WSJ: Steps to Better Foot Health – Health Problems Underfoot

Your feet support your entire body – pay attention to them and warm them up before you get out of bed every morning.  A few simple exercises each morning will help keep them stretched and lubricated – especially important before you head out for a hike or run.  Bunions are a sure sign your shoe box (toe room) is too tight and that you may have mortons foot (big toe and 2nd toe same length or 2nd toe longer). 

I have mortons foot and these inexpensive orthotics have changed my arches and feet (and are a big improvement over the pricey custom orthotics I had for 10 years).  http://www.mortonsfoot.com

Foot pain can signal big and small problems. Even how you get out of bed matters.

[image]Stephanie Dalton Cowan

Are your feet healthy?

Even people who try to cover all the bases—avoiding fattening foods, hitting the gym and wearing sunscreen—may not be able to answer yes.

Doctors say people often ignore persistent but minor foot complaints, which can later develop into bigger problems, like lower back pain. Some common foot problems can mask underlying issues that are correctable if addressed early. Tender feet might be a sign of a pinched nerve, for example, or bunions might stem from weak arches. Other foot ailments, such as sores that don’t heal, can point to a more serious condition, such as diabetes.

Podiatrists say foot ailments are a growing problem as more people get physically active. Running marathons, for instance, puts added pressure on the feet and can worsen existing issues that might be caused by genetics or poor footwear choices. Feet also must bear the burden from the growing numbers of people who are overweight or obese.

Many people don’t wear shoes with proper support, which is especially harmful for active athletes, says Leslie Campbell, a spokeswoman for the American Podiatric Medical Association, a professional organization. “We see more young children coming in because they play sports like soccer and wear cleats, which are rigid, don’t absorb shock, cause fatigue and should be worn as little as possible,” she says. Dr. Campbell, a podiatrist at Presbyterian Hospital in Allen, Texas, recommends soccer players not wear cleats off the field and be sure to warm up adequately before playing so the joints are supple in the shoe.

Other sports, including football, basketball and tennis, require constant, quick side-to-side movements that increase the risk of ankle sprains. And long-distance running can cause overuse problems like heel spurs, pinched nerves in the ankle and excessive rolling of the foot, which is known as over- or underpronation.


What feet endure:


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1. Heels


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2. Distance running

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3. Flimsy shoes

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4. Standing for long periods

People can check for pronation problems by looking at the bottoms of their shoes. Uneven wear means the foot isn’t landing properly, which can cause a collapsed arch and lead to lower back pain, says Eugene Charles, a New York-based practitioner of applied kinesiology, an alternative medicine that combines elements of chiropractic, physical therapy and other disciplines. Orthotics are usually recommended in this case, he says.

Achy feet shouldn’t just be explained away by old age or standing a lot, says Dr. Charles. Rubbing the feet after a long day should feel good. But if the feet are tender to the touch, this could reveal an underlying problem such as overworked muscles or weak arches. Often the wrong shoes are to blame, so try footwear with more support.

Sometimes a foot problem starts in another part of the body. If the bones in the ankle make a crackling sound when the joint is rotated, this could mean a major muscle located in the calf and foot, called the tibialis posterior, needs to be strengthened, Dr. Charles says. A weak tibialis posterior can cause tendon problems and shin splints. Standing on one foot or doing calf stretches and heel raises can strengthen the muscle.

Another routine stretch that wakes up the muscles in the feet should be done in the morning before getting out of bed, Dr. Campbell says. Sit with legs straight out in front of you and angle your toes toward your head and then away from it. This works the Achilles tendon and the fascial band, which connects the front and back of the foot.

“Jumping straight out of bed in the morning when the muscles are cold can harm the fascial band and cause plantar fasciitis, a very common and painful inflammation of the bottom of the foot,” she says.

Other exercises include rolling your foot over a tennis or golf ball, which stimulates the nerve endings in the feet and protects from injury. Picking up marbles or towels with your toes strengthens the muscles in the toes and central part of the foot. And wrapping a rubber band around the toes and then expanding the toes outward supports the major muscles of the foot, Dr. Campbell says.

Elevating the feet whenever it is convenient is a good practice because it alleviates pressure, Dr. Charles says. Epsom-salt soaks and foot massages feel good, but usually don’t address actual problems. If people need a soak every day for their feet to feel normal, there may be something wrong, he says.

Going barefoot isn’t always a good idea. Shedding shoes on grass or on the beach can strengthen certain muscles, Dr. Campbell says. But walking barefoot on hard surfaces, which don’t provide support, can cause muscle strain and misalignment.

Keeping Feet Fit

Regular stretches and exercises can strengthen muscles and help prevent some common foot problems.

  • Before getting out of bed, wake up the foot muscles. Sit with your feet extended and angle the toes toward your head and then away from it. This works the Achilles tendon and fascial band.
  • Rolling your foot over a tennis ball stimulates nerve endings and protects from injury. Picking up small objects like marbles strengthens muscles in the toes and foot.
  • Calf stretches strengthen major muscles in the lower leg that affect the foot.
  • Wrapping a rubber band around the toes and then expanding the toes outward supports foot muscles.

To prepare for a vacation that will involve lots of walking, Dr. Charles recommends getting the feet in shape by starting to take walks a month before the trip and gradually ramping up the workout length. He suggests alternating the speed—walk very slowly for one block, then fast for another—to work different muscles and strengthen the foot overall.

Some foot ailments can signal bigger problems, for which a podiatrist or orthopedic surgeon should be consulted. For example, pain in the big toe can be a sign of gout, a form of arthritis. Sores that don’t heal can indicate diabetes and abnormal blood-glucose levels or peripheral artery disease. And soreness or a burning sensation in the ball of the foot can signal a pinched nerve.

Bunions and hammertoes are common ailments that are painful and usually indicate larger structural problems. Bunions are the bony bumps that form at the base of the big toe and hammertoes are toes with an abnormal bend in the middle joint. These can signal that the foot isn’t receiving enough support, either because of ill-fitting shoes like heels, or genetics that cause the foot to be too mobile.

Neglecting foot health can lead to more complicated issues later. Ken Schimpf, a 54-year-old design consultant in New York, says he has had shoulder, neck and back pain for over 30 years. Recently he went to Dr. Charles and found that much of his troubles originated from a foot problem. Mr. Schimpf broke his foot decades ago and, during the healing process, started walking with his right foot splayed.

Mr. Schimpf’s broken bone healed, but the ankle remained dislocated, Dr. Charles says. Over the years, the ankle caused muscle spasms that raised his right hip and caused alignment problems and pain in his upper body.

Dr. Charles has worked with Mr. Schimpf to manipulate the ankle back into place. “My back pain is much less and I don’t have the same soreness or debilitating pain,” Mr. Schimpf says. Although he has been physically active for years, now “when I hike and golf I don’t have to fight through the pain.”

Write to Angela Chen at angela.chen@wsj.com

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