Smart Steps to Pain Free Feet
Foot and Ankle Pain: In greater depth
Thanks mainly to high-heeled shoes with narrow toe boxes, women have four times the number of foot problems that men do. Fashionable but poorly fitting women's shoes can cause foot pain, injury and disabling conditions such as Achilles tendonitis, bunions, corns, compressed nerves (neuroma) and hammertoes.
Pregnant women have unique foot problems related to weight gain, swelling in the feet and ankles, and the presence of hormones that cause ligaments to relax -- often weakening the feet.
In older women, severe foot pain is a major cause of disability, impairing the ability to walk unassisted or perform everyday activities.
Sometimes foot pain results from underlying conditions such as diabetes or arthritis. Abnormal functioning of nerves in diabetics causes paralysis of small muscles in the foot, which results in clawing of the toes, loss of feeling, callused skin and foot ulcers. Osteoarthritis has a painful effect on the many joints in the foot.
Preventing Foot Problems
Shoes are all-important when it comes to preventing foot problems. Buy shoes late in the day when your feet are at their largest. Select shoes that are comfortable, practical and fit well. Shoes should fit the shape of your foot, and soles should provide shock absorbency. Heels should be no more than 2 1/4 inches high. Avoid pointed toes, thin soles and spike heels for prolonged wear. New shoes should not need a "breaking in" period -- they should feel comfortable immediately.
If you perform a particular sport or exercise three times or more per week, wear sports-specific athletic shoes, and replace those shoes as soon as the tread and heel wear out. Runners should replace their shoes after every 300 to 400 miles. For running or tennis, shoes should feature a wide, cushioned heel and sole, adequate arch supports, and a toe area deep enough so that the toes don't press against it.
A healthy lifestyle can also prevent foot problems. Maintaining a reasonable weight takes pressure off your feet. Don't smoke, since smoking decreases the blood supply to your feet. Eat a nutritious diet with enough calcium and vitamin D, and limit caffeine (consumption of coffee and soda may increase calcium loss). Walk regularly to improve circulation, increase flexibility and encourage bone and muscle development.
Foot and Ankle Problems and Injuries
- Bunions. The joint of the big toe becomes enlarged, causing the skin over the joint to swell. Pain and tenderness result, and severe cases can be disabling.
- Flexible flatfoot. This condition, the most common type of flatfoot, is characterized by partial or total collapse of both arches. Symptoms include pain, turned-in ankle, the sensation of shin splint pain and weakness in the leg or foot.
- Posterior tibial tendon dysfunction (PTTD). Often called adult-onset flatfoot, this condition usually happens in one foot only and is progressive. Pain on the inside of the foot and ankle, redness, swelling and arches that begin to flatten are symptoms.
- Hammer toes, claw toes, and mallet toes. With these deformities, muscles that control movement of the toes become unbalanced, forcing the toe joints to bend into abnormal positions. Except in very rare cases, the lesser toes are affected rather than the big toe.
- Bursitis. The heel swells, becomes inflamed and feels tender. Wearing shoes worsens the discomfort; rest improves the condition.
- Achilles tendonitis. The soft tissues in and around the Achilles tendon (which connects the heel bone to the calf muscles) break down, causing pain and swelling in the back of the calf.
- Stress fracture. A tiny crack in a bone will cause pain and weakness.
- Ankle sprain. The foot turns inward causing a tearing or rupture of the strong soft tissue ligaments on the outside of the ankle.
- Plantar fasciitis. The thick band of tissue on the bottom of the foot becomes inflamed where it connects to the heel bone.
Treatment
Treatment for foot problems may include a change of footwear or modification to shoes, shoe inserts, custom orthotics, pain medication, cortisone injections or physical therapy. Sometimes surgery is required when conservative treatments are insufficient.
Minor foot and ankle injuries can often be treated through the RICE method (rest, ice, compression, elevation). After 48 to 72 hours, or after the swelling is gone, the application of heat and gentle-movement exercise can help restore flexibility. Use of an ankle brace for several months after a sprain can prevent reinjury.
Treatment for major injuries may involve special shoe devices; a brace, splint or cast; surgery, medication and physical therapy.
Treatment for diabetic foot problems include medications to clear up infections and reduce swelling, as well as custom walking boots, walkers and cushioned shoe inserts which protect the bottom of the feet. Sometimes a total contact cast is required. Outfitted with more padding than standard versions, a contact casts cover the entire foot to stabilize it.
Foot treatment for arthritic conditions first involves controlling inflammation. Medication along with physical therapy, orthotics and exercise are treatment options. Surgery will often be curative if conservative measures fail.
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