These days, we all lead demanding and active lives. In a single outing, we can run to the store, pick up the dry cleaning, spend a few hours at the office, throw in a workout, stand in line at the bank and take the dog for a walk. We are constantly on the go, and always on our feet, ready to tackle the next errand or take on the next "to-do."
But have you ever stopped to think about the intricate and biological wonder that has taken you to all those places? Your feet. Made up of 52 bones and more than 100 ligaments, tendons and muscles all working together, this crucial part of your body works hard to keep you on the move. When was the last time you took into account how much your feet affect your lifestyle, and for that matter, how much your lifestyle affects your feet?
"The foot is the most complicated part of the body, but the most neglected by most people," says Raymond Margiano, Ph.D., founder and CEO of Foot Solutions, Inc., which focuses on providing a line of shoes, arch supports and foot care accessories. "A lot of people don't understand it, but the feet are the foundation of your body, similar to the foundation of a building. Over time, you start seeing stress cracks in the foundation, and the building starts to lean. The foundation of your body is critical to your alignment; everything above your feet needs that solid support."
Margiano, who has been in the footwear and pedorthic industry for more than 20 years, is not alone in his opinion. Dr. Carl Kihm, podiatric physician and surgeon with Village Podiatry Centers, says we oftentimes take our feet for granted until we experience an ongoing problem that is painful or debilitating.
"Our feet are our foundation and they allow us to be mobile and live," Dr. Kihm says. "If the bones and joints of your foot and/or ankle are in poor condition, this can affect your posture, pace, the pressure distribution and time spent on each foot while walking, which can ultimately lead to knee, hip and back pains."
Dr. Kihm, who sees patients at Village Podiatry Center's Marietta-Kennestone and Douglasville offices, says early assessment and treatment is the optimal way to keep your feet healthy. "Do not ignore your feet. If they hurt, you should listen to your body and you should not try to deal with the pain," he says. "Consider which factors make them feel worse and avoid these."
Clearly, paying attention to your feet and what your body is telling you are the first steps in obtaining happy and healthy feet. But what are we dealing with here? And what do we do to tackle common foot problems?
The Usual Suspects
Dr. David Scott of Resurgens Orthopaedics, who specializes in foot and ankle issues as well as trauma and knee surgeries, puts foot health into simple terms. "When you don't take care of your feet, they hurt, and you don't get to do what you like to do," he says. "Take care of your feet, and you get a lifetime of foot health and wellness." However, despite the straightforward advice, 10 to 20 percent of people have some kind of recurring or chronic foot problem. Here are a few of the more common ailments:
A bunion is a condition where the big toe gradually dislocates, and can get more severe and painful over time. This condition is caused by the bone structure of your feet, which is hereditary. Dr. Kihm says some shoes can make the condition more painful, but shoes are not the cause of bunions.
Treatment: "Wide-toed shoes and padding may be helpful to reduce this kind of pain," Dr. Kihm says. "However, because bunions are a bone condition, sometimes, surgery is required to address and correct the bony etiology and painful deformity."
A hammertoe is a deformity of the second, third or fourth toes, in which the toe is bent at the middle joint. If left untreated, a hammertoe may become fixed and require surgery.
Treatment: "Everything in your body has some kind of balance, such as the bicep and the tricep in your arm," Dr. Scott says. "The hammertoe is a sort of imbalance in the toe where the first knuckle is bent up and the second knuckle gets bent down." Dr. Scott says a hammertoe can be surgically straightened by removing the knuckle and lengthening the tendons. The knuckle is then fused straight. "You have to balance all of the joints to correct the hammertoe," he says. Dr. Scott also says forefoot problems in the ball of your foot may be the result of tight calf muscles. "When your calf muscle is tight, it puts more pressure on the ball of your foot when you walk," he says. "People who experience bunions and hammertoes should have their calf muscles checked, and if tight and causing more pressure on the ball of your foot, they should be lengthened during surgery."
Corns are pressure-induced callus formations on the toes. Dr. Kihm says each patient is assessed individually to determine why these are occurring.
Treatment: "Your podiatrist can usually trim your corn and this can allow for an immediate relief of pain," he says. "If your shoes are too tight or if you have hammertoes associated with these corns, these can be causative factors that need to be addressed to prevent the corns from returning." Padding around the toes can also reduce the pressures that create corns. However, Dr. Kihm says he cautions people with poor sensation, especially diabetic patients, not to use medicated corn pads. "These contain salicylic acid that dissolves away the corn, but can also dissolve away healthy skin and create wounds and more severe problems."
Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed. The bottom of the heel becomes tender and sore. Dr. Scott says there are many factors that cause plantar fasciitis. "The aging of the tendon and the stress we put on it in day-to-day life is one factor," he says. "We are also heavier than we should be, and not as athletic as we should be." Dr. Scott says while sometimes there is an event where you may injure your heel, very frequently, there is not one factor to put your finger on.
Treatment: "Given enough time, plantar fasciitis will actually go away, but you can do things to speed it up," Dr. Scott says. Maintaining a healthy body weight, stretching the upper calf muscle, wearing good footwear or anti-inflammatory medications are all possible forms of treatment. "Ninety-five percent of heel pain, however, gets better with stretching," he says.
An ingrown nail occurs when the side of the nail grows into the skin. When left untreated, the irritated nail can create infection. Causes include footwear that crowds the toes, not properly cutting the nail or toenail injury.
Treatment: Dr. Kihm says to prevent ingrown nails, avoid cutting your nails too short and do not cut them on a sharp curvature. If you develop an ingrown nail, see your podiatrist for treatment; an in-office procedure is oftentimes performed, which can remove the ingrown nail and prevent it from returning.
If the Shoe Fits...
Certain aches and pains can be avoided by simply paying attention to the shoes you put on your feet. Margiano says most foot problems are caused or aggravated by wearing ill-fitted shoes. "Ninety percent of people are not wearing properly fitted shoes... you want to wear shoes like the shape of your foot, with room and support for walking or running," he says. "Your foot takes the impact if you're not supporting it properly."
For women, the daily use of high-heels is a major culprit in foot pain. "Women will have five times more issues with their feet than men, and the main reason is the female tendency to wear shoes more for appearance than for comfort," Margiano says.
For a woman to avoid issues due to high-heels, Margiano suggests not wearing heels higher than 1.5 to 2 inches, as well as wearing high-heels in moderation. "You don't want to force your feet into this awkward position," he says. "Heels slam those toes into a narrow wedge, and are the leading cause for bunions and hammertoes."
But men aren't free from shoe discomfort either. According to Dr. Kihm, men are five times more likely to have a traumatic fracture of their heel bone than women. "These kinds of injuries are usually experienced when jumping or falling from a height, and since men, for example, work more frequently on roofs, this makes sense."
Dr. Scott says men also are more prone to overuse and sports-related injuries, and injuries among his male and female patients are equal. However, women still take the brunt of footwear-related pain. "I see two or three women patients for every male," he says. "Women are in for more shoe-related issues due to restrictive footwear, and I see more foot and ankle issues with women."
Flip-flops and ballet flats, which offer little arch support, are also a concern for health care professionals. Margiano says there are many foot injuries that result from the foot not being supported, like fallen arches. "Your foot, overtime, will collapse, and being flat footed puts more pressure on your ankle and knees," Margiano says. "You can purchase custom inserts for flats or heels to support the arch... a lot of things can be done for fashionable footwear. When you put in an insert, your foot feels better and feels more supported."
Dr. Kihm says there are many different reasons for fallen arches, and some may have more to do with heredity. "If this problem is noted in children, or since childhood, this typically reflects the patient's inherited bone structure of the arch of his or her feet," he says. "When this problem arises in adulthood, the cause can be the result of tendon damage and dysfunction. We commonly see this in older and overweight females, and it commonly only involves one foot at a time."
For an inherited or developed issue, Dr. Kihm suggests wearing supportive sneakers with rigid arch supports to help prevent or treat these conditions. However, when pain, fatigue or weakness is associated with fallen arches, Dr. Kihm warns that you should report for a physical exam, as these conditions may get worse with time.
Put Your Best Foot Forward
Understanding the steps to take in addressing foot problems will help put you on the right track for a healthier lifestyle. And taking care of your feet can be a simple process. Dr. Scott offers this final advice:
"Keep your weight near your ideal range, pick your activities carefully. When you change activities, you should change it in a gradual way so your feet don't fracture or break. Wear comfortable shoes," he says. "Also, calf stretching and a flexibility routine are important. Those who have stayed flexible as they age tend to do better. Flexibility should be a long-term part of everyone's fitness goals."
Having the right footwear is crucial to maintaining healthy feet. But we don't think about it as much as we should. According to Dr. Kihm, the pressure on your feet exceeds your bodyweight when walking, and can reach four times your body weight when running. "We don't think about this a lot and maybe we 'put up' with our feet being sore or painful," he says. "It should not be this way and it does not need to be. Proper footwear is very important so you can support and protect your feet as they function."
The Right Support
Bubba Sloan, co-founder of High Country Outfitters, knows his way around a hiking boot. Sloan says, when it comes to footwear, making sure you have the proper fit is important. "If there was one shoe on the market that I think would fit everyone, I'd sell one shoe," he says. To find the right boot keep these tips in mind:
- The sole: You need sturdiness in the sole of the boot so the foot stays in a stable position. Boots which cover the ankle are not meant to prevent rolling your ankle, but to protect from rocks or other abuses on the trail.
- Socks: Merino wool lets the foot breath and doesn't cause temperatures to rise in the boot like synthetic socks.
- Boots: A light weight, waterproof boot is a good starting point for new hikers.
For those who wear heels on a daily basis, it's no surprise to hear that high heels cause a range of foot problems.
- Dr. Kihm: "High heels change the forces on the foot as they shift the pressure to the front of the foot. They also have a narrow toe box, which crams the toes together, and can cause corns and calluses, or make bunions more painful."
- Dr. Scott: "It's common sense and we all know it, but we like fashion. You'd rather look good than feel good sometimes. Shoes that are wide enough for your feet, with good thick bottoms, and don't constrict the bone are ideal. Fashion footwear is tight, and doesn't fit how the human foot was made... very few people can wear high heels when they're older."
Raymond Margiano, CEO - Foot Solutions, Inc., www.footsolutions.com
Dr. Carl Kihm - Village Podiatry Centers, www.villagepodiatrycenters.com
Dr. David Scott - Resurgens Orthopaedics, www.resurgens.com
Bubba Sloan - High Country Outfitters, www.highcountryoutfitters.com