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Reducing Your Risk of Foot Pain

General Guidelines

Follow these tips from the American Podiatric Medical Association for preventing foot pain:

  • Don't ignore foot pain-it's not normal. If your pain persists, see your doctor, an orthopedic surgeon, or podiatrist.
  • Inspect your feet regularly:
    • Pay attention to changes in the color and temperature of your feet.
    • Look for thick or discolored nails (a sign of developing fungus), and check for cracks or cuts in the skin.
    • Peeling or scaling on the soles of feet and in between the toes could indicate athlete's foot.
    • Any growth on the foot is considered abnormal.
  • Wash your feet regularly, especially between the toes. Be sure to dry them completely.
  • Trim toenails straight across, but not too short. Be careful not to cut corners; it can lead to ingrown toenails.
  • Make sure that shoes fit properly. Purchase new shoes later in the day when feet tend to be at their largest, and replace worn out shoes as soon as possible.
  • Select and wear the right shoe for specific activities (ie, running shoes for running).
  • Alternate shoes. Don't wear the same pair of shoes every day.
  • Avoid walking barefoot, which increases the risk for injury and infection.
  • At the beach or when wearing sandals, use sunblock on your feet, as you would on the rest of your body.
  • Be cautious when using home remedies for foot ailments. Self-treatment can often turn a minor problem into a major one.
  • If you have diabetes, see an orthopedic surgeon or podiatrist at least once a year for a check-up. If you have diabetes, poor circulation, or heart problems, you should not treat your own feet (including toenails) because they are more prone to infection.

Specific Guidelines

Depending on your foot concerns and lifestyle, there are a variety of steps you can take to protect your feet. These include:

Selecting Proper Shoes

In general, the best shoes are well-cushioned and have a leather upper, stiff heel counter, and flexible area at the ball of the foot. The heel area should be strong and supportive, but not too stiff, and the front of the shoe should be flexible. New shoes should feel comfortable right away, without a breaking in period. There should be plenty of room for all five toes.

  • Getting the Correct Fit-The best way to prevent nearly all foot problems is to choose well-fitted shoes with a firm sole and soft upper. You should purchase them in the afternoon or after a long walk, when your feet are at their largest size. There should be a ½ inch of space between your largest toe and the tip of the shoe, and the toes should be able to wiggle upward. You should stand when being measured, and both feet should be sized, with shoes bought for the larger foot. It is important to wear the same socks as you would regularly wear with the new shoes.
  • The Sole-Ideally, your shoes should have removable insoles. If you are an older person, thin hard soles may be the best choice. Elderly people wearing shoes with thick, inflexible soles may be unable to sense the position of their feet relative to the ground, which increases the risk for falling. Some research suggests that thick soles may even be responsible for foot injury in younger adults who engage in high-impact exercise.
  • The Heel-High heels are the major cause of foot problems in women. If you insist on wearing high heels, look for shoes with wide toe room, reinforced heels that are relatively wide, and cushioned insoles. You should also keep the amount of time you spend wearing high heels to a minimum.
  • Laces-The way shoes are laced can be important for preventing specific problems. Laces should always be loosened before putting shoes on. If you have narrow feet, you should buy shoes with eyelets farther away from the tongue than people with wider feet. This makes for a tighter fit for narrower feet and a looser fit for wider feet. If, after tying the shoe, less than an inch of tongue shows, then the shoes are probably too wide. Tightness should be adjusted both at the top of the shoe and at the bottom. When high arches cause pain, eyelets should be skipped to relieve pressure.
  • Wearing Shoes-Place moleskin pads next to areas on your skin where friction is likely to occur. Once a blister occurs, moleskin is not as effective. Change shoes during the day. As soon as the heels show noticeable wear, you should replace the shoes or heels.
  • Special Purpose Footwear-Avoid extreme variations between your exercise, street, and dress shoes.
    • Exercise and Sports-The shoes you wear for exercise should be specifically designed for your preferred sport. For instance, a running shoe should cushion your forefoot, while tennis shoes should emphasize ankle support. Buy your shoes at a store with knowledgeable sales people. Your athletic socks are almost as important as your shoes. Experts often recommend padded acrylic socks.
    • Occupational Footwear-A number of occupations put the feet in danger. If you are in a high-risk job, you should be sure your footwear is protective. For example, nonelectric workers at risk for falling or rolling objects or punctures should wear shoes with steel toes and possibly other metal foot guards. Electric workers should wear footgear with no metal parts (or insulated steel toes) and rubber soles and heels. Chemical workers should wear shoes made of synthetics or rubber, not leather.
  • Insoles-An insole is a flat cushioned insert that is placed inside the shoe. They are designed to reduce shock, provide support for your heels and arches, and absorb moisture and odor. People respond very differently to specific insoles. What works for one person may not work for you. The thickness of your socks must be considered when purchasing insoles. You do not want insoles to squeeze your toes up against your shoes.
    • Purchasing Insoles-Insoles can be purchased in athletic and drug stores. Shoe stores that specialize in foot problems often sell customized, but more expensive, insoles. In general, over-the-counter insoles offer enough support for most people's foot problems. Most well-known brands of athletic shoes have built-in insoles.
    • Heel Cushions for Shortened Achilles Tendons-If you have developed short, tightened Achilles tendons (often caused by wearing high heels for prolonged periods), you should consider using heel cushions. Like insoles, heel cushions are inserted inside your shoes. They should be at least 1/8 inch, but not more than ¼ inch, thick; however, with tightened Achilles tendons, try to stretch them out each day, otherwise wearing high heels or heel cushions will only increase the problem.

Practicing Correct Walking and Exercise

In addition to wearing proper shoes and socks, you should also walk often and correctly to prevent foot injury and pain. Your head should be erect, your back straight, and your arms relaxed and swinging freely at your sides. You should step out on your heel, move forward with the weight on the outside of your foot, and complete the step by pushing off the big toe.

  • Stretching-Gentle stretching of the Achilles tendon and posterior calf muscles after warm-up and before running can help prevent Achilles tendinitis and heel pain.
  • Hiking-You should prepare for long hikes by putting moleskin pads on the heel and other parts of your foot that might be rubbed by the shoe. Shortly after starting and at the end of a hike, your foot should be checked for irritation and redness.

Caring for Toenails

Toenails should be trimmed short and straight across. Filing should also be straight across using a single movement, lifting the file before the next stroke. The file should not saw back and forth. A cuticle stick can be used to clean under the nail.

Preventing Toe Pain

To prevent corns and calluses and relieve discomfort:

  • Do not wear shoes that are too tight or too loose. Wear well-padded shoes with open toes or a deep toe box (the part of the shoe that surrounds the toes). If necessary, have a cobbler stretch the shoes in the area where the corn or callus is located.
  • Wear thick socks to absorb pressure, but do not wear tight socks or stockings.
  • Apply petroleum jelly or lanolin hand cream to corns or calluses to soften them.
  • Use doughnut-shaped pads that fit over a corn to decrease pressure and friction. They are available at most drug stores.
  • Place cotton, lamb's wool, or moleskin between the toes to cushion any corns in these areas.

Preventing Foot Disorders in Diabetes

Preventive foot care can reduce the risk of amputation in people with diabetes by 44%-85%. Some tips for preventing problems include the following:

  • Inspect your feet daily and watch for changes in color, texture, or odor; also look for firm or hardened areas, which may indicate infection and potential ulcers.
  • When washing your feet, the water should be warm (not hot), and the feet and areas between the toes should be thoroughly dried afterward. Check water temperature with your hand or a thermometer before stepping in.
  • Apply moisturizers, but not between the toes.
  • Gently pumice corns and calluses. Trim toenails short, but not so short that they can become ingrown. File the edges to avoid cutting adjacent toes.
  • Do not use medicated pads or try to shave corns or calluses by yourself.
  • Avoid high heels, sandals, thongs, and going barefoot.
  • Change your shoes often during the day.
  • Wear socks; those with extra padding may be very helpful.
  • Avoid tight stockings or any clothing that constricts your legs and feet.
  • If foot pain, numbness, or tingling is worse at night, diphenhydramine (Benadryl) may help.
  • Consult a specialist in foot care for any problems.

Preventing Foot Problems in Childhood

  • Early Development-The first year in a person's life is important for foot development. You should cover your baby's feet loosely, allowing plenty of opportunity for kicking and exercise. The child's position should be changed frequently. Staying too long on the stomach can strain the feet. Children generally walk between 10-18 months; they should not be forced to start walking early. Wearing just socks or going barefoot indoors helps the foot develop normally and allows the toes to grasp. Going barefoot outside, however, increases the risk for injury and other conditions, such as plantar warts.
  • Shoes-Children should wear shoes that are light and flexible. Since their feet perspire greatly, their shoes should be made of materials that breathe. Footwear should be changed every few months as the child's feet grow. Footwear should never be handed down.
  • Sports-High-impact sports can injure growing feet. You should be sure that your children's feet are protected if they engage in intensive athletics.

Preventing Blisters During Hiking or Strenuous Activity

Hiking or strenuous walking can cause blisters. To prevent them, one study reported that treating feet with antiperspirants before setting out on your hike might be helpful. Stop after several minutes and put moleskin on any areas that are rubbing.

Using Skin Creams and Foot Baths

Skin creams can help maintain skin softness and pliability. Taking a warm footbath for 10 minutes, two or three times a week will keep your feet relaxed and help prevent mild foot pain caused by fatigue. Adding ½ cup of Epsom salts increases circulation and adds other benefits. Taking footbaths only when your feet are painful is not as helpful. A pumice stone or loofah sponge can help get rid of dead skin.

Having Massage Therapy

Here is an exercise you can use on your own feet. Using your thumb, index, and middle finger, rotate each toe in a circular motion. Then, make a fist and rotate it slowly around the bottom of your foot. Finally, gently twist each foot, as if wringing wet clothes, moving the top and bottom in opposite directions.

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Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted March 2011