Partners with Clarian Human Motion
Prevention
The following steps can prevent foot problems and foot pain:
• Wear comfortable, properly fitting shoes. They should have good arch support and cushioning.
• Wear shoes with adequate room around the ball of your foot and toe.
• Wear sneakers as often as possible, especially when walking.
• Avoid narrow-toed shoes and high heels.
• Replace running shoes frequently.
• Warm up before exercise, cool down after exercise, and stretch adequately.
• Increase your amount of exercise SLOWLY over time to avoid putting excessive strain on your feet.
• Lose weight if you need to.
• Learn exercises to strengthen your feet and avoid pain. This can help flat feet and other potential foot problems.
• Keep feet dry to avoid friction. This may help prevent corns and calluses.
• Avoid alcohol to prevent attacks of gout.
Skin creams can help maintain skin softness and pliability. Taking a warm footbath for 10 minutes two or three times a week will keep the feet relaxed and help prevent mild foot pain caused by
fatigue. Adding 1/2 cup of Epsom salts increases circulation and adds other benefits. Taking footbaths only when feet are painful is not as helpful.
A pumice stone or loofah sponge can help get rid of dead skin.
Reflexology is a type of massage therapy that manipulates hands and feet. A pleasant exercise using this method can be done while taking a bath. Use the thumb, index, and middle finger to rotate
each toe in a circular motion. Then, make a fist and rotate it slowly around the bottom of the foot. Finally, gently twist each foot as if wringing wet clothes, moving the top and bottom in opposite
directions.
Correct Walking. In addition to wearing proper shoes and socks, walk often and correctly to prevent foot injury and pain. The head should be erect, the back straight, and the arms relaxed and swinging
freely at the side. Step out on the heel, move forward with the weight on the outside of the foot, and complete the step by pushing off the big toe.
Foot Exercises. Exercises specifically for the toe and feet are easy to perform and help strengthen them and keep them flexible. Helpful exercises include the following:
Raise and curl the toes 10 times, holding each position for a count of five.
Put a rubber band around both big toes and pull the feet away from each other. Count to five. Repeat 10 times.
Pick up a towel with the toes. Repeat five times.
Pump the foot up and down to stretch the calf and shin muscles. Perform for 2 or 3 minutes.
Early Development. The first year of life is important for foot development. Parents should cover their babies' feet loosely, allowing plenty of opportunity for kicking and exercise. The child's
position should be changed frequently. Staying too long on the stomach can strain the feet. Children generally walk between 10 and 18 months. They should not be forced to start walking early. Wearing
just socks or going barefoot indoors helps the foot develop normally and strongly and allows the toes to grasp. Going barefoot outside, however, increases the risk for injury and other conditions,
such as plantar warts.
Shoes. Children should wear shoes that are light and flexible, and since their feet perspire greatly, their shoes should be made of materials that breathe. Footwear should be replaced every few
months as the child's feet grow. Footwear should never be handed down.
Sports. High-impact sports can injure growing feet, and parents should be sure that their children's feet are protected if they engage in intensive athletics.
Shoes
In general, the best shoes are well cushioned and have a leather upper, stiff heel counter, and flexible area at the ball of the foot. The heel area should be strong and supportive, but not too
stiff, and the front of the shoe should be flexible. New shoes should feel comfortable right away, without a breaking in period.
Well-fitted shoes with a firm sole and soft upper are the best way to prevent nearly all problems with the feet. They should be purchased in the afternoon or after a long walk, when the feet have
swelled. There should be a 1/2 inch of space between the longest toe and the tip of the shoe (remember, the longest toe is not always the big toe), and the toes should be able to wiggle upward.
A person should stand when being measured, and both feet should be sized, with shoes bought for the larger-sized foot. It is important to wear the same socks as you would regularly wear with the
new shoes. Women who are accustomed to wearing pointed-toe shoes may prefer the feel of tight-fitting shoes, but with wear their tastes will adjust to shoes that are less confining and properly
fitted.
Ideally, the shoe should have a removable insole. Thin, hard soles may be the best choice for older people. Elderly people wearing shoes with thick inflexible soles may be unable to sense the position
of their feet relative to the ground, significantly increasing the risk for falling. Some research suggests that thick soles may even be responsible for foot injury in younger adults who engage
in high-impact exercise.
High heels are the major cause of foot problems in women. Although people believe that foot binding is a problem limited to Chinese women of the past, many fashionable high heels are designed to
constrict the foot by up to an inch. Women who insist on wearing high-heeled shoes should at least look for shoes with wide toe room, reinforced heels that are relatively wide, and cushioned insoles.
They should also keep the amount of time they spend wearing high heels to a minimum.
The way shoes are laced can be important for preventing specific problems. Laces should always be loosened before putting shoes on. People with narrow feet should buy shoes with eyelets farther
away from the tongue than people with wider feet. This makes for a tighter fit for narrower feet and looser for wider. If, after tying the shoe, less than an inch of tongue shows, then the shoes
are probably too wide. Tightness should be adjusted both at the top of the shoe and at the bottom. Where high arches cause pain, eyelets should be skipped to relieve pressure.
If shoes do require breaking in, moleskin pads should be placed next to areas on the skin where friction is likely to occur. Once a blister occurs, moleskin is not effective. Shoes should be changed
during the day and rotated in their use. As soon as the heels show noticeable wear, the shoes or their heels should be replaced.
Exercise and Sports. Shoes purchased for exercise should be specifically designed for a person's preferred sport. For instance, a running shoe should especially cushion the forefoot, while tennis
shoes should emphasize ankle support. Athletic socks are almost as important as shoes. Experts often recommend padded acrylic socks.
Occupational Footwear. Because a number of occupations put the feet in danger, workers in high-risk jobs should be sure their footwear is protective. For example, non-electric workers at risk for
falling or rolling objects or punctures should wear shoes with steel toes and possibly other metal foot guards. Electric workers should wear footgear with no metal parts (or insulated steel toes)
and rubber soles and heels. Chemical workers should wear shoes made of synthetics or rubber, not leather.
Aerobic Dancing
Sufficient cushioning to absorb shock and pressure, which should be many times greater than shock from walking. Arches that maintain side-to-side stability. Thick upper leather support. Box-toe.
Orthotics may be required for people with ankles that over-turn inward or outward. Soles should allow for twisting and turning.
Cycling
Rigid support across the arch to prevent collapse during pedaling. Heel lift. Cross-training or combo hiking/cycling shoes may be sufficient for the casual biker. Toe clips or specially
designed shoe cleats for serious cyclers. In some cases, orthotics may be needed to control arch and heel and balance forefoot.
Running
Sufficient cushioning to absorb shock and pressure. Fully bendable at the ball of the foot. Sufficient traction on sole to prevent slipping. Consider insole or orthotic with arch support for problem
feet.
Tennis
Allows side-to-side sliding. Low-traction sole. Snug fitting heel with cushioning. Padded toe box with adequate depth. Soft-support arch.
Walking
Lightweight. Breathable upper material (leather or mesh). Wide enough to accommodate ball of the foot. Firm padded heel counter that does not bite into heel or touch anklebone. Low heel close to
ground for stability. Good arch support. Front provides support and flexibility.
Taking fashion to extreme limits, some women have turned to cosmetic surgery as a drastic way to fit into high-heel shoes. Procedures include surgical shortening of the toes, narrowing of feet,
or injecting silicone into the pads of feet. The American Orthopaedic Foot and Ankle Society (AOFAS) www.aofas.org has expressed concern over this apparently growing trend. The AOFAS strongly advises
against cosmetic foot surgery and urges consumers to carefully consider the relative risks and benefits of undergoing unnecessary surgical procedures.
Insoles and Orthotics
Insoles are flat cushioned inserts that are placed inside the shoe. They are designed to reduce shock, provide support for heels and arches, and absorb moisture and odor. In general, they can be
very helpful for many people. For example, in a study of foot pain in New York police officers, more than 60% of them reported more comfort and less foot pain after using insoles. People respond
very differently to specific insoles. What may work for one person may not for another. The thickness of socks must be considered when purchasing insoles to be sure they do not squeeze the toes
up against the shoes.
Purchasing Insoles. Insoles can be purchased in athletic and drug stores. Shoe stores that specialize in foot problems often sell customized, but more expensive, insoles. In general, over-the-counter
insoles offer enough support for most people's foot problems. Most well-known brands of athletic shoes have built-in insoles.
Brands and Materials. There are many types of insoles available. They are composed of various materials, such as cork, leather, plastic foams, and rubber materials. Very beneficial insoles are
now made from viscoelastic polymers (such as Sorbothane, Airplus, Spenco, Dr. Scholl's Massaging Gel, and others), which are gel-like materials that act both as liquids and solids. In a 1999 military
study comparing Sorbothane with foam insoles, Sorbothane offered better protection against heel strikes while marching and running.
Heel Cushions for Shortened Achilles Tendons. People who have developed short, tightened Achilles tendons, usually women who have worn high-heeled shoes for prolonged periods, should consider using
heel cushions. Like insoles, heel cushions are inserted inside the shoes. They should be at least 1/8 inch thick, but not more than 1/4 inch thick.
For severe conditions, such as fallen arches or structural problems that cause imbalance, podiatrists or physicians may need to fit and prescribe orthotics, or orthoses, which are insoles molded
from a plaster cast of the patient's foot. Orthotics are usually categorized as rigid, soft, or semi-rigid.
Rigid Orthotics. Rigid orthotics are used to control motion in two major foot joints that lie directly below the ankle. They are often used to prevent excessive pronation (the turning in of the
foot) and are useful for people who are very overweight or have uneven leg lengths. Some experts warn that rigid orthotics may cause sesamoiditis or benign tumors that form from pinched nerves.
Soft Orthotics. Soft orthotics are designed to absorb shock, improve balance, and remove pressure from painful areas. They are made from a lightweight material and are often beneficial for people
with diabetes or arthritis. They need to be replaced periodically, and because they are bulkier than rigid orthotics, they may require larger shoes.
Semi-Rigid Orthotics. Semi-rigid orthotics are designed to provide balance, often for a specific sport. They are typically made of layers of leather and cork reinforced by silastic.
Orthotics vs. Insoles. Before seeking prescription orthotics, people with less severe problems should consider testing the lower-priced over-the-counter insoles. One study found that 72% of people
reported less foot pain from store-purchased insoles compared to 68% of those who had them custom made.
You should consult a specialist in foot care if you have any problems with your feet.
Other resources include:
www.aofas.org -- American Orthopaedic Foot and Ankle Society
www.acfas.org -- American College of Foot and Ankle Surgeons
www.apta.org -- American Physical Therapy Association
www.diabetes.org -- American Diabetes Association
ndep.nih.gov/campaigns/Feet/Feet_overview.htm -- National Diabetes Education Program
www.arthritis.org -- Arthritis Foundation
Reviewed By: Andrew L. Chen, M.D., M.S., Orthopedist, The Alpine Clinic, Littleton, NH. Review provided by VeriMed Healthcare Network.
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