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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28 year old woman with a bunion and hammertoe

Not everyone goes to the doctor when they have a medical problem, and when many people do go, they don’t always seek out the best trained doctor for their problem. Today, medicine is very specialized. There are entire medical journals and textbooks for every part of the body: head, stomach, veins, and yes, feet. That is where podiatrists come in.

What is a Podiatrist?
Podiatrists or Doctors of Podiatric Medicine (DPM) are physicians who specialize in the treatment of foot and ankle problems. Most podiatrists have spent at least three or four years studying the basic sciences in a university or college after graduating high school, then studied four more years at a school of podiatric medicine, and then most go on to do foot and ankle residencies for two to three additional years or in some cases, even more.

What Kinds of Problems Do Podiatrist Treat?
Podiatrists treat all problems related to the foot or ankle, and the length is endless. However, the more common problems I see are heel pain, arch pain, ingrown toe nails, bunions (bumps on the inside of the big toe), hammertoes (bent toes), flat feet, foot or ankle arthritis, fungal toe nails, 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, dry skin, and moles, cysts or tumors.

When Should I Call a Podiatrist?
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.

Some people with foot or ankle problems never 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 their feet they didn’t know they had stepped on anything sharp.

In all patients foot problems can quickly become serious, but diabetics are especially at risk. It is not unusual for diabetics who don’t seek podiatric care promptly to 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 needs to have any foot or ankle problem checked by a podiatrist immediately.

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.

Lastly, 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 Pain
The most common complaint I hear from my patients is, “I should’ve come to see you sooner.” If you have a foot or ankle problem, the best advice I can give you is, don’t wait for it to hopefully go away—it may not.

To have Dr. Nirenberg look at your foot or ankle problem, visit Friendly Foot Care.

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Times Correspondent | Monday, September 01, 2008 |

The relatively painless procedure of giving a injection of alcohol in the foot has been “out for a few years,” according to Dr. Michael Nirenberg, podiatrist for Crown Point’s Friendly Foot Care, but like anything else new in medicine it starts slow by testing the waters to see how people do with it.

Nirenberg has been giving the shot for several years but has seen a growth because of its good results. A new podiatrist at Friendly Foot Care, Dr. Michael G. Lacey, has performed the procedure for the last seven years in Chicago.

The doctors stress that the injection is not for everybody.

“Some people may still need a small surgical procedure,” Nirenberg said.

“Others don’t need a shot or surgery, but may require a custom-made arch support. But for those who do — it’s better than surgery.” Patients typically receive four to seven injections over a period of four to six weeks. Those treated don’t have to stop their activities or miss a day of work. Patients also need not rest or soak their feet afterwards, they can drive straight home and go for a jog.

The shot itself, which “kills” the neuroma, only takes a few seconds.

“We’ll use a diagnostic ultrasound to confirm where the neuroma is at but a lot of times we don’t need it,” Nirenberg said.

He said most insurance companies cover the injection because they recognize the benefit of having a person get a shot as opposed to surgery.

Without surgery, of course, a patient avoids any possible complications that go with it like scar tissue or infection. Surgery would also likely mean a six-to-eight-week recovery period.

Valparaiso’s Leigh Romanov had the treatment done on her right foot, now she’s doing the same for her left one.

“The shots don’t hurt at all,” she said. “I feel like I have my feet again.”

Surgery was Romanov’s only other option. Her feet tingled so much she had to give up running. It got to a point where walking barefoot caused pain.

“I’m running now, it was fantastic,” she said. “It takes about five to six (injections) to notice a difference, but it’s pain free.”

A shot of alcohol — or more specifically, an injection of alcohol — could alleviate a painful nerve problem that occurs in the ball of the foot and affects millions of Americans. For many patients, this alcohol injection is an alternative to surgery.

“We’re saving people from going under the knife,” said Dr. Michael Nirenberg of Crown Point’s Friendly Foot Care.

Getting on the nerves

Dr. Lou Santangelo, chief resident of podiatry at Chicago’s Norwegian American Hospital, has been giving the alcohol injections for the past few years. Santangelo, who is currently working out of Lansing Foot and Ankle Center, provides the injection for both patients suffering from neuroma and those with nerve entrapment, in which the nerve becomes irritated because of scar tissue in the area.

“Some people would prefer to take the nerve out,” Santangelo said. “But that’s a surgical procedure n so this is a way to avoid surgery but still give the patient relief. It works pretty well.”

There are other types of foot injections to relieve pain as well.

Dr. Armand Gasbarro, who’s operated Lansing Foot and Ankle Clinic in downtown Lansing for 48 years, said patients who suffer from general inflammation may require a steroid injection.

“It reduces the inflammation,” Gasbarro said.

This type of injection also reduces a patient’s pain following surgery.

“It diminishes post-operative pain tremendously,” Gasbarro said.

SOURCE: Times Newspaper, Sept 1, 2008.

http://nwitimes.com/articles/2008/09/01/get_healthy/get_healthy/docad1b375ecd4e9051862574b30065c8b5.txt

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