The things about your feet you ought to know

Ev­ery­thing you need to know about the health of your feet, and how to keep them in tip-top shape

Women's Weekly (Malaysia) - - Contents -

O ur feet are of­ten the most ne­glected part of our body, yet they carry us on a jour­ney of 128,000 km, or more, in a life­time – the equiv­a­lent of walk­ing three times around the world. Here, you’ll find out ev­ery­thing you need to know about foot health, and the steps you can take to keep your hard­work­ing feet in good shape all year round.

Your feet have a to­tal of 52 bones, (which is more than a quar­ter of all the bones in your body), 66 joints and a net­work of 200 mus­cles, ten­dons, lig­a­ments, blood ves­sels and nerves. These all work to­gether to sup­port your body, ab­sorb the im­pact of your weight and help you move.

Here are the most com­mon foot con­di­tions, what you can do to help man­age them, and how you can pre­vent prob­lems from oc­cur­ring.

TROU­BLED TOES

Bent, bumpy, twisted or sore toes of­ten in­di­cate larger struc­tural prob­lems. Treat­ment de­pends on the sever­ity of the prob­lem, and the amount of pain it causes you.

BUNIONS

A bunion is a bony bump that forms when your big toe pushes against your next toe, forc­ing the joint of your big toe to get big­ger and stick out. The first sign you have a bunion may be dif­fi­culty putting on tight shoes. The big toe joint car­ries a lot of the body’s weight when we walk, so bunions can cause ex­treme pain if left un­treated.

If you of­ten wear tight, nar­row or high-heeled shoes, you are at risk of get­ting bunions.

WHAT YOU CAN DO

Stick to prop­erly-fit­ted shoes and avoid shoes with a pointy toe. Treat­ments for bunions in­clude: • Top­i­cal anti-in­flam­ma­tory med­i­ca­tion to ease swelling. • Wear­ing wider or deeper shoes. • Pad­ding and tap­ing. Your po­di­a­trist will show you how to do this to re­duce stress and al­le­vi­ate dis­com­fort. • Orthotics may be used to re­dis­tribute your weight to stop the bunion rub­bing against your shoe. • Surgery to re­align the joint.

CLAW TOE

Claw toe of­ten af­fects the four smaller toes at the same time. The toes bend up at the joint where the toes meet the foot.

WHAT YOU CAN DO

See your po­di­a­trist who may fix the is­sue by rec­om­mend­ing the fol­low­ing: • A splint or tape may be used to hold your toes in the cor­rect po­si­tion.

• Phys­io­ther­apy may help. • If you have claw toe in the later stages and your toes are in a fixed po­si­tion, a spe­cial pad can re­dis­tribute your weight and re­lieve pres­sure. • Surgery is usu­ally only rec­om­mended as an op­tion when other treat­ments are shown to be in­ef­fec­tive.

CLAW TOE EX­ER­CISES

• Use your hands to stretch your toes and toe joints to­ward their nor­mal po­si­tions ev­ery day. • Use your toes to pick up mar­bles, or to crum­ple a towel laid flat on the floor.

TOE­NAIL WOES

Healthy nails are usu­ally smooth and con­sis­tent in colour, but in­grown toe­nails, in­fec­tions and nail de­for­mi­ties are all quite com­mon and can in­crease as we age.

NAIL CARE

Nails left to grow too long can thicken, be­come hard and start grow­ing into the sur­round­ing skin. To help keep your nails in good shape: • Use a strong pair of clean nail clip­pers. • Trim toe­nails straight across. • Avoid cut­ting nails too close to the skin or into the cor­ners. • Af­ter clip­ping, smoothen your nails with a file or emery board, us­ing down­ward strokes.

TREAT YOUR NAILS

Although there are some things you can do at home to deal with toe­nail prob­lems, pro­fes­sional care may also be needed.

IN­GROWN TOE­NAIL

An in­grown toe­nail – most of­ten on the big toe – de­vel­ops when the side of the nail digs into the skin of the toe. This can lead to pain and in­flam­ma­tion, and some­times in­fec­tion.

If you suf­fer in­grown toe­nails you can prob­a­bly blame your genes be­cause they of­ten run in fam­i­lies. In­cor­rect trimming tech­nique, shoes that are too tight or too short, or trauma to the foot may cause an in­grown toe­nail.

WHAT YOU CAN DO

In­grown toe­nails should be treated straight away. Don’t at­tempt to dig out a badly in­grown toe­nail your­self – see a po­di­a­trist. Sim­ple things such as soak­ing the foot in warm wa­ter three to four times daily, keep­ing the foot clean and dry the rest of the time, and wear­ing well-fit­ting shoes that do not press hard against your toes should help clear up milder cases.

NAIL IN­FEC­TION

Toe­nail fun­gal in­fec­tions can look very un­sightly, be dif­fi­cult to treat and re­peat in­fec­tions are com­mon. The in­fec­tion is usu­ally spread from the sur­round­ing skin. Signs of nail in­fec­tion in­clude nail thick­en­ing or crum­bling, dis­coloura­tion, sep­a­ra­tion of the front of the nail from the nail bed, pain in your toes and an un­pleas­ant odour.

In some cases, in­fec­tions can cause pain, red­ness, swelling and, some­times, dis­charge around the area from where the nail grows, and also from the skin next to the nail.

WHAT YOU CAN DO

Prompt at­ten­tion is needed in or­der to re­duce the risk of se­ri­ous com­pli­ca­tions in­clud­ing more wide­spread in­fec­tion ex­tend­ing up the leg. Your po­di­a­trist may rec­om­mend top­i­cal and oral prepa­ra­tions, as well as re­moval of the in­fected part of the nail.

DE­FORMED, THICK­ENED OR BRIT­TLE NAILS

These can re­sult from in­jury to the nail bed, such as stop­ping some­thing heavy on your toes, toe-stub­bing, wear­ing shoes that cramp your toes or a fun­gal in­fec­tion. Skin con­di­tions like pso­ri­a­sis may also af­fect the nails, and cause un­nat­u­ral thick­en­ing.

WHAT YOU CAN DO

See your po­di­a­trist reg­u­larly. De­formed, thick­ened or brit­tle toe­nails can ben­e­fit from proper grooming, in­clud­ing reg­u­lar trimming, shap­ing and nail care.

HEELS THAT HURT

Heel pain can de­velop sud­denly or evolve grad­u­ally over time. Cer­tain con­di­tions can lead to strain on the heel bone and the soft tis­sues at­tached to it, re­sult­ing in pain. Heels usu­ally hurt most first thing in the morn­ing, or af­ter a pe­riod of rest.

PLAN­TAR FASCI­ITIS

The plan­tar fas­cia is a band of tis­sue that runs along the sole of your foot from the heel to the mid­dle foot bones. If tis­sue is dam­aged or torn by too much pres­sure, it can lead to plan­tar fasci­itis. • Cer­tain sports. Ac­tiv­i­ties that place a lot of stress on the heel bone, like run­ning or danc­ing. • Flat feet or high arches. These con­di­tions may in­crease strain on the plan­tar fas­cia. • Be­ing mid­dle aged or older. Heel pain tends to be more com­mon with age­ing. • Be­ing over­weight. Ex­cess weight places a greater me­chan­i­cal load on the plan­tar fas­cia. • Be­ing on your feet. Oc­cu­pa­tions that re­quire a lot of walk­ing or stand­ing on hard sur­faces may lead to plan­tar fas­cia pain in the long run. • Wear­ing shoes with poor arch sup­port or stiff soles. Poorly de­signed shoes may con­trib­ute to the prob­lem.

WHAT YOU CAN DO

The con­di­tion usu­ally im­proves on its own within a year, but you can con­trol symp­toms with: • Night splints to hold the plan­tar fas­cia and the Achilles ten­don in a length­ened po­si­tion overnight. • Orthotics to help dis­trib­ute pres­sure to the feet more evenly, and to stim­u­late the small foot mus­cles. • A phys­io­ther­a­pist can give in­struc­tion on a se­ries of ex­er­cises to stretch the plan­tar fas­cia and Achilles ten­don and to strengthen lower leg mus­cles, which sta­bilises the an­kle and heel.

HEEL SPURS

A heel spur is a bony growth un­der the heel bone that can only be seen on X-ray.

They oc­cur when cal­cium de­posits build up as a re­sult of ex­ces­sive stress on the heel bone, lig­a­ments and nerves

near the heel. Causes in­clude: • Prob­lems with how the feet func­tion. • Fre­quent run­ning on hard sur­faces. • Non-sup­port­ive footwear. • Be­ing over­weight or obese.

WHAT YOU CAN DO

The best plan of ac­tion is rest, in­flam­ma­tion con­trol and spe­cific stretches and mas­sage tech­niques your po­di­a­trist can teach you.

CALLUSES AND CORNS

A cal­lus is an area of hard, thick­ened skin on the foot that forms in re­sponse to pres­sure or fric­tion, usu­ally through poor-fit­ting shoes. When pres­sure on the foot is con­cen­trated in a small area, a corn, which has a cen­tral core, may de­velop.

WHAT YOU CAN DO

• Have your shoes prop­erly fit­ted next time you shop. • Soak your feet reg­u­larly and ap­ply mois­turiser daily to soften ex­ist­ing calluses and corns. • Wear a foam pad over the corn to help re­lieve the pres­sure. • For corns on the toes, small foam wedges are use­ful for re­liev­ing pres­sure. • Con­sult a po­di­a­trist who will check for ab­nor­mal­i­ties or de­for­mity in bone struc­ture and de­cide if you need orthotics to re­lieve pres­sure on cer­tain ar­eas of the foot. TIP: Don’t cut corns or calluses your­self, as in­fec­tion can eas­ily de­velop and small cuts can quickly be­come se­ri­ous wounds.

CRACKED HEELS

Cracked heels are the re­sult of dry skin, which can be ex­ac­er­bated by wear­ing open-backed shoes like san­dals or thongs, in­creased weight, or fric­tion on your heels caused by ill-fit­ting shoes or by wear­ing shoes with­out socks. Symp­toms range from mi­nor cracks in the skin’s sur­face to deep, painful cre­vices that may bleed or even be­come in­fected.

WHAT YOU CAN DO

• Ap­ply mois­turiser to your feet and heels daily. • Wear san­dals or shoes with en­closed heels where pos­si­ble, and avoid the pro­longed use of thongs or walk­ing around in bare feet. • Con­sult a po­di­a­trist im­me­di­ately if you no­tice a lot of thick, hard skin or painful, open cracks.

THER­APY FOR YOUR FEET

Some po­di­a­trists will make use of the foot mo­bil­i­sa­tion tech­nique (FMT) to treat con­di­tions like heel pain, claw toe and bunions. Foot and an­kle joints that are stiff and lack nor­mal move­ment of­ten de­velop be­cause of the foot not func­tion­ing cor­rectly over many years.

FMT can im­prove move­ment of these joints, but it’s not a quick fix treat­ment op­tion and a num­ber of vis­its will usu­ally be needed.

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