Barefoot Running May Be Better

As a podiatrist, my teachers, professors and peers, espoused that feet need help, specifically they need good support, cushioning, and padding. But, more and more, I started reading about people and cultures that go barefoot and not only do they have fewer foot, ankle, knee and even back problems. Now, I am re-thinking everything I learned.

Was The Human Foot Designed to Walk and Run Barefoot?

The human foot is incredible, strong, dynamic and adaptable. For thousands of years our feet survived and functioned fine (maybe even better?) without elaborately padded, supported $100 Nikes. Further, persons without their hands can learn to drive and paint with their feet. Take a look at the masterpieces created by the Mouth and Foot Painter Artists association. Why can’t a runner learn to run barefoot?

Recently, Christopher McDougall has reinvigorated the barefoot running debate with his book Born To Run. Previously, some runners have had great success barefoot, including the late, great Abebe Bikila from Ethiopia.

Runners have been plagued with foot, ankle and knee problems. It comes with the territory: two to three times the weight of the runner’s body coming down on each foot with each stride. The advocates of barefoot running claim they can literally feel the ground and as a result, the biomechanics of their running gait changes to lessen the force of your foot landing.

Advocates of barefoot running contend that shoes worsen the chance of injury.

The scientific literature on barefoot running (and barefoot walking) is scarce, but at this point the published research leans toward running and walking barefoot, and I would have to agree—barefoot is better!

I just may be the first podiatrist to advocate running barefoot, but let me clarify this statement: I don’t believe barefoot running  is for everyone. I will discuss who and who shouldn’t run (or walk) barefoot in just a moment. First, let me talk briefly about the medical and scientific literature.

The scientific literature on barefoot running is sparse. But, what is out there supports more foot and ankle injuries in people wearing running shoes than in persons going barefoot. This is also true of plantar fasciitis, some knee problems, and other injuries. It appears that running shoes decrease sensory feedback, interfering with the body’s natural shock absorbing tendencies. Further, running shoes may actually decrease the runner’s awareness of their foot and the foot’s position, increasing the risk of injury.

Our feet have many muscles within each foot and many that attach to our feet that originate in the leg. Wearing running shoes may lessen or diminish the “firing” of some of these muscles. When the foot is not in shoes, it adapts—rapidly—to uneven surfaces, and in theory, forcing us to “use” all the muscles in our foot.

Who Should Run Barefoot (and who should not!)

Reasonably experienced runners in good condition with healthy feet should try barefoot running (when conditions and terrain warrant it). By “healthy feet” I mean their foot has a good, stable structure, and good sensation. Their foot does not have an excessively high arch or low arch and they are not diabetic. Further, their foot should be free of any significant deformities—no bunions, hammertoes, or other bone problems. Persons who are diabetic, have decreased sensation, or a foot that is not healthy or flat or high arched etcetera, likely needs corrective support, such as good running shoes and/or orthotics.   

Learning to Run Barefoot

Barefoot runners have a different gait than shoe-wearing runners. Learning to run barefoot takes time and training. I imagine not everyone will be able to teach themselves and their feet to adapt to barefoot running. Remember, some of the superstar athletes who run barefoot may have grown up in cultures where shoes were not the norm and as result, you have someone whose foot is more use to being bare than in a shoe. Further, persons who are in these “barefoot” communities may have a foot with genetic adaptations geared toward barefoot running—meaning, generations of going barefoot have essentially bred a foot that works better when bare.

What to Watch Out For When Running Barefoot

Barefoot running isn’t without risks. Start slow and build up gradually. Research the right way to build up proprioception reflexes in your feet, ankles and legs, and build up the muscles. Don’t run where you can injure your feet—avoid nails, rocks, broken glass etcetera.. (Part of the reason the medical community has strongly advocated shoes is because of the risk of puncture wonds. Every podiatrist has seen his or her share of glass and nails inside their patients’ feet. Further, cold weather can cause frostbite on unprotected feet.)

Vivo Barefoot Running Shoe

Vibram makes a shoe that increases the ability to feel the ground, as does Terra Plana and Nike Free (see links below). One scientific study does support that Vibram’s Five Finger’s reasonably simulates barefoot conditions.

I would be interested to hear about your experiences running barefoot. Specifically, I am curious if there are any successful barefoot runners who have a poor foot structure (i.e. flat foot, bunions, pronation etc.)

Resources for Barefoot Running

The point of this article is to get people thinking about barefoot running and decide for themselves if it is right for them. Here are some resources to help you learn more about barefoot running (and I would recommend reading Chris McDouball’s book Born To Run):

Running Barefoot

Society for Barefoot Living 

Wikipedia on Barefoot Running

Barefoot Runner

Living Barefoot

Vibram Five Fingers

Terra Plana

Go Barefoot

Enjoy Going Barefoot

Review of Nike Free

Nate Luzod – A barefoot runner’s journal

Barefoot Ted’s Adventures

Barefoot Running in Seattle

How to Begin Barefoot Running

Freeing the Captives… 2 Barefoot Soles at a Time

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Ask the Foot Doctor Your Questions

Today we start a new feature: the chance to ask Dr. Nirenberg a foot or ankle question.

The Internet has changed how we learn and understand our world, and our medical problems and conditions—especially our foot and ankle problems. Information is now literally at our fingertips! I firmly believe knowledge is power. However, due to legal issues and restrictions on physicians practicing telemedicine, answers to questions are strictly for informational purposes. Readers will still be able to learn much by asking questions, but the answers are not a substitute for medical care (for a more medical detailed disclaimer read this site’s Terms of Use).

As for your questions, we are looking for great, fascinating foot and ankle questions that our readers will find interesting.

The questions can concern anything related to our feet and ankles, from simple warts or corns to arthritic or weak ankles, and everything in-between. Questions do not have to be strictly medical related. (For example, I was recently asked why our feet are ticklish, and soon I will post an entire article on this fascinating question.)  

So start asking your questions right now! Click Ask a Question.

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Be Careful What You Put In the Toilet

I am not sure how to categorize this post (perhaps, under “Dumb Things People Do With Their Feet”).

In any event, don’t try this at home. An inmate at a city jail has been charged with felony mischief for using his foot to block the toilet and flood his cell.

I don’t want to think about the germs on his foot!

Read about this nonsense here: Buffalo News

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Dempster Fractures His Big Toe

The Chicago Cubs pitcher, Ryan Dempster, is asking that right now. This week he broke his big toe. Many people think nothing can be done for a broken toe. Sometimes this is the case, but often a podiatrist can help alleviate the pain and ensure the broken toe heals as well as possible.

For sports fans like my partner at Friendly Foot Care, Dr. Michael Lacey, when he heard about Ryan Dempster’s broken big toe, he wondered aloud if, the Cubs’ Billy Goat curse was at work, yet again.

Broken Toes (Fractured Toes) Are Common

It is easy to break your big toe or any toe for that matter. Our feet are vulnerable, exposed to uneven surfaces, objects scattered on the floor–everything from dog toys to kid toys to last night’s shoes or work boots, to a package left in the hallway and on and on. It is easy to injure our feet or toes. 

The most common way people fracture the big toe is by slamming it into the post of their bed in the middle of the night. The next day they show up limping into my office with the toe sore and swollen.

Dr. Lacey and I have also seen broken toes (fractured toes) occur from objects dropped on the foot, everything from a steel beam to a frozen turkey, and from every imaginable kind of sports injury.

Dempster’s “sports injury” is unique. He wasn’t sliding into home plate or running to make a great catch. He was leaping over the dugout fence with a flourish—trying to show off—rather than just walking around the fence.

Toe Injuries Are Often Avoidable

Most toe fractures or broken toes are preventable. To prevent nighttime slams of your feet into the bed post, just add a child’s night light to your bedroom. For Dempster, I imagine that from now on we will see him walk around the dugout fence.

For Foot or Toe Fractures, Remember R.I.C.E.

The first thing to do if you bang your toe (assuming you have good circulation and are not a diabetic) is follow the basics of foot injury — R.I.C.E. This stands for: Rest, Ice, Compression and Elevation.

The next thing is to see a doctor who knows feet (hopefully a podiatrist!).

What Will The Foot Doctor Do for a Broken Toe?

The usual way podiatrists treat a foot or toe fracture when the broken bones are in good, stable position is with immobilization—perhaps by cast, splint, or taping and padding. If the fractured bones are not in good position, they first need to be put back in the correct position. This may require the podiatrist to nudge the bones into their correct position or actually opening up of the toe and doing surgery.

The only way to know if the fractured toe needs surgery is with an x-ray and then by having the x-ray reviewed by a podiatrist or other qualified foot specialist. Consequently, if you are unlucky enough to hurt, bang or crush a toe, make sure you immediately seek medical care with a foot expert.

Source: Chicago Tribune

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Feet talk. Of course, they don’t rattle on like some annoying relative. They do often mirror overall health, at times being the first place to show signs of serious medical problems.

Is That Pain in the Foot a Tumor in the Neck?

For example, when a 41-year-old man came to my office with pain and swelling in his foot, he thought he had injured himself playing baseball; instead, we discovered a tumor in his neck. The tumor was altering chemicals in his body. One of these, uric acid, was so severely elevated that it couldn’t be contained in his bloodstream and entered several joints in his foot, causing his pain. The patient had the tumor removed, and a month later his foot pain disappeared. This case was especially rewarding because had this tumor not been caught, it could have affected his heart, possibly becoming fatal. (Read more about it HERE).

Most instances of feet revealing medical conditions are not this dramatic, but many systemic problems often show up in our feet first.

Nailing Down Nails

Let’s start with our toenails. Nowadays, with MRIs, CT scans, and hundreds of blood tests to choose from, few doctors look at toenails. Sadly, some don’t even give feet a cursory glance. But in ancient times, examining the toenails was as important as having patients stick out their tongue.

A small change in our toenails’ color, shape and pliability may be the only indication of a more serious medical problem. Toenails that become rounded or “clubbed” may mean the person has lung cancer, emphysema, liver disease or a heart problem.

Brittle nails could signal poor circulation, an iron deficiency or a kidney or thyroid problem. Short, small nail beds may be a sign of heart disease, and grey nails may mean the person has glaucoma.

Don’t Forget Your Vitamins

If you’re not eating your vegetables, toenails can reveal that too. A spoon-like or flat nail could mean a lack of certain B vitamins. Splitting and fraying of toenails may signal a need for folic acid or vitamin C. Small white patches on toenails could signal a zinc deficiency. (Read more about vitamins and our feet HERE).

Is That Redness on Your Foot an STD?

A rash or redness on the feet could be a sign of infection, a circulation problem or a sexually transmitted disease. That’s right, STDs—in my practice, I’ve seen signs of AIDS, herpes, syphilis and gonorrhea show up in the foot.

People are usually surprised to hear about sexual diseases in the foot. But when feet, oftentimes the big toe, get involved in sexual activity they are just as susceptible as any other body part to infectious diseases. Some diseases, like AIDS, cause growths and other skin changes on the feet, and others, like herpes, spread to the feet when the person removes their underwear.

Are your feet swelling up? When only one foot swells, it often signals a problem within the foot itself, such as infection or a fracture. It might also be due to a blood clot or a circulation problem. If both feet swell, it could mean you have heart, kidney or liver failure.

Is it just Dry Skin or Something More?

The skin of our feet tells us a lot, too. Dry skin may be a sign of an under-active thyroid, diabetes, poor circulation or malnutrition. Sweaty skin could mean an overactive thyroid, menopause, anxiety or a psychiatric disorder.

Bone deformities, such as heel spurs or bunions, may be a clue that the person has certain types of arthritis. Your doctor should check for these, as many arthritic diseases can affect the entire body, including the heart.      

Final Thoughts on Reading Your Feet

So, feet can reveal quite a lot of information about a person’s overall health, even when the condition has nothing to do with feet. On the lighter side, feet reveal plenty about a person’s personality as well. People love to adorn their feet with toe rings, ankle bracelets and even tattoos.

The most interesting tattoo I’ve seen was a trail of black ants on a young man that began at his big toe and went up his leg, apparently to his groin—I didn’t check.

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Most people don’t think much about their feet, let alone take time to look at them. But, nearly everyone cares about their weight.

Now, a remarkable new scale—the Insight Foot Care scale—facilitates daily foot exams when you weigh yourself.

Still, most people are probably wondering why they should check their feet daily. One word: melanoma. This disease can affect anyone and can lead to a foot amputation and even death. 

Before we discuss melanoma, let’s talk about the main reason for the Insight Foot Care scale—prevention of diabetic foot amputations.

For diabetics, the smallest sore, blister, or infection can quickly accelerate to a severe problem or gangrene, and quickly lead to the need for amputation of a toe, the foot, or even the leg.

Studies show that one in five diabetics will endure an amputation. Sadly, most of these amputations are preventable, if caught early.

Diabetes often causes decreased sensation in the nerves of feet and as a result, people with diabetes may not feel a sore or infection on the bottom of their foot.

Many diabetics often don’t realize they have an infection or sore on their foot until they try to remove their sock and it sticks the foot (from pus).

In fact, I have had diabetic patients come to see me for sores on the bottom of their feet and when I take an x-ray, I discover a needle or other sharp object inside the foot. Because these patients have decreased sensation, they usually don’t have any pain, and as a result, are surprised to learn they stepped on a needle or other sharp object.

Loss of sensation in diabetic feet is often due neuropathy, which literally means, “a disease of the nerves.” Neuropathy is nothing to get nervous about, but you do need to take it seriously.

Neuropathy affects millions of people each year, and though diabetics are most affected, it also occurs in people with thyroid problems, vitamin deficiencies, alcoholism, and some types of arthritis, and as a possible side-effect of chemotherapy treatment.   

Anyone with neuropathy (lacking normal sensation in the feet) is at higher risk for recognizing serious foot problems too late.

Healthy people, without diabetes, can feel pain and this is the body’s way of alerting us that there is a problem. But, without that pain sensation the only way to catch a problem is to see it—that is why diabetics or those people without normal sensation must check their feet daily. In a moment, I will explain how the Insight Foot Scale makes checking your foot easy.

First, let us return to melanoma, a deadly disease that can affect anyone.

Melanoma is a cancer that often starts as a small mole, lesion, or freckle.

When melanoma occurs on the foot it is usually not caught until it is too late, often resulting in the loss of the foot or leg, and even death. Each year more than 8,000 people die from melanoma—nearly one death every hour.

Fortunately, when caught early, most people with melanoma survive.

Melanoma does not discriminate. It occurs in the young and old, in African-Americans and in Caucasians, and in males and females. Though, Caucasians or fairer-skinned people are at higher risk.

Any suspicious moles, lesions, or freckles on your foot could be melanoma and a podiatrist should evaluate these. The Insight Foot Care scale makes checking for melanoma on the bottom of the foot easy.

The Insight Foot Care scale makes examining your feet not only easy, but also fun.

The scale arrived in a well-padded box and came with detailed, easy to follow instructions.

Since my partner in practice with me at Friendly Foot Care, Dr. Michael Lacey, is a type 1 diabetic, I asked him to help me test the Insight Foot Care scale.

The scale appears to be well built and sturdy. Certainly, able to withstand being stepped on repeatedly by some of the populations heavier people.

The scale’s has a modern, sleek design ensures it would never be an eyesore in even the most luxurious of bathrooms. As far weighing yourself, the numbers are large and easy to read.

The real innovation of the scale is its two illuminated tilted mirrors that magnify the bottom of your feet. These mirrors allow you to observe every detail of the bottom of your feet each day your weigh yourself.

Dr. Lacey and I found the Insight Foot Care scale easy to use, fun, and most importantly it succeeds in doing what it advertises: allows great visualization of the bottom of your feet.

In summary, I believe everyone should have (and use!) this scale, especially if you are diabetic or have neuropathy. 

I give the Insight Foot Care scale 5 Toes Up!

Link: Insight Foot Care scale 

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Is Dr. Nirenberg a real doctor? Hear what Seinfeld has to say:

Podiatrists, or Doctors of Podiatric Medicine (DPM), are, in fact, real physicians.

Podiatrists specialize in treating foot and ankle problems. Podiatrists treat all problems related to the foot or ankle, and the variety of cases is endless. However, the most common problems I see are:

• Heel and/or arch pain

• Ingrown toe nails

• Bunions (bumps on the inside of the big toe)

• Hammertoes (bent toes)

• Flat feet

• Foot or ankle arthritis

• Fungal toenails

• Sores (ulcers)

• Infections

• Sprains and fractures

• Ankle pain or weakness

• Nerve problems and neuropathy (numbness, burning, or tingling)

• Shin splints

• Gout

• Athlete’s foot

• Sports medicine and diabetics foot problems

• Children’s foot problems

• Swelling or discoloration

• Plantar warts

• Arthritis of foot and ankle

• Heel spurs

• Arthritis

• Tendonitis

• Blisters

• Corns and Callouses

• Moles, cysts, tumors or lesions

When to Call a Podiatrist:

1. You Have Foot or Ankle Pain

Some aches and pains in our feet or ankles may go away in a day in a two; others do not, and that is when you need to go to a podiatrist.

Many people who see me for a painful foot or ankle have had pain for several days or weeks, but some have been limping around for several months or even over a year!

Pain is the body’s way of telling us something is wrong. Don’t ignore it.

However, not all people with foot or ankle problems have pain. For example, diabetics who have neuropathy (a deterioration of the nerves of their feet) may fracture a bone or develop an infection or sore on their foot and not have any pain.

Recently, I had a patient with diabetes come to see me complaining of a small sore on the bottom of their foot; an x-ray revealed a needle inside the foot.

Because the patient had very little feeling in her feet she didn’t know she had stepped on anything sharp.

In all patients, foot and ankle problems can quickly become serious, but diabetics are especially at risk.

Diabetics who don’t seek podiatric care promptly often develop gangrene and need a toe or the whole foot amputated.

Prompt treatment is essential. All diabetics or anyone else with decreased feeling in their feet need to have any foot or ankle problems checked by a podiatrist immediately.

2. You Notice Changes in Your Feet

Some people may notice one foot swelling or flattening.

Diabetics and others with neuropathy may not have pain, however these are the people most at risk for a particularly serious problem called charcot arthropathy.

In charcot arthropathy, the bones of the foot weaken and slide out of position, and may actually break through the bottom of the foot, leading to infection and even amputation.

For other patients, a rapid flattening of one foot may mean the main tendon holding up their foot has torn.

It is a good guideline for anyone who notices swelling, redness, increased warmth, or a change in the shape of his or her foot or ankle to see a podiatrist promptly.

3. You Find Something Abnormal On Your Foot or Ankle

A podiatrist should check any lumps, bumps, cysts, tumors, or moles on your foot or ankles. These problems are usually harmless, but occasionally they can be cancer and life threatening.

Final Thoughts on Foot and Ankle Problems

If you have a foot or ankle problem or pain, the best advice I can give you is: Don’t wait for it to go away—it may not.  

If you experience persistent pain, notice changes in the shape or color of your feet, or find an abnormality, then see your podiatrist right away. To learn more about podiatry, podiatrists, and podiatric medicine, visit the website of the American Podiatric Medical Association

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Our feet take a beating.

We put in long hours, walking an average of seven to ten miles a day.

We tread on artificial surfaces such as asphalt, concrete and tile, often carrying a briefcase, purse, baby or laptop—and for some of us all four!

And with each step two to three times our body weight comes down on our feet, not to mention the strain of jogging, stair stepping or high impact aerobics.

So what can you do to keep your feet healthy, beautiful and strong enough to make it through the day?

I hear this question often as a podiatrist and more often from female patients, which doesn’t surprise me, since women experience four times more foot problems than men.

Fortunately, both men and women can do simple, inexpensive things to care for their feet, and when your feet feel great, your whole body will too. Consider the following five ”musts” for healthy, beautiful feet.

1. Use a good moisturizer

The skin of your feet is increasingly prone to drying out as you age. Dry skin is not only ugly but can crack open and possibly become infected, especially in diabetics or those with poor circulation. A good moisturizer can soothe dry skin.

The secret to finding a good moisturizer is not by price; more expensive doesn’t mean better.

Read the ingredients and avoid products with alcohol or alcohol derivatives.

Generally, lotions contain alcohol to make them absorb faster, but the alcohol hinders the product’s ability to moisturize your skin.

The best dry skin products tend to be creams without alcohol. These are gooier and absorb slowly, so I recommend applying them just before going to bed.

2. Keep your feet dry

This may seem to contradict using moisturizer, but dampness around your feet, specifically between your toes, can be a breeding ground for bacteria.

When washing your feet, be sure to dry them well, especially between the toes.

Towels can pick up bacteria or fungus, especially if they are damp or dirty, so wash them often with bleach or hot water and never use the towel that dried your feet on the rest of your body or face.

A good tip to keep feet, and especially toes, free from moisture is to use a foot powder enriched with zinc or menthol, or even both. A sprinkle a day will not only keep toes from perspiring, but also lessen odor.

3. Beware of nail polish and acrylic nails

Men can skip this tip, but women should heed it. Nail polish and acrylic nails trap moisture, increasing the chance of fungus infecting toenails, causing the nails to thicken and turn yellow or, in severe cases, black.

Toenail fungus can also infect the surrounding the skin and in some cases, particularly when the person is diabetic or has poor circulation, can lead to the loss of a toe or even the foot.

Some women who notice their toenails beginning to darken or yellow from fungus cover the nails with polish to hide them; ironically, this only makes the problem worse.

Am I saying you shouldn’t wear nail polish or acrylic nails? Not at all. Nail polish or acrylic nails can cheer up the ugliest of feet, don’t cost a lot and are generally among the safer pleasures for your feet.

When using nail polish or acrylic nails think of them like a dieter having a scoop of ice cream: occasionally it is okay, but not every day.

If you have a special event, feel free to wear nail polish or acrylic nails; just remove the polish or fake nails when you get home. The more your nails can “air out” the better.

4. Wear sensible shoes

This seems obvious, but many people choose style over comfort (one study showed that 88 percent of women have at some point knowingly squeezed their feet into shoes that were too small).

Like eating that fattening scoop of ice cream, wearing Jimmy Choos or other stylish shoes occasionally, for brief periods usually won’t cause problems.

However, wearing ill-fitting shoes too often can cause the toes to crunch up, possibly causing permanent deformities, pinched nerves, corns, calluses or other problems.

People with diabetes or poor circulation need to be especially careful, as these problems can result in serious infections.

The secret to making sure shoes fit properly is to shop for them late in the day when your feet are likely most swollen.

When you walk in the shoes you try on, try to avoid the soft, plush carpet found in most shoe stores. If you’re in a mall, leave the shoe store and walk on the mall’s tile floor.

Most importantly, if shoes hurt in the store they will hurt when you get them home–a shoe should never need to be “broken in.”

5. Check your feet daily

The last tip to taking care of your feet is more common sense than secret. Check your feet every day.

It’s amazing how many people don’t look at their feet; or if they do see a problem or have pain, they shove their foot into a shoe and try to forget about it.

When examining your feet, watch for any blisters, redness, swelling or open sores, and be sure check between the toes as this is a common area for infections to start. A good way to see the bottom of your feet is to use a mirror.

If you find a foot or ankle problem, see a podiatrist promptly.

Most foot and ankle problems are easy to take care of when caught early. The biggest complaint I hear from my patients is, “I wish I had come to see you sooner.”

Your lifetime of healthy, beautiful feet

Your feet work hard all day long, and they need a little care to remain strong.

When you use these tips to take care of your feet, they can be healthy, beautiful and ready to carry you anywhere.

To learn more about podiatry, podiatrists, and podiatric medicine, visit the website of the American Podiatric Medical Association

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Bunions, Flat Feet & Weak Ankles

Most of us don’t think about our feet until they hurt.

Even then, we limp around hoping the pain will go away. But with two to three times our body weight pushing down on each foot with every step, it usually doesn’t.

Fortunately, you can do a few things for relief.

1. Wear Only Great-Fitting Shoes

In one study, 88% of women admitted that at some point they knowingly squeezed their feet into shoes that were too small.

Further, as we age, our feet tend to become larger, but most people insist on wearing the same shoe size they wore years ago.

In addition to making sure your shoes fit properly, make sure they have a good arch support and that the heel counter—the area that wraps around your heel—is firm and strong.

2. Feet Need Exercise, Too

I can hear the couch potatoes now:  “My feet get enough exercise.”  Perhaps, but walking to the fridge or standing in line at McDonald’s isn’t exactly exercise.

Most people agree our entire body needs exercise, but few people think about keeping their feet in shape.

Yet, with the average person walking over a hundred thousand miles in their lifetime, feet need all the help they can get.

Foot exercises tone, stretch, and strengthen feet, while alleviating fatigue, soothing soreness, and increasing blood flow.

3. Take the Plunge

Nothing soothes sore, aching feet more than a relaxing footbath.

You can use a bathtub or plastic basin, or for some serious relief, I recommend buying a massaging footbath.

Make sure the water is warm, not hot (I’ve seen patients soak in water so hot they received second-degree burns).

Add good quality bubble bath to the water; and for those who are not diabetic or have poor circulation, adding Epsom salts is great, too.

4. Moisturize Your Way to Healthier Feet

Good moisturizers can sooth dry, irritated skin.

The secret to finding a good moisturizer for your feet is not by price; more expensive doesn’t mean better.

Read the ingredients and avoid products with alcohol or alcohol derivatives—the best dry-skin products tend to be creams without alcohol.

These are gooier and absorb slowly, so I recommend applying them just before going to bed.

5. Nailing Down Nails

Caring for your nails will go a long way in helping to alleviate foot problems.

Long, jagged, and thickened toenails can catch on socks or pantyhose, dig into adjacent toes, or suffer injury by pressing against the inside of our shoes.

In my practice, I have seen unkempt nails lead to blisters, infections, ingrown toenails, and even gangrene.

When trimming your toenails, follow the contour of the toe and avoid cutting into the corners. Smooth any rough edges with a nail file.

Final Thoughts on Aching Feet

Caring for your feet is your responsibility. However, when problems don’t go away, become serious, or if you have diabetes or poor circulation, get professional help and see a podiatrist.

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Many of my older patients wish they had taken better care of their feet when they were younger.

Thankfully, doctors and the health food industry are finally recognizing what many people have wanted for years: safe, natural ways to keep their feet strong and healthy.

The safest, simplest way to keep your feet healthy throughout life is already in your kitchen: water.

Water regulates temperature and metabolism, delivers electrolytes to muscles and lubricates our joints.

With each foot containing 33 joints and depending on 19 muscles, even slight dehydration can cause your feet to cramp and fatigue.

I recommend drinking eight glasses of water a day.

Guzzling Mountain Dew, Mocha Frappuccinos or six-packs of Bud Light isn’t the same.

Caffeinated and alcoholic beverages can actually cause dehydration.

Drinking water, not only for your feet, but also for your whole body, should be common sense, yet at any time, 75 percent of Americans are mildly dehydrated.

Moderate or severe lack of water can make feet cold and more vulnerable to infection.

Dehydration can also make toenails brittle and the skin of our feet dry.

Dry skin may not seem like a big problem, but on the feet, dry skin can crack and develop deep, painful fissures that are at risk for infection.

A patient with dry skin on their heel.

I’ve seen simple breaks in the skin, particularly in the feet of the elderly and people with diabetes, lead to catastrophic infections, at times resulting in the foot’s amputation.

However, dry skin on the feet may indicate more than just a lack of moisture.

Sometimes it’s psoriasis, a fungal infection or a sign of a more serious condition, such as diabetes, poor circulation or a thyroid disorder.

If your feet have severe or persisting dry skin, you should see a podiatrist.  

The best way to soothe dry skin is with moisturizers and applying vitamin A, D and E. You can put these on your feet separately, mix a concoction or buy a vitamin-enriched cream.

When choosing a cream, don’t go by price; more expensive doesn’t mean better.

Read the ingredients and avoid products containing alcohol or alcohol derivatives, which actually dry skin. Surprisingly, alcohol is common in many so-called moisturizers.

Dry, irritated skin also responds to foot powder, particularly when the powder is enriched with zinc or menthol.

A sprinkle a day will not only help keep the skin moisturized, but also lessen odor and perspiration.

Urea also helps keep feet healthy. A natural compound, urea attracts moisture, slowing its escape from the skin. Look for it by itself or in moisturizers.

For patients with severely cracked heels, I often prescribe medicated creams containing 40 percent urea.     

I also recommend urea for frail, brittle toenails.

To strengthen toenails, apply Biotin, a B vitamin, and take calcium and vitamin A. Vitamin C helps nails too—not that they have to fight off colds, but they can get painful hangnails, which this vitamin prevents.

Caring for your feet as you age also means keeping your bones strong.

Bones form the foot’s foundation, in turn supporting our entire body. With aging, bones lose strength and develop osteoporosis.

Combine osteoporosis in your feet—each foot a jigsaw puzzle of 28 small bones—with a one hundred and fifty or two hundred pound person landing on them repeatedly and you have a great chance for fractures.

Women past menopause are at the greatest risk for osteoporosis.

A simple test can check for osteoporosis and, if necessary, your doctor will prescribe medication.

To help prevent osteoporosis, eat foods rich in calcium and vitamin D and exercise regularly, doing activities that put weight on your feet such as walking, aerobics or weight lifting.

Lastly, vitamins and minerals—and in rare cases, even water—are not always safe for everyone. Before starting any supplements, always check with your doctor.

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