And Other Things You Can Live With But Could Get Along Very Well Without - The all-important feet

The podiatrist is the specialist who treats foot problems. Causes of foot ailments range from lack of cleanliness to ill-fitting shoes and overindulgence in athletic activities (see “Care of the Feet” in Ch. 5, The Middle Years , “The Vulnerable Extremities” in Ch. 23, Aches , Pains , Nuisances , Worries ).

An ache, pain, or other disorder of the foot can be particularly annoying because it usually hampers mobility. A severe problem can keep a person bedridden, sometimes in the hospital, for substantial periods of time. As humans, we move about on our feet. They deserve the best of care from us, as their owners, and from the podiatrist in case a serious problem arises.

Podiatry , the science of foot care, has become more and more important as Americans have taken to athletics and exercises of various kinds. Most of these activities require the use of the feet. Increasing numbers of persons in the adult years are also taking up walking, jogging, or running as diversions or exercises.

Podiatrists believe that some persons “walk old”—they give the appearance, by the way they walk, of greater age than their chronological years. Others “walk young,” or walk normally. Those who walk old may be inviting foot problems, and a fact of podiatric science is that every foot problem has its reflection in another part, or other parts, of the body.

By contrast, good foot and body posture often suggests that the owner of the feet enjoys good health in other parts of the body. Foot care may in effect help other body parts to function better. Because many problems with parts of the body remote from the feet make good foot posture and normal walking difficult or impossible, individuals with diverse problems, such as back pains, sometimes go to a podiatrist for treatment. The back pain may disappear when the feet have been brought into good working order.

Diabetes and the Feet

“Care” for the feet of diabetics means prevention. The diabetic tries to keep his feet so healthy that he avoids major problems. He knows that diabetes affects blood circulation, and that the leg and foot are extremely vulnerable to circulatory problems. Where blood cannot reach a limb or member, gangrene becomes a possibility.

Foot Care

What kind of care serves the diabetic best? Effective care means that the diabetic takes steps quickly to treat such problems as abrasions or ulcers that refuse to heal. Other conditions that warn of possible future problems are dry skin, numbness, and dry or brittle nails. Ulcers that appear in the skin of the foot and that appear to have roots in deeper layers of tissue serve as danger signals. Such ulcers may appear on the site of an injury, cut, or scratch. A physician will usually prescribe medication, dietary adjustments, or other measures.

Ulcers may result from neglect of a corn or callus. But such neglect itself indicates the risks that diabetics incur: they may neglect to have a foot problem such as a corn treated because their disease has, over time, reduced the sensitivity of their feet. They may lose much of their ability to feel pain, heat or cold, or stress in the foot. Because of such problems, diabetics generally follow certain rules of foot care, including the following:

1. • Give the feet a daily examination for cuts, bruises, or other abnormalities
2. • Use only prescribed medications in caring for the feet—and avoid over-the-counter preparations
3. • Visit a podiatrist regularly, as often as once a month, and avoid medical “treatment” of one's own feet or even cutting one's own toenails
4. • Wash the feet daily in warm, not hot, water and dry them carefully, including the area between the toes
5. • Use a gentle lubricant on the feet after washing and drying—and never go barefoot
6. • Avoid the use of items of clothing that may interfere with circulation, including wraparound garters and support hosiery
7. • Avoid “holey” socks, darned socks, or anything else that may irritate the soles of the feet and
8. • Avoid constructive boots or shoes

Jogging and Running

The podiatrist usually tries to learn about a patient's work, his hobbies and sports, and other facts before undertaking treatment. In particular, the podiatrist asks whether the patient runs or jogs or takes part in other strenuous exercises. With such background information, he or she can suggest appropriate treatment.

A podiatrist will advise runners or joggers on the kind of footwear that would be best—especially if problems have been encountered or may be expected. Shoe inserts may be custom-designed if needed. The podiatrist may also advise runners and joggers to run on softer surfaces rather than cement. Jogging or running “in place,” without forward movement, is to be avoided if possible; even when jogging inside the home or apartment, the jogger should move from room to room.

Podiatrists point out that even the more serious knee and ankle problems incurred in running and jogging can be treated. “Jogger's ankle,” pain resulting from too much jogging and the attendant strain, can be controlled if the jogger will use moderation. Beginning joggers in particular should start slowly and gradually increase their level of participation. Runners’ knee problems may be cured in many cases by treatment that enables the feet to carry the weight of the body properly. In part, the treatment requires practice in throwing the body weight onto the balls of the feet, not on the inner sides of the feet. The remainder of the body, including the knees, can be kept in proper alignment with the feet if the weight falls where it should.

Podiatrists also advise runners, joggers, and others taking part in sports to make certain all their clothing and equipment are appropriate. That applies especially in skiing, ice-skating, and other sports requiring extensive foot use. Proper equipment helps runners and joggers avoid colds and similar respiratory problems.

With proper equipment, including good shoes, and a moderate approach, runners and joggers can avoid many other potentially troublesome physical difficulties that could require podiatric care. These others include fallen arches; corns, calluses, and bunions; and “aging feet” that grow weaker from lack of proper foot attention.