Your feet are one of the hardest working parts of your body but they are also one of the most neglected. Emma Stevenson, podiatrist from The College of Podiatry, gives the lowdown on how to ensure you have healthy feet, inside and out.
What are the most common foot complaints?
Most of us will experience some sort of foot complaint at some point in our lives, however a lot of people will put up with foot pain and not seek professional help.
The most common complaints that podiatrists can treat are blisters, corns and calluses, dry, cracked heels, verrucae, athlete’s foot, bunions, ingrown toenails, and they can help people who experience frequent pain or discomfort with their feet. Podiatrists also play a key role in the management of diabetes as people with diabetes require regular foot checks because they are at increased risk of infection in the foot.
How to deal with common foot complaints:
An ingrown toenail is a nail that pierces the flesh of the toe. It can feel as if you have a splinter, and it can be inflamed or infected. In more severe cases it can cause pus and bleeding. There are many genetic factors which can make you prone to ingrown toenails, including posture, the way you walk, or excessive pronation of the feet. One of the most common causes is cutting toenails too short. To relieve discomfort, you can bathe your foot in salt water, which can help to prevent infection. A sterile dressing can then be applied. Resting your foot as much as possible can also help. If you are unsure about your condition, always visit a podiatrist.
Dry, cracked heels
In the summer, many of us like to wear sandals. The combination of the skin being physically unsupported and also exposed to the elements risks dry, cracked heels. Pressure will be reduced if the heel is physically supported and preferably cushioned. This is best achieved by wearing shoes with a heel support. In contrast, flip flops and sandals have no heel support and the heel is subject to greater stress. To treat cracked heels use a good quality cream which contains urea.
A bunion is a bump that starts to develop where your big toe joins the foot. Contrary to popular opinion, bunions are not actually caused by shoes; rather some people have a genetic predisposition to them. However, footwear can make the problem worse, so if you are developing a bunion it’s important to see a podiatrist who will be able to assess you and advise on appropriate footwear and exercises to help avoid the problem getting worse. In some extreme cases, surgery is required, but a podiatrist will be able to advise on your individual case.
Athlete’s foot is a fungal infection which is most likely to happen if your feet are regularly in damp, warm conditions – common if you’re running! It tends to affect between the toes but can appear on any part of the foot. Look out for persistent flaking, red skin. This can look either ‘wet’ or ‘dry’, as both are forms of athlete’s foot. There are over-the-counter remedies available. You can buy treatments which specify they only need to be applied once. These tend to be the most convenient solution for people as they often forget to apply other treatments regularly, which can mean they are not as effective.
Callus and corns
Corns and callus are the body’s reaction to the friction of skin rubbing against a bone, shoe or the ground. Callus (or callosity) is an extended area of thickened, hard skin on the soles of the feet. It is usually symptomatic of an underlying problem such as a bony deformity, a particular style of walking or inappropriate footwear. Corns are caused by pressure or friction over bony areas, such as a joint, and they have a central core, which may cause pain if it presses on a nerve. If you have corns or callus, you can treat them yourself by occasionally gently rubbing with a pumice stone or a chiropody sponge when you are in the bath and apply moisturising cream to help remove the thickened skin a little at a time. It is best not to cut corns yourself, especially if you have diabetes or circulatory issues. A podiatrist will be able to help by reducing the bulk of the corn and apply astringents to cut down on sweat retention between the toes.
Blisters are painful, fluid-filled lesions produced by friction and pressure often caused by ill-fitting footwear, stiff shoes, excessive moisture, foot deformities or wrinkled socks against the skin. If you suffer from a blister, apply some padding to cushion the area or use a waterproof plaster. They will normally clear up themselves within three to seven days. Blisters can become a more serious concern if you have diabetes and may not heal so easily, so it is important to see your podiatrist for advice.
Verrucae are plantar warts that commonly occur on the soles of the feet or around the toe area. They are caused by the Human Papilloma Virus (HPV), which is highly contagious through direct person-to-person contact. If you suffer with verrucae, avoid touching them and they should clear up of their own accord within six months. An over-the-counter ointment or gel can also be used. In painful cases, if they have been present for longer than six months, or if they are spreading it is worth visiting a podiatrist. A podiatrist may use stronger acid treatments, Cryotherapy (freezing), or laser surgery.
Ongoing foot pain
If you experience frequent and ongoing pain or aching in your feet it is worth seeing a podiatrist to have this investigated properly. It is not normal to experience frequent foot pain and may mean you have an underlying issue that needs treating.
Recommendations for footwear
It’s all about the right shoe for the job. For an everyday shoe you should ideally have some type of fastening to hold the foot in place so it doesn’t slip around – such as a buckle, laces or a boot style shoe. The shoe should comfortably accommodate the width of the foot and not be excessively narrow or tapered around the toes. The heel height should be relatively low (no higher than 2cm) but try to avoid completely flat shoes with very thin soles as these offer no shock absorption or support for the foot.
Try to opt for a shoe in a natural material such as leather or suede to allow the foot to breathe and if you can, alternate the shoes you wear each day to allow the shoes to ‘dry out’ and help prevent them becoming smelly from sweat.
It’s also important to make sure shoes fit you properly. Do try the shoes on in the shop and buy them in the afternoon when your feet are at their biggest (feet naturally swell throughout the day). Look at the width as well as the length of the shoe; many stores offer shoes in wider shoe fittings now.
Try to keep slip-on shoes such as ballet pumps, court shoes or high heels for special occasions, as they are not the best shoe for wearing every day or for long periods – particularly if you are walking around or standing. Flip flops are fine for the house or the beach, but again try to avoid wearing them for long, frequent periods as they offer little support.
Heels, the good the bad and the ugly:
Many people think a podiatrist will tell them they can’t wear high-heeled shoes. This is not the case, it’s just about wearing the right shoe for the activity you are doing. Wearing high heels for the occasional night out or for a special occasion is unlikely to do you any long-term harm. It’s where we see people wearing them every day or for frequent, long periods that we see damage to the foot.
It’s worth noting that everyone’s feet are different and depending on the structure of your foot, some people are able to accommodate higher heels more than others. One of my colleagues at The College of Podiatry has developed a formula to calculate the perfect heel height:
- Take off your shoes, sit down and hold one leg straight out in front of you, relaxing your foot.
- If your foot sits naturally at a right angle to your outstretched leg and does not dangle, then you have less mobility in the talus and will be more comfortable in flat shoes than in high heels. If the top of your foot falls forwards, in a straightish line following your leg, you are a natural heel wearer.
To find your optimum heel height, get a friend or partner to help stretch the tape measure from your heel in a straight line parallel to the floor, then place a pencil at the ball of your foot at right angles to the tape.
Reading the tape measure where it hits the pencil will give you your ideal heel height.
Visit www.feetforlife.org for more information on foot health and to find an HCPC registered podiatrist near you.