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Published by Adam Glass.

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Table Of Content INTRODUCTION-THE FOOT ............................................................................................. 4

FOOT AGE IS MEASURED IN DISTANCE .......................................................................... 7

MAINTAINING HEALTHY FEET....................................................................................... 11

HEELS THAT HURT ......................................................................................................... 17

ARCH AFFLICTIONS AND FLAT FEET .............................................................................. 22

TEO AFFLICTIONS .......................................................................................................... 25

FOOT INJURIES .............................................................................................................. 32

SKIN AND TOENAIL PROBLEMS .................................................................................... 36

CONDITIONS THAT AFFECT THE FEET ........................................................................... 50

THE ABCDES OF MELANOMA ....................................................................................... 58

FOOT MASSAGE ............................................................................................................ 61

PERIPHERAL VASCULAR DISEASES ................................................................................ 63

SURGERY ....................................................................................................................... 65

TREATING FOOT PAIN ................................................................................................... 69

CHOOSING THE RIGHT SHOES ...................................................................................... 72

CONCLUSION ................................................................................................................ 76


INTRODUCTION-THE FOOT The foot is so well designed that even Da Vinci himself praised its structure. The famous

painter was also a deft hand when it came to human anatomy.

One of his pieces showcases the human foot, which he reportedly also called “masterpiece

of engineering and a work of art.”

Scientific research has led us to see that the beauty of the foot lies in its practicality and its

design.

Your foot has been constructed in a way that it can bear its weight, but a thousand times

over multiple times a day. It is then able to do it all over again the next day.

It has an excellent ability to absorb impact and maintain balance, keeping us upright in our

daily lives, whether we're running or walking.


Parts Of the Foot The human foot can be divided into three parts. The first

part, or the forefoot, includes the five toes. Together, the

toes have 14 bones, known as phalanges. There are two

phalanges in the big toe and three in each of the others.

The phalanges are connected to the metatarsals. The big

toe’s root also houses two smaller bones, or sesamoids. The

sesamoids are in touch with the two tendons, which are

very important to the foot’s function. The sesamoids lend

their support to both the tendons, as well as make the big

toe stronger. Five bones (such as the cuboid, navicular), and

three cuneiforms, form the midfoot.

This group of broadly shaped bones is in a closed arrangement. The calcaneus (heel bone),

talus (located between calcaneus and two lower leg bones) are two of the largest bones in

the body and make up the hindfoot.

Not only does the foot have a complicated underlying bone structure, the various tendons

and muscles attached to this structure makes movement possible.

The ligaments attach the bones to the joints. The plantar fascia is a ligament-like connective

tissue that runs from the heel, to the ball of the foot.

The plantar fascia provides support to the foot’s arch. Another connective tissue, the

Achilles tendon, connects your foot to calf muscles and enables you to shift your weight to

your toes when you lift your feet to walk or run. Injuries of this tendon can therefore result

in a lot of pain.

Walking On Foot

The components mentioned above work together seamlessly to help you walk, stand still,

sit, stand, etc. The partially relaxed plantar fascia occurs when you stand still, and the

weight of your body is divided equally between both feet.

During walking, the heel touches the ground to absorb what would otherwise be a shock

when your weight hits the ground. Your weight is transferred to ball of your foot and toes

after they touch the ground.


Another weight shifting occurs, this time to the other foot, as you lift your first foot to take

another step. Also known as the gait cycle, foot care specialists analyze it when they are

looking for problems to do with your foot’s shape or function.

The foot is connected to the rest of the body via muscles, joints, bones, and ligaments in a

kinetic chain. When you apply force, the last link of the chain results in movement. Injuring

your hamstring can strain the Achilles tendon, maybe even tearing it. Thus, losing stability

in one part of the body can mean bad things for the rest of the body as well.

Finding Help

As we age, our feet develop problems, and while a primary care physician can solve some of

these through medication or physical therapy, they do not specialize in foot care. A

podiatrist can provide this to you.

These professionals spend four years specializing in foot and ankle disorders. They earn a

Doctor of Podiatric Medicine (D.P.M.) degree, after which they have to complete three years

of hospital residency training. Another choice for you is to visit an orthopedist - a surgeon

whose specialization lies in musculoskeletal problems. They too go through 4 years at

medical, and then 5 years of residency.


FOOT AGE IS MEASURED IN DISTANCE

It's not the age of the body that matters when it comes to your feet, it's the number of steps

you've taken. Even though the foot undergoes changes as you age, the amount of wear and

tear depends more on lifestyle and footwear.

The foot is like any other machine in this regard. If you have been taking a high number of

steps every day, and the paths that you tread are rough trails, then your feet are likely to

seem more worn out than if you walk only occasionally, and on properly made roads. Thus,

it is possible for a foot to be older, at least chronologically, than the owner of that foot is.

Ballerinas are one example who have been spent their life pushing or squeezing their feet

into small shoes , and also engage in strenuous activity that mostly affects the feet.

Other factors that make a difference on how much wear and tear a certain individual’s feet

have seen include their weight. The more a person weighs, the harder your feet have to

work to support that weight.

All this means that unlike most parts of our body that reach their expiry date at the end of

our lifespan, foot pain can be a problem at any age. You do not have to be a certain age to

develop toenail fungus, or even have a matching family history, to have the condition. It is

nevertheless still important to know how age can affect your feet. Due to the varying


conditions that different people live under, it would be better for you to consider the

following as guidelines, and not depend only on them to keep your feet healthy.

The foot goes through various changes as we age, and it is also influenced by how much

distance we cover. The changes the feet undergo and how these changes occur have been

divided into three broad phases.

Birth To 30

When a child is born, they are born with an added layer of protection on their their feet.

This protection is in the form a layer of fat at the bottom that cushions the rest of the foot.

The young ones are in need of this sort of protection because their bones are not ossified,

but made of cartilage. In adults, this stuff is mostly used in cementing joints, or in the ears

and the nose. Since the bones are still forming, even in toddlers, the layering keeps the

bones protected.

The bone formation continues right into our late teens, and the foot develops accordingly.

As the child ages, their feet become stronger. In most cases, people live a foot problem-free

life until they reach their thirties.

30 To 40

As you enter into middle age and older, your feet age as well. This involves changes that

result in weaker muscles than before, and lower resilience in tendons and ligaments. Even

the potential of shock absorption of your feet takes a hit. Nevertheless, most people are still

able to coast through their thirties.

The big four 0 is when most foot problems arrive on the scene. One indication of aging feet

at that phase of your life are achy feet. At the end of most busy days, you will crawl into bed

with arches, balls of your feet, and heels, that ache. The natural resistance of your feet to

outside attacks, such as nail fungus, bunions, and hammertoes, also fails, and the feet

become more susceptible to injury.

If you started taking care of your feet early in life, then there is a chance that they will still

be healthy at this age. In that case, pick exercises that will stretch and strengthen the

muscles, help the tendons and ligaments stay supple, and you will be problem free for

another decade or more.


50 And Over

Most people have walked at least 75k miles by the time they enter into the fifth decade of

their lives. However, as we explained before, you do not have to be a certain age for that to

happen, and your lifestyle influences your feet’s age more than most things. Thus, an active

lifestyle that involves a lot of exercise or activity could mean that you might have already hit

the 75,000 milestone, even before you turned 50.

The changes that this age brings include the loss of at least half, or more, of the layer of fat

that protected your soles when you were younger. Other changes include possible weight

gain, which means your shoe size is also bigger than it used to be. Due to the increased

weight, the rest of your body applies more pressure on your feet than it used to, leading to

considerably less elastic ligaments and tendons. Your gender also has a part to play in this

scenario.

Most mothers will experience increased shoe size during pregnancy. The hormones released

during that momentous event help the body parts, including the ligaments, to relax. At this

age, many women are at the menopausal phase of their lives as well. Menopause is a drastic

series of changes that includes the loss of estrogen.

As a result of these changes, women will lose the density in their bones, and be highly

vulnerable to osteoporosis. Osteoporosis greatly increases stress fractures risk in most

bones, and the bones of their feet are not immune to it either.

If a hairline fracture is not treated immediately, it widens and results in a major shifting of

the bones around it. The only remedies that are available to women at that age are regular

exercise and a balanced diet.

If you are in your fifties or older, you have to be even more careful. This is because you are

even more susceptible to a set of problems that might result in a disability. Chronic foot

pain becomes a reality in old age, and its leading causes include bunions, calluses, and

corns.

Add to these factors other complications that most old people are likely to be experiencing,

such as osteoarthritis, obesity, and other systemic problems, and the importance of looking

after your feet becomes even more apparent.


However, while most of the problems are unavoidable since they are age-related, there are

some things that we can change. This includes not making your feet suffer by slipping them

into ill-fitted shoes and inviting foot problems. As you age, a foot problem can take a

completely different meaning. It may have meant a day of missed work or two while young,

but as a senior, it could mean something different. It could lead to a fall down the stairs,

which the aging body cannot take. It can also result in pain transferring to other parts of the

body.

Caring For your Aging Foot As You Age

As mentioned before, your feet will age like the rest of your body as you grow older. One

age-related effect is the loss of tissue elasticity. This event can make you predisposed

painful microtears or ruptures, among other things. Some steps that will help prevent

injuries are as follows:

Regular stretching of feet

Wearing comfortable shoes

Use cushioning shoe inserts during exercise

Consider alternative exercises that will put less pressure on the foot joints

Regular feet exercise or massages for increased circulation

Eating well

Regular moisturizing of your feet

For less yellowing of nails, if you wear nail polish, remove the nail polish every week and

allow the nails to breathe for a day.


MAINTAINING HEALTHY FEET It will take more than just investing in a pair of comfortable shoes if you want to keep your

feet healthy. We thought we’d help you out with some tips just to get you started. While

getting ready to go out or for work, we take immense care when it comes to our

appearance. Our feet, however, are often overlooked and the best they can hope for is

being slipped into a shoe.

While stuck in that shoe, we forget that just like the rest of us, our feet also feel the effects

of the heat, and have to put up with all the strain as we run around completing our chores

and daily tasks.

However, those same neglected feet come to the forefront once we start having foot

problems. Ladies usually put their feet through the most torture. They spend day after day

in the confines of tight, high-heeled shoes.

When you keep your feet healthy, you are not only making things easier on yourself at

present, but also avoiding future problems that can result in disability. Taking care of your

feet is not rocket science; in fact, all the things that you do to improve your overall health,

also keep your feet healthy.


Two lifestyle factors stand out when it comes to maintaining a healthy, active, and engaged

life. The first of those factors is maintaining a healthy weight. Regular exercise and

stretches of the feet are the other factor to keep in mind.

Weight Maintenance

What does maintaining a healthy weight have to do with your feet? Your weight and the

health of your feet are closely connected, since your feet have to take the brunt of your

weight, every time you take a step.

You may already be watching your weight, because it has already been linked by research to

many health conditions, ranging from cardiovascular disease, to high cholesterol and blood

pressure, diabetes to cancer, infertility to snoring.

If weight can play such an important part in keeping your body healthy, is it a surprise that it

is also connected to various foot problems? As you gain pound after pound, your feet have

to work harder to absorb that weight.

That is why, when you visit a foot care specialist, it is highly likely that they will ask how

much you weigh and compare it with your height, along with other lifestyle details, before

giving a diagnosis. Obesity will mean that the specialist will not only give pain meds, but also

suggestions on how to get shed some pounds.

There are two main things that can help you maintain your weight at a healthy level. The

first of them requires consuming just the right amount of calories every day.


The second is staying active enough to burn the excess calories you consume every day.

According to Harvard nutrition experts, there is no magical diet plan that would help make

that happen. Nevertheless, there are three things that can help.

Physical Activity

The U.S. Department of Health and Human Services has issued Physical Activity Guidelines

for Americans. If you are following them, you should engage in 150 minutes of moderate

aerobic exercise every week. Two examples of such forms of exercise include biking and

walking.

The exercise can be divided between seven days of the week, so you could do 30 minutes of

walking, five days a week, which may be ideal for most people. The other recommendation

is two strength-training sessions a week. It is advised that you let your muscles rest by

taking a 48-hour break in-between the two sessions. No matter which exercises you choose,

make sure to protect your feet with shoes that support and keep them cushioned

throughout.

We exercise for three reasons - to burn calories, build muscle and to prevent our muscles

degrading with age. Of these three reasons, the last one is most important. When you have

more muscle in your body than fat, your resting metabolism is higher. That means, your

body burns energy at a higher rate when you’re at rest. Consequently, you burn more

calories than someone with a lower resting metabolism would.


Find A Diet That Works

As we mentioned, there isn’t a sure-fire diet plan that will help everybody lose weight.

Therefore, the most diet experts can offer are general guidelines. Following their advice,

you will not only lose weight, but more importantly, eat better.

Most fad diets will instruct a person to skip one kind of food completely. This is never a

good idea; a good diet includes enough food to meet your nutritional needs.

The Harvard School of Public Health advises that people should eat healthy instead of

dieting, meaning that, unlikely as it sounds, a typical 'diet' is counterproductive.

A healthy diet includes a low amount of refined

carbohydrates, such as the ones present in white bread.

It also limits the amount of added sugars, such as the

ones that are a part of many soft drinks and the like.

The best diet will incorporate an abundance of fruits and

vegetables, whole grains, and meat for protein, or

protein alternatives, such as green peas and Quinoa, if

you are vegan or vegetarian. It will also prefer vegetable

oils for cooking over synthetic ones.

Be A Defensive Eater

Being a defensive eater requires you to know exactly when you feel full, and to stop eating

when that happens. If you are going out to eat, try to share your desserts or entrées, and

avoid oversized portions.

Another way to stay on your guard, is by making a note of the calorie count of foods. A glass

of cola or grapefruit juice can both hide as many as 100 calories. While the second option

may be healthier, it is better to opt for water or seltzer, both of which have no calories.

Stepping Towards Healthy Feet

Some ways to keep your feet healthy include ensuring that they are clean and dry at all

times, exercise them regularly, and be on the lookout for any changes in their color. When

you do trim your toenails, try to do so in a straight line.

To keep them fit, you will need to exercise your feet on a regular basis. One of the easiest

ways to do so is by going on regular walks. Walking requires all parts of the feet to be


engaged. It also helps the rest of your body by maintaining your cardiovascular health,

helping circulation, and improving your mood.

The first rule of exercise is to warm up before you start. You can do that by marching on the

spot for a few minutes. Then stretch your feet muscles, so that they are not shocked when

you begin exercising. If you are exercising for the first time, you should start slow and

gradually pick up the pace.

While walking, make sure to follow the following tips so that your feet stay protected:

Wear footwear that is comfortable, supports your feet, and allows them to breathe.

Let your arms swing freely while your back stays straight.

Choosing Athletic Shoes

Shoes that fit you properly will have enough room to support the

width of your feet. If you are going running, then wear running

shoes that can absorb the impact. If you are going to a tennis match,

you will need to move from side to side, and since running shoes

only favor forward movement, they are unsuitable for the task.

You will know it is time to buy new shoes when your feet start to

hurt after exercise. A good pair of running shoes is good for 300-600

miles. When you are not exercising, pick shoes that will cushion your

feet, are wide in the toe region, and flexible at the ball of the foot.

Exercises For Foot Fitness

The first thing you need to do is try this exercise to limber up:

1. Sit down with your feet resting on the ground

2. Lift a foot off the floor, make circles with your big toe by moving it in the air in a

clockwise direction

3. Repeat 15-20 times

4. Repeat in a counterclockwise direction

5. Do the exercise with the other foot

To stretch the bottom feet muscles:

1. With your feet together, stand up

2. Take a step back with one leg, raise your heel, and press your toes against the

ground.

3. Stay like this for 20-30 seconds.

4. Do it with the other foot


For stretching the top muscles:

1. Take the same starting position

2. Raise the heel of one foot, curl your toes under, and press them against the floor.



To stretch your Achilles tendon:

1. Your starting position is at an arm’s length from a wall.

2. Pressing your hands against the wall, keeping your feet together

3. Take a step back with one leg, bend the other knee slightly while the heel of the first

leg stays on the ground.



To stretch the hamstrings:


2. Extend a leg, put your heel on the floor while the toes point upwards

3. Place your hands on the other thigh and hinge forward at the hip


To strengthen your ankles


2. Lift a left leg and place the center of an exercise band under the ball of that foot

3. Press against the band as you would on the gas pedal of your car

4. Hold foe a few seconds before releasing

5. Repeat 10-15 times

6. Do it with the other leg

To strengthen your calves

1. Put sneakers on and stand up straight with your feet resting on the ground

2. Stand on your heels for a few seconds and then bring them back to rest

3. Repeat 10 times

4. Start with five sets of 10

5. Increase the intensity after two weeks by standing on only one foot at a time

Exercises that improve flexibility reduce the risk of injury. To help build flexibility, start

slowly with gentle daily stretches that focus on one group of muscles at a time. On the other

hand, strengthening exercises are those in which your muscles work against resistance, such

as weights or exercise bands.


HEELS THAT HURT Not only are heel afflictions very common, there are several types. The most common

sources of heel pain are as follows:

Plantar Fascia

An inflamed plantar fascia or fasciitis, a degenerating plantar fascia or fasciosis, or both, can

lead to pain at the bottom of the heel.

What It is And How It Works

It occurs when the plantar fascia is forced to endure forces that are either excessive or

happen repeatedly. As the ligament ages, it loses its elasticity and is more susceptible to

microscopic tears.

Symptoms

In developing both plantar fasciitis or fasciosis, the inside of your heel becomes

painful before you leave your bed.

The pain might ease up during the day, only to return later


Treatment

While both afflictions may go away on their own, for some people, it could take 6 weeks for

that to happen, and up to a year for others. For quick relief, you will need to seek treatment.

The best strategy is often to take things easy for a few days when the pain first arrives.

Stretch your foot and ice it. You can also take a nonsteroidal anti-inflammatory drug

(NSAID), such as ibuprofen, to help with the pain.

Cushion or shoe inserts that relieve orthopedic issues are another option for pain relief.

However, there is little evidence to suggest that investing in custom orthotics, which are

often costly, will help relieve heel pain.

One other approach to pain relief is wearing low-heeled shoes that will take the pressure off

your aching heels. If the pain continues for two months or more, then it is better that you

see a foot care specialist.

If the pain has lasted for a year or more, which happens rarely, then you might need to have

surgery. A fasciotomy will entail removing the part the plantar fascia that is causing you

pain. Other approaches include gastrocnemius recession.

In this procedure, the lining of tight calf muscles is cut to relieve the plantar fascia of the

pressure.

Like all surgical procedures, there will be the risk of potential complications. These risks

include arch collapse, or a damaged tibial nerves, both of which will cause the pain to

return. It is always a good idea to discuss all the risks with your surgeon before getting an

operation.

Stretching The Plantar Fascia

1. While sitting down, rest one foot on the floor.

2. Place the other ankle on the resting knee.

3. Gently pull back the toes of the raised foot until you feel your sole stretching

4. Massage the stretched plantar fascia with the other hand

5. Stay this way for 10 seconds

6. Repeat 10 times

7. Do this for the other foot

8. Repeat it thrice a day


Heel Pain

The shortening of the Achilles tendon due to some kind of damage, inflammation, or

degeneration can also lead to heel pain.

What It Is And How It Works

Together, the Achilles tendon and the plantar fascia work to move the foot. Heel pain due to

Achilles tendinitis can occur when the tendon is inflamed. Achilles tendinosis occurs due to a

degraded tendon.

Both these problems and subsequent treatment occur in the same way. At times, people

also suffer from both disorders simultaneously. However, an inflamed tendon can be saved

from further structural damage.

Running and overexertion are two major causes of Achilles tendinitis, but sometimes ill-

fitting footwear and switching from the regular use of high heels to lower ones, can also be

to blame.

On the other hand, Achilles tendinosis is made worse by weight gain, which can speed up

the fraying of the tendon. Other factors include genetic susceptibility.

Symptoms Pain: Behind the heel Worsening after you have spent a long time standing up Intensifying by the day’s end

Treatment Initially, you will need lots of rest and to stretch your feet to treat both Achilles tendinitis

and tendinosis. If the inflammation increases, taking an NSAID might help. When it comes to

stretching, it will have to be eccentric stretching that may be done with or without the help

of a physiotherapist.

However, if the pain does not go away, or in case of persisting swelling, you should visit your

foot care specialist. One of the suggestions that the specialist will make is to k immobilize

your leg below-the knee.

This can also be achieved by wearing a night splint while sleeping. A brace like that will keep

the relevant parts, such as plantar fascia, Achilles tendon and calf, stretched at all times.


Keeping the tendon stretched helps if you are suffering from Achilles tendinitis or

tendinosis.

In the case of a tendon that has been damaged completely, you may have to undergo

surgery. The procedure involves tendon removal, along with any spurs impinging on it.

Newer approaches include cutting and lengthening the gastrocnemius muscle. This is either

done in lieu of tendon removal, or sometimes in addition to it.

Eccentric Stretching

In a standard stretch, the muscle in question will first relax, and then lengthen. In an

eccentric stretch, however, the muscle elongates, but tightens instead of relaxing. A greater

external force than the anything the muscle itself can generate makes it act that way.

The energy from the muscle is transferred to the tendon next to it. In case of the Achilles

tendon, its elasticity improves and results in reduced microtearing.

Eccentric contractions can be experienced by running downhill, down stairs or by lowering

weights.

Inflamed Bursa

A fluid-filled sac cushioning a tendon is known as a bursa, and it can get inflamed. When

that happens, the condition is known as bursitis.

What It Is And How It Works

Some causes of bursitis include the growth of an abnormal bone, ill-fitting shoes, or

overexertion. As its name suggests, posterior heel bursitis is the name given to bursitis at

the back of the heel. Shoes that support and cushion your feet prevent bursitis.

Symptoms

Pain:

Behind the heel

Worsening after you have spent a long time standing up

Intensifying by the day’s end


Treatment

Posterior heel bursitis treatment is similar to that of Achilles tendinitis or tendinosis. Resting

the foot, icing it at regular intervals, applying compression, and keeping it elevated can help.

If not, a pain reliever might work. Inserting a gel sleeve into your shoe can be another

solution, since it will cushion the area.

Take an NSAID if the swelling still does not go away, but it might take a month or more for

the inflammation to completely disappear.

If the pain persists, go visit your foot care specialist. Their recommendations will likely be

physical therapy or using shoe inserts to lessen the discomfort. Nevertheless, be prepared

for the condition to stay for as long 6-12 months.

After the tendon is relieved from pain, you will need to start stretching it gently. This will

help prevent further episodes of bursitis.


ARCH AFFLICTIONS AND FLAT FEET

Having flat feet is a lot more serious than it sounds. Let's find out why.

The structural integrity of your foot’s arch may be compromised and result in an ache that

you feel in the middle of the foot. When the pain goes untreated, the condition may worsen

with time. Eventually the arch will collapse, resulting in flat feet, or fallen arches. However,

some people are born with flat feet.

While DHEA is readily available over the counter in many health-food stores and

pharmacies, it would be wise for you to consult your doctor to determine just how much

DHEA intake you will require.

Another hormone that may help with fibromyalgia is. This particular hormone is very

effective as a sleeping aid. Sleep, especially deep delta sleep if you remember, is important

as it helps with the production of serotonin, which directly affects fibromyalgia. Dosage

varies between 1 - 3 mg per night, but patients suffering from insomnia may require a

higher dosage, which is again best determined by your doctor.


Flexible Flat Feet

What the condition is and how it works.

Flexible feet have arches that will flatten on being pressurized, and come back to their

original position when the pressure is removed. Most children have flexible feet. However, it

is also found in adults. The chief causes are flexible joints, loose ligaments and a genetic pre-

disposition.

Symptoms

Very rarely painful, this condition presents symptoms where the person’s feet will

ache after long periods of standing up or walking.

Treatment

Wearing shoes that provide extra support to the arch of the foot are one approach towards

treating flexible flat feet. Other solutions include shoe inserts. However, in case of

persistent symptoms, you might want to visit your foot care specialist and invest in custom

orthotics.

Rigid Flat Feet What the Condition is and How it Works

When people suffer from rigid flat feet, it is more painful. Their feet lack arches, even when

they are sitting. Another condition, tarsal coalition, is of even more concern since it is a

result of fusion of foot bones. This not only flattens the arch of the foot, but also limits the

foot’s flexibility.

Symptoms

An ache that travels up to the ankle Pain intensifying after exercise

Treatment

Less severe cases can be treated with shoe inserts, orthotics, and NSAIDs. Wearing

comfortable shoes and icing or providing heat to the area once it starts to ache are also

helpful. Physical therapy is advised by some specialists, while others might suggest either a

walking cast or a brace. In severe cases, the bridge of bones is either removed via surgery,


or made to fuse completely. It might take some time for people who undergo surgery to

recover. It can take as long as 6 months, and perhaps even longer in some cases.

Posterior Tibial Tendon Dysfunction

What the Condition is and How it Works

The posterior tibial tendon suffers some kind of damage in this condition. Chief causes

include injury and the wearing out of the tendon from use. Degradation of this tendon over

time can cause it to lose its elasticity. Women who wear high heels for extended periods of

time are more susceptible to it.

Symptoms

The tendon aches and becomes weak

The arch of the foot and the inner side of the ankle both hurt

The sufferer may develop flat feet, stemming from flexible feet

The pain reaches the outer side of the foot and develops into rigid flat feet.

In severe cases, the person may not be able to walk

Stages

1. Inflamed tendon but arch unchanged

2. Degeneration of tendon; arch partially flattened; flexible flat footedness

3. Rigid flatfoot and arthritic changes in the hindfoot

4. Arthritis reaches the ankle joint

Treatment

In order to avoid surgery, early treatment is always

better. Initially, NSAIDs, a brace, or custom orthotic

are suggested by the doctor. Gently exercising the

Achilles tendon can help make the foot muscles

stronger. The most common surgical procedure is

heel osteotomy, where the heel bone is cut and

realigned. In tendon transfer, the tendon is repaired

with fibers from another tendon.


TEO AFFLICTIONS They may be one of the smallest parts of your body, but they play a big role. Let's find out

about the various afflictions of the toe and how to treat them.

Bunions and Bunionettes

What the Conditions are and How They Work

Toe pain is often caused by bunions or hallux valgus deformities, plaguing more than half of

all American women. In women, they also occur earlier and are more severely deforming.

A bunion is the result of misaligned foot bones. In this condition, the first metatarsal and the

metatarsophalangeal joint move away from the other metatarsals.

Consequently, the big toe turns inward. A bunionette, or tailor’s bunion, affects the base of

the fifth small toe. Both disorders may be caused by arthritis, misaligned feet, obesity, be

inherited or wearing pointy shoes.


Symptoms

For bunions, a painful bony protuberance under the big toe, or fifth toe for

bunionettes. Treatment

Padding the bump, using a shoe stretcher that stretches the area next to it, or orthotics that

help redistribute your weight, are some solutions.

Severe bunions are treated by wearing wide shoes, while NSAIDs can help with inflamed

ones. You may also try applying compresses -both hot and cold- for pain relief. However, in

case of persistent pain that interferes with your life, you may need surgery.

Keep in mind that surgery might not completely remove all symptoms, and will likely take 6-

12 weeks to heal. During the healing period, you will have to stay off your feet.

Depending on the severity of the condition, mild bunions can be treated using the modified

McBride procedure. The bone on which the protuberance extends from is shaved and the

connective tissues realigned in this procedure. It will take at least six weeks for you to

recover.

A Chevron procedure is also used for moderate bunions. In it, the surgeon cuts and shifts

the bone close to the metatarsal head. The recovery period may be extended to 12 weeks,

and include using crutches or another device to keep the weight off of the healing foot.

In case of severe bunions, the surgeon cuts the metatarsal bone farther down, rotates it,

and realigns it with pins, screws, or plates.

Known as proximal osteotomy, you will need three months to recover from this procedure.

In suture-button correction, two stainless steel buttons are used as fixation points to hold

the metatarsal bones together. Recovery may take six weeks.

Residual symptoms can be a side effect of surgery in some people. For others, atrophy of

muscles might be a concern when the postoperative shoe or cast is removed. Surgical

procedures are similar for bunionettes, but with shorter recovery times.


Hammertoe

Hammertoe also results in toe pain. They are deformities that result in the curling of a toe,

due to the contraction of tendons and ligaments within it.


The curled up toe resembles a hammer, hence the name of the condition, hammertoe.

When this develops, wearing shoes might become difficult since the top of your toe may

keep rubbing against it. As a result, a hammertoe can also cause bursitis, irritation, corns, or

calluses. Often, when a bunion forms on the big toes, it displaces the second toe, which

develops hammertoe.

The likelihood of contracting a hammertoe increases in people who wear shoes with narrow

toe boxes. Unsurprisingly, men are four times less likely to develop hammertoe than women

are. Besides high heels, clogs, and sandals that must be gripped by your toes are all involved

in increasing the risk of hammertoes.

Mallet toe and claw toe are conditions related to hammertoe. In mallet toe, the tip of the

toe bends, while in claw toe all three joints of the toe are contracted. The tendency of

developing all three conditions may also be inherited, or occur due to another underlying

disorder, such as arthritis. A neurologic disorder, such as neuropathy, may also be the

underlying cause of claw toe.

Symptoms

The second toe (mostly) bends and curls into a shape, resembling a hammer

The top of the toe becomes painful and irritated

Treatment

Applying pressure to the toe will flatten most cases of hammertoes, since they are flexible in

the initial stages. If that is the case, using a crest pad can relieve irritation. Place the pad in a

way that top of the shoe presses down on it and the toe is flattened. However, this is not a

permanent solution, and once you have developed a hammertoe, the pain and

inflammation will not go away completely.

Icing the toe can relieve some of the inflammation and pain of a hammertoe. So can soaking

the toe in warm water, or exercising it. If the pain still persists, then you might have to make


a splint to support it or use an insert to ease pressure off of it. Using a shoe stretcher will

also give the inflamed toe room to relax.

In severe cases, surgery might be needed. If the hammertoe is flexible, a tendon transfer will

restore it. In that procedure, a tendon from under the toe is relocated. Part of bone must be

removed in cases of inflexible hammertoes. Most of the healing will take place within three

months of surgery, but it may take longer in some cases.

Osteoarthritis


Your foot has more than 30 joints, and all of them can be affected by arthritis. This is what

makes your feet so susceptible to osteoarthritis. This condition usually presents as stiffness

and pain when you wake up in the morning.

Even though the symptoms will gradually decrease during the day, they will reappear later.

Chances are that the pain will cause you to start walking with an abnormal gait, which can

then develop into a limp. The only way to lessen the pain would be to get some rest.

Osteoarthritis is a common cause of foot pain, and while it may develop in any part, it

affects the toes most frequently.

When someone suffers from osteoarthritis, it may be due to hallux rigidus. In this condition,

the big toe loses its flexibility in the metatarsophalangeal joint. The major causes of

osteoarthritis are injury and the wearing down of the joints due to over-use.


In osteoarthritis, the cartilage surrounding a joint becomes less flexible. Such cartilage

cannot provide the support and lubrication that your bones need. Thus, the resulting pain

and inflammation makes walking difficult.

We use our feet so frequently and they support most of our body’s weight. Consequently,

the likelihood of these limbs being damaged by constant use is pretty high.

Another factor that can worsen this condition is weight gain. Due to obesity, your body ends

up putting more pressure on your joints, forcing them to work harder for longer.

This is yet another reason why we all need to keep our body weight within a healthy range.

Foot injury and a history of previous injuries are two other factors that can lead to

osteoarthritis. In order to keep your feet protected, wear shoes with cushioned soles that

actually fit your feet well.

Symptoms

More pain in the morning that recedes during the day only to return

Stiff joints

Treatment

To relieve pain and keep joints flexible, performing stretching and strengthening exercises is

a good idea. Exercises that gently stretch the joints will not only keep them loose and

limber, but also take off some of the pressure that plagues the cartilage around them.

Hot or cold packs and NSAIDs are two other ways to relieve pain and alleviate inflammation.

A COX-2 inhibitor, such as Celebrex may also be used, however, be careful of the side effects

and health risks associated with the medication. Surgery is often the last resort.

Arthritis often does not show on the x-rays, and the only way to confirm a diagnosis is to go

see a doctor when you notice joint pain in your feet.

Gout

Gout causes arthritic symptoms and happens when uric acid starts to accumulate in the

joints. It is the leading form of inflammatory arthritis in men.



Having gout means either your body produces an excess of uric acid, or it cannot excrete it

properly. The crystallized form of the excess uric acid becomes a part of your joints, causing

inflammation, soreness, sudden jabs of pain, redness, and swelling.

The part of the foot that is most affected by gout is the base of the big toe. Levels of uric

acid increase when you eat foods containing purines. Men are more likely to be suffering

from gout due to their naturally high levels of uric acid. However, that changes for women

during menopause, which is why most women are prone to developing gout much later in

life.

Symptoms

Affected joint is inflamed or painful

Eating purinecontaining foods increases the pain

Treatment

An NSAID or a corticosteroid, such as prednisone, can be used to treat gout. Injecting

adrenocorticotrophic hormone can stimulate cortisone production within your body.

Allopurinol is a drug that can reduce the body’s production of uric acid.

List of Purine Containing Foods

High Purine Content

People suffering from gout should not consume the following foods:

anchovies

chicken or beef broth

gravy

kidney

mackerel

meat extracts

partridge

scallops


Moderate Purine Content

One serving (100 g) per day:

asparagus

meat

mushrooms

oatmeal

spinach

Sesamoids

Located under the base of the big toe are two small bones or sesamoids. When

overstressed, sesamoids can become inflamed, irritated, or even fractured. This condition is

known as Sesamoiditis.


Your sesamoids work like pulleys. Their function is to help make the big toe’s movements

smoother. In order to avoid developing Sesamoiditis, wear shoes that support your feet

while cushioning them. This is especially important when you indulge in any kind of sport.

Symptoms

Pain and swelling in the affected area

Treatment

Icing the affected area can relieve both the pain and inflammation. You can relieve the

pressure by cushioning the area with shoe inserts or orthotics. The inflammation takes 2-3

months to subside, during which time you should continue use of inserts, rest your foot, and

take an NSAID pain reliever. If the pain persists, go see your foot care specialist.


FOOT INJURIES Foot injuries are very common, but knowing what injury you have is slightly harder. Here,

you can learn about the most common injuries of the foot and how to treat them.

Fractures

An injury that leaves a bone broken can do so in several ways. Either it breaks cleanly, just

chips part of it, or leaves hairline cracks known as stress fractures. The latter are a result of

repeated stress that is not sufficient for a clean break. Osteoporosis is another factor that

can lead to fractures.


We fracture our toes most frequently by stubbing them against things or by dropping

something on them. Metatarsal injuries occur when you twist your foot or drop something

on it. If you are unsure whether the hurt you are feeling is a fracture, check if your injured

foot can bear your weight. If that is painful, then seek help immediately. If you are still

unsure, check to see if the injured area feels pain or tenderness when you touch it.


The first thing you should is get an x-ray done. However, some fractures do not show up on

an initial x-ray. Therefore, be on the lookout for persisting pain that sticks around for more

than ten days. If that is the case, get another x-ray.

Symptoms

Pain directly above the bone

Swelling/Pain persists after RICE

Inability to put your weight on the injured foot

Treatment

Special hard-soled shoes

Plastic-and-foam fracture boots

Buddy tape on the broken bone

Splint

Cast

Surgery, in case of significantly displaced bone

RICE Regimen

Resting requires that you keep pressure off the injured foot and make sure to keep it

inactive for long periods.

Icing will reduce inflammation. Crush the ice, wrap it in a towel or a plastic bag, and apply to

the area. You can also use a frozen bag of peas or a cold compress.

Compression requires wrapping the injured area in an elastic compression bandage. It helps

take away the swelling, if wrapped snugly enough that it does not stop blood circulation in

that area. You will know how tight the bandage should be - loosen it if your toes start

turning purple or white.

Elevating the injured part reduces both inflammation and pain. No matter how you do it,

just ensure that the area is kept above waist level.


Stress Fractures What the Condition is and How it Works Overexertion can result in stress fractures in young people, while in middle-aged or elderly

people, osteopenia, reduced bone density or osteoporosis might lead to them. Most stress

fractures tend to occur in the metatarsals, but can also occur in the heel.

To prevent stress fractures from developing, always build up to strenuous exercises, instead

of exposing your body to a shock. Another solution is to wear shoes that will keep your feet

safe during the activity. Warming up will also increase flexibility and joint motion, thus

protecting your bones from shocks.

Symptoms Tenderness, redness, or swelling

Development of pain with an increased level of activity

Treatment

Go see a doctor if you suspect a stress fracture. While they may order an x-ray, the fracture

might not show up in it, and might require a bone scan or an MRI. Involving the injured foot

in any kind of activity might break the bone. Rest and use an immobilizing device to speed

up healing, which can take between 4-6 weeks.

Sprains


Ligaments connect bones with each other, and at times, they are torn as a result of a foot

sprain. In a midfoot sprain, the foot twists in an odd way from the middle, or you drop

something in the middle part of your foot. It is a common sprain type, as is the turf toe

sprain. In it, the big toe is bent too far back. When engaging in an activity, wearing sturdy

shoes with thick soles can help protect your foot from sprains. Stretching, exercising, and

warming up before exercising are other ways to prevent sprains.

Symptoms

Pain, swelling, and tenderness

Joint bent at an odd angle


Treatment

To help heal a sprain, follow the RICE regimen. NSAIDs might help too, but you will have to

continue taking them for 1-4 weeks. If the pain persists, see a doctor because there is a

possibility that it might be a fracture instead of a sprain. Severe sprains may also require

splinting, casts, and take several months to heal. To speed up your recovery, try to stay off

that foot.


SKIN AND TOENAIL PROBLEMS

The inside of the foot isn’t the only part that is prone to injuries. Your skin and toenails are

at risk as well. Your foot skin and toes reveal a lot about your inner health. Even the small

symptoms can be indications of serious problems and systematic diseases. Hairless feet and

toes provide some comfort during sandal season, but natural hair loss in that area is a sign

of serious blood circulation problems. Similarly, frequent foot cramping is a sign of

dehydration and severe nutritional deficiencies. The most common and frequently ignored

conditions that affect the foot skin and toenails are as follows:

Ingrown Toenails

Ingrown toenails are one of the most common toenail problems. It occurs when the corners

or edges of the nails dig into the skin next to the nail and start growing there.

What It Is and How It Works

Ingrown toenails can occur in both men and women. Diabetic people, people with poor

circulation or sweatier feet are more vulnerable to the risk of ingrown nails. Ingrown


toenails occur when the corner of nail pierces the skin next to the nail. The corner of nail

starts growing into the skin and causes pain and inflammation.

The common causes of ingrown toenails include wearing shoes that cause pressure on the

big toes, poor posture, toenail injury, irregular toenails, improper foot hygiene, and cutting

your toenails incorrectly.

Symptoms Swelling or inflammation occurs in the skin next to the nail.

You will feel severe pain upon putting pressure on the toes.

A white colored fluid or pus will build inside the skin around the toes.

The skin around the toes will overgrow.

Treatment

The medical diagnosis of an ingrown toenail is evident from its physical condition. An

untreated ingrown toenail may lead to soft-tissue infections and ultimately, tendon and

bone infections. Diabetic people, or those with compromised immune system, should never

treat it at home.

The home remedies for ingrown toenails have a risk of nail border offence, therefore you

should ideally seek a podiatrist’s advice in this regard. In minor ingrown instances, the

podiatrist will soak your foot in a medical solution followed by careful trimming of the nail.

The chances of infection are usually low in this type of treatment. The doctor will most

probably suggest you a nonsteroidal anti-inflammatory drug, like iBuprofen, to help you

with post-treatment pain.

In the case of an infectious ingrown toenail, the podiatrist will temporarily detach the

border of the nail. The procedure is called partial matrixectomy.

If it recurs, the surgical procedure called permanent matrixectomy is the only solution. The

nails grow from a layer called matrix, which is embedded under the skin.

In matrixectomy, the matrix is destroyed to avoid recurring ingrown toenails. The procedure

is conducted with surgical dissection, electrical or chemical therapies. The post-treatment

care includes topical treatment and bandages.

The essential preventive measures for avoiding ingrown nails is to soak your toes in salt

water at least once a week (if you do not have fungal infections), wearing low-pressure

shoes, and moisturizing your feet regularly.


You should also use anti-microbial soap or Epsom salt solution to wash your feet.

Blisters

Friction, repeated rubbing, or recurring pressure results in raised skin filled with water-like

liquid, called blisters. These occur between the top layers of the skin due to prolonged

pressure or rubbing. Blisters are mostly formed on hands, toes, or heels of feet.


A blister looks like a pocket of fluid formed between the upper layers of the feet. Friction,

rubbing, and burning are the most common causes of blisters, but they can also be formed

due to freezing, chemical burns, and infections. Blisters formed due to chemical burns, heat

burns, or frostbite are categorized as second-degree burns.

Frequent rubbing or friction increases the temperature inside the skin. The upper layers of

skin swell to form a blister. It is mostly filled with water or pus, but a blister formed due to

nerve damage is filled with blood. Blisters are also formed in moist, or very dry, conditions.

The ultimate purpose of blisters is to prevent infection, burn or damage reaching the

deeper layers of your skin. Leaving the blister untreated, or struggling to treat it without

understanding the mechanism, may aggravate the condition.

Blisters may also be caused due to wearing tight shoes, brisk walking, high energy workouts,

or a burn.

Symptoms It looks like a small skin bubble.

The bubble or pocket is filled with water-like or transparent white fluid.

You will feel warmth around the blister.

Frequent itching, redness or minor pain also symbolizes blisters.

Treatment

Blister plasters and hydrocolloidal dressings are mostly used for small blisters. These

plasters and dressings cover and cushion it, preventing it from popping and stopping

infection. They also absorb moisture and allow the skin to heal faster.

A hydrocolloidal dressing or plaster has chewing gum like material rubbed on the inside

layer. This substance is called hydrocolloid. It absorbs the moisture and prevents infection.


Apply the plaster on blister and watch the gel forming in it within a few hours of application.

After a few days, the moisture will be completely absorbed and the wound will be healed.

You can take off the plaster carefully now. There should be a new layer of skin. Apply

another plaster if the skin is not ready yet.

Make sure to avoid bursting or peeling off the blister skin. It can lead to serious infections.

Other medical treatment of blisters, aside from hydrocolloidal dressing, includes bandaging

the blister.

Wash the blister and sterilize a needle. Remove fluid with the help of the needle and wash

the infected skin again. Finally, pat dry and apply an antibiotic ointment, and bandage the

area. Remember that a podiatrist or general physician should always follow this procedure.

The post treatment prevention includes avoiding wearing tight shoes, avoiding activities

that may cause friction or heat, and consulting a doctor if you see skin reddening or

swelling.

Calluses and Corns

Calluses and corns are thick, hardened and yellowish layers of skin that are formed on

pressure points or around the boney areas of the feet. These mostly come about when your

skin tries to protect itself against pressure and friction.


Ill-fitting shoes, friction, brisk walking, and frequent rubbing on foot skin can cause skin

thickening around boney areas. Corns and calluses fall in the same category of foot skin

problems.

They mostly formed around the boney areas or near little toes. These may or may not be

painful. However, they may penetrate the deeper layers of skin, causing infections,

inflammation, and severe pain.

People with diabetes or bunions or those with sweaty feet are more likely to develop corns

and calluses.

The cushioning under our feet degenerates by the age of 65. This is why people over 65 tend

to develop corns and calluses more frequently and easily. The risk factors associated with

corns and calluses include abnormalities in gait, foot anatomy, and bunions.


The Difference Between Corns and Calluses

A corn is smaller than a callus. It looks like a small round pocket of hardened and yellowed

skin. Corns may sometimes press into the deeper skin layers, becoming more painful. There

are two types. Soft corns are formed between toes, generally between fourth and fifth toe.

Sweat maintains the tenderness of soft corns, but these are more prone to infections. The

other type is hard corns. These are formed on the outer side of toes, generally around little

toes. Poorly fitted shoes most commonly cause hard corns.

Calluses, in contrast, are larger and broader. They do not have a well-defined border like

corns. Calluses mostly form under the sole, around the boney area. Calluses are less painful

than corns, but recurring calluses may become painful.

Symptoms

Thick, regular or circular layers of skin on the upper side or inside the toes

Thick, irregular layers of skin under boney parts of the toes on the foot sole

Dry, flaky or scaly skin

May or may not be painful

Treatment

If you have painless corns and calluses, then avoiding the source will help you treat and

prevent them. People with healthy immune systems can recover without topical

applications. Make sure to keep your feet dry and clean. Use an anti-microbial moisturizer

after cleaning your feet with Epsom salt solution. People with diabetes, bunions, or

unhealthy immune system should always consult a doctor.

The medical treatments include trimming down the scalp, chemical treatments, and in

extreme cases, surgery. In trimming or paring down, the podiatrist will clean the infected

skin and use a scalpel blade to remove the thickened skin.

This is a very delicate procedure and should not be tried at home. Sometimes regular

trimming, followed by anti-microbial moisturizer and prevention from the source, is all you

need to treat corns and calluses.

In chemical treatment, wart-removal products or products with salicylic acid are topically

applied on the skin, repeatedly. The dead thickened skin will soften and peel off. This

procedure is less painful, but it should not be applied on people if you suffer from a

compromised immune system or diabetes.


Finally, there is surgery. It is very rarely required. However, it is the last resort when every

other treatment fails.

For prevention, use a soft inlay cushion in your shoes to protect your sole and toes. Use

rehydrating topical creams to avoid skin thickening. Always keep your feet clean and dry.

Toenail Fungus

Almost 50% of nail abnormalities are caused

by nail fungus. Onychomycosis or nail fungal

infections are characterized by thickening,

flaking, and yellowing of nails, followed by

crumbling edges and abnormalities.

Toenail fungus is a common, but under-

diagnosed, ailment. It is caused by fungus

infection under the surface of the toenail.


Nail fungal infections mostly occur in the toenails. Nail fungus is caused by the action of a

group of fungi called dermatophytes.

Candida is the most common dermatophyte responsible for nail fungus. Usually, when there

is a small separation between nail and skin, or any skin incursion near it, these pythogens

enter through these and start growing the fungus. The growth of fungi is fast, and becomes

faster when the infected area is kept warm or moist.

People with heavy perspiration, slow nail growth, or diminished blood circulation usually

develop toenail fungus.

A family history of fungal infections is also a common cause.

People who work in a moist environment, like swimming pools or beaches, or wear socks

and shoes for long periods, also easily develop it. People with injured toes, diabetes, poor

immune system, poor blood circulation, or AIDS are prone to toenail fungus growth.


Symptoms

Thick, brittle, and crumbly nail

Yellowish or dark color of the nail

Irritation and rashes around infected skin

Slight foul odor (uncommon symptom)

Treatment

Toenail fungus is often mistreated with regular cleansing and moisturizing. However, these

over the counter treatments cannot prevent toenail fungus from recurring. You should visit

a podiatrist as soon as the color of your nail starts changing. In toenail fungus, the

discoloration of nail occurs as soon as the nail starts becoming thicker. Flaking starts when

the nail completely becomes yellow.

The treatment of toenail fungus depends on the condition of infection. Generally, the first

visit to podiatrist includes examination of the infected nail/nails and mapping out a

treatment plan. The podiatrist will recommend you an antibiotics course, along with topical

treatment. In extreme case, debridement -(removal of infected nail)- and its debris becomes

compulsory.

Oral antifungal treatments include a three-month treatment regimen, which may be

extended up to six months if the fungal infection recurs. Sometimes, the person has to

undergo surgery for permanent removal of the infected nail. In this treatment, the infected

nail is removed from the root and its debris cleaned. The procedure is painful, but it

prevents the re-growth of deformed nail.

Regular inspection and proper hygiene can help you prevent the growth of toenail fungus.

Change shoes and foot hosiery regularly, at least once - preferably twice - daily. Avoid ill-

fitted shoes and use disinfected or sterilized nail trimming tools. Wash your feet properly

and always dry them before wearing socks. Always use disinfected pedicure equipment and

tools at home.

Athlete’s Foot

Athlete’s foot is often wrongly thought of as a foot problem that happens to athletes only. It

is actually a contagious fungal infection that can occur for a number of reasons.


What It Is and How It Works Tinea pedis or athlete’s foot is a common fungal infection that appears on the upper layer of

skin.

It usually develops between the toes, but it may grow on other parts of the foot.

Tinea pedis or athlete’s foot is a common fungal infection that appears on the upper layer of

Athlete’s foot is a contagious fungal infection, but it requires warm and damp environment

to grow.

The infection usually starts between the toes and spreads to other parts of the skin. It may

infect other parts of skin that come in contact with the infected area.

This is why scratching or touching the infected areas is not recommended at all. Sometimes,

bacteria acts upon the infected skin and causes redness, inflammation, and severe itching.

The Ways You Can Get It

Trichophyton is a fungal group, mainly responsible for Athlete’s foot and other foot

problems like ringworm and jock itch. It also belongs to the group Dermatophytes, which

live on other organisms for survival, meaning that they are parasitic in nature.

The fungi does not affect the skin when it is dry and clean, even if they come in direct

contact with it. However, they multiply rapidly when the skin is warm and moist.

People who wear socks for long hours, or keep their feet warm and moist, are prone to

developing Athlete’s foot. It is called this because a majority of athletes wear socks and

shoes for long hours.

In direct contact, the fungi grows when an infected person touches you. In indirect contact,

the fungi grows when you touch an infected object like clothes, shoes or surfaces, like

communal showers and swimming pools.

People with poor immune systems or diabetes easily grow Athlete’s foot and other foot

fungal infections.

Athlete’s Foot is also called Jungle Rot. This term is used for the people who work in tropical

climates or areas, especially forests.


You may also grow Athlete’s foot by sharing your clothes, towels, socks, shoes, or pedicure

tools with someone, or even from a salon that has poor cleanliness.

Symptoms Usually a scaly or reddish skin symbolizes Athlete’s foot.

You will feel itching and irritation just after the removal of socks and shoes.

It is because the fungi resist environmental dryness.

Sometimes, blisters or ulcers may also grow on the infected skin.

Thin skin peels off from some parts of the foot.

Chronic Athlete’s foot leads to the removal of upper layers of skin.

It may easily spread due to direct contact. The risk areas include hands and the other

foot.

Athlete’s foot is often confused with eczema.

Treatment

Athlete’s Foot may easily regrow, or cause other types of fungal infections. Therefore, you

should not wait to see a podiatrist. The treatment for Athlete’s Foot compromises of two

stages. In the first stage, the podiatrist diagnoses the infection and in the second, the

podiatrist prescribes treatment medication.

The podiatrist will conduct a potassium hydroxide test to determine the exact condition of

foot. It is essential to determine the condition of infection and diagnose any related

infections like psoriasis and dermatitis. A negative result is followed by Wooden light test. If

both tests are negative, then further samples are required to determine the condition.

For minor Athlete’s Foot, over-the-counter medications and self-care is all you need to treat

the infection. But sometimes, more powerful antifungal treatment is required.

The antifungal treatments include powders, ointments, and oral medication. Remember

that not all types of antifungal treatments, recommended by a pharmacist, are suitable for

everyone. The treatments are different for pregnant women, breastfeeding moms, and

children.

It is also different for people with other types of fungal infections. Make sure to inform your

general physician or podiatrist any pre-existing fungal infections you may have.


Prescription Antifungal Medications

All types of antifungal treatments work similarly. They affect the fungal cell walls to kill

them. The dead cells fall from the skin. Post-treatment medications prevent the re-growth

of fungi on the affected area.

The anti-fungal treatments come as powders, sprays, creams, and oral pills. They can be

categorized as topical antifungal, oral antifungal, intravenous antifungal, and intravaginal

antifungal treatments. The last category is used for vaginal infections only.

The third category includes injecting antifungal treatment into the bloodstream. It is

required for extreme infections only, when the infection spreads out and covers large areas

of the body.

The prescription antifungal treatments used in the treatment of Athlete’s Foot are

categorized into two stages. The first stage includes cleaning the infectious area and keeping

it dry. The second stage includes the use of prescription medications to kill fungal cells and

remove them from the upper layer of the skin.

Medicated powders such as Tolnaftate, Tinactin, Miconazole or Lotrimin, are used for foot

cleaning and keeping it dry. Sometimes, a solution of aluminum acetate or Burow’s solution

is also required. The infected feet are soaked in the solution twice a day.

Prescription topical antifungal applications include Clotrimazole, Lotrimin, Terbinafine spray,

Lamisil spray, Miconazole, Econazole nitrate, Spectazole, Ketoconazole cream, or Nizoral.

Sometimes, oral antifungal pills are also required. The common anti-fungal oral pills include

Fluconazole, Diflucan, Itraconazole, Sporanox, Griseofulvin, Terbinafine or Lamisil. These

pills may aggravate a liver disease, therefore you should always undergo a laboratory test

before taking these pills. Make sure to inform your general physician about the state of

your liver before starting any medication.

Sometimes, the doctors recommend an antibiotic pill in combination with the antifungal pill,

if bacterial infection aggravates the existing fungal infection.Antacids often interfere the

action of antifungal pills. Not all antifungal pills should be given to elderly people, pregnant

women, breastfeeding moms, and young children.

Hydrocortisone is often recommended to treat irritation, itching, and swelling of skin.

Hydrocortisone should not be used for more than seven days. Pregnant women and

breastfeeding moms should avoid taking hydrocortisone.


Applying Antifungal Medications

You should always read the instructions before applying an antifungal cream or solution.

1. Always apply an antifungal cream or solution to dry and clean skin only. Use

medicated powders to keep the skin dry and clean.

2. Apply the cream on the infected area, and also on the area around the infected area.

If you are using an antifungal solution then carefully dab it on infected skin with a

clean cotton ball.

3. Make sure to wash your hands after treating the fungal infection.

Warts

Formed by the infection of human papillomavirus (HPV), warts may grow on the skin of any

person. Commonly known as plantar warts, these are hard and grainy growths, common in

young people and occasional in elderly people.


There are around 100 types of Human Papilloma Virus, out of which, HPV 1, 2, 4, 27, and 57

are associated with plantar warts. Immunosupressed people are more vulnerable to grow

warts, whereas those with healthier immune systems rarely grow warts.

HPV spreads by direct or indirect contact.

The common indirect contact sources include swimming pools, locker rooms, public place

floors, and public showers. Plantar warts are mostly formed on the sole of the foot.


Plantar warts tend to grow in the areas which undergo a large amount of friction and force.

The virus infects only the uppermost layer of skin. Warts look like calluses, but are generally

thicker and harder. They resemble small, dark colored cauliflower heads.

Warts are commonly divided into four types.

1. Common warts, or verucca vulgaris, are a cauliflower-like growth. Such warts grow

after clotting of the blood vessels. They are dark gray or black in color.

2. The plantar warts grow on heels and toes. When you put pressure on plantar warts,

they immerse into the skin and regrow when you remove pressure. Plantar warts

also have a cauliflower-like structure, but they are usually white in color with one

black dot in the center.

3. Plane warts are yellowish or brownish in color. They mostly grow among young

people and children.

4. Mosaic warts grow on the sole of the foot. They are also dark in color and have a

cauliflower-like structure. Usually, two or more mosaic warts grow in one place.

Symptoms Small, grain like skin growths

Hard and thickened skin like calluses, but they grow inwards and outward (unlike

calluses which grow outward only)

Pain or foot tenderness

Swelling around wart

Redness or pale skin around wart

Black pinpoints or cauliflower-like structure

Treatment

A doctor can easily identify a wart just by looking at it. A microscopic examination is very

rarely required. Some people apply duct tape on warts to pull out them. This treatment may

create a direct contact of bacteria with warts and aggravate the condition.

For small warts, the doctor may prescribe you salicylic acid products for topical application.

This treatment also includes dietary changes for improved blood circulation and

strengthened immune system. Other topical application ingredients include podophyllin,

glutaraldehyde, and formaldehyde.


Cryotherapy is the process of destroying wart cells using a cold nitrogen solution. Propane

spray and dimethyl-ether spray is also used to freeze and destroy wart cells.

Surgery is rarely required. The doctor may numb the affected area and use a curette to

scrape it off. Bigger warts are carefully cut out in surgical treatments. Laser treatment and

electrocautery treatments are also available to burn and destroy them.

Cantharadin is a unique wart treatment, which is often preferred due to its painless

procedure. In this treatment, the doctor applies a solution to the affected area.

The solution is extracted from the blister beetle. It will lift the dry wart and make a blister

under it. The doctor will then remove it and bandage the blister.

Warts commonly occur in people with a poor immune system. Antigen shots like Retinoids

and Blenoxane are injected in this treatment, followed by immunotherapy.

Antibiotics are for bacterial infections, whereas warts are caused due to viruses. This is why

antibiotics are not effective treatment. Sometimes, different types of treatments are

combined to manage them.

Wear special socks to cover your warts. Avoid direct or indirect contact with people that

already have them. Avoid using combs, brushes, towels, socks, and shoes of other people.

If you have warts, make sure to cover them with a bandage before going in the public places

like communal pools and locker rooms. Never scratch or pull on them.

Pedicure Safety

Spas and salons are the common most places to grow fungal infections. A pedicure is a great

way to pamper your feet, but some shops, salons and spas are not as clean as they seem to

be.

Many salons do not use sterilized or anti-bacterial equipment and tools for pampering your

feet. The best way to pamper your feet and ensure their safety and health is to do a

pedicure at your home.

Equipments and Tools to Do Pedicure at Home

You will need:

A nail polish remover

Clean cotton balls


Cotton pads

Cuticle stick/pusher or orange stick

Cuticle oil or baby cream

Nail clippers

Nail filers

Buffing block

Base coat

Sugar scrub

Basin for soaking the feet

Foot moisturizer

Towels

Follow these instructions:

1. Wash your feet. Soak cotton balls in nail polish remover and remove old nail polish.

2. Use buffing block to remove the dead cells, which make your nails look yellow, from

them.

3. Now, pour warm water, ½ cup Epsom salt, a few drops of foot wash, a few drops of

essential oils, and 2 tablespoons lemon juice in the basin. Soak your feet in it for

about 10–20 minutes. Epsom salt will help fight inflammation and any infections.

4. Dry your feet with a towel.

5. Use nail clipper to shape your nails. Cutting corners may lead to ingrown toenails.

The best way to cut foot nails is to cut them in three steps, and in straight shape.

6. Apply cuticle cream on your nails and leave it for a few minutes.

7. Now apply a scrub on your feet and massage for 3–5 minutes.

8. Leave on the scrub while scrubbing your feet with pumic stone or buffing block.

9. Make sure to scrub all parts of feet, including heels and balls.

10. Now wash the feet and use cuticle clippers to remove the dead cuticle.

11. Clean the sides of your nails with an old toothbrush.

12. Wash your feet and pat dry.

13. Apply a foot cream or moisturizer.

14. Rub a cotton ball on your nails to remove any extra oil.

15. Apply cuticle oil and leave it to dry.

16. Apply base coat and your favorite nail polish.

17. Your nails say a lot about your inner health. Clean and healthy feet are a sign of a

healthier you.


CONDITIONS THAT AFFECT THE FEET

Your feet might be an indicator of any serious diseases you may be suffering from, and are

completely unaware about. From thyroid issues to heart disease and diabetes – all these

have a negative impact on the physical condition, as well as the pain, of the feet.

Diseases that Cause Feet Problems

Below are some of the health conditions, and the effect they have on your feet.

Nerve Damage

A person suffering from nerve damage, or an underlying neuromuscular condition, will

probably have high-arched feet. One such neurological condition is called Charcot-Marie-

Tooth (CMT). This is indicated by thinning in the arch muscle of the foot. This genetic

disorder damages the peripheral nerves that are present in the spinal cord and brain.

Numbness in the feet, muscle loss in the lower legs, alteration in gait, and problems with

balancing are a few of the conditions caused by CMT. With time, this can also be seen in the


hands and arms of the individual. If you feel any changes in your foot, consult your

podiatrist as soon as you can.

Lupus or Anemia

A toenail with the depression deep enough to hold a water droplet is a sign of lupus or

anemia . The depression (koilonychias) indicates a deficiency or excess of iron in one’s body

(hemochromatosis). Spoon nails are also caused because of a lack of blood supply to the

toes and fingers in Reynaud’s disease, or an attack on cells, organs, and tissues by the

body’s immune system in lupus.

Infants are more likely to have spooned nails. However, it returns back to normal after a few

years. A visit to the physician and blood tests can help you in finding out the reason behind

nail depression.

Heart Disease or Lung Cancer

Clubbing of the foot is the sign of heart disease, lung cancer, intestinal disease, or chronic

lung infection. This usually happens when blood flow to the fingertips and toenails increases

through small arteries. This leads to swelling of the tissues and deformation of the foot. The

fingers and toes become wider, and the foot is rounder. Get yourself checked in

circumstances of any abnormality on the feet.

Diabetes

The greater the glucose level in your body, the poorer the blood circulation will be, and

there will be a greater chance of nerve damage. In such a situation, the feet do not get

enough blood. If there is a wound on your feet, and lack of blood flow in that area, the

healing will be really slow, and incomplete. Diabetes is one of the major diseases that are

diagnosed by the condition of an individual’s foot. You may also feel numbness and tingling

if you are suffering from the disease.

Skin Cancer

If there is a vertical line in a dark color underneath your toenail, there is a chance that it

could be a hidden melanoma or acral lentiginous melanoma. These are types of skin cancer

that can be found on different parts of the body.

Usually, it is believed that body parts that face direct exposure to sunlight are at the

greatest risk. Your mouth and eyes can also have these signs.

For your feet, if there is a black line that starts from the base of the nail to the end of the it,

you should see your dermatologist or podiatrist to find out if it is malignant or not.

Moreover, you also need to ensure if it is not some kind of fungus, which can cover the

entire nail and is yellow-brown in color.


Thyroid Conditions

If you have dry feet in spite of using moisturizers, there is a high chance you may have a

thyroid problem. Thyroid is a gland present in the base of your neck. It produces a hormone

that maintains the blood pressure, nervous and skeletal system development, metabolic

rate, and tissue growth.

When it stops producing the hormone, it causes dryness in the skin.

This dryness can give you cracked feet and brittle toenails. Initially, you can make use of

moisturizers to figure out if it is not being caused because of lack of proper foot care. You

can then consult your doctor and get your thyroid gland checked.

These serious conditions have the potential to compromise the quality of life of an

individual, and in some cases, also cause mobility issues.

Treatment of the feet in such conditions is possible only when the actual disease is treated.

Most of the diseases mentioned above are chronic and less likely to be completely cured. So

consult the doctor, and start your treatment as soon as possible. The treatment can be

more beneficial the earlier it takes place.

Diabetes and Serious Feet Conditions

Diabetes is when individuals have an excess of glucose in their blood for a long period of

time. Diabetes not only causes foot conditions, it is also responsible for ruining the tissues

within the feet. Foot problems are common among diabetic individuals because of the nerve

and blood vessel damage the disease is known to cause.

The major feet problems that a diabetic individual may suffer from are:

1. Diabetic Neuropathy

2. Peripheral Vascular Disease

The damage to the nerves in the feet and legs is called Diabetic Neuropathy, and issues with

the flow of blood to the feet can cause Peripheral Vascular Disease.

You can prevent these problems by keeping the level of glucose in your blood and your

blood pressure normal, while looking after your feet on a daily basis, and going to a

podiatrist or doctor for regular checkups.

The damage to the nerves and blood vessels caused because of diabetes can be so bad if left

unchecked that it can even lead to amputation.


Other common feet issues that a diabetic person may suffer from are; calluses, corns,

Athlete’s foot, bunions, foot ulcers, dry skin, ingrown toenails, hammer toes, and plantar

warts. Below are the ways you can take care of your feet in such conditions.

Ways to Take Care of your Feet

Here is a guideline created by the American

College of Foot and Ankle Surgeons that

physicians can use to manage the foot problems

of diabetic individuals.

Patients who have diabetes, and are looking for

ways to protect their feet, can utilize these

guidelines as well.

1. Knowing the Foot

Sometimes, we bruise our feet without even realizing it. So checking your feet

properly on a daily basis is essential for healing any wounds. This will also keep you

updated about any deformation, growth, or discoloration that might have happened,

so that you can figure out the reason behind those issues and treat them.

2. Practicing Good Foot Hygiene

Foot hygiene is important if you want to keep it fungus free. This is why you should

regularly wash your feet, and remember dry them thouroughly. If you have dry skin,

make sure to moisturize it. If you have oily feet, foot dust powder can help you in

keeping them dry. The area between your toes needs to be dry, so do not apply

moisturizer in there.

You can avoid ingrown toenails and infections by cutting your nails straight. You can

either get a professional to trim your nails, or you can do it yourself. A professional

should be able to deal with hardened nails. If you are doing the cutting yourself, you

need to be very cautious while handling the scissors or nail cutters.

3. Protecting the Foot

Decently cushioned shoes and socks can secure you against friction. It is important

that your shoes fit. Lack of proper shoes can lead to diabetic complications that have

the potential to cause amputation. Pointy toes and high-heeled shoes can damage

the feet. Therefore, use of such shoes should be limited..


4. Losing Excess Weight is Important

The greater the body weight, the greater the pressure on the feet. This increased

pressure leads to more damage to the feet because of blisters, ulcers, corns, cracked

feet, and many more.

5. Regular Exercise is Important

Working out regularly can enhance blood flow to the feet, and aide the healing

process.

6. Stopping Smoking Plays a Part

Smoking damages the small blood vessels in the feet causing circulation to be

affected, thereby increasing the time required for healing. This is the reason most

diabetic individuals who require amputations are smokers.

7. Practice Drinking in Moderation

If you are diabetic, drinking has the potential to impair your nerves. So do not over

consume alcohol. According to the American Medical Association, men under the

age of 65 should not consume more than two standard drinks in a day. On the other

hand, women can have one drink per day. One drink equals 12 ounces of beer, 1.5

ounces of hard liquor (vodka, bourbon, etc.) or 5 ounces of wine.

8. When to Seek Help

You should see a doctor if you are facing any of the foot problems that we have

mentioned here, especially if you are suffering from diabetes. Some people do try to

treat the issue at home, but seeking professional advice is highly recommended, as

self-treatment may lead to further damage.

9. Get Medicare-Funded Shoes

Medicare therapeutic shoes are used to reduce the risks of leg and foot amputation.

Medicare covers 80% of the equipment costs, such as shoes and insulin pumps, but

you need to meet your annual deductibles. Qualifying them can get you molded

shoes, specially designed for your foot, which can offer you additional support. Your

doctor can order them for you if you join the Medicare program.

Nerve Problems Associated with Foot

Problems in the nerves can cut off the flow of blood, which can lead to numbness, lack of

sensitivity, or pain in the feet. When a person is performing a task with numb feet, they

might end up injuring them without consciously being aware of it, and overworking that

area can further damage the nerves.


There are two types of nerve problems:

1. Neuroma

2. Peripheral Neuropathy

Neuroma is a swollen or pinched nerve, whereas peripheral neuropathy has to do with

greater damage to the nerve, usually due to systematic conditions. These conditions include

diabetes.

Morton’s Neuroma

A compressed, pinched, or injured nerve leads to the development of neuroma. This can

make your feet swell and become painful. The branches of the plantar nerves, which are

responsible for supplying feeling to the toes and feet, are the area most impacted by these

nerves. Areas between the second and third, or third and fourth, toes is where neuroma is

located. This condition is referred to as Morton’s neuroma.

Conditions and Workings

Morton's neuroma commonly causes numbness in the toes and feet similar to pins and

needles, as well as an intense, sharp burning pain, which can be likened to an electric shock.

It infects the ball of the foot, and thickens the tissues around the nerves. The thickening

leads to the burning, or numb feeling. Most often, people who wear high heeled shoes

suffer from Morton’s neuroma.

Symptoms A feeling like you are wearing socks and standing on a pebble

Numbness, sharp or painful feeling in the ball of your foot

Tingling in the toes.

Treatments

The painful or numb feeling should not be ignored. You should see a doctor immediately.

Three types of techniques are used to diagnose the disease including the use of MRIs, X-

Rays and an Ultrasound. The treatment options include therapies and surgical procedures.

In physiotherapy, a foot pad and arch support is adjusted inside your shoes. These shoes can

be customized or purchased with the help of a doctor.

Other treatments include steroid shots injected in the painful area, removal of the

compressed nerve in surgical treatment, and decompression surgery. The latter one is a


complicated treatment. In it, the surgeon cuts the nearby structures - ligaments and

tendons - to release pressure from the nerve.

Peripheral Neuropathy

In peripheral neuropathy, there is an increase of plaque (a fatty substance) in the arteries in

your legs. This build up restricts the blood flow to the lower parts of the legs and your feet.

Conditions and Workings

In human body, the peripheral nervous system connects the nerves coming from the central

nervous system to other parts of body. In peripheral neuropathy, the peripheral nerves are

damaged, which leads to a malfunctioning peripheral nervous system. The damage is mostly

caused due to injury, chronic illness, inherited disorder, or infection. When the system

works irregularly, it sends signals of pain, even if the body is functioning normally.

Symptoms

Tingling in the hands and feet

Excessive sweating

Diarrhea or constipation

Digestive problems

A drop in blood pressure

A weak feeling in your arms or legs

Numbness in hands and feet

A shocking sensation

Treatments

Peripheral neuropathy is diagnosed with blood tests, a CT Scan or MRI, nerve biopsy (though

this is rare), electromyography, and nerve conduction study. The treatment of peripheral

neuropathy depends on the source of disease. If it is caused due to the deficiency of a

vitamin, then oral supplements are recommended to overcome the deficiencies.

Over-the-counter pain medications like Tylenol and non-steroid anti-inflammatory pills are

also recommended. Other prescription medications include corticosteroid injections,

cyclooxygenase-2 inhibitors, tramadol, pregabalin, Cymbalta, and anti-depressants. For

drug-free therapy, Transcuteneous electronic nerve stimulation (TENS) treatment is also

recommended, but it is not for everyone.


Skin Cancer

Skin cancer can affect the lower extremities, including the feet. Frequent exposure to

sunlight or other radiation sources may lead to skin cancer, with melanoma being the most

common.

Condition and Workings

The foot related skin cancers are mostly caused by frequent sun exposure, inherited traits,

chronic inflammation, chronic irritation, or exposure to chemicals. There are different types

of skin cancers, including Basal Cell Carcinoma, Malignant Melanoma, Squamous Cell

Carcinoma, among others. These may appear as inflammation, skin allergies, moles, skin

outgrowths, and swelling due to nerve damage.

Skin cancers are often left untreated, as they are mistaken for other types of skin diseases.

However, you should immediately consult a podiatrist for examination, diagnosis, and

treatment, if you notice any symptoms.


THE ABCDES OF MELANOMA

Melanoma is one of the most fatal skin cancers. Melanocytes are small skin cells located

under the epidermis. These are responsible for producing a dark pigment called melanin.

Melanocytes maintain the dark coloration of skin and defend the skin against different types

of skin diseases. Melanoma occurs when cancerous tumors start growing in melanocytes.

The cancer mostly occurs in the concealed areas, like the feet.

Foot melanoma can sometimes be life threatening. Most often, it is easily treated, if

diagnosed on time. People with fair skin are more susceptible to it, although age, gender,

family history, moles, and exposure to ultraviolet rays are some other factors to consider.

Symptoms

The common warning signs of melanoma include:

A sore, which does not heal

Appearance of a small spot (mostly white or brown) on the skin

A pigment that spreads around the spot

Itchiness, pain or swelling in the spot

Development of a mole (most important)


It is important to understand the development of a mole. Many people have normal moles,

less than 6mm in brown, tan, black, or wheatish in color.

A normal mole does not change its structure, color or diameter, whereas a cancerous mole

eventually changes its color, diameter and shape (refer to Inspection section).

Some people develop moles in the early stages of their lives. These are not dangerous, but

ones that develop after 18 years age should be immediately inspected.

A cancerous mole shows other signs, including development of a lump in it, development of

scales on it, and oozing and bleeding inside the mole.

Inspection

Diagnosis and timely treatment are essential for the curing foot melanoma. You can

carefully examine your skin by understanding the ABCDEs. You should immediately consult a

podiatrist if:

A (Asymmetry): The lesion is asymmetrically divided into two halves.

B (Borders): The borders of lesion are uneven or flaky.

C (Color): The foot skin has more than one color, and the colors are unevenly

divided.

D (Diameter): The lesion or skin extension is bigger than 6mm.

E (Evolution): The lesion changes its size and color.

The doctor will analyze the color, size and texture of the lesion. Any kind of pain, itching,

bleeding, or irritation may be a sign of second degree cancer. The doctor will also inspect

the lymph nodes under arms and neck. Medical examination of the skin spots, followed by a

session with dermatologist will lead you to an accurate diagnosis. Three types of scanners in

emerging technologies can help inspect the growth of Melanoma. These include Screening

scanners (handheld screening), Precision scanners (quantitative identification and

characterization of lesions), and Full-body imaging scanners (3D visualization of lesions).

Protection

According to the American Academy of Dermatology, around 90% of melanoma occurs due

to over-exposure to sunlight. People with a family history of melanoma should get examined

at least once a year. You can take other preventive measures as well, including these:

Do yourself the biggest favor you can and wear protective clothes before going out

in the sun. Add protective accessories like hats and sunglasses.


Always wear 45 SPF sunscreen before going in the sun. Make it a habit.

Avoid indoor tanning beds.

If you want to soak up the sun and absorb its Vitamin D, then schedule your routine

before 10 AM and after 4 PM. Avoid peak rays of the sun.

Avoid taking your kids out during peak hours. A child who has suffered sunburn is

prone to develop melanoma later in life.

Treatment

The first step in Melanoma treatment is accurate diagnosis. There are five stages of

melanoma, starting from stage 0.

Stage 0 does not penetrate deeper than the epidermis. The most common treatment is the

removal of lesion (wide excision surgery), along with a small margin of skin around it.

Sometimes, the treatment is followed by radiation therapy.

Stage 1 Melanoma is also treated by wide excision surgery. Most often, the surgery is

followed by lymph node dissection, such as the removal of all lymph nodes surrounding the

cancer site. Vaccination and clinical trials follow the treatment to avoid melanoma

recursion.

Stage 2 treatment includes wide excision surgery, followed by the removal of lymph nodes.

Sometimes, doctors recommend a post-treatment adjuvant therapy, vaccination and clinical

trials.

In stage 3, the surgical treatment is followed by clinical trials and vaccination. If it does not

work, doctors recommend radiation therapy. If radiation therapy also does not work then

chemotherapy, immunotherapy, or a combination of both is the last option.

Stage 4 is the most advanced stage. The treatment includes surgery or radiotherapy.

Targeted immunotherapy drugs have proved to be more effective in Melanoma treatment

than chemotherapy. This is why, targeted immunotherapy is recommended in stage 4

Melanoma as a follow-up treatment. Chemotherapy is always the last option in the

treatment of Melanoma.

A combination treatment of immunotherapy vaccines with radiotherapy or chemotherapy is

often recommended for recurring Melanoma.


FOOT MASSAGE

In modern days, foot massages are often defined as therapeutic treatments like

aromatherapy, reflexology, and acupressure. In reflexology and acupressure, specific

pressure points are targeted during the massage.

Both massage techniques are based on ancient Chinese practices, which explains that there

are 10 pressure points under foot that connect with overall human body, including the

central nervous system.

In aromatherapy, the nerves absorb the scent of the specific essential oils and herbs used

during the massage.

This way, the nerves relax, and so does the entire body.


Foot massages have become a spa luxury today. But do you know that a regular foot

massage at home unlocks just as many benefits? Here are some of them:

Foot massage helps you tackle one of the biggest problems these days; sleep

deprivation.

It helps improve blood circulation and nutrient supply to your body.

It helps fight depression, stress, anxiety, and other psychological problems, by

relaxing your nerves.

A massage, done in circular motions under your toes, can help relieve back and neck

pain.

It makes the cushioning layer of fat under your feet healthier, and improves mobility.

Foot massages help prevent injuries.

It improves your sex life.

A 5-minute massage around your ankles and heels can help alleviate migraines and

headaches.

It helps fight the chronic pain caused by plantar fasciitis and flat heels.

Insomnia, fatigue, headaches, mood swings, and other symptoms of PMS or menopause,

can be easily handled with a regular foot massage.


PERIPHERAL VASCULAR DISEASES

Peripheral Vascular Diseases affect the blood vessels that connect brain and heart with

other parts of body. These circulation disorders interfere with the circulation process of

veins and arteries, which supply blood to legs, arms, feet, and the organs under the

stomach.

What it is and How It Works?

Blood plaque builds inside the blood vessels and makes them harder and narrower. This

condition is called arteriosclerosis. This plaque decreases the flow of oxygen and blood to

the legs and arms. If the plaque continues to build, it may convert into clots, which

ultimately obstructs the blood vessels.

When Peripheral Vascular Diseases strike the deeper veins, the condition is called Deep Vein

Thrombosis. When the disease occurs in arteries, it is called Peripheral Arterial Disease.

When the arteries or blood vessels narrow, this condition is called Atheroma. This fatty

plaque does not develop overnight. It works like fungal growth in water pipes, slowly and

gradually.


The Peripheral Arterial Disease (PAD) mainly targets the arteries that take blood to your legs

and feet. Some lifestyle factors that trigger PAD include an unhealthy diet, excess alcohol,

smoking, obesity, and lack of physical activity. High cholesterol, high blood pressure, high fat

levels, kidney diseases, and diabetes also trigger PAD, which can be treated by treating the

source disease. Some fixed factors, which cannot be altered, include early menopause,

family history, and age.

Symptoms The symptoms of early PAD include:

Poor toenail growth

Poor hair growth on legs, and below the knees

Weak pulse in your feet

Cold feet

The symptoms of advance PAD include:

Reduced blood supply while resting

Regular pain in legs and feet

Development of sores or ulcers on feet

Tissue death or gangrene on foot

Thinning of foot skin

Restlessness

Treatment

The doctor will take your blood pressure and conduct a simple test called Ankle Brachial

Pressure Index on your arm to diagnose the disease. Sometimes, advanced tests such as

blood tests, CT Scans, MRIs, and ultrasounds of the arteries are also required. Sometimes,

Angiography is the only source of diagnosis.

6 out of 7 people with PAD are at high risk of heart disease or angina attack. The immediate

treatment includes management of PAD symptoms to resume the physical activities, and

restricting the progression of arteriosclerosis to reduce the risks. It also includes an

immediate course of medication, including blood pressure and cholesterol lowering pills,

blood sugar control pills, prevention of blood clots, and symptom-relief medication to

improve the blood flow. In advanced stages, surgery, angioplasty, or Thrombolytic Therapy

is required to control blood flow in blocked arteries. A supervised exercise program is highly

recommended for efficient oxygen supply.


SURGERY

Foot Surgery

When it comes to surgery, it can be a risky, complicated and difficult decision to make. With

it, comes a long period of recovery, and with something as complex as your feet, with all its

bones, joints, and muscles, a lot of rest is required in order for you to heal. Every surgical

procedure is different from one another, which makes each person’s recovery process

different as well. Here are a few of the types of foot surgeries.

Arthroscopy/Endoscopy

Arthroscopy is a type of Endoscopy, which is also known as keyhole surgery. To do this

surgical procedure on the foot, it requires the use of a very small fiber optic camera, which

is called an arthroscope. The device is placed into the joint of the ankle, and it magnifies the

images of the inner joint, which are then displayed on a video monitor for the surgeons to

see. With this device, they no longer need to operate with large incisions in the foot,

meaning a shorter recovery process and less scars.


This type of procedure also allows the doctor to diagnose any problems that could not have

been seen using X-rays and CT scans. It can be used to treat a number of foot conditions

such as: ankle fractures, torn ligaments, removal of loose bones or cartilage, pain in the

subtalar joints, synovitis, ankle arthritis, ankle instability and scar tissue, also known as

arthrofibrosis.

Bone Fusion (Arthrodesis)

Bone fusion, also known as ankle and foot arthrodesis, is a surgical procedure that is done

to relieve any kind of pain in the foot, and deformities caused by fractures, arthritis and

infections that have not fully healed. It is done is to relieve any pain that the patient has in

their ankles or feet. It positions the bones in such a manner that they fuse and join together.

Metal screws are used in the procedure to hold the bones together in the correct position.

Treatment for this procedure means that the patient must keep their foot elevated at all

times, in order to decrease the swelling and the risk of infections. Ice packs are also

commonly used to reduce swelling. Activity and pressure on the foot is not encouraged, but

breathing exercises and slight movements in the foot are advised to maintain flexibility.

Bone Reconstruction Some of the reasons why people need bone reconstruction in the foot are:

Pain while walking on a hard surface

Heel and bone spurs

Infections

Deformities in the joint or bone due to arthritis

Difficulty wearing shoes

Problems with standing, or movement of the foot

The objective of this surgery is to reduce pain and restore the foot's function and

appearance. The surgery also depends on the patient’s age, type of disorder and the

severity of the symptoms. Once the surgery has been completed, recovery consists of

resting the foot for a few weeks, taking medication, icing the swelled areas, bandaging and

physiotherapy.

Soft Tissue Repair

A Soft Tissue Injury (STI) is a common injury that occurs in the muscles, tendons and

ligaments. The most common kinds of STI’s are sprains and strains. When a person strains or

sprains their foot, instant swelling occurs and pressure cannot be put on the foot. Repairing

or healing of a soft tissue injury has 3 phases:


1. Phase 1 - Acute Inflammatory Phase: This is when the foot swells up, becomes red

and has a lot of pain. The most common treatment for this phase is taking

medication such as aspirin, ibuprofen or naproxen, which will help with reducing the

pain and swelling. Acupuncture is also another helpful treatment for reducing the

pain and so is manual lymphatic drainage massage therapy . The most common

treatment is the RICE method which stands for Rest, Ice, Compression and Elevation.

2. Phase 2 – Repair Phase: After the injury has occurred, acupuncture, massage

therapy, manipulative therapy, and physical therapy are all advised, and painkillers

are no longer needed.

3. Phase 3 – Remodeling of Tissue: When the tissue is being remodeled, this can take

many months or even a year, while continuing with all the recommended therapies

in stage 2.

Arthroplasty (Joint Replacement)

This surgical procedure is done to restore the function of any joint in the foot by resurfacing

the bones. A prosthetic joint can also be used in this procedure. Different types of arthritis

affect the joints, which is the main reason for conducting this surgery. It can be done under

general or local anesthesia. An incision will be made on the area of the joint. It will then be

closed with surgical staples, or stitches, and bandaged.

Choosing Wisely Initiative: Five Things Physicians

and Their Patients Should Question

The choosing wisely initiative is basically a list that was created by the National Medical

Specialty Societies, so that patients and their physicians could discuss and question evidence

based recommendations that doctors provide. The list provides information about tests and

procedures, and whether they should be carried out or not:

1. Do not carry out a surgery for bunion or hammertoes without any symptoms

2. Do not perform a surgery for plantar fasciitis before trying non operative care for 6

months

3. Avoid using x-rays for evaluation of the foot and ankle, without standing in the

absence of an injury

4. Do not use alcohol injections for Morton’s neuromas


5. Do not use shoe inserts for patients who have no symptoms of symmetrical feet or

high arches.

Having Foot Surgery

Any kind of surgery is never a painless and easy procedure to undergo, no matter how minor

it may be. But when you have foot surgery, there is a long recovery period where your foot

will have constant swelling and pain from the incisions. The more the swelling, the more the

pain. Depending on how extensive the foot surgery is, it could take months or even a year

for the swelling to go down.

People who want to undergo cosmetic foot surgery for the sake of having ‘pretty feet’ or to

wear ‘high heels’, need to know that cosmetic surgery has more risks than benefits. If you

have perfectly functioning feet, you don’t need cosmetic surgery to fit into a specifically

styled shoe.

There are many disadvantages of cosmetic surgery and since you are balancing on your feet

with your full weight, every single day of your life, you need your feet in good condition.

There are many risks that come with cosmetic foot surgery, including infection, nerve

damage, scarring and chronic foot pain. Secondary deformities can also occur, which leaves

the foot injured and prevents you from performing normal activities.


TREATING FOOT PAIN

Foot pain is a common symptom for many conditions that affect the feet. It can generally be

treated with pain relievers or medications, depending on the condition and how severe it is.

The easiest and most common way to treat any kind of foot pain is the RICE method which is

resting, icing, compressing and elevating, along with medication.

The more you rest your foot when it is in pain, the more the tissues will heal. Resting your

foot means that there should be no pressure put on the affected area. You can use crutches

to help you walk, as well as ankle supports, which may help bring comfort.

Placing ice on the affected area for about 20 minutes at a time should also bring down the

swelling and pain. If there is extreme pain with icing, then it is best to remove the ice pack.

Placing ice in a plastic bag, or wrapping it in a towel, is the best way to go about it.

Compression and elevation should help to reduce the swelling and prevent any flare-ups on

the affected tissues. Here are some other ways to treat foot pain:


Analgesics: Analgesics are medications provided to patients who are suffering from

pain and need instant relief. There are many common pain relievers such as Tylenol,

ibuprofen, aspirin, paracetamol, naproxen, among many others.

Topical Analgesics: Topical analgesics are those medications that are applied on the

skin to help reduce pain in the muscles or joints. These medications can be creams,

gels, rubs, and also sprays. Some of these medications contain derivatives of

cayenne pepper, which is why they might burn or sting upon initial application.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) – This type of medication is for

oral use and come in the form of pills and tablets, such as ibuprofen, aspirin,

voltaren or naproxen. Start off by taking a low dosage when you want to relieve

pain, until it goes away. If you have pain as well as inflammation in your foot, a

doctor can prescribe a higher dose of medication for relief. NSAIDS may be

commonly used with or without a doctor’s prescription, but they do have side

effects, which is why it is best to ask a doctor for a prescription, as he or she could

tell you what would be best suitable.

COX-2 Inhibitor: This is a type of prescription NSAID. A commonly used medication

of this sort is Celebrex, which is used for inflammation and reducing pain, as well as

for reducing the risks of gastric ulcers and bleeding.

Opioid Analgesics: These prescription drugs are much stronger for the relief of pain

and inflammation and com in a much higher dose than NSAIDS and analgesics. One

of the most commonly used Opioids is called Codeine.

Nerve Pain Medications: When there is pain that is caused by nerve damage, the

usual pain relievers may not help. In these cases, doctors usually prescribe nerve

pain medication to help manage it. Two of the common used to treat nerve pain in

the feet are Elavil and Neurontin. Other nerve pain medications include Lyrica and

Cymbalta, used for the relief of pain associated with seizures and diabetes.

Nerve Blocks: Nerve blocks are injections that numb the pain affected area in the

foot. They work by not letting the pain signals reach your brain. This is an effective

way to reduce severe pain, and can also be used during a surgical procedure to

numb the areas.

Corticosteroids: This medication can be given in the form of pills and injections. The

injections are directly inserted into the affected pain areas, such as joints and soft

tissues in the foot or ankle.


Oral Medications for Foot Pain

Foot pain can be unbearable at times, depending on the severity of your foot condition.

Here is a list of oral medications to help with pain relief:

Aleve: Aleve is a very strong NSAID medication. It is an over-the-counter anti

inflammatory drug that is used for pain relief.

Aspirin: Aspirin is a great pain reliever for oral use, as well as topical use. Having the

right dosage can rid you of your pain, or crushing the pills and putting mixing them

in warm water, can relieve pain and swelling as well.

Ibuprofen: In the case of foot injuries that have brought on intense foot pain, you

can have ibuprofen, which is a strong medication used for speedy pain relief.

Tylenol: If your foot pain is mild and doesn’t require extremely strong medication,

then Tylenol is a good option.

Celebrex: Celebrex is a strong medication used for pain in the joints and muscles. It is

especially good for people who have trouble walking and for people who suffer from

arthritis.


CHOOSING THE RIGHT SHOES

Choosing the right shoes is important when it comes to keeping your feet pain free. Follow

these simple hints and tips to be walking on air in no time! Investing in a good pair of shoes

is like an investment in foot health. However, it isn’t that easy a task when there are so

many commercials that only care about selling their product.

To buy the right pair of shoes, you need to start with an inventory of your closet. Trace the

shape of your feet on a piece of cardboard. Then measure every pair of shoes that you have

against that drawing. Only the shoes that will fall outside the lines perfectly will be the ones

you should consider comfortable shoes.

Wearing shoes where you have to squeeze your feet in is always a bad idea. At times, most

women have had to slip on some heels for this party or that meeting. Men too, have been

known to wear ill-fitting shoes on special occasions. What you can do is wear them as

infrequently as possible, if not stop wearing them altogether.


Investing in good shoes is very important.

Invest in more than one pair of comfortable shoes. Keep a separate pair, if you can afford it,

for work, special occasions, and casual wear. Look for brands that blend comfort with style

and fashion to get the best of both worlds. There are also manufacturers whose specially

designed soles can cushion the feet more completely.

While it might be difficult to wade through the manufacturer marketing hype, you can do it.

Get your recommendations from the American Podiatric Medical Association website. Look

for their Seal of Acceptance when you are out buying shoes. However, one thing is still more

important than any seal of approval – how you feel when you put the shoe on.

Comfort Analysis

For men, the best choice of footwear happens to be the Oxford-styled shoes. Even then,

when purchasing a pair, go for shoes with cushioned soles and a not too tight, but snug fit.

Women should invest in low-heeled shoes that have cushioned heel and a roomy toe box.

What to Look for In a Shoe

Choose material that will allow your feet to breathe. This

not only keeps your feet comfortable, it also keep them dry,

and thus prevents foot fungus. For women, the heel height

matters more than its width does, since high heels are bad

for the feet. Platform shoes that raise the rest of the foot

along with the heel are alright.

For men, shoes that have sturdy, supportive soles are a

good choice.

Sneakers or boots are options for men with ankles that ache or are weak. Extra-depth shoes

work for people with diabetes or rheumatoid arthritis. Custom-designed shoes, if they can

be afforded, are yet another option for people with specific deformities.

Some other helpful hints include:

Measuring the shoe against your drawing of your feet: that way, you only buy the

ones that are a good fit.


Go shoe shopping in the afternoon since that is when heat makes your feet

expand.

Shop wearing the socks that you will be wearing with those shoes to ensure a

good fit.

Measure both feet when buying shoes, because not only are they different sizes,

but doing so every time you buy shoes will also offset how much your feet might

have grown in that time.

Before buying, spend some time walking around in your new shoes. This will let

you determine if they are roomy enough at the balls of the feet, as well as near

the toes. Check if the heel pinches, as well. Thinking that you can break them in is

faulty logic and should be avoided

Flip-Flops

Flip-flops are the worst things to wear if you are going for a long walk or need to reach some

place quickly. This is because wearing flip-flops can cause foot pain that can travel up your

leg, to your hips and even lower back. Injuries, such as sprained ankles and tendinitis, can

also be prevented if we avoid wearing flip-flops for too long.

Running Shoes

The minimalist model of running shoes that is currently in fashion shifts your landing

position forward. What this does is lessens the impact of a heel landing. However, these

shoes are not suited to everyone. Wear them only if you land on your midfoot or forefoot,

naturally.

Reading Shoes

Take your old shoes with you while out buying new ones. This will help you buy the ones

that suit your wear patterns in the best way possible.

A worn ball of the foot means tight heel tendons that need to be stretched with heel

raises.

A worn inner sole mean that you turn in and need orthotic support.

A toe-shaped ridge on the upper could mean that you either have hammertoes or

are wearing shoes that too are small for your size.

A worn outer sole might indicate that you turn out and need orthotics.


A bulging big toe indicates that you might have a bunion.

A worn out part above the toes means that the shoe front is too low for you.

Orthotics

Orthotics are customized to correct whatever foot structural problem you might have.

However, most shoe inserts are made of either foam or silicone pads, and are not as

effective as their manufacturers would have you believe. Instead of spending oodles of

money on orthotics, invest in a good, sturdy well-fitting pair of shoes.


CONCLUSION

Now you know everything there is to know about foot pain and how to manage it, so here's

a quick refresher that you can use anytime you need to.

One of the most important steps in foot care involves choosing the right shoes for the right

occasion. If you are going to play tennis, then wearing your running shoes can put undue

stress on your feet.

Whether you are going to be engaged in an activity or just going to work, it is essential that

your feet be encased in shoes that not only provide cushioning, but also protect them. Thick

soled, low heeled, and shoes that allow room near the toe box are ideal for most occasions.

Secondly, as you have seen mentioned at multiple places, taking care of your feet involves

keeping them flexible and supple. This can be achieved through regular exercise. The report

includes different kinds of exercises that are not time consuming, yet are very effective.

Another thing to keep in mind is that when you exercise, you must be wearing shoes that

will help support your feet throughout the activity. Yet another thing to remember is to


warm up before you start exercising. Failure to do so results in something like a shock for

your body. It can lead to potential fractures, sprains, and various other forms of injury.

Thirdly, taking care of your feet means regularly monitoring them for any kind of changes. If

you hurt yourself, you should immediately look at the injury. In most cases, the RICE

regimen will help provide a great deal of relief. If the pain persists even afterwards, then

you can take pain relievers.

Keep in mind that not all pain relievers will work for you. Some of them will have unpleasant

side effects that can blindside you, if you have not done your research.

However, there are injuries that even painkillers will fail to correct. Sometimes, painkillers

do work, but only after a considerable period of time. If the pain stays for long periods, then

you should go see a foot care specialist. This is important because not getting immediate or

timely care can worsen the situation. A sprain may turn into a fracture, if left unattended.

In severe cases of injury, you may even need to get surgery. Before making that decision,

have a long talk with your doctor. Discuss what the procedure will involve, and whether it

will remove the pain and other symptoms completely.

Also, have a talk about the duration of recovery, because it takes some injuries more than 6

months to heal. Throughout the period of recovery, you not only need to stay off your feet,

but also may have to wear immobilizing devices to help with the healing.

Remember that starting to take care of your feet early in life will always be beneficial.

Neglected feet can even result in disabilities as you age. Later in life, you will most likely be

combating other age-related issues, such as less denser bones and osteoporosis that will

only make things worse, in case of a fall. Start taking care of your feet now, so that you can

have a better quality of life later on.

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