1. Getting to know your feet

2. Objectives Participants will: Describe general foot anatomy facts
Identify common conditions that can affect the feet
List common foot health tips

3. Anatomy of the Foot

4. Foot Facts The human foot contains: 26 bones 33 joints
100 tendons, muscles, and ligaments
250,000 sweat glands
Hundreds of thousands of miles of blood vessels

5. Foot Facts Each of our feet carries half the weight of our bodies
An average day of walking exerts several hundreds of pounds of pressure on each foot
Approximately 75 percent of Americans will experience some type of “foot ailment” sometime in their life
Many systemic diseases will first show up in the feet
As women age, they have four times more foot problems than men

6. Common Foot Ailments

7. Common Foot Ailments Hammertoes Athlete’s foot Heel pain Blisters
Heel spurs
Warts
Plantar fascitis
Neuroma
Athlete’s foot
Blisters
Bunions
Corns and calluses
Foot odor
Ingrown toenails

8. Common Foot Ailments Athlete’s Foot Skin disease caused by a fungus
Generally starts between the toes and on the soles of the feet
Is highly contagious
Can get this from public showers, spas, swimming pools and gym floors
Signs and symptoms: dry, scaly skin, itching, redness, blisters, and swelling of skin
Prevention: Change shoes and socks daily and avoid going barefoot in public places

9. Common Foot Ailments Blisters
Caused by friction from poorly fitting shoes, socks, or hosiery
Common foot ailment
Treatment: do not “pop” the blister; wash the blister and apply a moleskin bandage
If you are diabetic and find a blister, notify your health care provider. Do not treat at home
Stress importance of not treating with home remedies if you have diabetes or have circulatory problems because it can lead to complications.

10. Common Foot Ailments Bunions Misaligned big toes
Joint will become painful and swollen
Tends to run in families
Wearing shoes that do not fit
Signs and symptoms: big toe joint will appear to slant outward with the big toe turning in toward the other toes
Consult your health care provider if you think you have a bunion

11. Common Foot Ailments Corns and Calluses Layers of dead skin
Caused by poorly fitting shoes
Corns are generally found on the toes and calluses are generally found on soles of the feet
Can be painful
Wash and apply a moleskin bandage
Do not cut off the corn or callus, if they are causing excessive pain or become red and swollen consult your health care provider
Moleskin is a special bandage you can get at your pharmacy or discount store.

12. Common foot ailments Foot Odor Generally caused by improper foot care
Can be a symptom of some type of infection
Some people are more prone to foot odor
Ask health care provider for over-the-counter treatment options

13. Common Foot Ailments Ingrown Toenails
Nails where the corners or sides grow inward into the skin
Can be very painful
Caused from improperly cut toenails, ill-fitting shoes, fungal infections, family history, and/or foot anatomy
Consult your health care provider for treatment options

14. Common Foot Ailments Hammertoes Toes bend into a claw-like position
Most often occurs in second toe
Caused by ill-fitting shoes and muscle imbalance
Consult health care provider for treatment options

15. Common Foot Ailments Heel Pain
Primary causes are: stress put on heel and supporting ligaments, standing for long periods of time, especially on hard surfaces, and ill-fitting shoes
Other causes include obesity, gout, arthritis, and circulatory problems

16. Common Foot Ailments Heel Spurs Overgrowth of bone in the heel
Generally not painful unless inflammation occurs
Associated with plantar fascitis
Consult health care provider for treatment options

17. Common Foot Ailments Warts Caused by a virus Are contagious
Are more common in children
Can be picked up by walking barefoot on dirty surfaces
Consult health care provider for treatment options

18. Common Foot Ailments Plantar Fascitis
Inflammation of the band of tissue connecting the heel to the ball of the foot
Caused from excessive pressure or stretching
Heel pain is a hallmark symptom
Consult health care provider for treatment options

19. Common Foot Ailments Neuroma Benign (non-cancerous) growth of a nerve
Generally occurs between the third and fourth toes
Caused by ill-fitting shoes or abnormal bone structure
Symptoms: pain, burning, or numbness between the toes that runs to the ball of the foot
Consult health care provider for treatment options

20. Tips for Foot Health Do not ignore foot pain
Inspect your feet on a regular basis
Inspect your toenails
Perform routine nail care
Perform daily foot washing
Wear properly fitting shoes
Replace worn out shoes on a regular basis
Avoid walking barefoot
Match your shoes to your activity
Alternate shoes on a daily basis
Try to avoid home remedies for foot ailments
If you have specific diseases such as diabetes, high blood pressure, or arthritis, consult your healthcare provider for changes in your feet
Bullet 1: Foot pain is not normal. Foot pain can be a sign of illness or injury. If you have persist foot pain, consult your health care provider.
Bullet 2: Inspect your feet daily. Check for changes in color, temperature, or texture. Inspect for signs of excessive dryness, scaling, redness, pallor, or swelling. Inspect for signs of blisters, sores, cracks, or corns and calluses.
Bullet 3: Inspect your toenails on a daily basis. Look for signs of ingrown toenails, color changes (yellow, blue-purple, or pale), any abnormal or painful toenails.
Bullet 4: Trim toenails straight across. Do not cut too short. Do not cut the corners of the toenails. Carefully file your toenails to make sure you do not leave jagged edges. Special note: If you have diabetes, poor circulation, or heart problems, consult your health care provider for nail care.
Bullet 5: Wash feet daily using a mild soap and warm water, dry well. Make this your time to perform inspection of your feet and toenails.
Bullet 6: Buy new shoes later in the day. It is at that time your feet are at the largest. Replace worn out shoes on a regular basis.
Bullet 7: Consult your shoe shoe for assistance in accurate foot measurements and shoe type.
Bullet 8: Do not continue to wear worn out shoes. They may cause undo injury to your feet.
Bullet 9: Do not go barefoot. You may step on sharp objects and injure your feet or you may pick up germs that can lead to infection.
Bullet 10: Wear walking shoes for walking, running shoes for running, etc.
Bullet 11:
Bullet 12: Do not treat foot ailments and injuries at home. Especially if you are unsure of what may be wrong.
Bullet 13: It is important to consult your health care provider if you have diabetes, circulatory problems, or arthritis for foot ailments and injuries. Seek help to avoid long-term complications.

21. Your Feet and Specific Diseases

22. Aging and Your Feet

23. Aging Foot Facts As we age our feet change: Feet spread out
Feet lose fat pads on the soles
Toenails become thicker and brittle
Bones become more brittle

24. Tips for Aging Feet Shoes and Socks Wear properly fitted shoes
Shop for shoes late in the day
Wear shoes with a firm, non-skid sole and a soft upper region
Avoid high heels and shoes with pointed toes
Do not wear pantyhose or stockings with a seam
Do not wear garters or constricting hose or socks

25. Tips for Aging Feet Activity Walk whenever possible Grooming
Examine your feet daily
Wash your feet twice a day with a mild soap and warm water, dry well
Do not use home remedies to treat foot ailments
Trim toenails straight across and gently file
(diabetics should have toenails trimmed by health professional)
Visit your podiatrist once a year

26. Arthritis and Your Feet

27. Arthritis Facts Arthritis can cause decreased mobility
Arthritis affects more than 40 million Americans
Foot anatomy makes feet prone to arthritis
Women develop arthritis four times as often as men
In 2006 one in five adults were diagnosed with arthritis

28. Causes of Arthritis Family history Joint injury Joint infection
Inflammatory disease such as colitis.
Drug use
Autoimmune disorders
Autoimmune disorders are diseases in which our immune system turns upon itself and causes illness. Some common autoimmune disorders are lupus, RA, and type 1 diabetes.

29. Symptoms of Arthritis Swelling in one or more joints
Pain and tenderness in the joint
Decreased mobility or motion
Early morning joint stiffness
Skin changes in joint region: e.g., rash

30. Types of Arthritis Osteoarthritis Most common type of arthritis
Also called degenerative joint disease
Commonly caused from normal wear and tear on the joint
Comes on gradually, usually showing up as we age
Symptoms include a dull, aching pain in the joint, most often at night
Increased weight increases pain in the joint

31. Types of Arthritis Rheumatoid Arthritis Chronic, inflammatory disease
Comes on suddenly
Classified as an autoimmune disease
Symptoms include severe and lengthy early morning stiffness and pain, fatigue, and weight loss
Generally affects joints on both sides of the body
Causes “knobby-like” appearance to joints

32. Types of Arthritis Gout Abnormal build-up of uric acid
Most often affects the big toe
Men are affected more often than women
Condition is often aggravated by eating certain foods
Uric acid is a normal by-product from the diet.
Big toe is affected more due to pressure from walking in that region.
This can be the most painful form of arthritis.

33. Diabetes and Your Feet

34. Diabetes Facts Chronic disease
Number one cause of disability in Kentucky
Sixth leading cause of death in Kentucky
Number one cause of non-traumatic amputation of the lower extremities
Can cause nerve and blood vessel damage to the extremities
Blisters, cuts, etc can become life-threatening injuries to someone with diabetes.

35. Foot Examination If you have diabetes check your feet daily for:
Changes in skin color/temperature
Unusual swelling
Ingrown toenails
Fungal infections
Bleeding from corns, calluses, or blisters
Dry or cracked skin around the heels
Do not treat foot ailments with at home remedies. If you have diabetes, seek medical attention

36. Tips for Foot Health Examine your feet and toes daily
Wash your feet twice a day with a mild soap and warm water, dry well
Lose weight
Take part in daily physical activity
Wear thick, soft socks
Stop smoking
Cut toenails straight across and file gently
Wear properly fitted shoes
Visit your podiatrist once a year
Do not go barefoot
Do not wear high-heel shoes or shoes with pointed toes
Do not drink alcohol in excess
Do not wear tightly fitting hosiery or socks

37. Injuries and Your Feet

38. Before Seeing the Doctor…..
Rest and restrict activity
Apply ice to injured area
Lightly wrap the injured area
Elevate injured area
If you have a cut, wash gently and apply pressure to the area
If you have a blister, do not open it. Apply bandage to the area
Do not attempt to remove sharp objects such as glass from the foot
Injuries can occur quickly. Some can be medical emergencies. Follow some quick tips to prevent long-term complications.
Bullet 1: Do not walk around on the injured foot or ankle.
Bullet 2: Wrap ice in a towel or wash cloth. Do not apply directly to the skin. It can cause frost bite. Rule of thumb is 20 minutes on and 40 minutes off.
Bullet 3: Wrapping the area too tightly can increase swelling.
Bullet 4: Elevate above heart level to decrease swelling.

39. Injury Prevention Wear good fitting shoes
Wear the right shoe for the activity
Do not go barefoot
Avoid or walk carefully on slippery surfaces
Make sure walkways and pathways are well-lit

40. Women and Foot Health

41. Foot Facts Women may experience foot pain more often than men
Shoe selection can be the cause of foot pain and injury
High heels change how you walk and where pressure is put on the foot
Heels 1 inch or higher puts the foot in an unnatural position
High heels 3 inches or higher puts seven times more pressure on the ball of the foot
Women are affected by arthritis four times more often than men
Pregnancy causes physical changes that can affect foot health

42. Tips Learn to make better shoe selections
Try to avoid shoes with high-heels and pointed toes
Try to avoid flip-flops and open-toed sandals
Do not wear stockings or socks with seams
Do not wear stockings or garters that constrict the legs
If you are pregnant, wear soft, low-heeled shoes
Inspect the foot daily
Perform daily foot care
Trim toenails straight across, gently file

43. Common ailments Metatarsalgia or pain in the ball of the foot Bunions
Hammertoes
Neuromas
Achilles tendonitis
Heel pain
Pump-bump or enlargement in the back of the heel bone caused from excessive wearing of pumps
Arch tendonitis
Arthritis

44. Conclusion Follow tips for good foot health
Inspect feet daily for changes
Do not use home remedies
If you have diabetes, see your podiatrist once a year
Buy good fitting shoes
Avoid going barefoot
Avoid high heels and shoes with pointed toes
Eat a nutritious diet, take part in daily physical activity, get adequate rest and relaxation, do not smoke, do not drink alcohol in excess, do not abuse drugs, and see your health care provider on a regular basis

45. For more information http://www.ca.uky.edu/heel
Peggy Riley, RN, MSN
Extension Health Specialist
June 2008
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