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Dr Duncan

Be kind to feet week

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There are some fantastic walking trails around Western Australia - the Bibbulmun Track, Cape to Cape and many shorter ones around the metropolitan area. I’ve been involved recently in establishing one -The Pilgrims Trail - from Subiaco to New Norcia. It’s been a wonderful, creative,  cultural experience and this year will be our fifth year of organised walks. Next month two more walking groups will be following this trail and as a part of the preparation we recently sent out a reminder to all walkers that the three most important things about walking are boots, boots and boots!

Our feet are probably the greatest unsung heroes of our bodies! As health experts, we tell people that they should be taking 10,000 steps each day to help maintain good health. That means hitting the heels of your feet on the ground 10,000 times and expecting them to take that punishment without complaint, and then take it again decade after decade. And some of the females of our species even try to do this in footwear that might make them several centimeters higher, yet forces their toes into a cramped, wedged space inside a rigid structure known as the “High Heeled Shoe”! They may make a lady look awesome, but they also do Aaw-some things to their feet too!

Caring for our feet is really important - just ask anyone who has had recent foot surgery, or someone who suffers from the inflammatory joint disease known as rheumatoid arthritis. For these people, putting their feet into shoes and trying to walk is a real act of courage and a daily struggle. The thought of walking around their home can be full of pain and the idea of going shopping becomes something that fills them with dread. So I’ve designated this week as:

Be Kind To Feet Week

Long distance walkers - and ladies who wear high heeled shoes - are more likely to get blisters. Blisters are not only painful, they can be a real worry for those people who suffer from diabetes or poor circulation - also known as peripheral vascular disease. Diabetics and those with PVD have to be extremely careful if they get blisters, because if those blisters were to get infected, then there is a real possibility that this could lead to gangrene and amputation of the affected limb! So whilst we might laugh at people who limp with a blister, for some it can be extremely serious.

To reduce the chances of suffering from blisters we need to reduce the friction at the skin surface. This means keeping the skin dry, changing socks frequently and using dressings that lower the friction as soon as you feel a “hot spot”. If you’re a long distance walker then it’s also important that you wear your boots in before you set out as stiff, unyielding footwear will increase the chances of blistered feet. (Fashion conscious ladies take note too!). What happens when you get a blister is that the skin has sheared and plasma has accumulated within the skin. This needs time to be reabsorbed and the new skin underneath given enough time to mature into resistant skin. Sticking unsterile needles in them or threading a bit of cotton through them (one woman I met swore that this was the perfect cure!!) is not a great idea as this vastly increases the chances of surface bacteria getting into an area they shouldn’t get access to and in the case of a diabetic, this could prove lethal!

Low grade shearing stress over a period of time will stimulate the basal skin cells to replicate more quickly, and as they mature the thickened surface skin will start to form a callus which can produce its own complications. These calluses often form over the heel, or already deformed joints in the foot such as bunions on the big toe, or over the joints of hammer toes in the smaller digits of the foot. These need to be treated by accredited professionals and the patient’s footwear assessed for suitability and possible replacement with surgical footwear - and these are never as attractive for those who are fashion conscious!

Ingrown toenails (IGTN) are another blight on the foot, and extremely painful too. Yet again, those with PVD or diabetes should seek immediate medical advice should they suspect they have an IGTN. Interestingly, it’s young sportsmen and women who suffer most from infected nails, and for them the thought of kicking a football with such an infection is enough to bring tears to their eyes. As with most medical conditions, prevention is better than a cure: always cut your nails across the nail and don't dig down into the recesses at the side to get out bits of fluff as the points of your scissors can break the skin and introduce surface bacteria into those warm moist recesses where they love to thrive! Ongoing management of IGTNs means that you need to keep the foot dry and check that your footwear is not causing too much pressure on the ends of the affected nails. Most cases will heal with simple remedies but some may need antibiotics, and some of those may end up undergoing surgery to remove a wedge of nail.

We may not think about our feet often, but this being Be Kind to Your Feet Week, why not say “Hi” to them tonight when you take your shoes off and thank them for the wonderful work they do for you!

Article written by Dr. Duncan Jefferson. More articles here. For more information on health care and private health cover, visit HBF Insurance at www.hbf.com.au.

The content of these articles is not tailored for any particular individual's circumstances. The author does not take into account your physical condition, medical history or any medication you may be taking. Any advice or information provided by the author cannot replace the advice of your health care professional. The views expressed in this article are those of the author and do not represent those of HBF unless clearly indicated.

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