May 13, 2008

Feet



Think of Your Poor Feet




By LAURIE TARKAN






Correction Appended


THE average person walks the equivalent of
three times around the earth in a lifetime. That is an enormous amount
of wear and tear on the 26 bones, 33 joints and more than 100 tendons,
ligaments and muscles that make up the foot.

In a recent survey for the American Podiatric Medical Association, 53 percent of respondents reported foot pain
so severe that it hampered their daily function. On average, people
develop pain in their 60s, but it can start as early as the 20s and
30s. Yet, except for women who get regular pedicures, most people don’t
take much care of their feet.

“A lot of people think foot pain is part of the aging process and
accept it and function and walk with pain,” said Dr. Andrew Shapiro, a
podiatrist in Valley Stream, N.Y. Though some foot problems are
inevitable, you can slow the progress of many problems.

The most common foot conditions that occur as you get older are
arthritic joints, thinning of fat pads cushioning the soles, plantar
fasciitis (inflammation of the fibrous tissue along the sole), bunions
(enlargement of the joint at the base of the big toe), poor circulation
and fungal nails. If you have the following risk factors, take more
preventive steps as you age.

Are you overweight? The force on your feet is about 120 percent of your weight. “Obesity puts a great amount of stress on all the supporting structures of the foot,” said Dr. Bart Gastwirth, a podiatrist at the University of Chicago. It can lead to plantar fasciitis and heel pain and can worsen hammertoes and bunions. It’s also a risk factor for diabetes, leading to the next question.

Are you diabetic? Being farthest from the
heart, the feet can be the first part of the body to manifest
complications like poor circulation and loss of feeling, both of which
can lead to poor wound healing and amputation. Diabetics should have
their feet examined annually by a doctor and avoid shoes that cause
abrasions and pressure.

Do you have poor circulation? If you’re suffering from peripheral artery disease
— a narrowing of arteries in the legs — your feet are more susceptible
to problems, said Dr. Ross E. Taubman, president of the American
Podiatric Medical Association. Smoking also contributes to poor circulation.

Do your parents complain about their feet? Family history is probably your biggest clue to potential problems.

Do you have flat feet or high arches? Either puts feet at risk. A flat foot is squishy, causing muscles and tendons to stretch and weaken, leading to tendinitis and arthritis. A high arch
is rigid and has little shock absorption, putting more pressure on the
ball and heel of the foot, as well as on the knees, hips and back.
Shoes or orthotics that support the arch and heel can help flat feet.
Those with high arches should look for roomy shoes and softer padding
to absorb the shock. Isometric exercises also strengthen muscles
supporting the foot.

Are you double-jointed? If you can bend
back your thumb to touch your lower arm, the ligaments in your feet are
probably stretchy, too, Dr. Gastwirth said. That makes the muscles
supporting the foot work harder and can lead to injuries. Wear
supportive shoes.

Do your shoes fit? In the podiatric
association’s survey, more than 34 percent of men said they could not
remember the last time their feet were measured, and 20 percent of
women said they wore shoes that hurt weekly; 8 percent wore painful
shoes daily. Feet flatten and lengthen with age, so if you are clinging
to the shoe size you wore at age 21, get your feet measured (especially
mothers — pregnancy expands feet).

Do you wear high heels? “The high heel
concentrates the force on the heel and the forefoot,” Dr. Gastwirth
said. Heels contribute to hammertoes, neuromas (pinched nerves near the
ball of the foot), bunions and “pump bump” (a painful bump on the back
of the heel), as well as toenail problems. Most of the time, wear heels
that are less than two and a half inches high.

Do your feet ever see the light of day?
Fungus thrives in a warm, moist environment. Choose moisture-wicking
socks (not cotton), use antifungal powders, and air out your toes at
home.

Have you seen a podiatrist? Minor
adjustments — using drugstore foot pads or prescription orthotics — can
relieve the pressure on sensitive areas, rebalance the foot and slow
the progress of a condition.

Do you walk? Putting more mileage on your feet is the best way to exercise the muscles and keep them healthy.






This article has been revised to reflect the following correction:
Correction: May 16, 2008

An article in the special Well section on Tuesday about foot health described incorrectly peripheral artery disease, which reduces blood circulation to the feet. The disease involves narrowing of arteries in the legs, not veins.


http://www.nytimes.com/2008/05/13/health/13feet.html