Your feet take the weight of your whole body, so foot problems can quickly lead to discomfort and affect the way you walk. This can in turn cause knee, hip and back pain.

The good news is that looking after your feet can prevent most of these problems.

Investing a bit of time and thought into caring for your feet now can prevent them causing you pain later.

10 top tips Foot facts

• Each foot contains 26 bones and more than 100 ligaments.
• Your feet contain more than a quarter of all the bones in your body.
• The skin on your feet has more than 7,000 nerve endings.
• There are more than 125,000 sweat glands on each foot, more than anywhere else in the body.
• Your feet produce an eggcup’s worth of sweat each day.

Remember

1.     Don’t go to bed without washing your feet. If you leave dirt on the skin’s surface, it can become irritated and infected. Wash your feet every evening with soap and water.
2.     Dry your feet thoroughly after washing them and apply a moisturising foot cream (not body lotion).
3.     Gently remove hard skin and calluses with a pumice stone or foot file regularly.
4.     Always trim your toenails straight across, never at an angle or down the edges. This can cause ingrown toenails.
5.     Shop for shoes in the afternoon. Feet swell as the day goes on and if shoes fit in the afternoon when your feet are at their largest, you can be assured they will always be comfortable.
6.     If you have to wear heels at work, wear comfortable shoes to and from the office and only wear your smart shoes in the office. Also, try to vary the heel height, between low, medium and high.
7.     Be shoe savvy. Wear high heels and pointed shoes for special occasions only, and always wear the right shoes for the job (so no sandals for mountain climbing).
8.     Change your socks daily.
9.     Wear flip-flops to avoid catching athlete’s foot and verrucas when you use public areas such as gym showers, swimming pools or hotel bathrooms.
10.     But don’t wear flip-flops all the time. They don’t provide support for your feet and can give you arch and heel pain if you wear them too much.

Foot pain advice for over-60s

If you’re over 60, foot care becomes even more important. Age takes its toll: your skin thins, your joints begin to stiffen and your feet become more vulnerable to the cold.

Not only that, but as podiatrist Emma Supple says: “Physically, it gets more difficult for us to get to our feet, and failing eyesight doesn’t help.”

Emma says: “Go to see a professional for a foot MOT every six months and never put up with foot pain as if it is normal. Your feet shouldn’t hurt.”

Source:http://www.nhs.uk/Livewell/foothealth/Pages/Healthyfeet.aspx

 

Feet are one of the most neglected areas of the body.

Most of us ignore them unless they cause us problems, or we are showcasing them in open toed sandals or shoes.

So cancers of the foot and ankle are often missed or diagnosed too late.

Specialists warn that because of this survival rates from these particular cancers are poor.

One study found the overall five-year survival rates for patients with melanomas of the foot and ankle was 52%, compared with an 84% survival rate for those with melanomas elsewhere on their lower limbs.

‘Neglected’

Antony Kontos, a podiatrist at The London Foot and Ankle Centre, said a simple foot check could guard against an aggressive and often undetected skin cancer.

People are quite happy to conceal all sorts of things in their socks and shoes Antony Kontos

“People do not check their feet well enough,” he said.

“The feet are a generally neglected area.

“If feet were on display people would make much more of an effort, but they are not and are often hidden away.

“People are quite happy to conceal all sorts of things in their socks and shoes.

“These lesions are as far away from you as they can possibly be, underneath the toes or underneath the nails and have just been ignored or misdiagnosed as other things.

“But if they are late in presenting the prognosis is worse,” he said.

“People aren’t aware that melanomas can develop on their feet.

“Melanomas of the foot can resemble a bruised toenail or a blood blister and are often misdiagnosed.”

When to go for advice If the moles, marks or freckles are irregular or damaged Have changed recently – in size, elevation, colour or diameter If you have a black toenail but have no recent injury If there is a blackness on the toenail which does not extend along the nail as you would expect with a bruise If there is a mark or mole which is itching or bleeding or asymmetrical

As health professionals at the forefront of foot care, podiatrists play a key role in screening for foot cancer.

During the past three months Mr Kontos has identified two patients with foot melanomas.

Sun danger

He said one reason for the cancers was over exposure to the sun and warned people to cover their feet or protect them.

“Our feet are enclosed in shoes most of the year and then we pack our sandals for a holiday in very hot temperatures.

“This means feet are particularly susceptible to sunburn. However, although people are generally aware of checking other parts of their body for suspicious moles, they are unlikely to examine their feet.”

When Keith Benham’s toe nail turned black two years ago he assumed it was because someone had trodden on his foot.

Two years later though the discolouration was still there and he went for advice.

This January, Keith, aged 65, from London, was told he had a melanoma, lurking under his nail.

Mr Benham was told he had to lose the toe and now he must wait to see what the future holds.

But he said he had been unaware that the feet were at risk from cancers.

“I had noticed no problems with my feet. I had had a black toe nail for something over two years, but I had never suffered any pain. It just appeared to have gone rotten and the toe underneath was black.

“In January this year I spoke to a doctor, who said there was almost certainly nothing to worry about, but that there was one problem I could have and that I should get it checked.

“I saw the doctor and he referred me to Mr Kontos, he looked it for a fraction of a second and told me that I needed to go that day to see a specialist.

“The specialist saw me the next day and said he knew what it was. He said ‘I will do a biopsy, but even if the results are negative, I will do another one and if the results of that are negative I will do another one until I get a result’.

“He was right and at the beginning of March, he removed the offending toe – the fourth on the right foot.

“I didn’t even know this sort of cancer existed,” he said.

Source: By Jane Elliott  Health reporter, BBC News

http://news.bbc.co.uk/1/hi/health/7460534.stm

But it wont Happen will it?

The charity wants free foot care services for the elderly

Foot care services should be made freely available to all older people in Wales, says a charity.

Age Concern Cymru wants the NHS and the Welsh Assembly Government to provide the low level foot care measures it has outlined in a new report.

The services it is requesting range from basic nail cutting to general chiropody as it says good podiatry is essential to older people’s health.

The assembly government said it recognised the importance of foot care.

Age Concern said without access to free and comprehensive foot care services older people could become housebound, isolated and susceptible to falls.

Chief executive Robert Taylor said: “By introducing the simple, low level foot care measures outlined in this report, the health service could improve the quality of life for thousands of older people in Wales overnight.

‘Mobility problems’

“At the same time, the Welsh Assembly Government needs to take the lead in recognising the importance of foot care services for older people’s well being and ensure there is equal access to quality services across Wales.

“We simply cannot afford to let thousands of older people in Wales continue to suffer from foot and mobility problems because of a general ignorance about the serious effects of neglecting foot care services.”

The report is based on consultation and research with NHS bodies and local Age Concern groups.

An assembly government spokesman said: “We cannot comment on a report that we have not seen and had an opportunity to study in detail.

“However, the National Service Framework for Older People in Wales set standards for the quality of health and social services and fully recognises that the ability to care for one’s own feet decreases with age and highlights the importance of access to effective podiatry services.

“It is for local health and social services organisations to work together and identify local needs and deliver services appropriately.”

Source: http://news.bbc.co.uk/1/hi/wales/7680783.stm

This article contains a graphic image of an infected limb.

Pensioner John Parker, from Bromley, Kent, walks with a stick to help him balance.

But despite this John, who has type 2 diabetes, knows he is a lucky man.

For he has had months of diabetic ulcers and could have lost a few toes, or even his foot.

Thankfully, through aggressive treatment, doctors were able to save all John’s toes.

But recent figures show that many are not as lucky.

The NHS spends £600m a year on treating foot problems in people with diabetes, and £252m of this is spent on amputation.

Diabetes can cause damage both to the nerves of the foot, and to the blood supply that keeps the foot tissues healthy.

I think I must have very good healing properties – my mother lived to 104 John Parker

Both can lead to foot ulcers and slow-healing wounds which, if they become infected, can result in amputation.

Professor Mike Edmonds, a diabetic consultant at King’s College Hospital, London, treated John.

He said there are about 100 amputations a week in the UK because of foot ulcers.

But he believes at least half of these could have been prevented.

The key, he says, is to ensure patients get speedy, aggressive treatment, provided by experts across a range of disciplines.

It is an approach that Professor Edmonds has pioneered at his clinic, which takes on patients with the most severe of symptoms.

It has the facilities to offer interventions such as radiology to improve circulation in the legs, and bypass surgery to clear blockages in damaged blood vessels.

“Our remit is to get patients out of trouble quickly,” said Professor Edmonds.

“It is all about preventing the natural disease progressing to an irretrievable state.

“It is about putting all these measures into use to preserve the limb.”

Saving limbs

The clinic sees around 20-35 cases each day in the foot clinic, but only have about two to three amputations each year.

It compares very favourably with other units – particularly as some patients have been referred for a second, or even third, opinion.

John – who has had heart and renal problems – was admitted to the clinic as an emergency.

He realised he could lose some toes – but was not aware until after his treatment that his whole foot was at risk.

He underwent bypass surgery to clear the blockage in his leg and angioplasty to widen his femoral artery.

“Possibly he would not have been considered for surgery in other places because of his heart problems,” said Professor Edmonds.

“But here he had a package of multi-disciplinary care that saved his leg.”

John’s wife Sheila agreed that her husband had been a lucky man.

“They were a bit hesitant because of his heart trouble,” she said.

“They very carefully explained all the pros and cons.

“They told us afterwards that he could have lost his foot – but it didn’t sink in at the time.”

John agrees that the hospital was vital in his recovery, but also credits his own genes for helping.

“The bypass has healed perfectly,” he said.

“I think I must have very good healing properties – my mother lived to 104.”

Source: By Jane Elliott  Health reporter, BBC News

http://news.bbc.co.uk/1/hi/health/8131141.stm

Well are they?

One high street shoe retailer has seen a marked increase in sales of larger sizes. But are our feet really getting bigger or are we coming round to the idea of “sensible shoes”?

Clodhopper, Big Foot, Yeti, flippers, clown’s feet. You name it, Emma Supple has heard it from the patients who come knocking on the door of her foot care clinic.

Their motivation is to find some relief from the pain of years spent squeezing into shoes that are too small.

The result of this self-imposed form of 21st Century foot binding is a host of podiatric injuries, ranging from corns, callouses and blisters to trapped nerves, toes which have been compressed to resemble claws and a condition called mallet toe.

There’s a sort of peasant stigma – you become an object of derision, Christine Browning (size 11)

Just as the rest of our bodies are growing, upwards, frontwards and sideways so, it seems, are our feet.

Earlier this week, department store Debenhams reported a boom in sales of ladies’ size nine shoes – up 23% last year on 2008. It’s a similar story for men, according to the retailer, which said last year sales of men’s size 12s had soared while “requests for whopping size 14 and above are flooding in”.

Yet while some are seeking out big sizes, many – women in particular – are preferring to follow in the more moderately proportioned footsteps of the masses, and bearing the pain in silence.

But if we acknowledge that our bodies are bigger – for better or worse – than those of our parents or grandparents, why does this acceptance stop just south of the ankle bone? And why are our feet getting bigger? There may be more obesity, but does an extra couple of inches on the waist really transfer to the furthest extremities of the body?

Feet accompli

At 5ft 9ins Christine Browning is above average height for a woman. Her long legs and slim build – “on a good day people call me thin” – would draw envious glances from many other women. But her feet wouldn’t. She is a size 11.

“There’s a sort of peasant stigma. Women perceive narrow feet to be dainty, slim, refined. I used to feel awful. You become an object of derision,” she confides. “If you are with a bunch of women or girls talking about shoes and it turns into a discussion about feet you suddenly don’t want to be part of that conversation. You’ll find a way to get away.”

The sense of exclusion manifests itself elsewhere. Women with big feet can find it difficult to take up sports which demand a certain style of shoe – golf and tennis are two examples, she cites.

And while the overweight can work to draw in their waistline, with exercise and cutting calories, feet can’t be slimmed.

Ms Browning became so fed up with the limited range of outsize footwear for women she took matters into her own hands – buying a small business which sold big shoes and revamping its image and stocks. She is now the managing director of Special Feetures, which caters for women with long and narrow feet, and After 8 Shoes, which specialises in UK sizes 8½ to 11 for women.

It is one of several suppliers of big footwear. But still women with big feet are in denial.

“I get a lot of teenage girls in our clinic taking size seven or eight and their feet haven’t even finished growing at that point,” says Ms Supple.

Nine is the limit

And whatever size they end up at, nine is the de facto upper limit she says.

“There’s a mental block for women above size nine. They will say they’re size nine when they are bigger and just squash their feet in.”

In fact, it’s not just the big-footed that squeeze their feet into ill-fitting vessels.

Almost four in 10 women buy shoes knowing they do not fit, according to a recent poll by the Society of Chiropodists and Podiatrists. And nearly two out of 10 men do the same.

Yet male attitudes are more malleable, says Bruce Davis, an elder statesman of the outsize footwear market in Britain. As manager of Magnus Shoes, Mr Davis has been peddling big footwear since the mid-1960s.

“The female side of the business is vastly more difficult and demanding. I’ve heard comments many times like ‘I’d rather go barefoot than wear those’. Whereas for men, I can sell a brogue to a teenager and to a man in his 60s.”

But not all fashion appetites can be sated with the promise of polished tan brogue and options for men have grown in recent years. As with other significant but disparate communities, the internet has provided a focus for the big-footed, with specialist shops which are sourcing from places such as the US.

Supply is simply reflecting demand, says Mr Davis, who believes the trend for bigger feet can be traced back to the likes of shoemakers such as Clarks and Start Rite. By encouraging parents to buy sensible shoes for children, with plenty of room for growth, our feet grew more than they would have in ill-fitting footwear, says Mr Davis.

Pancaking feet

So should we brace ourselves for bigger feet all round – what Debenhams has bluntly termed “Big Foot Britain”? Will the outsized dispossessed become part of the mainstream?

Mr Davis is sceptical – both about High Street chains committing to bigger sizes, but also whether our feet really are growing as much as has been suggested. It’s difficult to be sure because the size of Britain’s feet has never been properly documented.

HOW BIG ARE OUR FEET? Average British woman’s foot is 24.5cm – roughly a size five Average man’s foot is 27cm – about a size nine No directly comparable historic data… …but in 1951 survey average woman’s foot was size 3½ Source: UK National Sizing Survey 2004

Podiatrist Matthew Fitzpatrick says our feet are growing but in terms of attitude, we are growing up.

“Are we seeing our shoes getting bigger or are we just seeing people becoming more sensible in their choice of shoes, particularly women?” he asks. In short – are women starting to reclaim their real shoe size and refusing to be hobbled by the crippling strictures of fashion?

A slew of big-footed confessions from the likes of Kate Winslet (size nine), newsreader Kate Silverton (also size nine) and singer Macy Gray (size 10) can only have helped the march towards “sensible shoes”.

Mr Fitzpatrick points out there is also evidence feet are being affected by diet. A recent study found obesity in children was leading to bigger feet, although in a more complex way than might be assumed. Children’s feet are pancaking under excess weight.

“When you are young the bones in your body haven’t hardened. So if you’ve got a foot in which the bones are still forming and an excessively heavy child putting the weight on that foot, the arch [of the foot] flattens.”

The technical term is “splaying” and Mr Fitzpatrick says his profession is seeing more children with flat feet associated with obesity.

Even then, feet are not necessarily getting longer, but wider. Yet people with wide feet often buy shoes that are a size too big to accommodate the spread.

“We are probably seeing a general growth in the foot but not as exponential and vast as we are being told.”

There were 199 lower limb diabetes related amputations in Northern Ireland between March 2010 and April 2011.

Diabetes UK Northern Ireland has said 80% of those were preventable.

The Putting Feet First campaign, launched on Tuesday, hopes to reduce amputations by 50% in five years.

Diabetic foot problems arise from reduced circulation to the feet and damaged nerve endings in the feet so the campaign aims to educate people on how to look after their feet.

“A single preventable amputation is one too many so the fact that hundreds of people in Northern Ireland have endured unnecessary foot amputations is nothing short of shameful,” said Iain Foster from Diabetes UK NI.

“Many people with diabetes aren’t even aware that amputation is a potential complication.

“We also need to make sure that people with diabetes understand what health care they should be getting.”

“Foot ulcers can deteriorate in a matter of hours so failing to refer someone quickly enough can literally be the difference between losing a foot and keeping it.”

The charity will work GP practices and A&E departments to increase awareness of the signs of early complications and the need for a quick and timely referral to specialist staff.

Diabetes UK Northern Ireland also want everyone with diabetes to get a thorough annual foot check and for foot ulcers to be referred to specialist diabetes foot care teams within 24 hours.

There are currently 73,500 people in Northern Ireland diagnosed with diabetes.

Sam Wright, 56, from Conlig was diagnosed with Type 2 diabetes more than 10 years ago but admits that he did not initially take care of his condition.

In December 2008 he started to experience problems with his left foot

“In March 2009, my life changed forever,” he said.

“This is when my left leg was amputated, just below the knee, in the Royal Victoria Hospital, Belfast.

“All this could possibly have been avoided if I had seen a podiatrist on a regular basis.

“Instead I left it until hard skin developed on my left heel. This skin then cracked and eventually ulcerated.

“I went to the local doctors on Monday morning – by Monday afternoon I was admitted to hospital and I was operated on that evening to try and save my foot.

“This was unsuccessful and the following Wednesday my leg was amputated.”

People can find out more about the campaign at the Diabetes UK website.

Source: http://www.bbc.co.uk/news/uk-northern-ireland-17340485

A diabetes charity has condemned the number of amputations on patients in south west England as “very poor”.

The amputation rate in England is 2.7 per 1,000 patients, but Somerset and Devon’s rates are 4.8 and 4.4.

Diabetes UK said numbers in the south west were “unacceptable” and blamed a “lack of organisation”.

NHS trusts said the rates were a “matter of concern” and more was being done to ensure early treatment of problems to avoid amputations.

A study, published in Diabetologia, compared lower-leg amputation rates for local health trusts across England over three years.

It showed that on average 2.7 adults out of a 1,000 diabetes patients had a limb amputated, but this rose to 4.8 in Somerset, 4.6 in Dorset, 4.4 in Devon and 4 in Plymouth.

Cornwall recorded a rate of 3.6 per 1,000 and Torbay’s rate was 3.1.
‘Unnecessary’

Graham Cooper, from Diabetes UK, said: “It is probably down to a lack of organisation and resources because most of these amputations could be avoided.

“Quite honestly it’s unacceptable that 80% of amputations are probably unnecessary.

“We need to know that everybody doing a foot check is qualified and experienced enough to know what they’re looking for.”

In a statement, NHS Devon, which includes Plymouth and Torbay, said GPs were “working hard” to identify people with diabetes and treat them quickly, and decisions to amputate were “never taken taken lightly”.

NHS Somerset said its rate was “a matter of concern” and it had plans to develop, promote and increase access to foot care services.

NHS Dorset said problems were “identified early and treated swiftly”.

NHS Cornwall did not provide a statement to the BBC.

Source: http://www.bbc.co.uk/news/uk-england-17522971

Diabetes UK Scotland has called for a foot risk tool, developed in Scotland, to be adopted across the whole of the United Kingdom.

‘Putting Feet First’ will highlight the fact that people with diabetes are 20 times more likely to have a lower limb amputated, and that around 80 per cent of the 1,000 diabetes-related amputations in Scotland could be preventable.

The charity wants sufferers, including those in Renfrewshire, to get a thorough annual foot check and for people with foot ulcers to be referred to specialist diabetes foot care teams within 24 hours.

And as well as demanding better NHS foot care, the charity is trying to raise awareness of the issue so that sufferers understand how important it is that they look after their feet.

Jane-Claire Judson, national director at Diabetes UK, said: “Scotland has a system for diabetic foot care which is envied elsewhere in the UK.

“Our traffic lights system for assessing risk of diabetic foot disease has been in place for a number of years and offers a simple but effective tool to detect and act upon risk.

“The system is at the heart of the Putting Feet First campaign.

“However, we need to make sure that everyone with diabetes is receiving the best possible foot care and avoiding the risk of complications and amputation.

“Quality of care makes a big difference to amputation rates. Foot ulcers can deteriorate in a matter of hours so failing to refer someone quickly enough can be the difference between losing a foot and keeping it.”

For more about the Putting Feet First campaign, visit www.diabetes.org.uk/putting-feet-first

Source: Mar 27 2012 by Jeff Holmes, Paisley Daily Express

http://www.paisleydailyexpress.co.uk/renfrewshire-news/local-news-in-renfrewshire/paisley-news/2012/03/27/take-care-of-your-feet-87085-30627374/

They may make your legs look longer, but heels over 3in high carry a health risk

A pair of high heels – not so elegant if you fall over and sprain your ankle. Photograph: Marc Tielemans/Alamy

High heels make your legs look longer and your bottom smaller. No wonder so many women wear them so much of the time. But a survey of 1,000 women by the shoe company MBT found that more than 40% had suffered an accident in their high heels – most often from falling over.

Heels more than 3in tall will seriously increase the pressure on the ball of your foot (up to seven times with heels over 3in high) and affect pretty much every part of your lower body as you walk. Still want to wear them?

The dilemma

High heels are fashionable and flattering. But research studies repeatedly show what we already knew: they make your feet hurt and they aren’t good for you. A study from Harvard showed that women who wear high heels increase their risk of arthritis of the knee by putting pressure on the inner compartment of the knee joint, compressing and damaging it.

A paper in the Journal of Experimental Biology showed that women who wear high heels don’t distribute weight evenly across their feet but transfer it to the ball of the foot and toes. The women studied developed shorter calf muscles and thicker Achilles tendons, making their feet hurt when they stood flat on the floor and their tendons inflamed and sore.

The American Academy of Orthopaedic Surgeons says that bunions, which are painful swellings on the side of the base of your big toe that can become red and sore, are linked to not only narrow but high-heeled shoes. So are hammer toes, which are painful deformities in which the toes curl up and can’t be straightened.

Falling over in heels is both inelegant and, more seriously, can lead to a sprained ankle. High heels also cause lower back pain because it is hard to keep your back aligned when you’re tottering around with your centre of gravity artificially pushed forward.

The solution

Most women wear shoes that are too small for them, which can increase the damage a high heel does to the foot. Make sure your shoes fit – there should be 1cm of room between your big toe and the end of the shoe. You should be able to wriggle your foot and not feel any pressure on the bones on the sides of your feet. Feet do not stay the same size throughout your life, so always try before you buy.

Don’t wear high heels as everyday shoes. Limit the time you wear them to no more than five hours. When you walk in heels, glide rather than stomp and put the heel down before the ball of your foot. Wear flat shoes if you have to do any serious walking.

Don’t give in to your child’s nagging for high heels. The younger girls start wearing them the more risk they have of developing backache and foot problems later in life.

Finally, it has been said that champagne and heels should never mix. You certainly have less far to fall in flats.

Source: http://www.guardian.co.uk/lifeandstyle/2011/oct/24/health-dilemma-high-heels?INTCMP=SRCH

 Symptoms of Raynaud’s can be very painful

A WITH Raynaud’s the small blood vessels in the extremities of the body go into spasm whenever there is a fall in temperature.

The most commonly affected parts are the fingers and toes and sometimes the nose and ears. The skin goes white then blue and feels extremely painful.

Although it can occur with temperature change in the summer it’s always worse with the low temperatures that occur in winter.

It is a common condition with up to 20 per cent of the population affected to some degree, especially women. I don’t know of any ointment that could help although any rub that warms the skin such as those used for muscle sprains can give short-term relief.

The most effective treatment for Raynaud’s is probably nifedipine which is taken by mouth. It widens blood vessels but unfortunately side effects can include headaches and swollen ankles which mean many people can’t tolerate it.

Other drugs that can be beneficial include ACE inhibitors and also SSRI antidepressants. There is some evidence that gamolenic acid (found in evening primrose oil) can be helpful but you need a dose of 320mg a day, so check the amount each capsule contains.

For many brands you will need to take four capsules twice a day. Simple lifestyle measures can make a big difference.

Wear thick socks and make sure your footwear is warm, sturdy and big enough to give your toes room to wriggle when you are wearing those socks.

Fur-lined boots are essential for cold winter weather. For more information contact the Raynaud’s & Scleroderma Association at www.raynauds.org.uk or telephone 0800 917 2494.