You and Your Feet

Our feet must last a lifetime and we expect them to keep going with very little special care. So why do we misuse and abuse them?

A foot is an amazing object. It comprises 26 odd-shaped bones placed together in a multi-arched structure joined together by ligaments, muscles and tendons. An intricate network of veins, arteries and nerves feeds the structure, which is surrounded by strategically placed fat and enclosed in skin of varying thickness. With every step we take, the foot alternates between being a rigid lever and a flexible shock absorber propelling us through our daily activities.

Our feet are body extremities and are at risk if any of the components malfunction. This risk increases with conditions such arthritis, osteoporosis and diabetes. Risk is also associated with lifestyle and this is why smoking is bad for you – nicotine causes the arteries carrying the blood to the legs and feet to harden or narrow – reducing the quality of circulation to the muscles and causing cold feet. Being overweight is also harmful to our feet, because the daily effort of carrying extra body mass strains and stretches all the soft tissues.  Any of these malfunctions can cause aches and pains in our feet.

The skin of the feet reveals a lot about a person’s general health and quality of foot care. Skin can be thick, thin, moist, dry, rough, scaly, smooth or shiny. Cracks (called fissures) can occur between the toes, where they are usually moist, or around the back of the heels or under the soles of feet, where they are usually dry. Calluses, corns, blisters, various nail conditions, infections, cuts and foreign bodies can all develop in the skin of the feet. To reduce the risk of these problems, we need to care for our feet with the same intensity as we care for our hands and faces.

Daily washing and drying should be a slow and careful process. Use a pumice stone, or callus file on hard dry skin to gently abrade it. Use a nail-brush to carefully remove dead skin cells from around toe-nails. Wash with warm water and soap or if you wish oatmeal granules to help epidermabrasion. (Try your own home remedy with olive oil and sugar). Always dry your feet thoroughly including between the toes.

Dry skin needs moisturising, preferably every night. This helps to prevent excessive dryness and fissuring, especially at the heels. Never pick or tear away dry skin as this could allow bacteria to enter and cause an infection. Occasionally the heel needs closing in plaster or even plastic (Glad wrap) to improve absorption. However it is better to avoid thick greasy substances, remember, moisturising is the key. Allantoin, Vitamin A, Vitamin E, aqueous cream, bees-wax, aloe vera and tea tree products all have their benefits. Find something that suits your skin and keep to it. Excessively thick and hard skin anywhere on the feet needs careful abrasion and cutting away by a podiatrist and because thick skin usually has an underlying cause professional care is essential.

Toe nails should be cut or filed to the shape of the end of the toe. Do not leave square pointed edges, as they can cut into the sides of the adjacent toes. Excessively thick nails are usually the result of injury or possibly a fungal infection. These can be drilled thinner by a podiatrist, who would also give you specific advice on further care. A podiatrist can also identify abnormalities and infections of the nails and send samples to the laboratory to test for fungal growth. One feature of fungal infection is yellow/brown discoloration of the nail, it is often crumbly and smells when cut.

Callus is the normal response of the epidermis to any mechanical stress and it forms initially as protection. Only when it becomes too thick, inflexible and painful should it be regarded as a problem. On the soles of the feet or ends and tops of toes, callus is a sign of friction and pressure. A corn is a concentrated area caused by compression of skin between footwear outside and the bone inside, and requires immediate attention. Although skin grows from the inside out, corns do not have roots! The primary cause for corns and callus is the structure and function of the feet themselves, which is aggravated by activity and footwear. The underlying cause can be identified by a gait and biomechanical analysis which is usually performed by a podiatrist.

Corn-plasters, paints and ointments should never be used to treat corns or calluses. They contain a powerful keratolytic – salicylic acid – which destroys the keratin not only of the corn but also of the surrounding healthy skin.

Most of us have experienced the pain of a blister on the foot. Blisters are the result of the skin layers undergoing friction in the shoe during sport or walking. If there is damage to underlying blood vessels a blood blister forms, this means that the epidermis is separating from the dermis below and is a very painful condition. The most important thing about treating a blister is to never burst them deliberately. Always try to protect the skin, by covering with gauze and plaster, until the fluid is absorbed, the blister shrinks and new skin grows underneath.

Choosing footwear is always difficult because the ideal shoe is foot-shaped, has a thick cushion sole and fastens across the top of the foot, thus becoming an extension of the foot. It is not supposed to re-shape or deform the foot! Few of us can afford all leather shoes nowadays and the synthetic materials used to reduce manufacturing costs often cause irritation and burning due to friction or occlusion (keeping air out). Try to have the appropriate shoe for what you are doing. Take your trainers to work if you are rushing to the shops during your lunch break. A very important trick to remember when choosing shoes is to turn them upside down and look to see if the sole looks straight or is curved like a banana. Don’t buy banana-shaped shoes!

Trainers make me think of foot odour. Fortunately, there are many preparations available for controlling foot odour. It is caused by sweat evaporating and the bad odour is due to the bacteria on the skin. Wash and dry thoroughly, try potassium permanganate as a footwash, normal underarm antiperspirants also work well. Wear natural fibre socks and avoid closing the foot in synthetic materials.

It is important to keep the feet mobile. To increase flexibility, stretching and massaging is good. Reflexology is can be beneficial locally and systemically for many people. Barefoot is good, so long as you do not have diabetes, but safer in your own home or garden where you can try to avoid all the obstacles such as stubbing, cutting, scalding, or burning injuries.

Above all if we take better care of our feet, they will look after us.