The foot has 26 bones of various sizes from very small (think little toe) to the large heel bone, 33 joints, 20 muscles, and 80 tendons and ligaments all of which provide stability while facilitating movement. Without our feet we’d topple over and have a great deal of difficulty getting where we want to go. With all the stress we put on our feet it is no surprise that many of us moan at the end of the day: “Oh, my aching feet.”
Most foot problems relate to poorly fitting shoes, overuse, or injury. Let’s take one problem at a time. Poorly fitting shoes and high heels is thought to be the culprit in the development of bunions. However, corns and callouses generally develop due to chronic rubbing (from shoes) over a boney prominence. The skin here becomes thick and hardened in an attempt to provide protection. When this irritation is on a toe you have a corn and anywhere else on the foot it is called a callous. Either can become painful. Poorly fitting shoes can also cause the middle part of a toe to flex causing hammertoe or the tip of the toe to flex causing mallet toe. A claw toe is a combination of both hammertoe and mallet toe. And then, because of the friction of the joint against a shoe, a corn could develop on top of the toe. Ouch!
Overuse problems include plantar fasciitis or Achilles tendonitis. The former involves the arch of the foot. When there is increased stress on the arch, microscopic tears can occur in the fascia, the sheath of connective tissue supporting the bottom (plantar) of the foot. Because of these tears, inflammation sets in and you have pain. When the inflammation goes unchecked, the body attempts to heal the tears and calcium deposits form. As the calcium deposits grow, you develop a heel spur. Walking in and of itself is not overuse, per se, but walking for extended periods of time such as on a vacation or doing a 5-mile hike when you aren’t used to hiking is. Your body weight could also put stress on the arches causing plantar fasciitis. Achilles tendonitis involves inflammation of the large tendon on the back of the heel. Again, the inflammation sets up a response leading to thickening of the tendon and decreased flexibility. This is why stretching and warming up is so important prior to exercise that is going to involve a lot of stress on this tendon, such a jogging or running.
And then there are just plain injuries like that stubbed toe in the middle of the night. But the one that is most irksome is the ingrown toenail. When the corners of the toenail are trimmed at an angle the nail will begin to grow into the skin. Add to this the pressure of a shoe and you end up with a very painful, swollen toe. Too often, the temptation is to continue cutting the nail at a sharper angle in hopes of averting the pain. The result, however, is a deeper ingrown nail and the risk of infection.
There are other podiatric maladies; this has been a brief overview of some of the more common ones. So take care of your feet, as they are the only pair you have.
Agnes Oblas is an adult nurse practitioner with a private practice and residence in Ahwatukee Foothills. For questions, or if there is a topic you would like her to address, call (602) 405-6320 or email firstname.lastname@example.org. Her website is www.newpathshealth.com.