Care for your feet

CARE FOR THE FEET

• The foot is a complex structure with 26 bones and 33 joints layered with an intertwining web of 126 muscles, ligaments and nerves

• The average person spends 4 hours on their feet

• The foot takes an average of between 8,000 and 10,000 steps each day

• The foot takes a combined force equivalent to several hundred tons.

Feet are small compared to the rest of body, and function to support body weight, act as a shock absorber, are levers to propel the leg forward, and serve to balance and adjust the body to uneven surfaces. The amount of stress placed on the feet has led to many sufferers of chronic and severe foot pain. To compound problems, the lower back is often affected by injuries or abnormalities in the feet.

Most incidents of foot pain are caused by poorly fitting shoes. The main culprits are the high heeled shoes which affect mainly the toes. Other causes of foot pain include:

• Improper walking due to poor posture

• High impact exercising such as jogging and strenuous aerobics

• Inherited or medical conditions that cause imbalance or poor circulation

• Arthritic conditions such as osteoarthritis, gout, rheumatoid arthritis, juvenile chronic arthritis, psoriatic arthritis

• Osteoporosis which causes bone loss

• Diabetes

• Foot problems, which make walking painful, can aggravate arthritis symptoms in other parts of the body – the knees, hips and back.

• Keep the skin clean ad dry. Use of a foot powder after drying is helpful.

• Nails should be kept clean and short and trimmed regularly. Toe nails should be cut straight across. Never cut down the corners as this will cause pressure from the shoes to push the margin of the toe up into the edge of the growing nail and damage the skin.

• Posture is important.

• Take a foot bath once or twice a week to keep the foot relaxed and to help prevent mild foot pain from fatigue. Half a cup of Epson salts increases circulation and adds other benefits.

• Removal of corns and layers of hard skin is best done by a podiatrist who can provide further advice on the treatment and medication of corns.

• Seek your rheumatologist to recommend an orthotist to make an insole or surgical shoe to your requirements.

Well-fitted shoes are best for preventing nearly all foot problems. Time should be spent finding shoes which suit your feet, are the right size and comfortable. Bear in mind that feet can change in size and shape and different brands of shoes vary in size, so insist on having shoes fitted every time a new pair is purchased.

Size:

• Shoes should fit. Your foot should not be able to slide about too much.

• Ensure there is adequate cushioning with at least 1/2 inch of space between the largest toe and the tip of the shoe and there is room to wiggle the toes.

• Stand while being measured.

• Both feet should be sized with shoes bought for the larger size foot.

• Shoes should be purchased in the afternoon or after a long walk, when feet have swelled.

Material:

• Good quality leathers are best for comfort as they "stretch" and allow the feet to "breathe"

• New shoes should feel comfortable right away without any breaking-in. They should have a padding and a flexible sole. Ideally the sole should be removable to enable cleaning.

• If shoes require break-ins, use moleskin pads next to areas where friction will occur.

• Avoid toe caps, ornamental stitching, brogue styles and expensive calf leathers which reduce the ability of the uppers to mould to the shape of your feet.

Soles:

• Soles should be light, pliable and hard-wearing.

• In a wedge-type construction (for instance, a shoe with a pointed toe), the sole should be able to bend along a line which should be drawn from the joint at the base of the big toe to the base of the little toes.

• The best soling materials are the moulded or microcellular rubbers, which have displaced heavy leathers.

Purpose:

• The proper type of footwear should be selected for the job it has to do.

• Shoes purchased for exercise should be specific for the sport. As soon as heels show noticeable wear, the shoes or heels should be replaced.

Heels:

• Heels should be wedge-shaped and not extreme. Walking is more comfortable with low heel (about one centimeter) than with none.

• Fashionable high heels are designed to constrict the foot up to an inch, one study suggests that wearing high heels may led to arthritis of the knee.

If you have arthritis:

• Look for roomy, wide, soft top shoes. Keep formal shoes for formal occasions. High quality running shoes are an excellent choice for they are light, absorb load very effectively and accommodate a wide fitting. Ask for a removable washable insole.

• Choose shoes with adjustable fastenings such as laces, velcro fastening, buckle and strap which allow for expansion to accommodate any swelling that may occur.

• Select shoes with flat heels and are raised no more than 2.5 cm (1 inch) to avoid weight being thrown into the toe joints. Wide heels will help cushion the heel of the foot or provide adequate balance.

• If your fingers cannot cope with normal laces, try elastic laces or shoes with a velcro flap.

• For women with "difficult" feet, basket weave uppers are most comfortable.

• Dark colors and suede finish help disguise mis-shapen feet.

• If your ankle is stiff and you can’t point your toes, use shoes that lace right down to the toes and the heel height must be exactly right (walking is more comfortable with a heel of 1cm)