Your feet are used to take baby steps, to walk and to run. No matter what your age, having healthy feet is an important part of good health.
Too often, people think that foot pain is normal. It is not. If you have foot pain, you should see a podiatrist to determine the problem and how to fix it.
Podiatrists are highly trained medical specialists who focus specifically on the foot and ankle. Their area of expertise includes diagnosis, treatment and helping you to keep your feet in a healthy condition. Podiatrists treat patients of all ages in all health care settings. Our active lifestyles, an aging population and an anticipated increase in the number of Canadians developing diabetes have increased the demand for podiatric services.
About the foot
Your foot is a very complex part of your body. Each foot contains 26 bones, which are held in position by hundreds of ligaments, tendons and muscles, making it an extraordinarily complex mechanism.
The total force accumulated on feet every day is well over one million pounds for the average adult. However, the foot acts as an amazingly versatile and complex set of shock absorbers that protect the body with every step. This is only one of many important reasons why you should take good care of your feet.
Every day you put considerable stress on your feet, so it isn’t surprising that your feet do hurt and/or develop various aches and ailments. When this happens, it is important to see a podiatrist.
An average adult applies over a million pounds of force to his or her feet daily.
Common conditions and ailments
- Athlete’s foot – a common fungal infection of the skin and nails which usually results in itching, scaling, redness and the formation of small blisters. You can lessen the likelihood of athlete’s foot through good hygiene, which includes washing your feet with soap and water every day; drying your feet carefully, especially between the toes; keeping your shoes and socks dry; changing your shoes regularly; and wearing wicking acrylic or cotton socks.
- Blisters – painful, fluid-filled lesions often caused by friction and pressure from ill-fitting shoes, stiff shoes, wrinkled socks against the skin, excessive moisture or foot deformities. To lessen the chance of getting blisters, keep your feet dry, wear socks as a cushion between your feet and shoes and wear properly fitting shoes.
- Bunions – a bunion is an enlargement at the base of the big toe caused by a misalignment of the joint. It may be swollen, tender and painful. Bunions can be caused by heredity, biomechanical deformities, neuromuscular disorders, arthritis, trauma or congenital deformities. Once you have bunions, surgery is the only way to remove them. However, wearing supportive shoes with orthotics and having the shoes stretched out over the protruding joint can help stop bunions from getting worse.
- Corns and calluses – a build up of the skin that forms at the points of pressure or over bony prominences, calluses form on the bottom and sides of the foot while corns form on the top of the foot and between the toes. They are often caused by repeated friction and pressure from skin rubbing against bony areas or against an irregularity in a shoe or by hereditary disorders. To reduce the likelihood of a corn or callus forming on your foot, wear supportive shoes with a wide toe box and a low heel, use over the counter creams (void of any acid preparations) and use a pumice stone or file (if you are not a diabetic).
- Hammertoes – a contraction deformity, resulting in bony prominences on the toes. Causes can include heredity, ill-fitting shoes, muscle imbalance or arthritis. Wearing a supportive shoe with a deep toe box, applying cold compresses and soaking the foot in lukewarm water can help relieve the pain.
- Ingrown nails – a painful condition caused by the nail growing into the surrounding skin, leading to inflammation and possible infection of the toe. This is a serious condition for people with impaired circulation, diabetes or other systemic diseases. Although it is usually hereditary, it can also be caused by tight pointy shoes, restrictive compression stockings or improper nail cutting. There are things you can do to minimize the likelihood that you will suffer from ingrown toe nails. Be sure to cut your toe nails straight across with only a very slight rounding at the corners in order to avoid creating a pointy edge, or visit a podiatrist on a regular basis to have the cutting done. Another option is to have the ingrown piece of nail removed permanently thereby eliminating the problem altogether.
If you have an ingrown toe nail, visit your podiatrist or doctor.
- Neuromas – often referred to as a pinched nerve, swollen nerve or nerve tumor, this painful condition is a benign growth of nerve tissue frequently found between the third and fourth toes (a.k.a. Morton’s Neuroma), however, it can also occur between the second and third toes. It may result in pain, burning, tingling or numbness between the toes and in the ball of the foot. Causes include improper or ill-fitting shoes, repetitive trauma, high-heeled shoes or heredity. Changing to lower heeled shoes, wearing supportive shoes with a roomy toe box and soaking and icing your foot can be helpful. In more painful cases, cortisone injections into the area may be helpful or surgical removal may be warranted.
- Toenail Fungus (Onychomycosis) – is caused by various fungi types and leads to considerable nail damage. The fungus develops in dark and damp surroundings so people wearing tight and closed shoes or women applying multiple nail polish coats are more prone to toenail fungus. That is because the fungus, once formed, thrives by gnawing away at the toenail protein called keratin.
- Warts – a growth in the skin caused by a viral infection, warts tend to be hard and flat with elevated rough surfaces with or without well-defined boundaries. They are frequently called plantar warts because they appear most often on the plantar surface or sole of the foot. Children, especially teenagers, tend to be more susceptible to warts than adults. Left untreated, warts can grow and spread into clusters. Avoid walking barefoot and don’t share footwear with others. Be sure to change your shoes daily, and keep your feet clean and dry. Most importantly, avoid home treatments, which often irritate the wart and make it grow even faster.
Note: because other more serious lesions, including carcinomas and melanomas, can be mistakenly identified as warts, it is wise to consult a podiatrist about any suspicious growth or eruption of the skin on your feet.
- Heel pain – an inflammation of the long band of connective tissue that runs from the heel to the ball of the foot (plantar fascia). Often referred to as plantar fasciitis. Causes include over-stretching the long band, muscle imbalance, bone deformity, obesity, trauma or tightness of the muscle at the back of the leg. To help prevent and/or alleviate this condition, warm up and stretch before exercising, wear appropriate shoes and use the RICE treatment (rest, ice, compression and elevation).
- Heel spur – a bony overgrowth on the heel bone. Heel spurs cause pain in the bottom of the foot and arch. This condition is the result of long-term chronic plantar fasciitis. As heel spurs are caused by falling arches, the best way to prevent them from occurring is to always wear footwear with good arch support. Avoid walking around in bare feet or with socks, slippers or flat shoes. If the heel spur remains painful, anti-inflammatory medications (oral or injectable), Extracorporeal Shock Wave Therapy and surgery are viable treatment options that your podiatrist can discuss with you.
Podiatrists are highly trained medical specialists who focus specifically on the foot and ankle
Many adult foot ailments are present at birth or have their origins in childhood. Because the feet of young children are soft and pliable, abnormal pressure can easily cause deformities. This is why podiatrists consider the first few years to be the most important in the development of the feet. By visiting a podiatrist periodically and regularly performing foot care you can minimize problems later in life.
The feet of young children are often unstable because of muscle problems which make walking difficult or uncomfortable. A thorough examination of your child’s feet by a podiatrist may detect an underlying defect or condition which may require immediate treatment or consultation.
Shoes are not necessary indoors when your child first begins to walk. Allow your child to go barefoot or wear just socks when indoors. This helps the foot grow normally and develop its musculature and strength, as well as the grasping action of toes. When walking outside or on rough surfaces, your child’s feet should be protected in lightweight, flexible footwear made of natural materials.
As your child’s feet continue to develop, it may be necessary to change shoe and sock size every few months to allow room for the feet to grow. Although foot problems result mainly from injury, deformity, illness or hereditary factors, improper footwear can aggravate pre-existing conditions. Footwear should never be handed down from one child to another.
Shoes are not necessary indoors for children when they learn to walk.
As a senior, you already have about 100,000 kilometres on your feet. But that doesn’t mean it’s too late for comfort. In fact, there are lots of things you can do to keep your feet in good condition. Try some of the following practices.
- Wear good quality running shoes or shoes designed specifically for walking.
- Have corns or callouses treated by a podiatrist.
- Perform gentle exercises such as moving your feet in circles or up and down to help improve mobility, flexibility and circulation.
- Do calf-stretching exercises to reduce tightness in the back of the lower leg muscles. Lean against the wall and place one foot forward and one foot back; bend the forward knee and you will feel the calf muscle of the opposite leg stretch. Hold for 10 seconds. Change the position of your legs and repeat the exercise.
- Use insoles to add cushioning to the soles of your shoes. As you get older, the fat pad under the bones at the ball of the foot tends to get displaced forward and reduces the cushioning at the ball of the foot. An insole will provide some extra cushioning.
- Have your foot mechanics evaluated by a podiatrist. Structural imbalances that can lead to bunions and callouses can be corrected.
- Treat any ingrown toenails. A podiatrist can painlessly clip away a segment of the nail to provide immediate relief or permanently remove the offending nail border.
- If you have varicose veins, elevate your feet when you can and walk as often as you can. Compression stockings may be beneficial too.
- Get involved in a walking program. Check with your general practitioner and then start a gradual walking program. Be sure to wear appropriate and comfortable fitting shoes.
If you have diabetes you are at a greater risk of foot problems. In fact, diabetes can often first be detected in the foot.
Diabetes is a systemic disease affecting many different parts of the body, and ideal case management requires a team approach. The podiatrist is an integral part of the treatment team and is often successful in preventing amputations. The key to amputation prevention in diabetic patients is early recognition and regular foot screenings, at least annually, from a podiatrist.
In addition to these check ups, there are warning signs that you should be aware of so that they may be identified and acknowledged by your family doctor or podiatrist. They includes signs such as:
- skin colour changes
- elevation in skin temperature
- swelling of your foot or ankle
- pain in the legs
- open sores on your feet that are slow to heal
- ingrown and fungal toenails
- bleeding corns and calluses
- dry cracks in the skin, especially around the heel.
Ulceration is a common occurrence with the diabetic foot and should be carefully monitored and treated by a podiatrist to reduce the possibility of amputation. Poorly fitted shoes, or something as trivial as a stocking seam, can create a wound that may not be felt by someone whose skin sensation is diminished. Left unattended, ulcers can develop and quickly become infected, which can lead to more serious consequences. Your podiatrist knows how to treat and prevent these wounds and can be an important factor in keeping your feet healthy and strong.
It goes without saying that women’s dress shoes are not necessarily designed with comfort in mind. However, women can use the following practices to keep their feet healthier and more comfortable both during work and after hours.
- Consider shoes with cushioned soles if you wear dress shoes.
- Compare the shape of your foot and the shape of the front of the shoe. Choosing shoes that better match the shape of your foot will create less pinching.
- Lower your heel height by even an inch, which will make a big difference.
- Do lots of stretching for your calf muscles if you’re active in sports. Lean against a wall with one foot forward and one foot back. This is especially important if you wear high heels at work, since your calf muscle undergoes shortening and will be over-stressed once it is placed in a lower sports shoe.
- Consider using insoles, which can add a lot of cushioning to your shoes. The insoles can be trimmed to fit a dress shoe and can also be shortened to reach just the ball of your foot so they don’t make the toe box area of the shoe too tight.
- Wear good quality running shoes or walking shoes; this will make shopping, prolonged walks or your journey to and from work more comfortable.
- Slip your shoes off, do some circles with each foot and up-and-down motions with your toes while sitting at your work desk, which will enable your feet muscles to relax and stretch.
Shoes, however, are not always the cause of women’s foot problems. Mechanical imbalances can create problems such as bunions, heel pain, arch pain and hammertoes. The causes of your foot problems should be evaluated and corrected by a podiatrist.
If you have diabetes it is important that you:
- wash your feet daily
- inspect your feet and toes daily
- wear thick, soft socks
- stop smoking
- cut toenails straight across
- exercise regularly
- visit your podiatrist for regular check ups
- be properly measured and fitted every time you buy new shoes
- wear appropriate footwear rather than going barefoot
- avoid wearing high heels, sandals or shoes with pointed toes
- drink in moderation
- avoid wearing anything that is too tight around the legs
- obtain help from a podiatrist to remove calluses, corns or warts.
With the increased amount of activity that most athletes do, both in terms of training and participation in their sport, it is no surprise that their feet and legs can take a pounding. As a result, many podiatrists see athletes, both professional and amateur, on a regular basis. For many, wearing the correct footwear for the sport can provide the needed support, or orthotics can be prescribed to provide additional support where required. If you are an athlete and you experience pain, visit a podiatrist for an examination.
Wear good quality running shoes or walking shoes
Commonly asked questions
Do I need a referral from my doctor to see a podiatrist?
No. You can contact a podiatrist office directly to make an appointment. Podiatrists are listed in the yellow pages telephone directories.
When should I see a podiatrist?
Any time you experience sore feet or pain, you should consider seeing a podiatrist. If you are a diabetic, you should see your podiatrist on a regular basis for check ups.
Why is an office fee charged to the patient?
Podiatric medicine is not included in the Canada Health Act; however, some provincial health plans (public medical insurance) provide partial coverage in select instances. Therefore, most podiatrists charge a fee to cover part or all of their services and treatment. Note: extended health plans (private medical insurance) often provide coverage for podiatric services — please verify with your individual plan.
Are visits covered by insurance?
Many private insurance companies include podiatric services in their coverage. Please check with your individual insurance company to find out if you are covered.
Where can I find out more information about podiatry?
There are several reliable Internet sites that provide information about podiatry, such as:
What are orthotics?
Prescription orthotics are custom-made shoe inserts that are designed to correct an abnormal or irregular walking pattern and to restore proper foot function and balance. Orthotics control each phase of the walking cycle, from the moment your heel contacts the ground to when your toes push off the surface.
Orthotics can often enhance comfort and prevent additional problems from developing, such as corns and calluses. Podiatrists prescribe orthotics as a conservative approach to many foot problems.
Orthotics fall into three main categories:
- rigid – used to control function; usually made of a firm material such as plastic or graphite
- semi-rigid – provides dynamic balance of your foot while walking or participating in sports; helps guide your foot through proper functions, allowing muscles and tendons to perform more efficiently
- soft – helps to absorb shock and take pressure off uncomfortable or sore spots of your feet.
How often should orthotics be replaced?
Orthotics should be replaced at least every two years.
are an important part of overall good health.
Regardless of the current condition of your feet, you can take actions to reach or maintain healthy feet for a lifetime.
Simple steps for taking good care of your feet include:
- wash and inspect your feet every day
- choose a quality brand of footwear that fits well and feels comfortable
- wear footwear that is appropriate for the activity you are performing (such as hiking shoes for hiking; running shoes for running)
- break new footwear in gradually; replace when the footwear loses its shock-absorbing ability
- control your weight (less weight means less pressure on your feet and legs)
- exercise daily to maintain circulation and muscle tone
- avoid crossing your legs (crossing your legs increases pressure on the nerves and blood vessels)
- see a podiatrist on a regular basis.
From your first baby steps you take and in all phases throughout your life, having healthy feet is important. You only have one pair of feet to last a lifetime so take good care of them!