Tips to Help Your Feet Look & Feel Their Best

Are you guilty of foot abuse? Raise your hand if you cram your tootsies into 4-inch high stilettos, wear flip flops or strappy sandals that offer no support, or go barefoot with little regard for the damage that splinters, burning hot sand at the beach, and uneven floors can cause.

"The environment you put your foot in can certainly influence whether or not you will have pain or other symptoms," says Gary Pichney, DPM, of the Institute for Foot and Ankle Reconstruction at Mercy Medical Center in Baltimore. "And there are a significant number of people who are predisposed to have a condition like high arches or flat feet, which can progress over time to a problem like a bunion, or an ingrown toenail."

Considering that you’ll walk thousands of miles in your lifetime (it’s estimated that by the time you hit 50 you’ll have walked 75,000 miles) it’s in your best interest to take care of your feet. Here's a guide to common foot problems, and how to prevent and treat them.

Sprains

The cause: Sprains can happen in a second, and the causes are usually less exciting than most would imagine. "A common reason for a sprain is minor trauma caused by simple things like stepping off a curb or uneven terrain wrong," says Anthony Blanchard, DPM, instructor of clinical surgery at the University of Cincinnati (part of the UC Health Podiatry Services; Blanchard sees patients in Cincinnati and at West Chester Hospital in West Chester, OH). "People also may repetitively impact their heels or strain their tendons." This can be compounded by wearing shoes that are built for style rather than for stability, he adds. "Sprains in the foot are definitely more common after the holidays, when everyone decides to start exercising and then overdoes it," Blanchard says.

Sprains and strains are more common in people with high arches. In fact, "A naturally high-arched foot is more susceptible to sprains," according to Daniel Drapacz, DPM, clinical director for the New York Foot Experts & Advanced Laser Foot & Ankle Surgeons. "High-top shoes [sneakers or any other full-coverage walking shoe] can provide ankle support to help protect against ankle sprains." And, he adds, it is crucial to keep track of the amount of wear and tear that you are putting your shoes through. "That once comfortable, supportive all-purpose shoe that you love to do everything in can leave you susceptible to foot sprains and strains when it becomes worn out from overuse," he says. "This happens, on average, after 300 to 500 miles of walking, when there are signs of unevenness when the shoes are placed on a flat surface. The shoes also will display noticeable creasing."

The treatment: Follow the tried and true RICE (Rest, Ice, Compression, and Elevation) protocol, Blanchard says. If a sprain doesn't improve within five days, you'll want to see a specialist to rule out a fracture. And once the sprain has healed, you may be told to wear orthotics (a device, like an insert or splint) or to stretch before exercise.

Bunions

The cause:These small bumps on the joint at the base of the big toe form when the bone around the big toe joint becomes out of place. They can be extremely painful if not treated, and shoes can get harder and harder to wear. Bunions tend to run in families, and if you have a genetic predisposition to bunions and then wear the wrong shoes, you may well end up with one. "If you wear shoes that are tight enough in the toe box that they squeeze the toes together or rub along the top of the toes, then this will increase the likelihood of a bunion," says Drapacz.

The treatment: Orthotics, padding and taping the area, medication, and physical therapy are all used to treat bunions. If these therapies don’t work, your doctor may recommend surgery. But the recovery period can be several weeks, so most people see surgery as a last resort.

Fungal Infections

The cause: Fungal infections (like Athlete’s Foot) are caused by too-small-to-see organisms and occur on the skin of the foot or the toenails (the most common area) due to the friction caused by an uncomfortable shoe, and it can be challenging to treat. Drapacz explains: "While you can't avoid contact with the microscopic organisms that cause toenail fungus, you can keep your feet clean and dry and clip the toenails properly to prevent infection."

The symptoms of a fungal infection in the nail or on the foot are varied and appear gradually, which means many people don't seek treatment until it's well established, Blanchard says. On the skin, you may notice dryness, redness, and scaliness, and possibly itching. A fungal infection in the nail can present with a thickening of the nail as well as a whiteish or yellowish appearance.

The treatment: Treatment ranges from medicated creams to oral anti-fungal drugs. Drapcaz recommends the following to help stop toenail fungus from spreading:

  1. Keep your feet dry and clean, especially before putting your shoes.
  2. Keep toenails properly trimmed. The ideal technique is straight across to that the nail doesn't reach past the tip of the toe.
  3. Make sure your feet can breathe by wearing properly fitted shoes.

And you need to be patient: Skin on the foot takes a month to replenish itself, and it can take up to eight months for a healthy toenail to grow back, Blanchard says.

Pronating

The cause: Pronating, when the foot rolls inward while you walk or run, is normal. But when you overpronate, and your foot rolls too far inward, it can cause problems, since your feet aren’t absorbing the shock of your stride by transmitting it to your legs and hips.

The treatment: The best treatment is an arch support or orthotic placed in the shoe. "That supports the arch, or instep, of the foot," Drapacz says. "The orthotic should be able to fit in the shoe without making the shoe feel uncomfortable." Additionally, he recommends a combination of physical therapy and muscle training.

Choosing a Shoe

Finally, don’t overlook this foot care basic: wearing the right shoes. What type of shoe should you wear? "It really depends on the consumer’s foot type and foot shape," Drapacz explains. "The easiest way to figure out your foot shape and to buy the right shoes is to take a look at your old shoes for clues on where you need support and where they are worn the most. You can even bring your old shoes with you to the shoe store when you are buying a new pair—most shoe professionals can give you some tips on what to buy based on the wear of your old shoes."

You’ll also want to base your choice on the activities you’ll be performing. For everyday wear, choose a shoe with a wider toe box, Drapacz says. "And for sports, a sneaker that bends at the front of the foot instead of the arch is very good," he says. A walking shoe should offer good cushioning and shock absorption for the bottom of your foot. But be careful: "It is easy for a consumer to get confused when buying a walking shoe, since they are often a modified sneaker design. Consumers can test the heel cushioning by placing the palm of the hand into the inside of the shoe and pressing down on the heel on a counter surface, observing the foam like material compressing, while the shoe is rocked from side to side. A rubber sole will not exhibit this behavior." Walking shoes should have enough height and width in the toe box to allow for the normal swelling that occurs in feet during the day, he explains.

Gary Pichney, DPM, reviewed this article.

Sources

Phone interview with Gary Pichney, DPM. October10, 2014. 

Email interview with Daniel Drapacz, DPM. October 13, 2014. 

"Bunions.” American Podiatric Medical Association. Page accessed November 6, 2014. 

"Foot Health." American Podiatric Medical Association. Page accessed November 6, 2014.