Getting Back on Your Feet
As long as they do their job and get us from A to B, many of us tend to ignore our feet and don’t give them much thought. But do this at your peril – feet need attention if we don’t want them to let us down.
The foot is a complex structure of 28 different bones, 214 ligaments and 38 muscles, bearing our body weight as we walk every day, allowing us to stand upright and perform the complex movements needed for motion and balance. The average person will take between 5,000 and 7,000 steps a day, and over 200 million in a lifetime. That’s a lot of kilometres – but how much thought and care do you really give your feet? Like most things, we often only notice them when they’re impaired – but as one of our most important body parts, their health should be high on your list of priorities.
While daily selfcare is important for your feet, a checkup with a trained professional once or twice a year can also ensure your feet are working at their optimum. Just as you would visit your dentist for a toothache, a podiatrist is who you visit when there’s something wrong with your feet and lower limbs. A podiatrist can also help to improve the performance of athletes and maintain general foot health.
Ricky Lee’s parents are both podiatrists, so it was a clear path for him to follow in their footsteps. In practice with his father and as director of the Australian Podiatry Association (NSW/ACT) Lee says, “As podiatrists, we manage and treat all concerns of the lower limb – from assessing children as they start walking and developing, through to sportspeople with knee or foot injuries or concerns, to diabetic foot management and general foot care such as ingrown toenails, corns and calluses.”
Pain is one of the main reasons people visit a podiatrist. “Pain in the feet is a common complaint,” says Lee, “as are ingrown or discoloured nails, corns, skin rashes, foot odour, foot injuries, as well as broader health problems such as diabetes or arthritis. It is a common misconception that painful feet are a normal side effect from everyday activities … if you feel relief when you remove your shoes at the end of the day it’s time to get some professional advice.”
PEAK PERFORMANCE
Podiatrists not only help when there’s a problem, they can also help enhance performance. “Podiatrists often work with their patients (and other medical or allied medical professionals) to help facilitate their exercise programme, taking into account any current or past injuries, underlying medical conditions, or biomechanics [the study of the body’s structure, function and motion], to help patients achieve their desired goals,” says Caron Orelowitz, an Auckland-based podiatrist who specialises in sports and exercise medicine.
“This can be achieved through stretching exercises, addressing abnormal biomechanics, footwear advice, injury prevention strategies and management – and, if need be, referrals to other health practitioners.” As participation in sporting activities has increased over the years so, too, have injuries, reflects Orelowitz. “For an athlete to perform at their best, the ability … to move the joints of their body through their full range of motion is of utmost importance.”
On her 35th birthday, Sarah set herself a goal of completing the local 10km fun run. She started training in her old runners – but three weeks into her routine she felt mild discomfort in her right heel. In one training session she felt a sharp pain in her heel which stopped her in her tracks, so she booked an appointment with Lee. A diagnosis of plantar fasciitis (an inflammation of the thick band of tissue that connects the heel bone to the toes) was made and a treatment plan was formulated.
Her training schedule was altered, she was given a prescription for new footwear with the correct support and structure for her feet, her foot was strapped to reduce the load on the structures of the foot and she was given a rehab/strength programme.
Within a week her symptoms had greatly improved and over the coming weeks, she was able to undertake the new running programme without pain, so she could reach her goal to complete the fun run.
DIABETIC NEUROPATHY
As the number of people diagnosed with diabetes climbs, so too does the number of cases of diabetic neuropathy. Diabetes can cause damage to the
nerves in the feet, causing diabetic neuropathy – a condition that causes tingling and pain, and can make you lose feeling in your feet. Orelowitz explains it’s common for people with diabetic neuropathy to experience falls due to weakness and loss of sensation. “Podiatrists can assist patients by assessing for possible biomechanical problems,” says Orelowitz. “Treatment can consist of foot orthoses, footwear advice, stretching, strengthening and proprioception exercises, and gait retraining.”
GOUT
Gout is a very painful condition caused by excess uric acid in the bloodstream. This leads to the formation of crystals that settle in the joints. The disease most classically affects the joint in the base of the big toe. “Since the toe is the part of the body that is farthest from the heart, it is also the coolest part of the body – and, thus, the most likely target of gout,” says Orelowitz.
While your GP can provide you with preventive medication, your podiatrist can help equip you with management strategies to help reduce the risk of a gout attack occurring, and manage your gout attack if it presents. “This can include wearing warm socks, keeping your feet warm, exercise, being mindful of stress and obesity, and helping you manage diabetes. They can also recommend the best footwear for your foot type and prescribe custom orthotics to help you feel more comfortable on your feet,” says Orelowitz.
DAILY CARE
Given how much we rely on our feet, keeping your feet healthy should be part of your everyday routine. Lee recommends the following simple techniques to maintain the health of your feet.
Keep your feet clean and moisturised
Take care of your feet by cleaning and moisturising them every day. Keeping your feet hydrated is about establishing a routine rather than having the most expensive cream sitting on the shelf, not being used. Most people moisturise their legs but neglect their feet. When you moisturise your feet, monitor them for any changes – including dry skin, brittle nails, discolouration, burning and tingling sensations, or feelings of cold and numbness, which are all warning signs of an underlying concern.
Maintain healthy nails
A common condition podiatrists see on a daily basis is fungal nail infections. This is when the nail becomes discoloured, thickened and brittle. To help avoid fungal nail infections, frequently wash and dry your feet, avoid going barefoot in public showers or pool areas, don’t wear the same pair of socks two days in a row, hang your socks inside out in
“Tea tree oil is a great natural way to help reduce fungal infections.”
the sun (UV light is a natural fungus killer), don’t share your footwear with other people, air your shoes regularly in the sun, and try not to wear the same pair of shoes each day. Tea tree oil is also a great natural way to help reduce fungal infections. Add a drop of tea tree oil to your moisturiser, or add a few drops to the water when you wash your feet. Making up a diluted spray and spraying your feet can help reduce the risk of fungal infection.
Wear correctly fitting shoes
To avoid pain, bruised toenails, corns, calluses, blisters, bunions and injuries, buy shoes that fit properly and are comfortable. People commonly wear shoes that are too small. There should be about 1.5cm of space between your longest toe (which may not be your big toe) and the end of the shoe.
Limit time spent in high heels
Try to reduce your standing and walking in high heels as much as possible, as they can lead to longer term foot concerns (like bunions) if worn excessively.
Lee’s final tip? “There’s evidence to say that shoe comfort can help reduce injury risk, so make sure that you get the shoe that is most comfortable – not just your favourite colour. Don’t underestimate comfort.”