Feet are one of the most important parts of the body, yet they’re often taken for granted. We depend on them for stability, balance, and most importantly, mobility. Sadly, people don’t think twice about squeezing their feet into uncomfortable shoes or walking around in shoes that are too large with no support. As we age, quality of life is impacted by our mobility and our mobility is affected by the condition and health of our feet. The U.S. National Center for Health Statistics reports that the leading cause of activity limitation in older people is impairment of the lower extremities. A large part of preventing such impairment and ensuring future mobility is taking the time to care for our feet. By paying attention to our feet, we can also check for warning signs of health problems such as diabetes and arthritis.
Your Foundation for Life
By Julianne Hale
Ira Kraus, DPM, FASPS, managing partner of Advanced Foot Care Centers and member of the National Board of Trustees for the American Podiatric Medical Association, compares our feet with the tires on a car. He says, “By the time most people are 50 years old, they will have walked 75,000 miles. If you put 10-15,000 miles on your car, you need to change the tires. We can’t change our feet so we have to take care of them.”
Just as tires serve as the foundation of a vehicle, our feet serve as the foundation of our bodies. They serve many functions in our lives: our feet keep us balanced, stabilize us to stand, and allow us to get around. Dr. Kraus encourages the older population not to become complacent if they have any problems related to their feet. He says, “Older patients should not assume that that just because they are getting older it is acceptable to have a lack of stability and balance. There are braces and other products to help with these issues.”
In addition to balancing our bodies and keeping us from falling, our feet can serve as a barometer for our overall health. Foot problems are sometimes the first sign of a serious medical condition such as arthritis, diabetes, and nerve and circulatory disorders. Because of this, foot irregularities, even those that appear minor, should never be overlooked. The National Institute on Aging says, “Both diabetes and peripheral artery disease can cause poor blood flow to the feet, which can cause scrapes or bruises to become infected more easily. This makes good foot care very important. Make sure to check with your doctor if you develop a sore on your foot that does not heal.”
As we age, our feet are particularly vulnerable to common foot problems. These include fungal infections, dry skin, corns and calluses, warts, bunions, ingrown toenails, neuromas, hammer toes, spurs, and swollen feet. Patients who find anything unusual should seek medical attention. Common foot problems can be caused by inappropriate or inadequate foot care, mechanical use, infection, and other underlying problems including diabetic vascular disease and congenital foot deformities. As with other common health conditions, prevention and detection are critical when it comes to your feet. This starts with proper daily foot care.
Because the feet can be an indicator for the health of the rest of the body, it is important to be on the lookout for signs of serious medical conditions. This point is driven home by Dr. Kraus, who says, “Many patients do not even know they have an underlying medical condition. Ten percent of the diabetic patients we see are non-diagnosed when they arrive.”
What symptoms, then, should patients look for in their feet that might indicate a more serious health condition? Dr. Kraus advises, “Patients should watch for neuropathy (sensory loss). The number one cause of this is diabetes, but it can also be caused by alcoholism and chemotherapy.” Other symptoms to watch for include cold feet and sores and bruises that will not heal – all of which can be indicative of vascular disease or diabetes, conditions that require lifelong treatment and monitoring.
Poor circulation in the feet is a common problem for many elderly patients. Circulation is vital to the health of our bodies and particularly important for our feet. Several steps can be taken to encourage adequate circulation in the feet. They include:
• Elevating the feet when seated
• Indulging in a foot massage or foot bath when possible
• Stretching and walking regularly
• Standing up and moving around intermittently when seated for long periods of time
• Crossing, uncrossing and switching sides when seated with legs crossed
Proper Foot Care
Practicing proper foot care is not complicated. It begins with simple observation. Dr. Karin Kennedy of the Kennedy Clinic and podiatrist on staff with Memorial Health Care System, advises patients to look at their feet regularly. She says, “Our feet must be examined at least once a week. Look for bruises, cuts, sores and calluses.” People with underlying health conditions should examine their feet more frequently. For patients who have trouble bending down and looking closely at their feet, Dr. Kennedy recommends placing the feet over a mirror and looking at them from above. Sometimes the help of a family member is needed to get a proper look.
Consider the following advice from WebMD for proper foot care:
Wash and Dry Your Feet Daily
• Use mild soaps.
• Use warm water.
• Pat your skin dry; do not rub. Thoroughly dry your feet.
• After washing, use lotion on your feet to prevent cracking. Do not put lotion between your toes.
Examine Your Feet Each Day
• Check the tops and bottoms of your feet. Have someone else look at your feet if you cannot see them.
• Check for dry, cracked skin.
• Look for blisters, cuts, scratches or other sores.
• Check for redness, increased warmth, or tenderness when touching any area of your feet.
• Check for ingrown toenails, corns and calluses.
• If you get a blister or sore from your shoes, do not “pop” it. Apply a bandage and wear a different pair of shoes.
Take Care of Your Toenails
• Cut toenails after bathing, when they are soft.
• Cut toenails straight across and smooth with a nail file.
• Avoid cutting into the corners of toes.
• You may want a podiatrist (foot doctor) to cut your toenails.
Be Careful When Exercising
• Walk and exercise in comfortable shoes.
• Do not exercise when you have open sores on your feet.
Protect Your Feet With Shoes and Socks
• Never go barefoot. Always protect your feet by wearing shoes, hard-soled slippers or other footwear.
• Avoid shoes with high heels and pointed toes.
• Avoid shoes that expose your toes or heels (such as open-toed shoes or sandals). These types of shoes increase your risk for injury and potential infections.
• Try on new footwear with the type of socks you usually wear.
• Do not wear new shoes for more than an hour at a time.
• Look and feel inside your shoes before putting them on to make sure there are no foreign objects or rough areas.
• Avoid tight socks.
• Wear natural-fiber socks (cotton, wool, or a cotton-wool blend).
• Wear special shoes if your health care provider recommends them.
• Wear shoes/boots that will protect your feet from various weather conditions (cold, moisture, etc.).
• Make sure your shoes fit properly. If you have neuropathy (nerve damage), you may not notice that your shoes are too tight.
The Right Fit
Shoes provide our feet with protection from the elements, support, comfort, and a touch of personal style. If the shoes do not fit, however, they can have the unwanted side effect of causing foot problems. Dr. Kraus recognizes that ill-fitting shoes are a huge problem. He explains, “The average day of walking brings a force equal to several hundred tons on your feet so they are subject to more injury possibilities than any other part of the body. An astonishing number of people wear shoes that just don’t fit right and cause problems for them.”
Dr. Kennedy likes to present her patients with a visual representation of their shoes and how the improper fit can impact their feet. She says, “I like to place a piece of paper on the floor and have someone trace the foot with a marker. Then I place the shoe on the drawing so that patients can appreciate how much they are squeezing their feet into their shoes.”
It is possible, however, to find shoes that provide everything a good pair should, along with personal style. You just have to know how to get the right fit. In order to ensure that shoes fit properly and to avoid shoe-related foot problems, Dr. Kraus advises, “Everyone should get measured and fitted for shoes. They need to look for a shoe with a firm sole and a soft upper that is best for the activities of day-to-day life. I would recommend shopping for shoes in the afternoon because our feet tend to swell throughout the day, and a shoe that fits perfectly in the morning may be too small by the afternoon.” Other tips for finding proper shoes that the American Podiatric Medical Association recommends are:
• Have your feet measured while you are standing.
• Always try on both shoes and walk around the store.
• Always buy for the larger foot, feet are seldom the same size.
• Don’t buy shoes that need a break-in period. Shoes should be immediately comfortable.
• Feet get larger and sizes vary so don’t rely on the size of your last pair of shoes.
• Buy shoes that fit well on the front, back and sides to distribute weight.
• Buy shoes that don’t pinch your toes, either at the tips or across the toe box.
• Try on shoes with the socks or stockings you will wear with them.
• If you wear prescription orthotics, take them along to shoe fittings.
Following these simple guidelines will help you prevent some of the common ailments that improper footwear can cause. Dr. Kraus explains, “Ill-fitting shoes can cause blisters, corns and calluses. If they are worn for an extended period of time, they can also cause structural damage to the feet.” Dr. Kraus has seen many patients with foot problems resulting from the shoes they wore as children. He explains, “I have many elderly patients that come to see me because their feet are damaged. When they were kids, they were forced to wear hand-me-down shoes in the wrong size because they couldn’t afford new ones.” While wearing improper shoes as a child is not something that can be changed, wearing proper fitting shoes as an adult can go a long way towards preventing future problems.
As we age, much of our independence and quality of life hinges on our mobility. In order to stay mobile, taking care of our feet is one important step. Paying attention to warning signs that our feet give us is critical, so visiting a foot care specialist yearly or more often if health problems persist is vital. Taking care of our feet will reward us by keeping our bodies stable, balanced, upright and mobile.
Julianne Hale and her family reside in Cleveland. She earned a Bachelor of Science degree from Illinois State University and then an MBA from the University of Phoenix. Julianne is a member of the Chattanooga Writers Guild, is married, and has three children.
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