Saturday, July 07, 2018

Top ten foot problems for walkers

With everyone now encouraged to take time out of their day to take exercise it seems there has never been a better time for shoes. Your intrepid reporter has scoured medical resources to find the top ten foot problems for foot walkers. These conditions may exist by themself or in combination with each other. Before taking up exercise it is recommended you consult your physician and podiatrist. Believe it or not, trimmed toe nails can put smiles on your miles. The information below does not constitute actual health care but offers instead to inform. Where painful symptoms exist, exercise to tolerance is recommended and in the event symptoms persist you are advised to consult your health care professional.

#1. Blisters
By far the most common complaint and one easily prevented by wearing good fitting, comfortable walking shoes with the added protection of two pairs of thin socks. Blisters are caused by friction on the skin surface when the foot moves inside the shoe with weight bearing. The two layers of sock act as a second skin and take the high temperatures away from the skin surface. When blisters are present seek advice and treatment from your health care professional.

#2.Black Nails
During long periods of activity when shoes do not fit then all manner of skin and nail damaged can arise due to friction and shear. Skin sells (the epidermis) proliferate and the local area becomes thicker (callus). Nails are modified skin cells and constant impaction causes the blood vessels to leak into the skin layers. Black nail is commonly seen in the great nail but others can be involved too. Symptoms are often asymptomatic (painless) but acute symptoms do arise too. This is reported as a burning hot pain. The culprit is invariably a narrow toe box or short shoes. Painful black nails respond to treatment of the inflammation. Other nails conditions such as ingrown nails are also associated with inadequate shoe fitting. It is a sensible precaution to cut toe nails every four to six weeks.

#3. Heel pain
Heel pain can masquerade as a variety of different conditions, including plantar fasciitis and heel spurs (see below). In most cases it relates to a bursitis, inflammation of the fluid sac (bursa) which protects the heel from trauma. In the past the condition was associated with occupations that require long periods of standing i.e. policeman’s heel. The acute symptoms respond to rest and treatment for inflammation with prevention of reoccurrence assisted by cushioned, well fitting walking shoes.

#4. Bursitis
Next to the heel, the big toe joint (first metatarsal phalangeal joint) is prone to friction (against the shoes). The is especially true when there is a broad forefoot caused by deformity of the great toe (hallux valgus). Firms bump form on the inner edge of the foot, at the base of the big toe. Bunions describe bursitis (inflamed fluid sac) which can be very painful. Acute inflammation responds to treatment but care is necessary to protect this vulnerable area if repeated episodes are to be avoided. Broad fitting walking shoes with soft uppers to accommodate the bunion area are recommended and laces may help foot fit.

#5. Plantar fasciitis
An inflammation of the band of fibrous connective tissue (fascia) running along the bottom surface (plantar) of the foot, from heel to ball. Pain is caused by the inflammation form microscopic tears or stretches in the fascia with weigh bearing. Often the condition lies dormant (asymptomatic) until triggered by a traumatic event such as hitting the kern or walking on different surfaces. Does not always respond to treatments and only time and rest will help? Exercise to tolerance and wear a lacing sport shoe appropriate to activity and incorporating support and cushioning. In some cases foot orthoses may help.

#6. Heel spurs
Bony outgrowths on the underside of the heel bone. Thought to be caused when the connective tissue that runs along the bottom of the foot is pulled at its attachment to the heel bone when weight bearing. Area may calcify to form a spur. Rarely painful (asymptomatic) but frequently shows up on foot X rays when walkers complain of plantar fasciitis. Good fitting walking shoes are recommended.

#7. Achilles Tendinitis
This is an irritation and inflammation of the tendon which attaches the calf muscle to the back of the heel bone (calcaneum). Acute symptoms are caused by overtraining or improper warm-ups. To help alleviate and prevent symptoms from returning a sports shoe style which has a well protected heel counter with an extension to the base of tendo Achilles is recommended. To reduce strain on the thick tendon heel lifts can be worn in the shoes.

#8. Shin splints
Either side of the shinbone is painful and there are signs of inflammation of the muscle or tendon beneath. Prolonged pronation during propulsion (inward foot motion while walking), may be causing imbalance between opposing muscle groups in the leg. Increased and unbalanced tone tears at the muscle or tendon. Rest will subside the symptoms and acute inflammation responds tom treatment. Good fitting walking shoes will lend support and bespoke (made to measure) foot orthoses can help.

#9. Sesamoiditis
The sesamoid bones sometimes called the "ball bearings" of the foot and sit together under the big toe joint and help the foot pivot during lift off. With excessive exercise the sesamoids can become inflamed, and painful. Rest and treatment of the acute inflammation are indicated. It is important to wear good fitting walking shoes and foot orthoses can help prevent reoccurrence.

#10. Stress fractures
These are incomplete cracks (fractures) in the small bones of the foot (usually the metatarsals bones) caused by overuse, or loss of bone strength. Females are at higher risk because frequent hormonal imbalances can affect bone strength but males too suffer stress fractures. Comfortable and supportive footwear can help prevent stress fractures and alleviate the symptoms when it is present. It is important to wear good fitting walking shoes and foot orthoses can help prevent reoccurrence.

(Video Courtesy: uraas2utube Youtube Channel)

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