Foot Care

1. Don't ignore foot pain. It's not normal. If the pain persists, contact our office.
2. Inspect your feet regularly. Pay attention to changes in color and temperature. Look for thick or discolored nails (a sign of developing fungus), and check for cracks or cuts in the skin. Peeling or scaling on the soles of feet could indicate Athlete's foot. Any growth on the foot is not considered normal.
3. Wash your feet regularly, especially between the toes, and be sure to dry them completely.
4. Trim toenails straight across, but not too short. Be careful not to cut nails in corners or on the sides; it can lead to ingrown toenails. Persons with diabetes, poor circulation or heart problems should not treat their own feet because they are more prone to infection.
5. Make sure that your shoes fit properly. Purchase new shoes later in the day when feet tend to be at their largest and replace worn out shoes as soon as possible.
6. Select and wear the right shoe for the activity that you are engaged in (i.e. running shoes for running).
7. Alternate shoes - don't wear the same pair of shoes every day.
8. Avoid walking barefooted. Your feet will be more prone to injury and infection. At the beach or when wearing sandals always use sunblock on your feet as the rest of your body.
9. Be cautious when using home remedies for foot ailments. Self-treatment can often turn a minor problem into a major one.
10. If you are a diabetic, contact our office at least once a year for a check-up.

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Whether you are a professional athlete or play sports just for fun, the demands made on your feet and lower limbs can lead to a range of injuries, including blisters, sprained ankles, torn ligaments, shin splints (leg pain), knee pain, low back pain and other joint or muscle problems. Added to these are common complaints such as corns, calluses and Athlete's foot. Your running style, poor footwear and even minor limb length differences can also contribute to injury.

Here are some tips for athletic foot care:

1. Wash your feet every day, and dry thoroughly.
2. Wear only good-quality, well-fitting cotton socks.
3. Always use the correct shoe for each sport and surface.
4. Get in shape. Being overweight or out of shape places added stress on the feet. Condition yourself gradually with stretching exercises for 15-20 minutes before starting and after any activity ("warm-up" and "warm-down").
5. Wear correct shoes. Footwear should be given the same consideration as any other piece of sporting equipment. Sports shoes should protect as much as possible, be durable, and should be right for the sport and surface. If running, the shoe should have adequate cushioning in the mid-sole and a flared heel for stability.

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Most blisters are caused by friction or minor burns and do not require medical attention. New skin will form underneath the affected area and the fluid is simply absorbed. You can soothe ordinary blisters with vitamin E ointment or an aloe-based cream.

Do not puncture a blister unless it is large, painful, or likely to be further irritated. If you have to pop a blister, use a sterilized needle or razor blade (to sterilize it, put the point or edge in a flame until it is red hot, or rinse it in alcohol). Wash the area thoroughly, then make a small hole and gently squeeze out the clear fluid. Apply a dab of hydrogen peroxide to help protect against infection.

If the fluid is white or yellow, the blister is infected and needs medical attention. Do not remove the skin over a broken blister. The new skin underneath needs this protective cover.

Preventing Blisters

You can prevent blisters by breaking in new shoes gradually, and putting petroleum jelly or an adhesive bandage on areas that take the rub - before the blister happens.

Also, wear socks that have heels instead of tube socks (they bunch up and cause blisters).

Acrylic and other synthetic-fiber socks are good choices. Because they don't breathe as well as natural fibers, however, you should wash and dry your feet after wearing them to prevent Athlete's foot.

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Because bunions develop slowly, taking care of your feet during childhood and early adulthood can pay off later in life. Keep track of the shape of your feet as they develop over time, especially if foot problems run in your family.

Exercising your feet can strengthen them. Learn to pick up small objects with your toes. Wear shoes that fit properly and that do not cramp or pinch your toes. Women should avoid shoes with high heels or pointed toes.

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Burning feet are a common complaint among many groups of people, most commonly those over 50 years of age and in diabetics. There are many causes. Heavy alcohol use may lead to the condition. Neuropathy and loss of sensation often are contributors as well. Other causes include thyroid dysfunction and gastric restriction in obesity. Some infectious diseases, such as leishmaniasis, a rarely reported neurologic change secondary to a bacteria, also may cause burning feet.

Treatment

Treatments vary, depending on the cause of the burning foot syndrome. Diagnostic tests often are performed before a diagnosis is made.

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Children with strong, healthy feet often avoid many kinds of lower extremity problems later in life. Contact our office to have your children's feet and lower extremities examined.

Infants

The size and shape of your baby's feet change quickly during their first year. Because a baby's feet are flexible, too much pressure or strain can affect their feet's shape. It's important to allow your baby to kick and stretch his or her feet. Also, make sure shoes and socks do not squeeze the toes.

Toddlers

Try not to force your toddler to walk before she is ready. Carefully watch her gait once she begins to walk. If your toddler's toe touches down instead of the heel, or she always sits while others play, contact our office. Many toddlers have a pigeon-toe gait, and this is normal. Most children outgrow the problem.

When foot care is needed

To help with flatfeet, special shoes or custom-made shoe inserts may be prescribed. To correct mild intoeing, your toddler may need to sit in a different position while playing or watching TV. If you child's feet turn in or out a lot, corrective shoes, splints, or night braces may be prescribed.

The foot's bone structure is well-formed by the time your child reaches age 7 or 8, but if a growth plate (the area where bone growth begins) is injured, the damaged plate may cause the bone to grow oddly. With a doctor's care, however, the risk of future bone problems is reduced.

Remember to check your child's shoe size often. Make sure there is space between the toes and the end of the shoe, Make sure their shoes are roomy enough to allow the toes to move freely. Don't let your child wear hand-me-downs.

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Corns and calluses are protective layers of compacted, dead skin cells. They are caused by repeated friction from skin rubbing against bony areas or against an irregularity in a shoe. Corns ordinarily form on the toes and calluses on the soles of the feet. The friction and pressure can burn or otherwise be painful and may be relieved by moleskin or padding on the affected areas.

Never cut corns or calluses with any instrument, and never apply home remedies, except under a podiatrist's instructions.

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1. Buy shoes late in the day. Never buy shoes that need "breaking in." They should be immediately comfortable. Request shoes with deep toe boxes and made of leather upper material. Do not wear new shoes more than two hours at a time. Rotate your shoes. Do not wear the same ones every day.
2. Contact our office immediately if you experience any injury to your foot. Even a minor injury is an emergency for a patient with diabetes.
3. Do not file down, remove or shave calluses or corns yourself.
4. DO NOT SMOKE. It decreases the blood supply to your feet.
5. Ask about soaking your feet
6. Do not trim your own toenails.
7. Do not use any chemicals or strong antiseptic solutions on your feet. Iodine, salicylic acid, corn/callus removers are dangerous.
8. Do not wear stockings or socks with tight elastic backs and do not use garters. Do not wear any socks with holes. Always wear shoes with socks.
9. Don't use any tape or sticky products such as corn plasters on your feet. They can rip your skin.
10. Examine your feet daily for redness, warmth, blisters, ulcers, scratches, cuts and nail problems from shoes or other sources. Look at the bottoms and between toes. Use a mirror or have someone else look for you.
11. Examine your shoes for foreign objects, protruding nails and rough spots inside before putting them on.
12. If the circulation in your feet is impaired, contact our office.
13. In the winter, wear warm socks and protective footwear. Avoid getting your feet wet in the snow and rain and avoid letting your toes get cold.
14. Keep feet away from heat (heating pads, hot water pads, electric blankets, radiators, fireplaces). You can burn your feet without knowing it. Water temperature should be less than 92 degrees. Estimate with your elbow or bath thermometer (you can get one in any store that sells infant products).
15. Lubricate your entire foot if your skin is dry, but avoid putting cream between toes.
16. NEVER walk barefoot, neither indoors nor out.
17. Never wear sandals or thongs.

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Experts say that problems with our feet can be the first sign of more serious medical conditions such as arthritis, diabetes, and nerve and circulatory disorders.

Here are some foot care tips for older people:

1. Practice good foot care. Check your feet regularly, or have a member of your family check them.
2. It also helps to keep blood circulating to your feet as much as possible. Do this by putting your feet up when you are sitting or lying down, stretching if you've had to sit for a long while, walking, having a gentle foot massage, or taking a warm foot bath.
3. Avoid pressure from shoes that don't fit right.
4. Avoid exposing your feet to cold temperatures.
5. Don't sit for long periods of time (especially with your legs crossed).
6. Don't smoke because it decreases blood supply and increases the chance of swelling and other circulatory problems.
7. Wear comfortable shoes that fit well. This can prevent many foot problems.

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Common Fungal Problems

Athlete's foot and fungal nails are the most common fungal problems with feet. A fungus is a common mold that thrives in dark, warm moist areas. On the feet, it can grow on and between toes, as well as on soles and toenails. Fungal problems can be a result of the environment (socks, shoes, heat and humidity) or weakened immunity from such disorders as diabetes.

Chronic fungal infections are most common in adults, while acute fungal infections are seen more often in children.

Athlete's Foot

A chronic infection caused by various types of fungus, Athlete's foot is often spread in places where people go barefoot such as public showers or swimming pools. The condition ranges from mild scaling and itching to painful inflammation and blisters. It usually starts between the toes or on the arch and may spread to the bottom and sides of the foot.

General Treatments

Depending on the type of infection you have, various kinds of medication may be used in treating your fungal problem. Successful treatment usually involves a combination of medication and self-care.

If your condition is not serious, over-the-counter and prescription powders, lotions, or ointments can often help treat scaling, itching, and inflammation. Consult us before taking any medication. Foot soaks may help dry excessive perspiration, but you should contact our office first. If your Athlete's foot does not improve, we may prescribe stronger medication.

Fungal Nails

Since fungal nails are usually more resistant and more difficult to treat than Athlete's foot, topical or oral antifungal medications may be prescribed. Permanent nail removal is another possible form of treatment for fungal nails.

After a fungal nail infection has cleared up, you can take steps to prevent the infection from coming back.

Keeping the fungus under control will help prevent a fungal infection of the skin from reinfecting the nail. Before bed, thoroughly wash and dry your feet, and apply a non-prescription anti-fungal cream to the entire foot from the ankle down. Use the cream every night, then gradually apply it less often. Keep your feet dry. Dry feet are less likely to become infected. Apply powder to your dry feet after you take a shower or bath.

Other tips:

1. Don't share nail clippers or nail files with others.
2. Don't share shoes or socks with others.
3. Try not to injure your nail, such as by cutting it too short (trauma to the nail may lead to infections).
4. Wear dry cotton socks, and change them two or three times a day if necessary.
5. Wear dry shoes that allow air to circulate around your feet (tight, enclosed, moist shoes contribute to fungal toenail infections).
6. Wear shower sandals or shower shoes when you are at a public pool or shower.

Prevention

Follow basic foot care guidelines and you more than likely can head off most common foot fungus problems.

Other Tips

1. Wear dry cotton socks, and change them two or three times a day if necessary.
2. Wear dry shoes that allow air to circulate around your feet (tight, enclosed, moist shoes contribute to fungal toenail infections).
3. Wear shower sandals or shower shoes when you are at a public pool or shower.
4. Don't share shoes or socks with others.
5. Don't share nail clippers or nail files with others.

Try not to injure your nail, such as by cutting it too short (trauma to the nail may lead to infections).

Prevention

Follow basic foot care guidelines and you more than likely can head off most common foot fungus problems.

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Ingrown nails are nails whose corners or sides dig painfully into the skin, often causing infection. They are frequently caused by improper nail trimming, but also by shoe pressure, injury, fungus infection, heredity, and poor foot structure.

Toenails should be trimmed straight across, slightly longer than the end of the toe, with toenail clippers.

If they become painful or infected, contact our office. We may remove the ingrown portion of the nail and if the condition reoccurs frequently, may permanently remove the nail.

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Your feet may be one of the first places to see the effects of osteoporosis. A stress fracture in the foot is often the first sign.

There is a lot you can do throughout your life to prevent osteoporosis, slow its progression and protect yourself from fractures.

1. Include adequate amounts of calcium and vitamin D in your diet.
2. Exercise regularly.

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The feet and hands contain more sweat glands than any other part of the body (about 3,000 glands per square inch). Feet smell for two reasons: you wear shoes and your feet sweat. The interaction between your perspiration and the bacteria that thrive in your shoes and socks generates the odor. Any attempt to reduce foot odor has to address both your sweating and your footwear.

Smelly feet can also be caused by an inherited condition called hyperhidrosis, or excessive sweating, which primarily affects males. Stress, some medications, fluid intake and hormonal changes also can increase the amount of perspiration your body produces.

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Take these precautions after having a pedicure:

1. Soak your feet in warm soapy water for approximately 10 minutes. This helps soften and clean skin and nails.
2. After the foot soaking, gently remove calluses with a pumice stone or emery board. This gets rid of dead skin cells and calluses. Some body scrub products can help exfoliate dead skin. Contact our office if you need to cut or shave calluses.
3. Push back the cuticles with an orange stick or a Hindu stone. Cuticles offer protection from bacteria and infection. Cuticles clearly overhanging the nail margins should be carefully trimmed. Any trimming which goes further than the nail margin or draws blood is unsafe.
4. Trim toenails straight across rather than in a curved pattern. This helps prevent ingrown toenails, allowing the straight edge of the nail to advance as one unit. Cutting the toenails in a curved pattern allows the recessed edges to grow into the skin. Trimming nails too short can promote ingrown toenails. The toenails should be trimmed just enough so that you can see a few millimeters of skin just beyond the nail margin. Nails should not overhang the edge of the toe.
5. Refine the nail edge with an emery board, maintaining the straight edge.
6. Apply cream and moisturizing lotion to the skin and nail margins.
7. Massage the cream or lotion into the feet. A foot massage can help relieve tension and tired, aching feet. You can get a good massage at home by rolling your feet back and forth over a rolling pin or bottle. Specialists in the body's reflexes, called reflexologists, believe that points on the foot correspond to other body parts and ailments can be relieved through reflexology. They believe the ball of the foot has a connection to the lungs, the heel to the lower back, and the great toe to the head. Although no scientific research exists to back up these claims, reflexology does seem to produce positive results in some people. People with significant medical problems should consult with a medical doctor.
8. Apply nail polish remover to the nails to gently remove excess lotion. This allows nail polish to adhere better to the nail. A pedicurist usually will apply polish as a base coat, then one or two coats of color, and finally a clear topcoat.
9. Space your pedicures apart by approximately eight weeks.

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• Balance. A good test for balance involves standing on one foot, with your arms out to the side and your eyes closed. If you are less than 30 years old, you should be able to balance for 15 seconds, 30-40 years old for 12 seconds, 40-50 years old for 10 seconds and over 50 years old for seven seconds. This can be improved with exercises.
• Circulation. Look at the color of your toes. Are they red, pink, purple or blue? Press down on the nail of your big toe until the color blanches. Now let go and allow the blood flow to return to your toe. The return of normal color should take 2-5 seconds in a person with average circulation.
• Flexibility. How flexible are your toes? Try to pick up a marble or a small dish towel. To test your ankle flexibility, hang your heel off of a stair. Now let the heel go below the level of the stair. If this causes pain, stop the test. If your heel goes below the level of the stair without causing strain in your calf, that is a good sign. If there is some strain, this can be improved with flexibility exercises.
• Pain. There should be no pain in the average foot.
• Sensation. Take a pencil eraser and lightly run it on the top, bottom and both sides of your feet. The sensation should feel equal in all quadrants. It may tickle on the bottom of the feet. That is normal.
• Skin. Check your skin for calluses, blisters or areas of irritation. Stand next to your shoes. Are they shaped like your feet or are they causing areas of constriction that may result in calluses, blisters or irritation? Put your hand inside your shoe. Are there seams, tacks or rough places in the shoe that correspond to the areas of irritation, calluses or blisters on your feet?

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Because they have traditionally played the role of homemaker, women have been on their feet a lot more than men. And today, with more women entering the workforce and wearing shoes like high heels, their foot problems are only aggravated.

Some general guidelines:

High Heels

Women invite foot problems with high heels. High heels may contribute to knee and back problems, disabling injuries in falls, shortened calf muscles, and an awkward, unnatural gait. In time, high heels may cause enough changes in the feet to impair their proper function. Most women admit high heels make their feet hurt, but they tolerate the discomfort in order to look taller, stylish, and more professional.

There are ways to relieve some of the abusive effects of high heels, however. Women can limit the time they wear them by alternating with good-quality oxford-type shoes or flats for part of the day. Tight-fitting high heels only compound the abuse.

Fortunately, women have other heel-size choices. Key is wearing the right shoe for the right activity - and that means varying heel height, and determining what heel is most suitable.

For example, there are comfortable and attractive "walking" pumps (also called "comfort" or "performance" pumps) for women for work and social activities. Several companies have also designed footwear for certain athletic activities, including aerobics, specifically for women.

Experts say the best shoes for women may be:

• A walking shoe with ties (not a slip-on).
• A Vibram type composition sole.
• A relatively wider heel, no more than a half or three-quarters of an inch in height.

Stockings?

Women who always wear nylon pantyhose expose themselves to a host of foot problems. Nylon doesn't breathe and the heat that it generates and traps causes excessive perspiration. A warm, damp area is an ideal place for fungal infections such as Athlete's foot.

Inexpensive nylon pantyhose can also cause forefoot problems, because they don't allow the normal expansion of the foot when walking, and may pull the toes backward when the pantyhose ride up. The cramping and pressure of the hose can contribute to ingrown toenails and hammertoes.

Pregnancy

Pregnant women need to observe good foot health to prevent pain and discomfort. Since the body undergoes changes and acquires a new weight-bearing stance, women should wear shoes with broad-based heels that provide support and absorb shock. Additional body weight also calls for more support, to prevent foot "breakdown."

The expectant mother often experiences more than ordinary swelling of her feet and ankles, which can aggravate existing foot conditions and promote inflammation or irritation. Pregnancy also triggers the release of hormones that enhance loose ligaments, which can contribute to foot strain. If problems develop, contact our office.

Women Over 65

Older women have more trouble with their feet than younger ones; fat pads on the bottom of the feet tend to deteriorate in the aging process. They can alleviate some foot problems by wearing properly fitted, well-constructed shoes that provide cushioning and have a soft, flexible upper that will conform to the shape of their feet. They also need leather shoes that "breathe" and can reduce the possibility of skin irritation.

Soles should be lightweight, with enough flexibility and shock-absorbing quality to provide solid footing and not be slippery. Low-heeled shoes provide greater stability, more protection for the feet, and greater comfort. Because older women often have circulatory problems, they have a special need to keep their feet warm in cold weather, to prevent frostbite or chilblains.

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Productive workers depend on their ability to use feet safely, with ease and comfort.

When your job requires you to stand on your feet for long periods, work in potentially hazardous areas or with potentially hazardous materials, you have some risk of foot injury. You can do a lot to prevent injuries by keeping your feet healthy and following safe work practices.

In any given year, there are about 120,000 job-related foot injuries, one-third of them toe injuries, according to the National Safety Council.

Off-the-job, follow simple foot care techniques.

On-the-job, you should develop safe work habits and attitudes. This includes wearing protective footwear when appropriate. Only one out of four victims of job-related foot injury wear any type of safety shoe or boot, according to the National Safety Council. The remaining three either are unaware of the benefits of protective footwear or complain about it.

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