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Most of us take our feet for granted. But our feet are vital to health and mobility, carrying us an average of 184,000 KMs in a lifetime. No wonder foot problems are common. As we get older, these problems can get worse and it is especially important to care for our feet. In older people, foot problems can mean the difference between needing institutional care and being able to live at home.
This guide to proper foot care was prepared for Canada's veteran population but also of interest to Canadians of all ages who want to put their best foot forward. In this guide, you will find some helpful suggestions for treating and preventing common foot problems. It is not intended, however, as a substitute for medical care. If your feet hurt, arrange to see a professional, such as an orthopedic surgeon, podiatrist, chiropodist or nurse.
Basic Foot Care
Follow these simple steps to keep your feet happy.
See your doctor right away if you notice any of the following:
Treatment
Most of the common foot problems described in this section will require some kind of treatment sooner or later. It is preferable that it be sooner for older people whose circulation has probably slowed down and who could actually lose a foot or a leg due to an untreated infection in the foot.When you visit a professional, he or she will identify your condition and treatment will take one of the following forms: medication, orthotics or surgery.Medication can be prescribed as a pill, an injection or a cream.Orthotics are corrective devices inserted inside your shoe and individually molded to your foot. They are made of a variety of materials, including plastic, leather and sponge. Such inserts adjust the way the weight is distributed and make it possible to live comfortably with many of these foot conditions.Surgery is sometimes required to correct foot conditions.
Footware
The foot tends to spread in the front under the body's weight as we get older. Because most shoes are narrower in the front than the foot itself, shoes can contribute to a variety of problems. Why not give yourself the foot test? Put your foot down on a piece of paper and trace around the bottom to see whether the front of your foot is wider than your shoe. If it is, it's time to go shopping for a new pair of shoes.
Proper Fit
Good Construction
Care of Shoes
Shoes will be more comfortable if looked after properly.
Soles should be strong and flexible and have a good gripping surface.
Foot Exercises
Simple foot exercises help maintain muscle tone, keep feet from getting tired and protect against cramps. Here are some good ones which can be done every day.
Walking: The Perfect Exercise
Walking is one of the best exercises for older people as it is not strenuous and costs nothing.By simply walking every day you can:
Other low-impact activities, such as swimming, golfing, cross-country skiing, snow-shoeing and skating, are beneficial to the whole body and, ultimately, the feet. So keep as active as possible and enjoy the benefits of healthy feet.
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If you are a diabetic or have poor circulation, it is especially important to pamper your feet. Diabetics may have a higher risk of ulcers and infection, be slower to heal and be prone to poor circulation. Signs of poor circulation, which often comes with aging and is common among smokers, are a blue or purplish skin colour, weak or nonexistent pulses in the feet and slow healing of cuts. If these problems are not recognized and treated, they can lead to gangrene and amputation.
For this reason, the following precautions should be taken.
Athlete's foot is a chronic fungal infection generally found between the toes. The skin is white, peeling and cracked and sometimes becomes itchy, red and infected. If the condition persists, consult a professional who will probably prescribe antifungal medication. Keeping the feet clean and dry, wearing clean, roomy cotton socks, changed daily, and alternating shoes every other day are all helpful.
Warts are caused by a virus that enters the skin directly either at pressure points or where the foot has been injured. Sometimes these warts can be mistaken for ingrown calluses on the bottom of the feet. A wart is round and has a crater in the centre. Consult a professional for advice on treatment, shoes, padding, dressing and medication or surgery. Warts are not a do-it-yourself project. The foot can be painfully scarred from improper treatment.
Corns and calluses are thickenings of the skin often caused by poorly fitting shoes and tight socks. Corns generally form on toes and calluses on the bottom of the foot. Corns and calluses can also be caused by faulty weight-bearing, i.e. when the weight is thrown on the second, weaker bone of the ball of the foot. Consult a professional for the treatment of painful corns and calluses. Specially fitted inserts can be effective. Do not trim or pare corns or calluses with scissors or razor blades or use corn remedies, including pads, containing acid which can burn the skin around the corn. Home treatment should be limited to rubbing lightly with a pumice stone or 100-grit sandpaper when the foot is dry and applying a moisturizing cream.
Ulcers of the feet are open sores that do not heal. People with diabetes or poor circulation are particularly prone to ulcers of the feet because the sense of pain and temperature in their feet is diminished so that they are insensitive to excessive pressure and are not aware of the warning signs. Consult a doctor who will, if necessary, refer you to the appropriate professional.
Ingrown toenails are a painful condition often caused by tight shoes or improperly cut nails. The nail grows into the skin causing the toe to become red and swollen due to infection. Ingrown toenails must be treated by a professional who may have to remove a portion of the nail. To help prevent infection of ingrown toenails, cut or file nails straight across and never shorter than the end of the toe. File any rough edges as they can cut into the next toe and cause problems.
Thick nail is any abnormal thickening of the nail. It can cause pressure sores and restricted movement, especially in older people and diabetics. Loose, detached nails are another nail problem, sometimes due to chronic fungus infection or associated with the chronic skin condition psoriasis. Consult a professional for either of these conditions.
Strained arches, sometimes called fallen arches, are common today due to walking on hard surfaces, such as cement and pavement. Symptoms are tired feet, pain in the legs and low back pain. If you suffer from any of these symptoms, wear well-fitting, comfortable shoes that provide good support and do foot exercises. If the symptoms continue, consult a professional. Special arch supports often relieve the condition. Physiotherapy, such as whirlpool and massage, can also provide relief.
Hammertoes are caused by a muscle imbalance, possibly inherited, or wearing shoes that are too short causing the smaller toes to buckle. The joints may stiffen permanently in this position. Corns form where the toes rub against the top of the shoes. If the pain persists, consult a professional. Wearing shoes with a deep toe box and a wider fit and using pads to ease the pressure both help.
This is a type of bunion in which the joint between the big toe and the foot becomes stiff or completely immovable, often causing painful calluses on the sole. Inserts in the shoes can provide some relief but the condition can only be corrected by surgery.
Metatarsalgia refers to pain in the front of the foot aggravated by abnormal pressure. It is usually associated with a high-arched foot or the spreading of the front of the foot with age. It results in a dull burning pain in the ball of the foot. Consult a professional if the pain persists.
Bunions are a painful deformity of the foot consisting of a bump at the side of the big toe caused when the big toe angles inward toward the second toe. Bunions, metatarsalgia and hammertoes often occur together. While bunions tend to be hereditary, they are frequently aggravated by wearing tight shoes when young. Consult a professional who may x-ray the feet and perform surgery to realign the bone or insert an artificial joint. Various shields and pads are available to relieve the pain of bunions and to hold the toe in alignment. Wearing well-fitted shoes and socks and soaking in a warm saline solution, such as Epsom salts, may relieve the pain and discomfort of bunions. The bunion area of the shoe can be stretched in the shoe store.
Pain in the heel can be caused when the ligament-like structure which runs from the heel to the front of the foot, is torn and partially pulled away from the heel. Consult a professional who will probably treat this with flexible arch supports, a plastic heel cup or foam rubber padding in the shoe. A Cortisone injection sometimes helps. To prevent this problem, wear comfortable, well-fitting shoes that provide good support.
Another painful condition in the heel is caused when the bone at the back of the heel is rubbed by the shoe and becomes inflamed. This can be prevented by padding and massaging the backs of new shoes to soften them before wearing them.
Cracked heels are ustially caused by excessively thick skin. If heel cracks are painful, consult a professional. At early signs of cracking, the heels can be rubbed with a pumice stone or 100-grit sandpaper when the skin is dry, followed by bathing the heels, applying a moisturizing cream and wearing clean cotton socks.
Fatigue fractures are small fractures of the metatarsal bone. They are often a sign of abnormal weight—bearing on an extra long metatarsal bone, usually the second one. Under the stress, the bone cracks, causing swelling and pain. A professional can treat these fractures with padding and surgical shoes. Keeping as active as possible helps in the healing process.
Pain in the front of the foot, especially when standing or walking, is sometimes due to swelling of a nerve causing it to be pinched between the front ends of the metatarsal bones. Consult a professional. this can sometimes be relieved by a shoe insert or a Cortisone injection. If the pain persists, the swollen part of the nerve can be surgically removed.
The common types of arthritis in the feet are osteoarthritis, rheumatoid arthritis and gout which usually attacks the big toe. Osteoarthritis is due to wear and tear and occurs mainly in older people. Its symptoms include pain, stiffness, swelling and a grinding sensation, particularly after prolonged activity. Rheumatoid arthritis can affect people of all ages and leads to pain and swelling in the joints as well as fatigue, fever and loss of appetite. In gout, the joint of the big toe is red, swollen and painful. People with arthritic feet are also prone to corns and calluses due to restricted movement of the joints in their feet. Consult a professional who may prescribe medication, padding, specially molded inserts or surgery. Wear comfortable, well-fitting footwear, lose weight if necessary and rest during the day if possible.
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