Children’s Feet Take 18 Years to Grow!
The feet of a newborn child are usually perfectly formed and lovely to look at. Unfortunately many parents easily forget that those feet need nurturing and protecting as they grow to maturity.
It’s going to take up to 18 years for that child’s foot to fully develop. Nevertheless, the newborn foot resembles the adult foot in every respect; it has normal contours and arches and fat padding, but when the foot bears weight it will look abnormally flat – this is one reason why all babies should be allowed to develop at their own pace and parents must resist the desire to get them up on their feet before they are ready.
A newborn foot is usually triangular in shape, broadest at the toes with a narrow heel. The shape and position is also very important, giving clues to any underlying neuromuscular or skeletal pathology. Podiatrists involved in managing children’s feet look for altered shape, restricted movements, stiffness and deviations in different parts of the feet.
For the first 6 months of life the feet are mostly cartilage, so they can be easily deformed by an ill-fitting sock or ‘babygro’ or sleepsuit. The feet and lower limbs of a baby are meant to move, stretch, kick and wriggle as part of normal growth. Freedom of movement is the keyword at this time, which means that any tight fitting devices, pram and cot blankets must be avoided.
Obviously, throughout the entire process of development and growth, correctly fitted footwear is essential for the child, as is the diagnosis and management of any disorder or anomaly, so if you are concerned about your child’s foot health, have their feet checked by a podiatrist.
You can read more about children’s feet here..
Do Crocs “bite” your feet?
The Crocs saga seems to be getting bigger every day. There are reports on various websites including www.fin24.co.za the Independent Online, www.mycrocs.co.za in Die Burger to name just a few, joining in the debate for and against this popular footwear.
Crocs are being blamed (along with other types of sandals) for injuries to people travelling on escalators in shopping centres. In Singapore a youngster lost a toe in an escalator accident.in November 2006, a Crocs spokesperson blamed poor escalator safety. Apparently there is also a Crocs Accidents blog on the Internet!
The Independent Online article has comments from a spokesperson from the Society of Chiropodists and Podiatrists in the UK, who agrees that Crocs "have shortcomings" and goes on to say that if a person only wears Crocs "they’re disastrous"," that they don’t give the feet enough support" and that "they are better suited to holiday wear." Read for yourself; http://news.independent.co.uk/health/article2950842.ece
Despite all the current negative publicity, Crocs remain enormously popular and 20 million pairs have been sold in the past 12 months, so there are plenty of very happy wearers worldwide.
My advice is to wear the real thing. Avoid knock-offs which are cheap and wear very quickly especially if you have a walking style that causes local increases in pressure.(Look for where you have callus under your feet). If you have diabetes with no complications then you might be OK, but avoid them if you have loss of sensation or poor blood flow to the feet – this advice applies to any footwear for people with diabetes anyway.
Finally. look out for Croc Mammoths – a fur-lined shoe designed for the Northern Hemisphere winter.
Crocs damage hospital equipment!
No monster crocodiles rising from the water, but those extraordinary – love them or hate them – funny-shaped garish coloured foot adornments. The UK tabloid newspaper The Sun reported on September 5th that in A Swedish hospital there have been incidents where a patient’s vital respirator and two other key pieces of equipment were knocked out by static electricity caused by Crocs. This resulted in a ban on the footwear.
In Sheffield, UK the health authority also barred Crocs to avoid problems in the operating theatres. Now it seems that a ban might be applied by other players in the UK National Health System (NHS). Apparently thousands of nurses and other NHS staff wear Crocs, with nurses being quoted as saying Crocs have relieved months of suffering with painful feet. In addition it appears that there is a possible problem with Health & Safety regulations with comments about infection control and the risks of needles being dropped through the holes in the uppers.
Read th article at http://thesun.co.uk/printFriendly/0,,2-2007410358,00.html
Do podiatrists like Crocs?
Some do, some don’t.
“They should not be worn by people with diabetes” says a colleague in Cape Town.
On the other hand, a British podiatrist, writing in Podiatry Now, thinks they have great therapeutic potential and presents a case history as evidence. He suggests that they be researched by the podiatry profession.
Some UK websites are full of therapeutic ‘evidence’ and testimonials.
WATCH THIS SPACE!
Sports Podiatry and Football Injuries-an end in sight?
What would podiatrists who treat foot injuries say about a football boot that will encourage players to consider injury protection as much as performance when choosing footwear? I found the following information in the July 2007 issue of the Brighton Graduate, the magazine of the University of Brighton Graduates Association.
The prototype boot, called the RF5, has spawned a new buzzword – ‘safe performance’. Designer Jonathan Farr at the University of Brighton says the aim of creating such a boot was "to provide protection of the foot and lower limbs alongside the feeling, efficiency and range of motion required to achieve maximum performance." According to Jonathan, "footwear in sports serves three major functions.
- provide adequate and effective adhesion between the feet and the playing surface
- protect the feet
- permit normal movement."
He believes that these functions have yet to be perfected in sports footwear as the interaction of the legs, feet, footwear and ground is still to be fully understood.
The design of the RF5was influenced by research into the causes of injury (etiology), measurements of body size and proportions (anthropometrics), and structure and function (biomechanics). In addition user-centred aspects, emotional elements and boot design were included.
The RF5 boasts some impressive features. An outsole that dissipates pressure and reduces unwanted foot movement; a stud pattern that spreads pressure and reduces foot fixation; a heel cup that helps prevent ankle and knee injury and contoured insoles to give arch support, help postural position and joint alignment.
The only illustrations are clearly computer aided design, so it remains to be seen whether the prototype and concept can be developed cost-effectively into production and then scientifically researched to prove that these design features really do prevent injury. Certainly it appears that some of the features have a therapeutic potential.
Unfortunately, RF5 may ultimately only be suitable for players on World Cup 2010 on your XBox! I hope not.
Good News on the Diabetic Foot
The Diabetic Foot Symposium at the VASSA Congress yesterday was a great success. It marked the launch of DFWG, the Diabetic Foot Working Group.
This is a voluntary association which will serve as the overall representative body to promote awareness and optimal management of people with diabetic foot problems in South Africa. Its objectives include the prevention of amputation, promoting academic standards and the establishment of relationships amongst role players.
I have applied to join this group and I hope that it will be instrumental in developing a fully multidisciplinary approach to the diabetic foot. The big challenge is to prevent some of the awful foot complications associated with diabetes in South Africa.
Also at the congress, Dr. Slabbert & Dr. Allard presented some data on a Lower Limb Amputation Survey in a South African Regional Hospital, which showed that, in their hospital, 74% of patients losing a leg for vasculopathy (disease of the blood vessels) are diabetic. (This by the way is in the first 6 months of 2007!!)
Through our practice we have set up a ‘virtual’ multidisciplinary diabetic foot clinic, where as the podiatrist I can refer patients to a vascular surgeon, physician, opthalmologist, dietician and diabetes nurse educator. I say ‘virtual’ because although we are not all in the same place at the same time, we have quick access to each as required.
They said that "an intensive diabetic foot programme is necessary to decrease the amount of amputations performed in South Africa.
A Word On…. Your Feet
Don’t miss Talk Radio 702 on Tuesday, 7 August at 7pm when I will be joining Prof Harry in this week’s "A Word on..Medical Matters" when we will be talking about feet. How to look after them and what to do when things go wrong with them – as well as answering listeners questions about their specific foot problems.
Check the programming at http://www.702.co.za/onair/lineup.asp
Fascinating Foot Facts
* The average adult takes in excess of 18,000 steps a day. For children it’s even more.
* In a lifetime your feet will walk approximately 112000 kilometres – that’s four time around the earth.
* Leonardo da Vinci called the foot a masterpiece of engineering. each foot has 26 bones, 19 muscles, more than 100 ligaments, thousands of nerve endings and a complex network of blood vessels.
Every time your foot hits the floor when walking it’s the equivalent of twice your body weight. if you are running this increases to three times your body weight.
Fascinating Foot Facts
* The foot has 250,000 sweat glands, they release about 200 mls of perspiration every day.
* Around 70% of foot problems come from wearing the wrong footwear or ill-fitting shoes. Many of these foot problems start in childhood.
* 85% of diabetic foot ulcers are caused by footwear.
* In the United Kingdom, about 30 million pounds is spent annually on foot care services for the elderly.
* Even the Bible records the foot problems of King Asa, David’s son……"nevertheless in the time of his old age he was diseased in his feet." (1 Kings 15:23).
6th Biennial Conference of the South African Podiatry Association
Approximately 120 of South Africa’s podiatrists gathered at the Indaba Hotel, Fourways, Johannesburg from Friday 6th to Sunday 8th July. Definitely the highlight of the SA podiatric calender!
The conference showed just how far Podiatry has come in recent years – despite the small number of registered podiatrists in the country – in providing quality foot care to the people of South Africa. For example; Podiatrists are developing into specialists in many areas of foot care and are working as key members of multidisciplinary teams in Sport – treating foot pathologies, researching biomechanics and understanding new footwear technologies. Their role in managing the Diabetic foot was confirmed. Research into the foot problems associated with Arthritis is developing. The field of Footwear design and manufacture is being influenced by podiatrists.
Papers were presented on Professional Ethics, Vascular Disease, Rheumatology, the Biomechanics of Cycling, Footwear sizing, the Diabetic Foot, Foot Surgery, Foot Biomechanics and Neurology.
A great weekend where new information was presented, ideas exchanged and practice enhanced.