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Feet get no respect

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The 115 ligaments, 19 muscles and 26 bones of the foot take a lot of abuse. And although humans have had several millennia to perfect footwear, poorly fitting shoes still cause most problems.

"Our feet were designed to walk over rough terrain, and the foot is very adept at changing position," says Tim Kilmartin, a podiatrist in Derbyshire, England. "It is not, however, adept at walking on flat, hard surfaces."

Unfortunately, most people take foot care for granted or ignore problems. "We often see patients who have had pain or other problems for six months or more that they were hoping would just go away," says Dr Kevan Kreitman, chief of podiatry at St. John North Shores Hospital, Detroit.

The ten most common foot ailments are:

  • Achilles’ tendonitis: Inflammation of the tendon that attaches the calf muscle to the back of the heel bone. Can be caused by improper warm-up or over training. Treatment: ice, rest, aspirin or anti-inflammatory medication. Chronic pain requires professional treatment.
  • Bunions: Misaligned big toe joints, which can become swollen and tender, causing the first joint of the big toe to slant outward and the second joint to angle toward other toes. Tend to be hereditary but can be aggravated by narrow shoes. Treatment: Surgery may be required.
  • Hammertoes: Toes are bent in a claw-like position, usually because of a muscle imbalance. Condition usually affects the second toe and often is associated with a bunion. Treatment: Select shoes and socks that don't cramp the toes; seek professional care. Surgery may be needed.
  • Heel spurs: Growths of bone on the underside or front part of the heel bone. Occur when the plantar (sole of the foot) tendon pulls at its attachment to the heel bone. Area can calcify to form a spur. Treatment: Professional help may be needed. Proper warm-up and appropriate athletic shoes can reduce strain to the ligament.
  • Ingrown toenails: Growths of bone on the underside or front part of the heel bone. Occur when the plantar (sole of the foot) tendon pulls at its attachment to the heel bone. Area can calcify to form a spur. Treatment: Professional help may be needed. Proper warm-up and appropriate athletic shoes can reduce strain to the ligament.
  • Neuromas: Enlarged, benign growths of nerves, most commonly between the third and fourth toes; caused by friction on nerves. Pressure from ill-fitting shoes or abnormal bone structure can contribute. Treatment: shoe inserts or cortisone injections. May require surgery.
  • Plantar fasciitis: Enlarged, benign growths of nerves, most commonly between the third and fourth toes; caused by friction on nerves. Pressure from ill-fitting shoes or abnormal bone structure can contribute. Treatment: shoe inserts or cortisone injections. May require surgery.
  • Sesamoiditis: Enlarged, benign growths of nerves, most commonly between the third and fourth toes; caused by friction on nerves. Pressure from ill-fitting shoes or abnormal bone structure can contribute. Treatment: shoe inserts or cortisone injections. May require surgery.
  • Shinsplints: Pain to either side of shinbone caused by muscle or tendon inflammation. Often related to excessive foot pronation (collapsing arch) but can be related to muscle imbalance between opposing muscle groups in the leg. Treatment: Check with a professional. Proper stretching and corrective shoe inserts can help prevent shinsplints.
  • Stress fractures: Incomplete cracks in bones caused by overuse. Treatment: complete rest. Check with professional. Untreated, stress fractures can become complete fractures, requiring casts. Extra padding in shoes helps prevent fractures.

To some extent, wearing the right shoes can prevent foot problems.

Footwear do’s and don’ts

  • Slip-ons and court shoes should be avoided. As your foot comes in contact with the ground, you continue sliding. This results in unnecessary stress on the forefoot.
  • Best wear supportive leather shoes and cotton socks while going on a shopping trip. Two thin pairs of socks rather than one thick pair, is recommended.
  • Nylon and Lycra get the thumbs-down; they squeeze the feet and prevent sweat escaping.
  • Support hose could also be a useful measure. The trick is to put your legs in the air when you're putting them on.
  • The ideal shoe is one that has plenty of room for the toes, is snug around the heel, has a wide heel no higher than 4cm and is fastened with laces, straps or a buckle. Blisters are usually caused because the shoe is not held firmly on the foot.
  • The best shoe is one made of leather with some arch support and a firm stiffener at the back of the heel - something most shoes don't have.
  • Once you're out shopping, don't rest on your laurels. When queuing, wiggle your toes, rock up and down on the balls of your feet or "pedal" your feet with your heels on the ground and toes pumping up and down.
  • If your feet are throbbing when you get home, throw off your shoes and lie on the sofa for 10 minutes with your feet slightly higher than your heart, so that any swelling goes down. Follow up with a footbath and a massage.
  • Taking a "contrast" footbath could be just what you need - alternating warm and cold to get the circulation moving. Peppermint oil revitalises your feet; lavender is relaxing and tea tree oils stops fungal infections.

Buying shoes

Wearing comfortable shoes that fit well can prevent many foot ailments. Here are some tips for getting a proper shoe fit:

  • The size of your feet changes as you grow older so always have your feet measured before buying shoes. The best time to measure your feet is at the end of the day when your feet are largest.
  • Most of us have one foot that is larger than the other, so fit your shoe to your larger foot.
  • Don't select shoes by the size marked inside the shoe but by how the shoe fits your foot.
  • Select a shoe that is shaped like your foot. < /li>
  • During the fitting process, make sure there is enough space for your longest toe at the end of each shoe when you are standing up.
  • Make sure the ball of your foot fits comfortably into the widest part of the shoe.
  • Don't buy shoes that feel too tight and expect them to stretch to fit.
  • Your heel should fit comfortably in the shoe with a minimum amount of slipping - the shoes should not ride up and down on your heel when you walk.

Walk in the shoes to make sure they fit and feel right. Then take them home and spend some time walking on carpet to make sure the fit is a good one.

Foot care for diabetics

Diabetics should pay extra attention to their feet due to poor blood circulation. The following steps can aid in the prevention of foot ailments:

  • Take care of your diabetes by keeping your blood sugar in a good range.
  • Check your feet every day for cuts, blisters, red spots and swelling.
  • Wash your feet every day.
  • Keep the skin soft and smooth by rubbing a thin coat of skin lotion in every day.
  • Smooth corns and calluses gently with a pumice stone.
  • Trim your toenails each week.
  • Wear shoes and socks all the time.
  • Protect your feet from hot and cold.
  • Keep the blood flowing to your feet by putting your feet up when sitting.
  • Be more active.
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