RW Guide To Healthy Feet

Keep on your toes and avoid frustrating foot faults


Posted: 5 October 2006
by Alison Hamlett

Your feet take 18,000 steps every day on average. When you run you'll add to that figure, as well as the amount of perspiration produced by the 250,000 sweat glands on each foot. With stresses like that it's no wonder your feet complain from time to time, but you can silence them with this quick guide to putting your best feet first.

Athlete's foot
Athlete's foot is a fungal infection caused by tiny parasites called dermatophytes. It thrives in warm, moist conditions and is often exacerbated by tight-fitting running shoes. A red itchy rash between the toes is a common symptom. "A daily footcare regime is important for preventing athlete's foot," says Jennie Kershaw from the footcare company Scholl. "It's important to wash your feet and dry them thoroughly, especially between the toes." Always put on clean, dry socks afterwards. Athlete's foot should respond to an antifungal cream or powder within a couple of weeks.

Blisters
Blisters are layers of skin that separate and fill with fluid and are caused by the heat that builds up from friction or pressure. "Moisturising the skin before a run may reduce friction and lower the risk of blisters forming," says Kershaw. If you're blister-prone, you could also apply a lubricant such as Vaseline to problem areas before you put your socks on. Debris in running shoes can also cause blisters. Stop to remove small stones, and if you know you'll be running on sand, consider wearing lightweight gaiters. Avoiding 100 per cent cotton socks will also help, according to a recent study at the University of Missouri-Columbia in the USA. In a test of 10 brands of socks, researchers found that nylon socks caused fewer blisters than cotton ones.

Bunions
Bunions are an inflammation of the big toe joint, caused by an increased inward angle of the toe. Pulled by the tendon on the top of the toe, the angle worsens, causing the big toe joint to stick out further and often resulting in a callus developing on the side of the toe. "Limit the advance of an early bunion by putting a soft wedge between the first and second toes," says RW medical adviser Dr Patrick Milroy. This will help to straighten the joint and reduce pressure from the side.

Corns
Soft corns usually develop between the toes as a result of the toes being squeezed too tightly together. Hard corns tend to form on the tops of toes. "Protecting sore spots as soon as they develop should help to prevent corns forming in the first place," says Kershaw. To relieve the pressure, put padding between the toes or on top of them and consider buying a shoe with a larger toe box.

Ingrowing toenails
Toenails can become ingrown if the nails are cut too short and rounded at the edges. As a result, the skin grows over the edge of the nail, creating a painful swollen area that may become infected. Soak the foot in warm water and attempt to lift the nail away from its embedded position. If there is no improvement, visit your GP. Prevent ingrowing toenails by cutting your nails straight across and making sure your shoes aren't too tight.

Morton's neuroma
A neuroma is a nerve inflammation, and Morton's usually results in pain between the third and fourth toes. The causes aren't fully understood, but tight shoes tend to worsen the pain since they put pressure on the inflamed nerve. The first treatment option is a steroidal anti-inflammatory injection but more stubborn cases may require simple surgery.

Plantar fasciitis and heel spurs
If you feel pain under your foot, your plantar fascia – a long band of tissue that begins at the heel and travels under the arch – may be inflamed. "It can be caused by heavy heel striking, which compresses the fascia, or forefoot running, which stretches the fascia," says Gavin Burt, an osteopath (www.backsandbeyond.co.uk). Sometimes the pull is so great that a spur of bone forms under the heel. "Tight calves or hamstrings, overpronation and poor nutrition – particularly a lack of vitamin C and omega-3 oils, which are important in ligament integrity – may also contribute," he adds. Massage of the calf muscle, taping the fascia to relieve pressure or wearing a plantar fasciitis night splint should help, or try this move: "Scrunch up your toes in the same way as you make a fist with your hand," he says. "Hold for five seconds then relax and repeat 10 times."

Stress fractures
A stress fracture is an overuse injury caused when muscles become tired and lose the ability to absorb the shock of your foot strike. "Foot pain that becomes worse and worse the further you run is a stress fracture until proven otherwise," says Milroy. If you suspect that you have a stress fracture, ask your GP to refer you for an MRI scan, as many stress fractures do not show up on conventional X-rays.

Toenail bruising
"Cut your toenails regularly," says Milroy. Wearing shoes that are too small (and put pressure on your toes) or too large (so your feet move around and jam your toes into the ends of the shoe) can both cause bruised toenails. "Painful bleeding and blackened toenails should be trephined (pierced) by your GP to let out the old blood and help to save the nail," he says.

Worn shoes
Make sure that your shoes are worn in rather than worn out. "Worn shoes can cause simple problems such as increased rubbing and trauma to the toenails," says Trevor Prior, consultant podiatric surgeon at Homerton University Hospital in London (www.premierpodiatry.com). "However, as the support and cushioning are likely to be lost as well, they could lead to more significant injuries such as plantar fasciitis, Achilles heel pain, knee pain and so on." Make sure you replace your shoes every 300–500 miles.


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Discuss this article

Fractures are difficult to dignose by xrays - they just don't show up - but there is a very easy way to "self diagnose" if you have a fracture.

Place a something which vibrates against the affected area. If it is fractured the pain will be excrutiating! You can use implement such as a tuning fork - even a mobile phone on vibrate will work as I discovered when I "diagnosed" my boss's foot injury making her jump 10 foot in the air!
Posted: 13/10/2006 at 16:47

Really? I have what I think are shin splints but I may just have to try that...
Posted: 13/10/2006 at 16:52

Be careful cos it really hurts! Will this work with shin splints? As they are tiny fractures I guess it may do.


Posted: 13/10/2006 at 16:55

Oohhh

I think if someone had put a vibrating phone on my stress fracture and it had that effect I would've punched them I think !!!!!!!!
Posted: 13/10/2006 at 16:56

She wasn't best pleased! still we found out she had a fractured foot...

Got her a few days off work ha ha!
Posted: 13/10/2006 at 17:09

James, I hope it doesn't work on shin splints coz that'll be my way of diagnosing myself with a stress fracture. They're similar aren't they?
Posted: 13/10/2006 at 17:15

Give it a go Matt and let me know how you get on!
Posted: 13/10/2006 at 17:27

Just tried with my phone. Nothing. I've not got a stress fracture...yippee!
Posted: 13/10/2006 at 17:36

its what we do to diagnose them
hadn't thought about using a phone though
good idea


Posted: 13/10/2006 at 17:44

Lurker are you a Doctor or Physio? I got the tip off my housemate who is a Chiropractor.

Do you know if the same trick would work with shin splints?
Posted: 13/10/2006 at 17:47

"shin splints" is an umbrella term for any problems in the calf area
so
it depends what the problem is

the vibration thing shows up a fracture because it literally vibrates the bits of bone against each other - hence the pain!!

i'm a pod


Posted: 13/10/2006 at 17:51

The pain is pretty spectacular!



Posted: 13/10/2006 at 18:25

Any moral support out there on broken toes  - (stubbed mine on a chair !)     Not as painful now but still swollen.  Haven't been able to run for six weeks.  Anyone have any idea how long this sort of thing takes.  Seems to be taking a long time to recover.

Have entered the Cardiff half marathon but looks unlikely I'll be able to compete now even at my snail pace. 


Posted: 13/09/2007 at 10:07

Have you seen a doc Cozee? I've broken toes before and been abel run soon after buy strapping them to a good toe. If it's the big or little toe I guess it would make a big difference though.

I once broke a toe on my to a skiing holiday. Walking was painful and the colours my foot went through! Skiing was fine though. The boot acted like a cast.
Posted: 13/09/2007 at 16:32

My typing was awful in that post! Pleae excuse me.
Posted: 13/09/2007 at 16:33

Thanks for that.  Doc strapped it and said give it six weeks but that was already after two. Its more like a burning sensation now.   I shall have jog  round the block as I am definitely walking better.  Thanks again.
Posted: 14/09/2007 at 07:23

Good luck Cozee.
Posted: 14/09/2007 at 10:45

I'm so experienced now with fractures I know when I've suffered another one! Don't need a tuning fork or anything else - the excruciatingly sharp pain when it happens and the dull ache that follows is pretty indicative, plus the bruising around the pain site. I've had 12 broken bones so far during my life.
Posted: 14/09/2007 at 10:47

Thanks BDB and Ironwolf.  

I shouldn't complain then  - this too will pass I hope ....


Posted: 14/09/2007 at 12:07

I couldn't disagree more that, for Morton's Neuroma, the first port of call is "steroidal anti-inflammatory injection but more stubborn cases may require simple surgery"  PLEASE IGNORE THIS VERY BAD ADVICE.  For a start, the injection even in the hands of an experienced sports medicine doctor, is hit or miss, while the surgery actually cuts the nerve, meaning that you lose all sensation in that part of your foot.  Very Bad.  I've had a neuroma in both feet, and both were cured by a simple addition to my orthotics in the form of a small built-up pad behind my metatarsal arch, lifting it and allowing the metatarsal bones to splay and relieve the pressure on the nerve.  This is by far the best, least invasive and most long-term solution.
Posted: 12/12/2007 at 16:27

The way it was explained to me was that most 'shin splints' are actually inflamation of the sheaths around the leg muscles rather than small fractures. As your leg muscles develop they can grow at different rates, and that causes the inflamation, especially if the sheaths have adhesions to each other as if often the case. Unsticking the muscles from each other helps, but believe me, it hurts like crazy, especially if your physio is unsticking 20 years worth!


Posted: 13/12/2007 at 12:58

Hello

Me and my freinds have suffered with numerous foot and leg problems,, GPs have been totally useless!!! Found a good chiropodist/podiatrist (my one deels with sports injuries), he's dealt with all mine and my freinds foot problems. He cured my shin splints, which was caused by mucle overuse!!!

His details if anyone wants to (he'll give free advice over the phone!!!!)

He is in St.Ives, Cambridgeshire above an opticians 01480 301337


Posted: 10/05/2008 at 18:48

Well I tried the phone thing and that didn't hurt.

Been running around 20+ miles for the last 6 months, had ITB problems - been sorted by a combination of physio and orthotics.

So since Sunday had dull pain on top of my foot  - really painful when walking. Had an xray - didn;t show up any fracture. Anyone got any other idea ?


Posted: 22/05/2008 at 13:30

Anyone know what a pain across the bridge of the foot could be? It started last week during 14 mile run and has continued this week.
Posted: 13/09/2008 at 18:10

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