Holiday Foot Problems?

Foot problems can spoil our holidays, because they are so unexpected. If you click on Foot Health Articles on this site, you can get some tips on holiday care for people with diabetes, I also wrote about a patient who suffered a holiday foot injury when he fractured his metatarsal as a result of a swimming pool fall!  Also, check out the post on Holidays: Sore feet and sun back on 13 December 2008.

If you have been spending lot’s of time in the pool you might have felt your feet burning. Watch out for the surface of the pool – if it is a bit rough -rubbing the skin on your soles away. [This happened to a little girl I know recently]. You get red-raw skin because the protective outer layer is worn away. Just  treat the area with antiseptic and a plaster, to keep the ‘bugs’ out and avoid an infection.

You can get a similar effect after that first, long-awaited barefoot walk along your stretch of beach! Our feet are usually protected in shoes and the skin is quite soft; our soft city-dwellers’ feet  need a gentle introduction to the great outdoors!

Even regular runners can get burning soles after that early morning barefoot  ‘quick 5 kays’ along beach! So don’t be afraid to wear your tekkies on the beach.

Sunburn on the foot

Sunburn is probably the most obvious holiday foot problem. Mostly to the tops of our feet and the front of the ankles. Use a high SPF cream or spray and re-apply during the day and if you go in the water.

Shoe rubbing is very common on holiday, as we spend more time in sandals. So look out for pressure or friction points that cause blisters – often made worse when there is sea sand added to the mix.

If you are somewhere exotic this New Year, try not to let sea anemone spines, puffer fish or jelly fish spoil your fun – but  who really sees them coming anyway?

Then there are always the snakes! Whenever you go into potential ‘snake- country’, think ahead and be prepared. Make sure at least one person in your group is equipped to deal with a snake bite.

Unfortunately, this time year produces a number of common injuries like cuts from hidden glass and metal, plus aches and pains from too much walking, golf or frisbee! So don’t worry too much about that new heel pain, achilles tenderness or arch pain. It should settle down – if not – see a podiatrist.

The same goes for that itchy rash – could be fungus!

However you celebrate the New Year – from where I am, I’ll get a free fireworks show on Kleinleeuwkoppie at Hout Bay, courtesy of Sol Kerzner – I wish you and your families all the best for 2010.

After A Fall, Don’t Ignore The Pain

At the end of last week, a 60-something lady was brought to me complaining of a very painful ankle, three weeks after she tripped and fell whilst walking in the Bush.

She was uncertain which way her ankle had bent when she fell, but said there was a lot of swelling and bruising, which was only now starting to go down. Whilst in the Bush she had managed only basic First Aid with a bandage, to keep the swelling down so that she could get her foot into her trainers, but walking was extremely painful.

During my examination I isolated a point of severe pain over the tip of the lateral malleolus. [That’s the bit of your fibula that sticks out on the outside of your ankle joint]. The area was also swollen and hot to touch. Moving the ankle caused pain and the lady walked with a stiff-legged limp. The provisional diagnosis was to eliminate a fracture as the ankle joint is very stable and usually the injury in these situations is of severe ligament damage. However, because of the local symptoms I was thinking fracture. The obvious thing to do was send for X-ray.

The X-ray report confirmed a fracture of the tip of the fibula bone, only slightly displaced, fortunately. However, perhaps more importantly, the radiologist reported the appearance of ‘low bone density’ and therefore the possibility of osteoporosis.

The lady is now wearing a “Moonboot” below knee walker – with some difficulty – and was referred to her GP for investigation into the low bone density, which is now underway.

Now I know this isn’t really podiatry, but when questioned further, before I referred her, the lady revealed that she had never had a mammogram or bone density test. These tests are as important for older women as the prostrate examination is for men.

So if you have a fall or trip, don’t just put it down to a sprained ankle and put up with pain; monitor the pain, bruising and swelling. Also, ladies, don’t wait for the next time you need an X-ray to check your bone density.

Remember:  podiatrists don’t just treat feet, we treat people.

You may also find these articles interesting linked to osteoporosis and bone density loss.

• Women not getting bone treatment (news.bbc.co.uk)
• Coeliac bone loss link uncovered (news.bbc.co.uk)

Fungal Infection – Your Christmas Present?

Athletes Foot is the name used to describe a fungal infection of the skin of the foot. Characterised by an itchy, blistering rash on the skin in the arch of the foot - which rapidly spreads to between the small toes and even the heels, it can ruin your Christmas.

Tinea Pedis is the medical name for this condition. It is worse in the hot summer months when feet are either trapped in their usual dark, sweaty environment, or exposed to areas where someone with the infection has walked.

Usually communal showers at the gym, in hotels, airplane carpets - the fungal spores are everywhere - just waiting for the perfect dark, moist environment to enable them to grow.

A fungal infection can also be spread by your favourite leather sandals, as the spores can live in the leather for ages!

Try to prevent Athletes Foot by following a few simple steps.

• AFTER WASHING ALWAYS DRY YOUR FEET THOROUGHLY, ESPECIALLY BETWEEN THE TOES
• WEAR CLEAN SOCKS EVERY DAY
• AVOID SYNTHETIC OCCLUSIVE FOOTWEAR IF POSSIBLE
• WEAR SLIP-SLOPS IN ANY COMMUNAL SHOWERING AREA
• USE AN ANTI-FUNGAL OR ANTISEPTIC FOOT SPRAY
• EXAMINE YOU FEET FOR SIGNS OF A RASH, SMALL BLISTERS IN THE ARCH OR WHITE ITCHY SKIN BETWEEN YOUR TOES
• BAREFOOT AND FRESH AIR IS GOOD, UNLESS THERE IS A MEDICAL REASON NOT TO BE

If you have a fungal infection treatment with oral medication can be costly, so start simple:

• GOOD FOOT HYGIENE
• SPIRITUS PEDIBUS FOOT SPRAY OR PROPRIETARY ANTIFUNGAL SPRAYS
• TOPICAL ANTIFUNGAL CREAMS
• HOWEVER, A COURSE OF ANTIFUNGAL TABLETS MAY BE NEEDED

Unfortunately, the fungal organisms that cause Athletes Foot tend to be very difficult to kill off. So even when your foot looks clear continue with the treatment for at least two more weeks.

One final word of warning. Not all rashes, or areas of itchy, moist skin are fungal infections. In the arch you might have a dermatitis. Between the toes it might be because your toes are stiff and bent. Or you might just need a good wash!!!

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