Regular trips to a podiatrist will help keep you on your toes

It's all too easy to take healthy feet for granted — they take you where you want to go without complaint and don't ask for much in return. But, over time, those puppies can really start barking due to corns, calluses, bunions and other assorted ailments.

Many people are surprised to learn that the normal aging process affects feet as much as any other body part. Feet become wider and flatter, the protective fat pads on the soles thin out and circulation throughout the feet can decrease, all of which can lead to foot pain and damage. But you don't have to suffer alone. You — and your feet — need an ally. That's where a podiatrist comes in.

Doctors of podiatric medicine focus their practices entirely on the foot, ankle and lower leg. Their medical education and training includes four years of undergraduate education, four years of graduate education at an accredited podiatric medical college and two or three years of hospital residency training. Each state requires podiatrists to be licensed to practice there.

"We're primary physicians and specialists for the foot and ankle," says Dr. Marlene Reid, president of the Illinois Podiatric Medical Association. "That's all we do, which means it's best to go to a podiatrist for any foot or ankle condition, large or small."

Unlike many familiar screening guidelines, like getting your first mammogram at age 40 or your first colonoscopy at age 50, there is no definite rule about when to start seeing a podiatrist. "I always suggest coming in for an initial look once you're past your 30s," says Dr. Kirk Contento of Contento Foot & Ankle Center in Palos Heights and Chicago. "We're all about preventing little problems from developing into something major later."

Here are three common foot conditions that become all the more common as we age, and here's what to do about them.

1. Toenail fungus - Podiatrists suggest seeing a podiatrist whenever a nail thickens or becomes discolored. "The doctor can thin the nail, then medicate topically or orally and get the patient started on a good home treatment regimen," Contento says. "Fungal infections often thicken the nail, which can lead to a secondary problem of an ingrown nail." Lasers are also an emerging new treatment for this common problem.

2.Arch strain and heel pain - One word here: Orthotics. Either custom or over-the-counter are fine, as long as you receive adequate arch support. "The tendon that supports the foot's arches weakens over time due to decreased blood flow, which means your arch drops," says Reid. "It usually starts as a vague feeling of weakness or muscle strain and is often misdiagnosed as plantar fasciitis. People tend to ignore it but it can cause the tendon to rupture, which may require surgical repair."

3. Arthritis - People tend to think about big-toe bunions when they think about arthritis in the foot, as arthritis often follows when bunions develop. But Reid, who practices in Naperville, says arthritis can develop in any joint. "Older people often develop arthritis across the top of the foot or in the instep, and it's quite painful," she says. "This is another instance where proper orthotics early on can make a big difference."

One last caveat: If you have diabetes, put your podiatrist on speed-dial because you'll be seeing a lot of each other. "Diabetes is a multi-organ disease that requires constant vigilance because decreased blood flow and neuropathy magnifies everything that happens in the feet," says Contento. "I want to see all my diabetic patients twice a year if they are not having problems and every 2 to 3 months if they are. Diabetics literally should not even be cutting their own toenails due to the risk of infection."

Fortunately, Medicare should cover nail trims every 60 days for people with diabetes. "That's a good interval," Contento says. "It lets me check the feet's skin, neurological status and circulation on a regular basis."

According to Reid, at a certain point, even people 55+ without diabetes should plan on leaving the regular foot care to a pro: "Once reaching or seeing your toes becomes a problem, plan on coming in every few months. An office visit charge of $40-$60 is well worth the peace of mind."

Copyright © 2011, Chicago Tribune

Medical Attention Or Been Hospitalized Because Of Wearing Trendy Shoes

LONDON, 2010 -- One in 10 women in Britain admit they've received medical attention or been hospitalized because of wearing trendy shoes, a survey indicates.

The survey of 3,000 women in Britain who wear high heels was conducted by Hotter Shoes, a British shoe manufacturer.

Nearly half of women say they have twisted their ankle because of their footwear and two-thirds admit wearing shoes that have caused them injury. The most frequently reported injuries caused by shoes were broken ankles, twisted knees, infected blisters, bunions and torn tendons.

"As a comfort shoe maker we were amazed to discover the pain and discomfort that women were prepared to endure for a pair of killer heels or an ill-fitting impulse sale bargain," Lisa McCarten of Hotter Comfort Concept Shoes says in a statement. "Nothing can ruin a day more than sore and tired feet, every person in our design and technical team works hard to ensure that our shoes are stylish and comfortable."

Runners: Fit Feet Finish Faster

Both long-distance runners and casual joggers can improve their performance by keeping their feet in top condition and taking steps to control foot problems common in runners.

The human foot is a biological masterpiece that amazingly endures the stresses of daily activity. For runners, the feet are more vulnerable to injury than any other part of the body, and these athletes should be on the alert for signs of foot problems that can slow them down if not treated promptly.

The most common complaint from runners is heel pain caused by inflammation of the ligament that holds up the arch, a condition known as plantar fasciitis. In athletes, heel pain can result from faulty mechanics and overpronation in which pressure is unequally applied to the inside of the foot. It also can be caused by wearing running shoes that are worn out or too soft.

At the first sign of heel pain, runners are advised to do stretching exercises, wear sturdier shoes and use arch supports. In some cases, icing and anti-inflammatory drugs, such as ibuprofen, are helpful. Should heel pain continue, custom orthotics, injections and physical therapy might be required? Surgery normally isn’t considered unless heel pain persists for more than a year and conservative treatment has failed to bring relief.

Neuromas and tendonitis are other common foot problems that affect runners. A neuroma is a pinched nerve between the toes that can cause pain, numbness and a burning sensation in the ball of the foot. Overly flexible shoes often are the cause and padding, orthotics or injections usually are effective. Sometimes surgery is the answer if pain between the toes continues for more than six months.

Serious runners can be sidelined with tendonitis if they ignore the warning signs of this overuse-related condition. There are several forms of tendonitis that affect the Achilles and other areas, and all are treated with rest, icing, stretching and anti-inflammatory medications, and sometimes with orthotics and physical therapy. Over-zealous training usually causes tendonitis, especially among beginners who try to do too much too soon.

A common myth among athletes is that it’s not possible to walk or run if a bone in the foot is fractured. Surprised patients often say “It can’t be broken, I can walk on it." That’s dead wrong, especially with stress fractures when pain and swelling might not occur for a few days. If a fracture or sprain is suspected, runners should remember the word RICE as an abbreviation for Rest-Ice-Compression-Elevation. Should pain and swelling continue after following this procedure for three or four days, you should see a foot and ankle specialist for an x-ray and proper diagnosis.

Other common foot ailments runners should watch for are:
Athlete’s Foot: This fungal skin disorder causes dry, cracking skin between the toes, itching, inflammation and blisters. It can be prevented and controlled by washing the feet regularly and carefully drying between the toes; switching running shoes every other day to allow them to dry; wearing socks made with synthetic material instead of cotton; and applying over-the-counter ointments.

Toenail Problems: Ingrown nails can cause inflammation and possible infection and usually are treated by cutting the corner of the nail with sterile clippers. Black toenails happen when a blood blister forms under the nail from trauma, and it’s best to let the nail fall off by itself. Fungal toenails are yellow, brown or black and sometimes are irregularly shaped and thick. They are best treated with oral anti-fungal medications.

Foot Odor: There are more than 250,000 sweat glands in the foot and daily hygiene plus regular changing of shoes and socks are best for controlling sweat and odor. Runners should avoid wearing cotton socks and running without socks. Foot powders, aerosols antiperspirants and vinegar soaks also are helpful.

Blisters, corns and calluses: Never pop blisters unless they are larger than a quarter or are painful or swollen. Use a sterile instrument to lance the corner, leave the top as a biological dressing, wash, apply antibiotic ointment, and cover with a Band-aid. Corns and calluses are caused by repeated friction, and should be treated by aseptically trimming the dead skin and eliminating the underlying cause.