Stay on your feet

What if I can’t get around? That scary thought starts nagging when something goes wrong with one or both feet. Mobility plays a huge role in keeping us independent, so taking good care of our feet is a smart investment. Getting around and staying independent largely depends on them.

Most of us don’t inherit perfect feet so we don’t walk or run perfectly either. And most of us, women especially, are guilty of forcing our feet into fashionable but dangerous footwear. Over the years, the strain on various parts of our feet will begin to tell. In fact, more than 300 disorders can make feet feel miserable. As they get older, feet naturally begin to spread, and the fibrous fatty pads cushioning the soles gradually thin and become less effective at absorbing the shock of foot hitting the ground. Feet seem to tire and feel sore easily, balance can be off.

^”Feet can either collapse or become quite rigid, depending on whether the condition is diabetic or arthritic,” says Kathryn Callfas, a certified pedorthist at the Pedorthic Clinic at Toronto’s Sunnybrook Centre for Independent Living (a pedorthist creates supportive appliances, such as orthotics, and makes or modifies footweato help clients walk normally and comfortably).

It’s tough to prevent some foot problems, she admits. “We’re all going to feel the effects of walking on our feet for so many years,” Callfas says. “We all get wear and tear in our joints.” She recommends that people having foot pain or who are concerned about their feet should see their doctor and perhaps be referred to a foot-care clinic.

Highlighting health problems
Paying attention to your feet also makes sense because they can point to problems with all-round health. Symptoms in the feet, such as swelling, pain at night or sores that take a long time to heal, may indicate peripheral vascular disease (PVD), or poor circulation in the lower limbs. PVD often accompanies diabetes and heart disease.

Taking ultra-good care of feet is critically important to people with diabetes. The disease can be complicated by PVD as well as nerve damage (neuropathy) that results in loss of sensation in the foot. When a cut or blister doesn’t hurt and isn’t noticed, the small injury can rapidly become a serious infection. The Canadian Diabetes Association (CDA) reports that 80,000 to 200,000 of the two million Canadians with diabetes will develop a foot ulcer. Eventually, 14 to 24 per cent of them will face the harrowing experience of amputation.

“We believe that at least 50 per cent of all amputations related to diabetes can be prevented,” points outs Lynn Baughan, manager of diabetes education programs and strategies for the CDA. People with diabetes are often slow to heal, possibly because growth factors needed for wound healing are defective. They need to check their feet daily, she says, to spot blisters, small cuts or redness caused by shoe pressure and to act to prevent these small problems from becoming serious infections. Over time, diabetes damages blood vessels, thickening artery walls and reducing blood circulation in the legs. Baughan advocates working with a physician to control blood sugar levels, as well as exercising and quitting smoking as strategies to limit circulatory damage and the risk of developing PVD. Their doctor may refer them to a special foot-care clinic with a physician specializing in treating diabetic foot ulcers and a podiatrist who can assist in finding footwear to accommodate their problematic feet.

Next page: Make sure the shoe fits

If the shoe fits…
Even if you don’t have diabetes, you need shoes that won’t harm your feet. Wear the appropriate shoe for the activity involved, advises chiropodist Justin Turner of the foot-care clinic at Sunnybrook. Leather-soled shoes are fine as dress shoes but aren’t for running or a lot of walking. Athletic shoes are probably the best type of shoes to wear, he says, because they can have features that keep the foot stable and can be cushioned in front or at the heel as needed. Laced shoes stay on the foot better than slip-on shoes and provide greater stability and support. He points out that a shoe with a back strap is preferable to a slide-on shoe. “You foot has to work very hard at staying in the footwear if there’s no back strap, so it gets tired.”

Turner has noticed in his practice that most people wear shoes that are too narrow. “The foot expands when it’s weight bearing,” he says, “so you should be standing when you’re getting fitted.” The shoe should be about a centimetre longer than the longest toe, which in many people is not the big toe, and roomy enough that toes can move freely. “And it’s important to remember that a size 6½ in one shoe is size 7 in another,” he adds. If you have orthotics, bring them to the shoe store to make sure they’re compatible with your footwear selection. Usually, the inner liner of the shoe comes out, and the orthotic fits in its place.

Women still want to look fashionable, even though their feet may remind them of years of abuse by high heels. Turner recommends lowering their sights. “Higher than 1-1/2 inches, you’re putting extra pressure on the front of your foot and that can lead to stress fractures of the metatarsals (the bones between toes and middle bones of feet). Most high-heeled shoes don’t have laces so they have to be tight to stay on the foot. That tightness contributes to the formation of bunions and hammertoes and causes corns on the little toes.” Ouch!

Footnotes:

  • The foot has 26 bones, 33 joints and more than 100 muscles, tendons (connecting muscles to bone) and ligaments (connecting bone to bone).
  • The American Podiatric Medical Association estimates that a 150-pound person places a total of 127,000 pounds on each foot by walking one mile. The group also calculates the average person walks 75,000 miles by the age of 50.
  • Walking helps increase blood supply to the feet, which helps wounds heal faster.
  • Foot pain isn’t normal. If you’re hurting, get it checked out.
  • Simple exercises strengthen feet. Chiropodist Justin Turner says the best one is to drop a towel on the floor and then “scrunch it with your toes as if you’re trying to pick it up.” He also suggests writing the alphabet on the ground with the toes.
  • In some parts of Canada, chiropodists are called podiatrists and in other parts of the country, podiatrists are regulated under a college or association of chiropodists.
  • Provincial health care may cover some podiatric services but not those of chiropodists. Qualifying veterans receive foot care coverage from Veterans Affairs Canada.