Happy, Healthy Feet!

The foot is an intricate network of bones (26), 33 joints, and various ligaments, tendons, and muscles. Feet take a daily “pounding” as a major shock absorber. It is estimated that an average person takes approximately 10,000 steps each day. Maintaining healthy feet means less distress on the legs, hips, back, shoulders and head. A happy foot makes for a happy body!

A broken foot or broken ankle is a common injury. This may occur from falling, taking a misstep, dropping a heavy object on the foot or possibly from being in a car crash. The fracture can range from tiny cracks in the bones to breaks that pierce the foot skin. The Mayo Clinic patient education reference for a broken foot bone suggests that most broken toes heal well, usually within four to six weeks. In less common situations, depending on the precise location and severity of the injury, a broken toe may become infected or be more vulnerable to osteoarthritis in the future.

Common foot problems and injuries (aside from fractures) include

• ankle sprains (an inversion sprain is most common and happens when the foot falls inward and the outer ligaments are stretched too far; the eversion sprain is when the foot is twisted outwards and the inner ligament is stretched).
• hammer toe (a deformity of the second, third or fourth toe in which the toe is bent at the middle joint, so that it resembles a hammer. Hammertoe results from shoes that don't fit properly or from a muscle imbalance; usually there is a combination with one or more other factors).
• bunion (bony bump that forms at base of the big toe. The big toe pushes toward the next toes as well as pushing outward on the metatarsal directly behind the big toe, with the joint enlarging and sticking out).
• neuroma (sometimes referred to as a “pinched nerve” or a nerve tumor; it is a benign growth of nerve tissue frequently found between the third and fourth toes; causes pain, a burning sensation, tingling, or numbness between the toes and in the ball of the foot, especially when walking).
• plantar fasciitis (plantar fascia is the thick tissue on the bottom of the foot which connects the heel bone to the toes and creates the arch of the foot. When this tissue becomes swollen or inflamed, it is called plantar fasciitis. This is one of the most common causes of heel pain. One cause is wearing shoes with poor arch support or soft soles.
• bone spur (an outgrowth of bone that can occurs along the edges of a bone; is most commonly found in joints where two or more bones come together; frequently associated with plantar fasciitis).
• Achilles tendinitis (associated with overuse and degeneration; generally results from repetitive stress to the tendon; symptoms include thickening of the tendon, development of a bone spur, pain and stiffness of the tendon in the morning, severe pain after exercising, and swelling most of the time).

Suggestions for keeping feet healthy and happy!

• Choose proper footwear by putting shoes to the 1-2-3 test as suggested by the American Podiatric Medical Association. Step 1: Press on both sides of the heel area of the shoe to ensure the heel is stiff and won't collapse. Step 2: Bend the shoe to check for toe flexibility. The shoe shouldn't bend too much in the toe box area, but it shouldn't be too stiff and inflexible either. Step 3: Try twisting the shoe; it shouldn't twist in the middle. If shoes don’t feel comfortable or you don’t feel steady in the shoes, don’t buy them. Bring your own socks to try on shoes and walk around for a bit of time. Comfortable, yet sturdy shoes are a must.

• Problems/solutions on types of footwear: you want to wear wedges (problem is twisting or spraining an ankle and the solution is trying a wider, flatter wedge and a rubber sole with good traction); you want to wear peep-toe sandals (problem is increased pressure on toes and the solution is to wear them only for short time); flats (problem is inadequate arch support/cushioning and the solution is to use inserts for shock absorption and avoid prolong wear); platforms and high heels (problem is pain in ball of the foot and the solution is to wear less than two inch heels which provide more stability); gladiator and strappy sandals (problem is irritation between toes, dead skin build-up around heels, lack of shock absorption and the solution is to select soft, supple leather as well as making sure the heels and toes do not land off the soles).
• Information about pedicures such as bringing your own utensils, scheduling early morning because foot salon baths are usually cleanest at that time, asking about sterilization procedures of spa equipment, and other recommendations for maintaining healthy cuticles and nails can be found at the American Podiatric Medical Association site.

Ice is Not Nice! Update on recommendations for treating a sprained ankle or knee using the acronym RICE (rest, ice, compression, and elevation): Eliminate the use of “rest” and “ice.” The National Athletic Trainers’ Association recommends early movement such as contracting and relaxing a joint because this improves blood flow which improves healing. Resting the injured area only delays healing. The purpose of ice right after a sprain was to cool the injury area and delay swelling and reduce pain. Now the recommendation is not to use ice. Why? Icing an injury shuts off the blood supply. Blood carries inflammatory cells called macrophages that release the hormone called insulin-like growth factor IGF-1 to the injured area to help in the healing process. Icing prevents blood flow, thus the release of the hormone. http://stoneathleticmedicine.com/2014/04/rice-the-end-of-an-ice-age/comment-page-2/

Suggested websites to visit for further information:

• http://www.apma.org/Learn/HealthyFeetTipsList.cfm?navItemNumber=535
• http://www.theorthopedicclinicassociationmd.com/home/tocaphysicians/orthopedic-care-foot-ankle/
• http://www.mayoclinic.org/symptoms/foot-pain/basics/definition/sym-20050792
• http://www.aofas.org/footcaremd/conditions/ailments-of-the-smaller-toes/Pages/Hammertoe.aspx
• http://www.summitortho.com/services/ankle-foot/