RW Guide To Healthy Feet

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.