This is an excellent question and one that we get asked routinely at Affiliated Foot and Ankle Center with locations in Howell, Edison, and Monroe, NJ.
The first thing to do is to contact your primary care physician and get a physical, and get a referral to see your podiatrist. Prior to starting any new training regimen, it is important to establish your fitness level and get your feet examined. It is important to establish your foot type and any limb length discrepancies prior to getting started. This way we are able to establish what type of shoes/brace(s) and/or orthotics you might need to help prevent injury.
I recently spoke with a friend of mine, John Reagan (brn2runcc@aol.com), who is a professional marathon runner/trainer for 15+ years. I mentioned that I personally wanted to train for a half marathon since the longest I have run recently was a 5K. The following is his guidelines for me (he learned of my fitness level and where I was at) personally. Please keep in mind that there is a difference between seeing your podiatrist and a professional marathon trainer. One will treat any foot and ankle ailments you might have prior to, during and after training as well as in the future as needed. The latter will coach/train you on how to prepare for the mental and physical (endurance, stamina, pacing) demands to accomplish your goals.
The following is the advice from my new coach on how to prepare for a half marathon:
“I would suggest your half marathon training would consist of running 4 days a week and starting with your long run of 5 miles and increasing your long run 1 mile every other week so if you give yourself 5 months (20 weeks) to train, start at 5 miles and cap your long run at 12 miles. The final month (4 weeks) consist of “tapering”, so your long run would go from 4 weeks prior to the race 12 miles; 3 weeks prior to the race 10 miles; 2 weeks prior to the race 8 miles and 1 week prior to the race 6 miles. The remaining 3 days you run a week, just focus on running distance as the most important thing is building a base and your endurance. Pick a day and run 1 mile less than your long run and the other two days running an easy 3 – 4 miles.”
This information is based off of his personal recommendation for me. For this reason, it is important to follow the guidelines above with the PCP and podiatrist, and then meet with a professional trainer. There are many variables to consider, and remember… this is a team effort. Don’t forget to subscribe to Runner’s World Magazine for more helpful tips and insights as well as getting the right pair of shoes. One shoe store I recommend locally runners is “Miles Ahead Sports” in Manasquan, NJ.
As a side note to this blog entry, there is a 5K race/walk taking place in Howell on Saturday, 6/4/11. Please visit www.TheRaceToEducate.com for more information or to register for the race.
By David Hunnicutt
Tags: Affiliated Foot and Ankle Center, athlete, athletes, Exercise, Exercising, howell, orthotics, proper footwear, runner, runners, running, running injury, shoes
Posted in Exercise, Footwear, shoes | No Comments »
Sunday, April 24th, 2011
Shin splints is a general medical term for medial tibial stress syndrome (MTSS), a slow-healing and painful condition in the shins, usually caused by exercise such as running, jumping, swimming, cycling, dancing, or other high impact sports. Fifteen percent of running injuries are shin splints. On the list of running injuries, shin pain ranks as one of the most annoying.
Specifically, the pain associated with shin splints is a result of fatigue and trauma to the muscle’s tendons where they attach themselves to the tibia. In an effort to keep the foot, ankle and lower leg stable, the muscles exert a great force on the tibia. This excessive force can result in the tendons being partially torn away from the bone.
Many cases of shin splints may be due to inappropriate footwear, or muscle imbalances in the legs where the shin muscles are not conditioned to withstand pounding on hard surfaces, such as wood floors, concrete, or hard ground. The onset of shin splints is most common after exercise, caused by high-impact training, excessive training, poor technique or biomechanical problems such as pes planus (flat feet) or pronation. Some studies have suggested that shin splints are more common in women. Standing for long periods of time and wearing high-heeled shoes may also induce shin splints. Dehydration and certain vitamin/mineral deficiencies may also contribute to the development of shin splints.
If you think you have shin splints, it is best to see a specialized foot and ankle physician to diagnose your condition, treat the injury, and give you tips on preventing the problem from returning. At Affiliated Foot and Ankle Center, in Howell, we have the all tools to diagnose and treat this irritating injury. Custom orthotics will help prevent the injury from recurring.
Control the pain with this proven three-step regimen:
Step 1: As soon as you sense any shin pain mid-workout, cut back on the training or change the routine to non-impact cross training, like the elliptical machine, cycling, or swimming. Less pounding and stress equals quicker healing time. RICE (Rest, Ice, Compression, and Elevation) post workouts.
Step 2: STRETCH. Tight calf muscles can increase your chances of developing shin splints. To loosen them up: find a leather belt. Lie down on your back with your legs fully extended, and place the belt around the ball of your foot, slowly lift the leg straight up while pulling your toes to your nose and hold for 30 seconds. Repeat on each leg 3 times. To stretch the shin muscles: Sit on your heels to open up the anterior compartment of the shin for 30 seconds and repeat 3 times.
Step 3: Reduce the wobble in your feet. Stabilizing your arches will lessen the stress on your shins. Custom orthotics will help stabilize and decrease the amount of stress on your shins whether you have flat feet or not. Get Fitted!
By Valerie Gregory, MSPT, CKPT
Tags: Affiliated Foot and Ankle Center, athlete, Exercise, Exercising, howell, orthotics, runner, runners, shin splints, valerie gregory
Posted in Exercise | No Comments »
Monday, February 7th, 2011
Living in the northeast and being surrounded by snowy, wet and slushy grounds, it is hard to find a shoe that fits for a change of environment. At Affiliated Foot and Ankle Center, LLP with locations in Howell, Edison and Monroe, we typically recommend a running shoe (example: New Balance or Asics) for post surgical and injured patients. Most patients complain because the slushy/icy pavement makes it uncomfortable and tough to walk with wet slippery sneakers. So what is the solution? Trail shoes.
Trail shoes are designed for rough and rocky trails, but it is the best shoe to wear for wet slippery terrain. Most trail shoes are waterproof and keep your feet dry in the cold wet weather. Trail shoes typically provide more protection than regular running shoes, with thicker soles to protect feet from rocks and debris, plus extra protection over the toebox or forefoot. For traction on varied terrain, rubber lugs on the outsole are usually deep and beefy, often with a multidirectional design for wet surfaces without slipping. Very deep lugs are designed for gripping, but make for less stability. Softer lugs are grippier, but wear faster than harder soles. Trail shoes usually have a wide and low profile so the foot is closer to the ground for more stability on irregular surfaces. Most trail shoes provide enough stability for people with mild overpronation, but severe overpronators may need some additional motion control. To correct overpronation, custom orthotics are recommended and can be supplied in our office. This would provide a firmer support for those who need extra help correcting their gait. Most people with a neutral gait or mild pronation can wear just about any trail shoe.
Picking the right shoe is one of the most important and toughest decisions people make. Having a hard enough time finding a comfortable shoe for an injured or abnormal foot, I recommend considering the following in evaluating shoes:
· Running stores are best for analyzing your gait. Even if the store doesn’t carry trail shoes, the expert staff at a running store can advise you on whether or not you need extra motion control. If you need help finding a running store in your area, your local podiatrist or foot & ankle surgeon can provide you with more information.
· Shop in late afternoon and wear typical socks. Feet can swell at least a half size during the day, so experts recommend trying on shoes in the late afternoon or evening. Socks also affect fit, so wear the socks you intend to wear with the shoes.
· Shoes should fit well right away. Shoes should feel comfortable right out of the box and recommend trying them on a carpeted surface
· Look for snug lacing. This is mostly a matter of individual preference.
· If you use orthotics, be sure the shoe is sufficiently roomy. Most trail shoes have removable insoles you can replace with custom orthotics, but roomier shoes let you place custom orthotics under the cushioning of the shoe’s own insole, which may be more comfortable.
· Replace trail shoes every 300 miles. EVA midsoles will have worn out by this time.
· Two pairs last longer. Alternating pairs so each has time to dry out completely between daily wearings can make both pairs last longer.
By Valerie Gregory, MSPT, CKTP
Tags: athletes, Exercising, howell, orthotics, proper footwear, runner, runners, shoes, sports injuries, trail shoes
Posted in Footwear | No Comments »
Tuesday, May 25th, 2010
Being a podiatrist in Howell, NJ by the Jersey Shore, a large number of patients that present to the office with pain in their feet have underlying deformities but still want to wear sandals for the summer. While sneakers with orthotics are the most supportive, it is not always ideal for the summer and going to the beach or being by the pool.
Flip-flops have become increasingly popular over the last couple years but can also cause injuries to the foot due to the lack of support. I actually broke my fifth metatarsal wearing a pair when it caught on the saddle of a door. There instability is in the thin sole with only two thin straps. The important thing to remember is that they are not designed for activity but for style. There are some sandals that are designed with more support and can actually have an orthotic built in or can have an orthotic put in them. The things to look for in a pair of sandals for the summer are supportive soles that you cannot bend in half. Leather works very well and reduced skin irritation. The sandal should also be larger than the foot so the foot does not hang over. Avoid ankle straps and gladiator style sandals as they may cause irritation and blistering. Birkenstocks have larger more supportive straps on the top and similar styles provide more support and stability. Wedges also will give increasing instability and may cause ankle sprains if the heel slips off. Look for sandals that provides cushion and arch support built into to it. You should also not be wearing the same ones that you have worn for years. Like regular sneakers and shoes that should be replaced as they wear down, so should your sandals. A good rule is every 6 months for regular activity and more often for increased activity. If the shoes or sandals have worn in such a way that they are rolled in or out it is time to replace them. If you are planning to do a lot of walking, sneakers and orthotics are still going to be the most supportive and provide the most benefit. APMA has listed sandals that they recommend. Check with your local podiatrist to see if they have them in their office or where you can find these more supportive sandals.
By Dr. Alison DeWaters
http://www.footdoctorsnj.com/adewaters.html
Tags: alison, ankle, ankle pain, ankle sprain, Ankle Sprains, arch support, Dr. Alison Dewaters, Dr. Dewaters, Exercising, feet pain, foot, foot injuries, foot injury, foot pain, fractures, heel pain, howell, orthotics, Plantar fascial band, plantar fasciitis, proper footwear, sandal, sandals, shoes, toe pain
Posted in General | No Comments »
Wednesday, May 19th, 2010
My wife and I woke in the morning and she said, “Since last night, my second and third toes are tingling.” I know what you are thinking but as you get older, the romantic night gets less and less. Well, back to the subject at hand!!!! I asked her did she injure her foot while working out and she said no!!! I look at her and gave her foot a firm squeeze from side to side and I felt some clicking. She had a neuroma!!!!
A neuroma is a nerve that gets thickened from overuse, shoes and injury. The nerves that get affected are the digital nerves which innervate or give sensation to the toes. They are not motor nerves. They are sensory nerves. Symptoms of a neuroma range from pain to tingling and numbness in the toes. It usually occurs in the second and third toes, and symptoms can be in the third and fourth as well as the fourth and fifth toes.
My wife came to the office where I took an x-ray and performed an ultrasound. X-rays are taken to make sure that no fracture is present. Ultrasounds are becoming a great diagnostic tool to evaluate soft tissue masses. On my wife’s ultrasound, a neuroma was seen and she was properly diagnosed. After the ultrasound, she proceeded to tell me that I would be sleeping on the couch because I squeezed her foot to hard!
I explained to her the treatment options. Some of the options were changing her shoes, padding the foot, cortisone injections, non-steroidal anti-inflammatories and sometimes surgeries. I suggested that she get a cortisone injection and use anti-inflammatories. She really did not want the injection but I explained, basically schmoozed her, into getting the injection. This would give her the most immediate relief from her symptoms. She got the injection and I padded her foot. Well, I saw her at home and during dinner I asked her, “How is your foot?” She said it was a little sore but it was 90 percent better. I told her she would need some orthotics, which are custom arch supports, because this would take the pressure off the area of the foot where the neuroma was present.
So, I am not in the doghouse with my wife and she was pretty impressed that I diagnosed her problem. She realized how painful a foot condition could be. Also, she realized how important feet are in regards to everyday activity. It is now a few days later and she told her aunt how much better her foot has been since the injection.
Do not let numbness in your feet get ignored. Visit our in office Howell and let Affiliated Foot and Ankle Center diagnose and treat your condition. Just as a side note, please do perform any of the exams that were portrayed in this blog…Thanks!
By Dr. Jasen Langley
www.footdoctorsnj.com
Tags: athletes, Dr. Jasen Langley, Dr. Langley, feet pain, foot, foot injuries, foot injury, foot pain, howell, Jasen Langley, neuroma, orthotics, runners, shoes, tingling, tingling in my foot, toe pain
Posted in General | No Comments »
Monday, May 3rd, 2010
This weekend was the New Jersey Marathon at Pier Village in Long Branch. I saw a lot of athletes all shapes and sizes were running to compete their best. Running is a sport for many ages and anyone can run. Plus it is cheap; you don’t need equipment or a gym, all you need is a good pair of running shoes. Because of the weather being warmer and days longer, I have seen more and more people running outside. Being a Physical Therapist at Affiliated Foot and Ankle Center in Howell, NJ many patients ask me, “Which running shoes are best for my feet?”
First you have to figure out the type of feet you have: flat feet, high arched feet, or neutral or normal feet. If you’re looking at your foot in a standing position, you’ll know you have flat feet if you don’t see any arch. The bottom of your foot, from your toes to your heel, is completely flat. If you do the footprint test, you won’t see an inward curve from your big toe to your heel. If you’re flat-footed, you’re most likely an overpronator, which means that your feet roll inward when you run. You will probably need a running shoe that maintains your stability. Look for the words “motion control” and “stability” on the box of running shoes you are considering. In addition to motion-control shoes, some flat-footed runners also need to wear orthotics. Orthotics or custom-made shoe inserts that correct foot issues can be made at our offices in Howell, NJ, Edison, NJ, Carteret, NJ or Monroe, NJ. We will make a custom mold of your feet and design an orthotic that best suits your needs.
If you have high arches, you’ll notice a high arch on your foot. If you do the footprint test, your print will curve inward, making the middle part of your foot look very thin. If you have high arches, you probably supinate or underpronate, which means your feet roll outwards as you run. You need to look for flexible shoes with a soft midsole that absorbs shock. When buying running shoes, look for options with the words “flexible” or “cushioned” included in their descriptions.
If you’ve examined your feet or your footprint and it doesn’t look flat-footed or high-arched, you most likely have a neutral or normal foot. Your footprint will have a noticeable curve inward, but not by more than 3/4 of an inch. This is the most common type of foot, and it’s also the least susceptible to injury provided it’s equipped with proper shoe gear. If you have normal feet, you can choose from a wide variety of running shoes, including ones made for neutral runners.
After you have examined your foot and you still cannot determine the type of feet you have, it will benefit you to be evaluated by a foot and ankle specialist. We can help you determine what type of feet you have and suggest shoes that are best suited for your needs.
By Valerie Gregory, MSPT, CKTP
http://www.footdoctorsnj.com/physical.html
Tags: ankle, ankle pain, arch support, Exercise, Exercising, feet pain, foot, foot injuries, foot injury, foot pain, heel pain, howell, nj, orthotics, plantar fasciitis, runner, runners, running, shin splints, shoes, sports, sports injuries, sports injury
Posted in General | No Comments »
With the arrival of winter, trendsetters are excited to see the styles that will be popular this season. Clothes are important, but do not forget about the bag! Whether you carry a luxury designer purse or a classy more affordable purse, one thing is clear – it better be big. From celebrities to college students, one of the most popular purse choices is the large tote. As purses get bigger, they also get heavier. Recently on his TV show, Dr. Oz weighed the bags of the women in his audience. One woman’s purse weighed almost 15 pounds! Can you imagine carrying a 15 pound bowling ball with you as you went about your daily activities? Well, this is what some women do every day. Inside of a typical heavy bag you may find an iPad, phone, book, wallet, magazine, extra shoes, lunch or snacks, toys for children, makeup, medication, and whatever else may fit. No doubt these women are well prepared, but their heavy purses may be causing health problems.
