Thursday, September 26, 2013

5 things people do wrong for their feet

I was recently talking to a close colleague who is an internal medicine physician.  As people who read my blog know, I like to blog about sports injuries and celebrity foot problems.  However, this doctor was interested to know what I believe are the most common things people do wrong with regards to caring (or often times, not caring) for their feet.  I thought about it, and in my 10+ years of experience I had an answer, I thanked my colleague for the question and immediately answered it.  I think this information is worth sharing.

5 THINGS PEOPLE DO WRONG FOR THEIR FEET:

1) Ignore foot pain:  Many patients think that pain in their feet will just go away.  It could, but odds are it will get worse if not treated.  For example, heel pain can affect how you walk as a patient can often compensate by walking differently due to the pain.  Walking differently can lead to tendon pain in the other ankle or in a different part of the painful foot.  Additionally, pain in the foot or ankle is often inflammatory in nature.  Inflammation that is allowed to worsen can often be much more difficult to resolve than when treated earlier.

2) Going barefoot:  Especially down south, many people do not like to wear shoes.  However, this can have significant consequences.  Of course, there is always a chance of injury without the protection of footwear.  Cuts and scrapes can be especially harmful to a patient with poor circulation or feeling in his or her feet.  Additionally, when one goes barefoot there is no support.  This can lead to tendonitis as tendons work to support a foot that a shoe should be supporting.  I often hear, "going barefoot is natural."  I counter this argument by replying "what is natural about concrete?"  You do best in a man-made supportive shoe when walking on this man-made surface.

3) Wearing flip-flops:  In Florida, these shoes are a year round favorite.  In other parts of the country, they come out when the snow thaws.  However, these shoes, especially the really flat flimsy ones, are just as bad as going barefoot.  They offer little support or protection for the foot.  It is hard, as people love these shoes, but at least try to get one with a rigid sole and even an arch.  A small heeled wedge sandal is much better than a flimsy flip-flop.  However, a trip to Disney World is probably best enjoyed in a sneaker.

4) Using medicated pads or callus remover:  I am fine with padding that can be bought in the drug store, as this can be a good conservative treatment for some foot problems.  However, any padding that says "medicated" can be very harmful.  Medicated pads usually contain salicylic acid.  Yes, real acid that damages skin.  The acid can not select the "good" tissue from the "bad" callused tissue and I have seen infections from using these products.  Unfortunately, in a few diabetic patients, I have seen the use of these pads lead to bone infection and toe amputation.  A callus is more than just something that can be removed easily as there is often an underlying deformity leading to this hardened uncomfortable skin.

5) Doing "bathroom surgery":  We likely have all done this.  A toe can be a little sore and we "dig out" a toenail in our bathroom using a dirty pair of toenail clippers or whatever object available.  This can lead to a bacterial infection needing antibiotics.  Again, as with medicated padding, I have seen bathroom surgery lead to amputation.

This is my list of 5 things people do wrong for their feet.  Podiatrists are trained to treat almost all foot or ankle problems.  I welcome new patients who are experiencing any foot or ankle pain.