FOOT PAIN
Forefoot pain, heel pain, ankle pain, leg pain,
knee pain, even back pain can all be caused by
biomechanical problems in the feet. This means
that there is some misalignment in the structures
of the foot. These problems can occur at any age.
Podiatrists treat many of these types of problems with
functional foot orthoses - these are inserts that go into the
shoes and act by supporting the foot in a more efficient
functional position. Once the foot is held in this improved
position by the orthoses, they will help reduce muscle strain,
prevent torsion and the added stresses being put on the muscles
and ligaments of the feet, knees, hips and lower back. Your body will
not have to try and control the poor mechanics, and shock absorption
will be improved.

Ageing Feet
Older feet naturally develop more problems because the skin tends to thin and
lose its elasticity. Healing can take longer and wear and tear to the joints over the years may have caused some degree of arthritis.

But painful and uncomfortable feet aren't a natural part of growing old or something to "put-up with". A lot can be done to improve comfort, relieve pain and maintain mobility.
It's not too late to start caring:

Cut those nails
Keeping toenails cut and under control will help keep you mobile but you may need help with this from your chiropodist/podiatrist or a friend.

Keeping warm
Try to keep your feet as warm as possible, but don't cook them in front of the fire! Warm stockings or socks can help. Avoid anything too tight which can restrict your circulation or cramp your toes. Wearing fleece-lined boots or shoes or even an extra pair of socks will also keep you warm but do make sure your shoes aren't tight as a result. Bed socks are also a good idea.

Choosing the best footwear
The older you get, the more you need a shoe which holds your foot firmly in place to give adequate support. Throw out those sloppy old favourites as they may make you unstable when you walk.
Look for shoes with uppers made of soft leather or a stretchy man-made fabric which is also breathable. Avoid plastic 'easy clean' uppers which don't allow the foot to breathe and won't stretch to accommodate your own foot shape.
Many shoes have cushioning or shock absorbing soles to give you extra comfort while walking. When buying shoes, ensure that you can put them on and take them off easily. Check that the heel is held firmly in place - you'll find that a lace-up or Velcro fastening shoe will give more support and comfort than a slip-on.
Your shoes should be roomy enough, particularly, if you intend to wear them everyday. If you suffer with swollen feet, it's a good idea to put your shoes on as soon as you wake up, before your feet have had a chance to swell.

Exercise
Exercise can help to keep feet healthy – it tones up muscles, helps to strengthen arches and stimulates blood circulation.


CRACKED HEELS
Cracked heels are common foot problems that are often referred to as heel fissures. Cracked heels are commonly caused by dry skin (Anhidrosis), and made more complicated if the skin around the rim of the heel is thick (callus). For most people this is a nuisance and a cosmetic problem but when the fissures or cracks are deep, they are painful to stand on and the skin can bleed - in severe cases this can become infected.

The skin is normally dry and may have a thick callus which appears as yellow or dark brown discoloured area of skin, especially along the inside border of the heel. Cracks in the skin are usually obvious.

If the cracks are bad enough there will be pain on weight bearing that is not there when weight is off the heel. The edges or rim around the heel will generally have a thicker area of skin (callus). Wearing open or thin soled shoes usually make the symptoms worse.

What causes cracked heels:
Some people tend to have a naturally dry skin that predisposes them to the cracks. The thickened dry skin or callus around the heel that is more likely to crack is often due to mechanical factors that increase pressures in that area (e.g. the way you walk).
Other factors that can be involved in the cause of cracked heels include:

• Prolonged standing (at work or home, especially on hard floors)
• Being overweight (this increases the pressure on the normal fat pad under the heel, causing it to expand sideways - if the skin is not supple and flexible, the pressures to 'crack' are
  high)
• Open back on the shoes (this allows the fat under the heel to expand sideways and increases the pressure to 'crack')
• Some medical conditions predispose to a drying skin.
• Skin conditions (e.g. psoriasis and eczema)

Applying an oil based moisturizing cream twice daily is really important to get on top of this problem. A pumice stone can be used to reduce the thickness of the hard skin. It is important to avoid open backed shoes or thin soled shoes.
Never try to reduce the hard skin your self with a razor blade or a pair of scissors. There is a risk of an infection developing and taking too much off.

Treatment
The  treatment of cracked heels may involve the following:

• Investigating the cause of the problem, so this can be addressed
• Removing the hard thick skin by debriding it (often the splits will not heal if the skin is not removed). This may need to be done on a regular basis. Regular maintenance may be the best way to prevent the problem.
• If very painful, strapping may be used to 'hold' the cracks together while they heal (a maintenance program after this to prevent recurrence is very important).
• Prescription and advice regarding the most appropriate moisturizer or emollient.
• Advice about footwear and self care of the problem.
• Insoles may be used to alter the way you walk to prevent the thick skin from developing (these are indicated in cases of heel callus and are not suitable for all cases).
• A heel cup may be used to keep the fat pad from expanding sideways. This is worn in the shoe and can be very effective at prevention if used regularly.

DIABETES
Diabetic feet require special care and attention and by following a daily routine to keep your feet clean and free from infection will help prevent potential foot problems. You should also make sure your footwear fits well and doesn't put pressure on or rub any part of your foot. A good way of ensuring this is to get your feet measured. People who suffer with neuropathy can often be wearing shoes that are a size too small.

If you can see and reach your feet cut them after a bath when the nails are softer. Remember to cut them following the shape of the toe, and not too short. File them, if that is easier.
To keep corns and hard skin under control use a foot file, emery board or pumice stone. Don't cut corns for yourself, or apply 'over the counter' lotions or acids unless prescribed by your Podiatrist or Healthcare Practitioner. If you have previously been advised that you can use ‘over the counter’ lotions check each year that this is still okay.

Any minor cuts or abrasions should be covered with a clean dry dressing, and blisters should be left to dry out on their own. If they burst, apply a clean dry dressing, but do not burst them yourself. Seek professional treatment if they do not heal quickly. Wounds (sometimes called ulcers) should be assessed and treated as a matter of urgency within 24 hours, especially if there is redness or swelling around the area, or where you have previously been warned to seek immediate attention.
I routinely perform assessments of patients to monitor the circulation and sensation status of their feet.


SWEATY FEET
Most of us have suffered from foot perspiration and odour from time to time, yet for some people, sweaty feet are a persistent problem which can be embarrassing and uncomfortable.
Sweaty feet is a complaint known as Hyperhidrosis, or excessive sweating, and has a lot to do with how the sweat glands in this part of the body work. With 250,000 sweat glands, feet do tend to sweat more than other parts of the body. But with a daily hygiene routine, few people should suffer from the embarrassment that it may cause.

Sweat glands in the feet
There are more sweat glands per inch in our feet than anywhere else in the body, and their function is to keep the skin moist and therefore supple. They secrete all the time, not just in response to heat or exercise as elsewhere in the body.

Possible causes
Sweaty feet can be caused by stress on the foot. This may be due to a structural problem, or because the foot is under strain or tired, for example, when you've been standing on your feet all day.

Hot weather can make matters worse, although sweaty feet is a winter, as well as a summer, problem. It can also be an inherited condition.
In adolescents, sweaty feet are probably caused by over-active sweat glands triggered by changing hormonal levels in the body. As the sweat glands on the soles of the feet (and the palms of the hand) respond mostly to emotion, mental or emotional stress is a common cause.

What to do
Simple hygiene is usually effective in dealing with sweaty feet. Try following our recommended daily foot hygiene routine.

Footwear
Careful consideration of footwear and socks is essential. Well-fitting shoes made of leather, which allow your feet to 'breathe,' are best.

As a lot of sweat is absorbed by insoles or the uppers of shoes, don't wear the same pair every day, and allow them to dry out before wearing them again. Detachable insoles are also a good idea. Socks that absorb moisture well, like wool, cotton, or wool/cotton mixture, will also help. Always wash your socks before using them again.

Other problems
An added problem that often accompanies sweaty feet is foot odour. This is caused by bacteria on the skin breaking the sweat down, which releases an offensive smell.

This can usually be prevented with careful hygiene, or medicated insoles which can have a deodorising effect. Wash your feet with an anti-bacterial soap such as Hibiscrub. There is also a greater risk of minor skin infections, through athlete's foot, or blisters.