Foot care

Good foot care is an important part of health maintenance. Each foot is made up of 26 bones, 33 joints and more than 100 tendons, muscles and ligaments. Logically, the feet bear a lot of pressure on a daily basis. Considering that the average person walks about 115,000 miles through the course of a lifetime, it's understandable that foot ailments are among the most common health complaints. In fact, more than half of all Americans will develop a foot problem at some point.


Common foot problems
Athlete's foot (also known as tinea pedis) is a fungal infection of the foot characterized by itching, blisters, scaly or cracked skin, and inflammation. The fungi that cause athlete's foot require a warm, moist climate to thrive.

A blister (a raised, fluid-filled area on the skin) is usually caused by persistent or repeated rubbing against the skin. The culprits are often new or poorly fitting shoes.

A bunion is an enlarged joint that typically develops at the base of the big toe. A bunion may also develop at the base of the little toe, referred to as a bunionette or a tailory, but they may also be caused or aggravated by wearing high-heeled shoes that are too narrow or tight in the toe or forefoot area.

A callus (an area of tough, thickened, dead skin that may form anywhere on the body, but generally on the palms, fingertips and soles of the feet) or a corn (an area of tough, thickened, dead skin that may form on the tops of the toe joints or between the toes) may develop from repeated pressure or rubbing of the skin against your shoes.

Foot odor is usually caused by excessive sweating of the feet.

Hammertoe (a deformity in one of the toe joints, most often the second toe) is often caused by wearing tight or poorly fitting shoes.

An ingrown toenail (when the edge of a toenail invades the surrounding soft tissue) is usually the result of improperly cut toenails, but the condition may also be related to tight shoes or stockings. Ingrown toenails most often affect the big toe.

A plantar wart (a benign skin growth that usually develops on the plantar surface, or sole, of the foot) is caused by the human papilloma virus (HPV). A plantar wart may make it painful to walk, especially if it's located on the ball of the foot.
Less commonly, foot pain may be related to various other causes, including:

arthritis (inflammation of a joint)
plantar fasciitis (inflammation or degeneration of the connective tissue on the bottom of the foot that maintains the arch of foot
peripheral neuropathy (a condition characterized by decreased sensation in the nerves of the hands and feet)
neuromas (benign growths on a nerve)

Pregnancy-specific information
The pressure that's exerted on your feet often increases during pregnancy as you gain weight throughout each trimester. Your feet may also become swollen. If necessary, you may need to wear larger shoes to ensure a comfortable fit. Pregnancy also affects your posture. As your abdomen enlarges, your pelvis tilts forward and the normal curvature of your spine increases. This changes your center of gravity, putting you at greater risk of injury from falls. It's helpful to avoid high-heeled shoes because they only accentuate the curvature of your spine. Shoes that offer good support will be more comfortable and provide more stability.

Senior-specific information
The chance of developing foot problems increases with age for various reasons, including the simple wear and tear of a lifetime of everyday use. Dry skin and brittle nails can also lead to more frequent foot problems. In addition, as you age you're more likely to develop diseases that increase the risk for foot problems, such as circulatory disorders. It's also important to keep in mind that the fatty pads on the bottom of the feet tend to decrease and provide less protection as you get older, and the feet often become larger. To ensure proper fit, have your feet measured when you buy new shoes.

Prevention
Foot problems are often related to dry skin, improper nail care, poor hygiene, or poorly fitting shoes or socks. Good foot care, on the other hand, can help you prevent many common foot problems and remain active as you age. Keep in mind the following suggestions.
Inspect your feet every day for changes in the skin and toenails, including the area between the toes. Wash your feet every day with mild soap and lukewarm water. Dry them thoroughly with a soft towel, especially between the toes. You may want to apply a moisturizer to your feet, leaving the spaces between your toes dry. Itr feet in warm water. Then, you may want to use a pumice stone to gradually reduce any skin thickened by corns or calluses. (This should NOT be attempted if you have diabetes or peripheral vascular disease, however.)

Wear properly fitting shoes made of materials that allow your feet to breathe, such as leather or canvas. This can help prevent moist conditions that may lead to blisters or athlete's foot. To prevent injury, wear shoes that are appropriate for the activity. Generally, it's wise to avoid wearing shoes with a heel higher than 2¼ inches. As heel height increases, additional pressure is exerted on the front of the foot. Finally, rotate your shoes by wearing a different pair at least every few days and replace shoes that are worn out.

When selecting new shoes, have both feet measured. Keeping in mind that feet tend to swell during the day, you may want to do your shoe shopping later in the day or try on the shoes at home at various times. Don't buy the shoes (or keep them) if they feel too tight! As a rule of thumb, you should be able to wiggle all of your toes when wearing the shoes.

Cut your toenails straight across to help prevent ingrown toenails. Be careful to avoid cutting the corners of your nails or cutting your nails too short. To prevent the spread of infection, don't share your nail clippers. If you go to a manicurist, make sure he or she uses sterile instruments.

Avoid tight or poorly fitting socks, which can reduce circulation to your feet. Change your socks every day -- more often if your feet become sweaty. It's best to avoid going barefoot because it increases the risk of injury and infection. It's also important to wear proper footgear in locker rooms, at the pool and on the beach. Remember to apply sunscreen to your feet if you're wearing sandals.

If you're overweight, try to lose the extra pounds. Excess weight increases the pressure on your feet. Over time, this can change the structure of the bones and ligaments in your feet. Walking is typically a good exercise option. To reduce the risk of injury, begin slowly and progress gradually to give your feet and other joints a chance to become accustomed to activity. Consult your doctor before starting a new exercise program or for additional help controlling your weight.
NOTE: The risk for foot complications increases if you have certain diseases, such as diabetes, arthritis or peripheral vascular disease. Many factors are often at play, including poor circulation and peripheral neuropathy. Foot sores may develop, increasing the risk of infection and more serious consequences. Annual or more frequent foot exams by your doctor, orthopedist or podiatrist are recommended.

As additional precautions:

If you cane the ability to feel temperatures with your feet may be lessened, which could lead to burns.

Avoid using any strong chemical agents on your skin, such as over-the-counter treatments for corns or calluses.

Avoid smoking, which can aggravate circulation problems.

Avoid extreme temperatures. If your feet are cold, wear an extra layer of socks. If you have peripheral neuropathy, don't use a heating pad or hot water bottle to warm your feet because it would be easy to burn yourself.

Never attempt "home surgery," which could aggravate the problem or lead to an infection.

If your toenails are thickened or deformed, have them trimmed by a trained professional.