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Keeping Middle-Aged Patients Active

Most of the common foot problems that bother active middle-aged people are restricting and easily treated if detected early. In most cases, conservative treatment will enable patients to return to activity relatively quickly. Middl~aged men and women are participating in a variety of exercises and athletic activities more than ever before. As a result, they are more vulnerable to foot and foot-related injuries. Fortunately, most foot ailments are minor and can be treated conservatively. Early diagnosis and treatment are keys to returning these active people swiftly and safely to their sports.

Hallux Valgus

Pathologic changes can lead to an angulation of the great toe and enlargement of the medial portion of the first metatarsal and thickening over the medial bursa. The causes of hallux valgus include, but are not limited to, heredity, metatarsus primus varus, pes planus, rheumatoid arthritis and neurologic disorders. Most patients affected by the disorder are middle-aged women.

Patients usually have pain over the first metatarsophalangeal (MTP) joint and have difficulty wearing shoes because of the medial prominence and associated toe deformities. Occasionally, the degree of deformity is not always consistent with the severity of the symptom and this needs to be considered during treatment. Shoes with a wide toe box and sufficient insole padding are recommended to make the patient more comfortable. Orthotics that support the longitudinal arch and redistribute the pressure areas may give some relief of symptoms. This treatment plan is often successful. However, surgery is an option when conservative treatment has failed.

Hallux Rigidus

Hallux rigidus is a degenerative arthritis in the first MTP joint and may be accompanied by pain, diminished range of motion and difficulty wearing shoes. Participants in sports with running or jumping may be predisposed to this aliment.

Treatment of this condition includes wearing low-heeled shoes with adequate width and depth to accommodate the increased bulk of the joint. The use of an orthotic or rigid insole to reduce the stress across the MTP joint may also be beneficial. If conservative management is not successful, then surgery is another option.

Summer Footcare

The warm days of summer are almost upon us. As we break out the summer wardrobe and footwear here is some foot care advice for the summer months.

Watch out for flip-flops: While flip flops are popular and convenient to wear, they put people at risk of developing foot problems. Flips flops don’t have the necessary support. A flat piece of rubber or leather does not provide enough support in the arch area of the foot. If worn for a prolonged period of time, they can cause severe arch pain or pain on the ball of the foot. Also, flip flops offer no stability for the foot, causing the foot to move while walking. As a result, blisters, or pain on the ball of the foot can develop.

Flip flops do protect the foot from the hot sand at the beach, or prevent the spread of athlete’s foot or plant warts at the pool, but you’re more prone to injury because you’ve got your toes exposed.

Cute ballet flats are not much better. They provide very little support in the arch area and if worn for prolong periods of time, can cause arch pain. Also, ballet flats are difficult to keep on the foot potentially causing blisters and pain in the toes as they work extra hard to keep the shoe on.

Prevent Fungal Infections: If you have prone to sweaty feet, you are more prone to fungal infections. In the warm, summer months, take time to expose your feet, without socks, to the air more often, especially if you wear shoes and socks all day. Have 2 or 3 different pairs of shoes that you rotate through. Beware of communal showers at swimming pools as foot fungus and warts can be easily acquired in these areas.

Injuries: Going barefoot in the summer is only natural and has some benefits for short periods of time, but is not recommended for outside the home. Too often, injuries occur from punctures or cuts. Always wear footwear outside the home. If engaging in water activities, such as canoeing or kayaking, try to wear water shoes or sandals to protect your feet along rocky shorelines or river beds. If an injury as occurred, contact your chiropodist/podiatrist or doctor.

If you are a diabetic, shoes should be worn at ALL times to avoid injury. Even the slightest scrap can be cause for alarm among people with diabetes, where healing can be difficult and may lead to limb amputation.

Heel Care: During the summer, the skin on the bottom of your feet is prone to dryness and cracking due to excessive sweating. In extreme cases, your feet can bleed or become infected. Use a pumice stone on your heels everyday in the shower or bath. Apply softening footcare to the heels twice a day. If an over the counter cream doesn’t help, talk to your chiropodist or podiatrist about a prescription product.

Apply Sunscreen: Don’t forget to apply sunscreen to the tops of your feet and toes. If your feet are exposed, they will get burned.

Have a safe and enjoyable summer and above all, keep those feet happy and healthy.

 

Seniors Need Regular Podiatric Check-Ups

Older people can develop systemic conditions like diabetes or vascular disease that cause problems in the extremities. Peripheral neuropathy, which can be a symptom of diabetes, causes loss of sensation in the feet and can affect walking and balance, making falls more likely, points out Dr. John Dailey, a podiatrist with The Missouri Foot & Ankle Institute in Washington, MO. Circulatory problems also can cause injuries to become ulcerated and painful because an inadequate blood supply slows healing.

“Usually, older patients see me when a problem has occurred, but preventive care would be better,” Dailey says. “Billions of dollars were spent last year on treating conditions of the lower extremities as a result of diabetes. Good preventive care could save money and help people avoid pain and suffering.”

Dailey’s preventive regimen includes regular podiatric check-ups. “I suggest everyone see a podiatrist for a preventive exam, just like you would see your primary-care physician on a regular basis,” he says. “Those who have health conditions should be checked twice a year. We may take x-rays, examine how you walk, and make sure you’re wearing appropriate shoes.”

Source: Connie Mitchell, Ladue News [10/15/09]
"Reprinted by permission from PM News. PM News is available free by writing to This email address is being protected from spambots. You need JavaScript enabled to view it. .";

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David Simard

David-Simard

David Simard has been practicing chiropody for the past 20 years.  He currently practices in Sault Ste. Marie, ON and his services extend to the Greater Algoma District.

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