Basic Foot Care Guidelines

Basic Foot Care Guidelines

1. Don't ignore foot pain. It's not normal. If the pain persists, contact our office.
2. Inspect your feet regularly. Pay attention to changes in color and temperature. Look for thick or discolored nails (a sign of developing fungus), and check for cracks or cuts in the skin. Peeling or scaling on the soles of feet could indicate Athlete's Foot. Any growth on the foot is not considered normal.
3. Wash your feet regularly, especially between the toes, and be sure to dry them completely.
4. Trim toenails straight across, but not too short. Be careful not to cut nails in corners or on the sides; it can lead to ingrown toenails. Persons with diabetes, poor circulation, or heart problems should not treat their own feet because they are more prone to infection.
5. Make sure that your shoes fit properly. Purchase new shoes later in the day when feet tend to be at their largest, and replace worn-out shoes as soon as possible.
6. Select and wear the right shoe for the activity that you are engaged in (e.g. running shoes for running).
7. Alternate shoes -- don't wear the same pair of shoes every day.
8. Avoid walking barefooted. Your feet will be more prone to injury and infection. At the beach or when wearing sandals always use sunblock on your feet as the rest of your body.
9. Be cautious when using home remedies for foot ailments. Self-treatment can often turn a minor problem into a major one.
10. If you are a diabetic, contact our office and schedule a check-up at least once a year.

Athletic Foot Care

Whether you are a professional athlete or play sports just for fun, the demands made on your feet and lower limbs can lead to a range of injuries, including blisters, sprained ankles, torn ligaments, shin splints, knee pain, lower back pain and other joint or muscle problems. Added to these are common complaints such as corns, calluses and Athlete's Foot. Your running style, quality of footwear, and even minor limb length differences can contribute to injury.

Here are some tips for athletic foot care:

• Wash your feet every day, and dry thoroughly.
• Wear only good quality, well-fitting cotton socks.
• Always use the correct shoe for each sport and surface.
• Get in shape. Being overweight or out of shape places added stress on the feet. Condition yourself gradually with stretching exercises for 15 to 20 minutes (warm-up and cool-down periods) before and after any activity.
• Wear correct shoes. Footwear should be given the same consideration as any other piece of sporting equipment. Sports shoes should protect as much as possible, be durable, and should be right for the sport and surface.

Blisters

Most blisters on the feet are caused by friction and do not require medical attention. New skin will form underneath the affected area and the fluid built up in the blister is simply absorbed back into the tissue. You can soothe ordinary blisters with Vitamin E ointment or an aloe-based cream.

Do not puncture a blister unless it is large, painful, or likely to be further irritated. If you have to pop a blister, use a sterilized needle or razor blade. Wash the area thoroughly, then make a small hole and gently squeeze out the clear fluid. Apply a dab of hydrogen peroxide to help protect against infection. Do not remove the skin over a broken blister. The new skin underneath needs this protective cover. Cover the area with a bandage and mild compression.

If the fluid is white or yellow, the blister is infected and needs medical attention.

Preventing Blisters

You can prevent blisters by breaking in new shoes gradually and putting petroleum jelly or an adhesive bandage on areas that take the rub—before the blister happens.  Wear socks that have heels instead of tube socks (they bunch up and cause blisters). Acrylic and other synthetic-fiber socks are good choices. Be sure to wash and dry your feet daily to prevent bacterial infections, such as Athlete's Foot.

Children’s Feet

Children with strong, healthy feet avoid many kinds of lower extremity problems later in life. That's why it is important to inspect your children's feet periodically.

Infants

The size and shape of your baby's feet change quickly during their first year. Because a baby's feet are flexible, too much pressure or strain can affect the shape of their feet. It's important to allow baby to kick and stretch their feet freely. Also, make sure shoes and socks do not squeeze the toes.

Toddlers

Do not to force a toddler to walk before s/he is ready. Once walking begins, watch the toddler's gait. Many toddlers have a pigeon-toe gait, which is normal. Some initially learn to walk landing on their toes instead of their heels. Most children outgrow both these problems. But other conditions detected early can be treated more easily.

When Foot Care Is Needed

To help with flatfeet, special shoes or orthotics may be prescribed. To correct mild in-toeing or out-toeing, your toddler may need to sit in a different position while playing or watching TV. If your child's feet turn in or out a lot, corrective shoes, splints, or night braces may be prescribed.

The foot's bone structure is well-formed by the time your child reaches age 7 or 8, but if a growth plate (the area where bone growth begins) is injured, the damaged plate may cause the bone to grow oddly. With a doctor's care, however, the risk of future bone problems is reduced.

Remember to check your child's shoe size often. Make sure there is space between the toes and the end of the shoe and that the shoes are roomy enough to allow the toes to move freely. Don't let your child wear hand-me-down shoes.

Corns and Calluses

Corns and calluses are protective layers of compacted, dead skin cells. They are caused by repeated friction from skin rubbing against bony areas or against an irregularity in a shoe. Corns ordinarily form on the toes and calluses on the soles of the feet. The friction and pressure can burn or otherwise be painful and may be relieved by moleskin or padding on the affected areas.

Never cut corns or calluses with any instrument, and never apply home remedies, except under a podiatrist's instructions.

Diabetic Foot Care

Diabetics are more prone to various foot problems than those without diabetes due to the development of painful nerve damage called peripheral neuropathy. Neuropathy can affect your entire body, but most often the legs and feet are the most prone areas to serious health complications.

The damage to your nerves can cause the loss of feeling in your feet, making it difficult to detect extreme temperatures and pain as easily, or readily, as someone who does not have diabetes. As a result, you could sustain a serious cut or wound and not even notice your foot is injured until an infection begins. Many diabetic foot problems can be prevented in some measure with improved blood sugar control and a strengthened immune system.

If you are among one of the millions of people in the United States with diabetes, it is important to visit your podiatrist for regular foot examinations in order to maintain healthy feet and a strong body.

Examine your Feet Daily

Careful inspection of your feet on a regular basis is one of the easiest, least expensive and most effective measures for preventing foot complications. By examining your feet daily, and after every injury, you are taking a crucial step to preventing serious foot problems. Noticeable changes, such as temperature, skin color, pain, or swelling may be warning signs for poor circulation or loss of sensation that could potentially lead to something more serious.

Annual examinations by your podiatrist are also vital for anyone with diabetes. A podiatrist can provide a more thorough exam and detect any signs of changes, such as broken skin or ulcers that can be detrimental to the health of your feet and body. Your podiatrist can also check for areas of high pressure or loss of blood circulation.

Clean Your Feet

With diabetes, it is important to keep your feet clean. Wash your feet daily with warm water and mild soap. After washing, make sure you dry your feet thoroughly, especially in-between the toes. You may also apply non-irritating moisturizer to prevent cracks and to keep your feet smooth.

Be sure to also avoid ingrown toenails, which can get infected, by keeping them trimmed neatly. If you are unable to cut your toenails safely, ask your podiatrist for professional assistance. And never attempt to cut your own bunions or corns as this can lead to infection, as well. Instead, remember to visit your podiatrist for safe and pain-free removal.

To further protect your feet from harm, be sure to:

• Avoid smoking, as it reduces blood flow to your feet
• Buy comfortable shoes that are not too tight or too loose
• Wear clean, dry socks and change them everyday
• Never walk barefoot in order to protect your feet from harmful objects

Diabetes is serious, especially when your feet are involved. Early detection and simple care are just a few things that can be done to control and prevent complications as they arise.

Your podiatrist plays a critical role in the prevention and management of complications of the foot in diabetics. Talk to your podiatrist today to see what you can do now to keep your feet safe, strong, and healthy.

Foot Care for Seniors

It's normal for people to experience some foot problems as they age. But experts say that problems with feet can be the first sign of more serious medical conditions, particularly among older adults. Health problems, such as arthritis, diabetes, nerve issues, and circulatory disorders, may first be manifested in the feet. That is why it is important to pay attention to your feet and seek medical attention as soon as you notice a problem.

Here are some foot care tips for older adults:

• Practice good foot care. Check your feet regularly or have a member of your family check them for you.
• Keep blood circulating to your feet as much as possible. Do this by putting your feet up when you are sitting or lying down, stretching if you've had to sit for a long while, walking, having a gentle foot massage, or taking a warm foot bath.
• Wear comfortable shoes that fit well to prevent pressures that can lead to friction and infection and keep your foot structure properly aligned.
• Avoid exposing your feet to cold temperatures.
• Don't sit for long periods of time (especially with your legs crossed).
• Don't smoke because it decreases blood supply and increases the chance of swelling and other circulatory problems.

Foot Self-Exam

What should you look for to make sure your feet are healthy? Here are some general guidelines:

• Balance. A good test for balance involves standing on one foot, with your arms out to the side and your eyes closed. If you are less than 30 years old, you should be able to balance for 15 seconds, 30 to 40 years old for 12 seconds, 40 to 50 years old for 10 seconds and over 50 years old for seven seconds. This can be improved with exercises.
• Circulation. Look at the color of your toes. Do they look like a normal nail color or are they leaning towards red, white, purple, or blue? Press down on the nail of your big toe until the color blanches. Now let go and allow the blood flow to return to your toe. The return of normal color should take 2 to 5 seconds in a person with average circulation.
• Flexibility. How flexible are your toes? Try to pick up a marble or a small dish towel with your toes. To test your ankle flexibility, hang your heel off of a stair. Now let the heel go below the level of the stair. If this causes pain, stop the test. If your heel goes below the level of the stair without causing strain in your calf, that is a good sign. If there is some strain, this can be improved with flexibility exercises.
• Pain. A healthy foot does not produce any pain.
• Sensation. Take a pencil eraser and lightly run it on the top, bottom, and both sides of your feet. The sensation should feel equal in all quadrants. It may tickle on the bottom of the feet. That is normal.
• Skin. Check your skin for calluses, blisters, or areas of irritation. Stand next to your shoes. Are they shaped like your feet or are they causing areas of constriction that may result in irritation? Put your hand inside your shoe. Are there seams, tacks, or rough places in the shoe that correspond to calluses or blisters on your feet?

Pedicures

Increased media attention has heightened awareness for the spread of infections from shared instruments and unhygienic practices in many salons. One way to avoid any exposure is to do pedicures for yourself at home. Here are some easy steps to follow that will make sure to keep your feet safe:

1. Soak your feet in warm soapy water for approximately 10 minutes. This helps soften and clean skin and nails.
2. After the foot soaking, gently rub the skin with a pumice stone or emery board. This gets rid of dead skin cells and calluses. Somebody scrub products can help exfoliate dead skin. (Please contact our office if you have deep calluses or corns and need help shaving them.)
3. Push back the cuticles with an orange stick or a Hindu stone. Cuticles offer protection from bacteria and infection. Cuticles clearly overhanging the nail margins need to be carefully trimmed. Do not trim any further than the nail margin or draw blood as this can lead to infection.
4. Trim toenails straight across rather than in a curved pattern. This helps prevent ingrown toenails, allowing the straight edge of the nail to advance as one unit. Toenails should be trimmed just enough so that you can see a few millimeters of skin just beyond the nail margin. Nails should not overhang the edge of the toe.
5. Refine the nail edge with an emery board, maintaining the straight edge.
6. Apply cream and moisturizing lotion to the skin and nail margins.
7. Massage the cream or lotion into the feet. A foot massage can help relieve tension and tired, aching feet. You can get a good massage at home by rolling your feet back and forth over a rolling pin or bottle. Specialists in the body's reflexes, called reflexologists, believe that points on the foot correspond to other body parts and ailments can be relieved through reflexology. They believe the ball of the foot has a connection to the lungs, the heel to the lower back, and the great toe to the head. Although no scientific research exists to back up these claims, reflexology does seem to produce positive results in some people.
8. Apply nail polish remover to the nails to gently remove excess lotion. This allows nail polish to adhere better to the nail. To apply nail polish, start with a base coat, followed by one or two coats of the nail color, and, finally, a clear topcoat.
9. Space your pedicures apart by approximately eight weeks.

Women’s Feet

High Heels

Women invite foot problems by wearing high heels. High heels may contribute to knee and back problems, disabling injuries in falls, shortened calf muscles, and an awkward, unnatural gait. In time, high heels may cause enough changes in the feet to impair their proper function. Most women admit high heels make their feet hurt, but they tolerate the discomfort in order to look taller, stylish, and more professional.

There are ways to relieve some of the abusive effects of high heels. Women can limit the time they wear them by alternating with good-quality, oxford-type shoes or flats for part of the day. Keep the heel height to no more than two inches and make sure the fit for the rest of the shoe is good. Varying heel heights whenever possible to wear shoes as low as possible in each situation. For example, there are comfortable and attractive "walking" pumps for women for work and social activities.

Experts say the best shoes for women may be:

• A walking shoe with ties (not a slip-on).
• Shoes with a Vibram-type composition sole.
• A relatively wider heel, no more than a half or three-quarters of an inch in height.

Stockings

Women who always wear nylon pantyhose expose themselves to a host of foot problems. Nylon doesn't breathe and the heat that it generates and traps can lead to excessive perspiration. A warm, damp area is an ideal place for fungal infections such as Athlete's Foot. Inexpensive nylon pantyhose can also cause forefoot problems, because they don't allow the normal expansion of the foot when walking, and may pull the toes backward when the pantyhose ride up. The cramping and pressure of the hose can contribute to ingrown toenails and hammertoes. If you must wear pantyhose, be sure they fit properly around the foot. Limit the length of time you wear them whenever possible and, like socks, wash them after every use.

Pregnancy

Pregnant women need to observe good foot health to prevent pain and discomfort. Since the body undergoes changes and acquires a new weight-bearing stance, women should wear shoes with broad-based heels that provide support and absorb shock. Additional body weight also calls for more support, to prevent foot "breakdown."

The expectant mother often experiences more than ordinary swelling of her feet and ankles, which can aggravate existing foot conditions and promote inflammation or irritation. Pregnancy also triggers the release of hormones that enhance loose ligaments, which can contribute to foot strain. To help overcome these problems, allow time each day to stay off your feet. Elevate the feet and legs when you are sitting to help prevent and reduce swelling. Don't sit for long periods of time. If problems do develop, please contact our office.

Women over 65

Older women have more trouble with their feet than younger ones, often because fat pads on the bottom of the feet tend to deteriorate in the aging process. Many foot problems for older women can be alleviated simply by wearing properly fitted, well-constructed shoes that provide cushioning and have a soft, flexible upper that will conform to the shape of their feet. Shoes made of leather that "breathes" can also reduce the possibility of skin irritation.

Soles should be lightweight, with enough flexibility and shock-absorbing quality to provide solid footing and not be slippery. Low-heeled shoes provide greater stability, more protection for the feet, and greater comfort. Because older women often have circulatory problems, they have a special need to keep their feet warm in cold weather, to prevent frostbite or chilblains. Most importantly, keep walking and moving around every day so that all the systems in the legs and feet remain stretched and circulation stays healthy.

Your Feet at Work

Productive workers depend on their ability to walk and move about safely, with ease and comfort.

When your job requires you to stand on your feet for long periods, work in potentially hazardous areas or with potentially hazardous materials, you have some increased risk of foot injury. You can do a lot to prevent injuries by keeping your feet healthy and following safe work practices.

According to the National Safety Council, in any given year, there are about 120,000 job-related foot injuries, one-third of them toe injuries.

In addition to following the same basic foot care guidelines for all people, when you are on the job be sure to develop safe work habits and attitudes. This includes wearing protective footwear when appropriate. The National Safety Council also reports that only one out of four victims of job-related foot injury wear any type of safety shoe or boot. The remaining three either are unaware of the benefits of protective footwear or complain about it.

Bunion Prevention

Because bunions develop slowly, taking care of your feet during childhood and early adulthood can pay off later in life. Keep track of the shape of your feet as they develop over time, especially if foot problems run in your family.

Exercising your feet can strengthen them. Learn to pick up small objects with your toes. Wear shoes that fit properly and that do not cramp or pinch your toes. Women should avoid shoes with high heels or pointed toes.

Burning Feet

Burning feet are a common complaint among many groups of people, most commonly those over 50 years of age and in diabetics. There are many causes. Heavy alcohol use may lead to the condition. Neuropathy and loss of sensation often are contributors as well. Other causes include thyroid dysfunction and gastric restriction in obesity. Some infectious diseases, such as leishmaniasis, a rarely reported neurologic change secondary to a bacteria, also may cause burning feet. 

Treatment

Treatments vary, depending on the cause of the burning foot syndrome. Diagnostic tests often are performed before a diagnosis is made.

Ingrown Nails

Ingrown nails are nails whose corners or sides dig painfully into the skin, often causing infection. They are frequently caused by improper nail trimming, but also by shoe pressure, injury, fungus infection, heredity, and poor foot structure.

Toenails should be trimmed straight across, slightly longer than the end of the toe, with toenail clippers.

If they become painful or infected, contact our office. We may remove the ingrown portion of the nail, and if the condition reoccurs frequently, we may permanently remove the nail.

Osteoporosis

Your feet may be one of the first places to see the effects of osteoporosis. A stress fracture in the foot is often the first sign.

There is a lot you can do throughout your life to prevent osteoporosis, slow its progression and protect yourself from fractures.

• Include adequate amounts of calcium and vitamin D in your diet.
• Exercise regularly.

Foot Odor and Smelly Feet

The feet and hands contain more sweat glands than any other part of the body (about 3,000 glands per square inch). Feet smell for two reasons: you wear shoes and your feet sweat. The interaction between your perspiration and the bacteria that thrive in your shoes and socks generates the odor. Any attempt to reduce foot odor has to address both your sweating and your footwear. Smelly feet can also be caused by an inherited condition called hyperhidrosis, or excessive sweating, which primarily affects males. Stress, some medications, fluid intake, and hormonal changes also can increase the amount of perspiration your body produces.

Prevention

Smelly feet generally can be controlled with a few preventive measures:

• Always wear socks with closed shoes.
• Avoid wearing nylon socks or plastic shoes. Instead, wear shoes made of leather, canvas, mesh or other materials that let your feet breathe.
• Bathe your feet daily in lukewarm water, using a mild soap. Dry thoroughly.
• Change your socks and shoes at least once a day.
• Check for fungal infections between your toes and on the bottoms of your feet. If you spot redness or dry, patchy skin, get treatment right away.
• Don't wear the same pair of shoes two days in a row. If you frequently wear athletic shoes, alternate pairs so that the shoes can dry out. Give your shoes at least 24 hours to air out between wearings; if the odor doesn't go away, discard the shoes.
• Dust your feet frequently with non-medicated baby powder or foot powder. Applying antibacterial ointment also may help.
• Practice good foot hygiene to keep bacteria levels at a minimum.
• Wear thick, soft socks to help draw moisture away from the feet. Cotton and other absorbent materials are best.

These preventive measures also can help prevent Athlete's foot which can flourish in the same environment as sweaty feet. However, Athlete's foot won't respond to an antibacterial agent because it's caused by a fungus infection. Use an anti-fungal powder and good foot hygiene to treat Athlete's foot.

Treating Smelly Feet

Persistent foot odor can indicate a low-grade infection or a severe case of hereditary sweating. In these cases, our practice may prescribe a special ointment. You apply it to the feet at bedtime and then wrap your feet with an impermeable covering such as kitchen plastic wrap. 

Soaking your feet in strong black tea for 30 minutes a day for a week can help. The acid in the tea kills the bacteria and closes the pores, keeping your feet dry longer. Use two tea bags per pint of water. Boil for 15 minutes, then add two quarts of cool water. Soak your feet in the cool solution. Alternately, you can soak your feet in a solution of one part vinegar and two parts water. 

A form of electrolysis called iontophoresis also can reduce excessive sweating of the feet, but requires special equipment and training to administer. In the most severe cases of hyperhidrosis, a surgeon can cut the nerve that controls sweating. Recent advances in technology have made this surgery much safer, but you may notice sweating in other areas of the body after the procedure.