Diseases, disorders and disabilities of the foot or ankle may affect the quality of life and mobility of thousands. However, many are unaware of the important relationship between foot health and overall health and well-being. This month has been designated World Foot Health Awareness Month. With this in mind, we would like to share a few tips to help keep feet healthy.

The feet are the most used parts of our anatomy. They work for us every day throughout our lives whether we stand, play, run or walk.

Most of us take them for granted until they hurt or perhaps ache or swell, which is common during the hot summer months.

Yet they provide important clues to the state of our health, according to chiropodists and podiatrists who are supporting World Foot Health Awareness month this May, to make people aware of the importance of foot care.

The shape, colour and even texture of feet can reveal tell-tale signs of underlying disorders such as poor circulation, diabetes, or skin problems.

Feet are often neglected but are extremely good indicators to what is going on in the rest of the body. Chiropodists and podiatrists are usually consulted about specific foot problems but they are frequently the first to diagnose certain disorders and ailments that give early warning signs in the feet and toes.

And research shows that an enormous number of us are vulnerable to foot problems. Two in three patients seeing a GP or dermatologist have at least one foot affected by a skin disease such as verrucas, corns or athlete's foot.

We also pay a high price for wearing unsuitable or ill-fitting shoes as they can lead to ankle sprains, lower back ache, shortened Achilles tendons, altered standing posture, increased oxygen consumption and reduced walking speed and mobility.

So put your best foot forward and give your feet a health check.

Ulcers and sores

Spots and blemishes that develop into red ulcers anywhere on your feet, especially if they don't clear up or keep returning, are often are a sign of diabetes. There may also be a numbness in the toes.

Sufferers often have sluggish blood, due to high glucose levels, which means not enough oxygen is reaching the nerve tissue in the feet, needed to heal ulcers.

Treatment: Visit a doctor who will test for diabetes and prescribe drugs.

Discoloured feet

Circulation problems can be indicated by the colour of the feet. A bluish colour indicates poor circulation, sometimes caused by smoking, and can be a sign of vascular disease or even heart disease.

Nicotine can severely narrow the arteries in the legs and feet, so that not enough blood and oxygen reaches the tissues in the leg, turning the feet blue.

Treatment: Apart from giving up smoking, regular exercise can encourage oxygen flow to the foot muscles.

Damaged nails

Ridged or pitted nails can signify eczema or psoriasis, a skin disease characterised by red, scaly patches.

Raised strips running across the nail can indicate Raynaud's disease - a circulatory problem which causes small arteries in the toes to go into spasm.

Raynaud's can be caused by rheumatoid arthritis and nerve disorders.

Treatment: A podiatrist or doctor will prescribe a treatment.

Back problems

Flat feet can indicate a curvature of the spine, and feet are often the root problem for back complaints. Walking improperly because of bunions or other painful conditions such as heel spurs where a spur of bone sticks out of the heel bone affects posture and can throw out spine alignment.

Treatment: Orthotics, a plastercast mould designed to correct posture, can be fitted to the inside of shoes.

For heel spurs, padding or strapping to alter the direction of ligament stretch may be recommended, or deep heat therapy to stimulate the healing process. If pain persists surgery may be considered.

Distorted toes

If your toes start bending towards the little toe and the arch of your foot begins to collapse, this could indicate the early signs of rheumatoid-arthritis, particularly if both feet are affected.

Treatment: A podiatrist may prescribe orthotics, a plastercast mould designed to support the foot.




Common problems



Can't spot a callus from a bunion? Discover what the most common foot problems are and how to help prevent them.

Callus

When we walk or stand, our body weight is carried first on the heel and then on the ball of the foot, where the skin is thicker, to withstand the pressure. When this pressure becomes excessive, some areas of the skin thicken, in the form of corns and callus, as a protective response.

A callus, or callosity, is an extended area of thickened skin on the soles of the feet, and occurs on areas of pressure. It is the body's reaction to pressure or friction, and can appear anywhere the skin rubs against a bone, a shoe, or the ground.

Most calluses are symptoms of an underlying problem like a bony deformity, a particular style of walking, or inappropriate footwear. Some people have a natural tendency to form callus because of their skin type.

What to do

You can control a small amount of hard skin by gently rubbing with a pumice stone, or chiropody sponge occasionally when you are in the bath. Use a moisturising cream daily. If this does not appear to be working, seek advice from a registered chiropodist (also known as podiatrist) or pharmacist.

The elderly can benefit from padding to the ball of the foot, to compensate for any loss of natural padding. Emollient creams delay callus building up, and help improve the skin's natural elasticity.

Bunions

The foot is roughly divided into three sections: the hindfoot or heel, the midfoot and the forefoot and toes.

The function of the toes, especially the big toe, is to help us balance, and to propel us forward during walking or running. The 14 bones of the toes are among the smallest in the body, and, not surprisingly, things can and often do go wrong. Some problems begin in childhood and may go unnoticed.

Others begin later on in life, perhaps as the result of injury or the added pressure of incorrect footwear.

What most people call a bunion is actually known as hallux valgus. This refers to the condition in which the big toe is angled excessively towards the second toe - and a bunion is a symptom of the deformity.

What to do

Your podiatrist can recommend exercises, orthoses (special devices inserted into shoes), shoe alterations or night splints (which hold toes straight over night) which may slow the progression of bunions in children.

"Conservative" measures such as these may help relieve symptoms, though there is no evidence they can correct the underlying deformity.




Choosing shoes



Keeping your feet healthy is only part of preventing foot problems. It is also essential that you wear well-fitting shoes. Take a look at our guide to buying and wearing the correct type of shoes for the activities you are undertaking.

Feet come in all sizes, yet although shoes differ in type and style, how many of us wear the best shoes for our feet?

The 26 bones in each foot do not fully set until we are around 18 years old, and the shoes we wear as children are vital to our future foot health. However, we can still do enormous damage to our adult feet by wearing the wrong shoes.

Choosing the best shoes

Badly fitting footwear can be very damaging to feet. In fact, many adults' foot problems occur because they wear poorly fitting shoes throughout their life. To help prevent damage to your feet, try applying the following rules when you buy shoes. Similar rules will help for buying children's shoes or shoes for specialist conditions such as diabetes.

What should you look for?

Heel: This takes a large proportion of a person's weight. Unfortunately, the height of the heel is often determined by fashion, not by the needs of our feet. Ideally, the heel should have a broad base and the heel height should be no greater than 4cm.

Heel counter: The portion of the shoe that grasps the heel of the foot at the sides and back, preventing the heel from sliding up and down while walking. Most importantly, it stabilises or helps maintain the position of the heel when the shoe contacts the ground.

As the heel counter softens or breaks down and loses its shape, the shoe becomes less supportive. Not all shoes have a heel counter. The heel counter should complement the shape of the heel of the foot.

Sole: The entire bottom of the shoe. It should be flat, except for a gentle slope upwards under the toes.

Upper: The material that forms the main part of the shoe covering the top of the foot. Ideally, it is composed of a natural material, e.g. leather.

Lining: Found inside the shoe and should be smooth and without seams.

Fastenings: This holds the foot in the shoe. Shoes should have laces, straps with buckles, or velcro to keep them in place. Slip on shoes are kept in place either because they are too small for the foot, or by curling the toes.

Simple methods of fitting shoes

Determine your foot length from the tip of your longest toe. In many people, this is the second toe, not the big toe! The correct length of a shoe can be determined by standing barefoot on a piece of thin cardboard and marking the place reached by the longest toe. When the cardboard is cut into a thin strip and inserted into a shoe, there should be 1cm between the end of the cardboard and the heel of the shoe. The width of the foot should correspond with the widest part of the foot while standing. Your shoe width size should match your foot width.

Children's shoes

Shoe fit can be a problem in children; the shape of the shoe should fit the natural shape of the foot. Your child may be unable to explain that his/her shoes are too tight.

Carefully examine your child's bare feet for any redness or areas of irritation. If problems are found, check the fit of the child's footwear. It is possible that the problem may not be associated with footwear, in which case, contact your local registered chiropodist/podiatrist.

A change in the shape of the shoe can help to solve the problem of a child who walks with toes pointing inwards, or outwards. Your chiropodist/podiatrist can advise you whether the shape of the shoes should be changed or special insoles (orthotics) used.

• This article is being produced thanks to The Society of Chiropodists and Podiatrists. For more information and footcare advice visit www.feetforlife.org

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