The foot being a commonly used part of our body deserves more care than we think. Average human walks 6000-10000 steps per day and this accounts for walking around the world 4 times in a lifetime.
Researchers recommend average human needs to be on his feet walking around for a minimum of 4 hours per day for a healthy lifestyle. For carrying out an active lifestyle with walking, running and sports activities healthy pain-free foot is mandatory. Thus foot-care indirectly prevents sedentary lifestyle and associated conditions such as obesity, hypertension, diabetes and cardiac ailments.
Foot And Ankle A Speciality By Itself
The human foot has 26 bones, 33 joints and over 100 muscles and is a complex biomechanical unit warranting specialised care and expertise in handling conditions associated with it. Unlike in Western countries, Foot and Ankle speciality is now developing in India.
A skyscraper without a proper basement tends to fall. The foot acts as a weight-bearing base of the body. Improper footwear can affect lower limb alignment leading to multiple joints pain and wear. Proper foot care starts from the selection of appropriate footwear considering the native alignment of the foot. Often foot pain is neglected considering it normal following exertion. A foot with an abnormal wear pattern of the footwear needs an evaluation from an expert to avoid future complications.
With the constant impact of running and walking foot and ankle is one of the commonest injured parts of the body. Around 95 % of foot injuries heal by themselves and with minimal treatment while 5 to 10 % may lead to chronic pain due to a concomitant cartilage/bone injury.
The ankle is one of the commonly injured joints, most of which are considered as sprain and treated with pain killers. Even though most of them heal well, some conditions with associated ligament or cartilage injury remain as a chronic pain generator for months. They may need ligament repair, cartilage repair which can be performed by keyhole procedures.
Many of us suffer from heel pain, which needs proper diagnosis. Pain at the bottom of heel which is worse in the morning is due to plantar fasciitis which response to footwear change and exercises. Pain at the back of heel could be due to bone growth, inflammation of a tendon or a tendon tear (Achilles tendon rupture).
Heel and ankle deformities like heel cord tightness or tear, altered ankle alignment, ankle joint arthritis may result in painful conditions hampering daily activities. Such patients need an expert viewpoint for successful management.
Flat foot is a condition where the arch of the foot is lost and the midfoot touches the ground causing the foot to rotate inward (pronation). While some flat feet are present since birth, some develop later due to obesity, diabetes and inflammation of the tendons. Painful flat feet are assessed to know the cause of pain. They are treated with rest, footwear modification, local injections and in some severe cases surgical correction. Midfoot problems like arthritis and joint dislocations can easily be missed.
It is a condition in which protective sensation of the joint is lost which results in the destruction of joints and surrounding bony structures may lead to amputation if left untreated.
The patient usually presents with swollen foot and ankle, warmth, redness in the foot, deformed foot, bony prominence, and ulcer formation. Such foot needs thorough evaluation including x-ray, blood investigations and nerve studies.
Management includes foot casting, footwear modifications in order to achieve a plantigrade foot. Surgical management includes resection of bony prominences, deformity correction and joint fusion.
Causes of forefoot pain may vary including pain over the base of toes, in between toes, deformity of toes causing difficulty to wear footwear, often the appearance of callosities over pressure points. Deformities of forefoot like Hallux Valgus (Great toe deviation), Painful great toe and claw toes are also being treated by a dedicated foot and ankle procedures.
Why A Specialist?
Foot and ankle specialist can offer comprehensive care in terms of
- Complete evaluation of the underlying condition
- Necessary imaging including stress X-rays, CT, MRI
- Gait pattern evaluation
- Foot pressure points evaluation
- Advice regarding appropriate footwear
- Guided physiotherapy and rehabilitation
- Fracture surgery
- Arthroscopy (Key hole surgery)
- Ligament repair or reconstruction
- Deformity correction including birth defects
- Total ankle replacement
- Joint fusion
- Bone marrow and stem cell therapy
- Tendon repair and transfer procedures
Tips For Healthy Feet
- Right shoe for the right activity.
- Use dedicated running shoes for running.
- Use stability shoes if you have a flat-foot
- Try and buy shoes in the evening when your feet are swollen and larger
- Don’t wear the same shoes alternate the shoes.
- Avoid walking barefoot
- Wear Socks that fit and change daily. Use non-elastic socks if you have neuropathy or diabetes.
- Avoid wearing flip-flops for long periods.
Dr Parthiban J, Senior Consultant Foot And Ankle Surgeon – Institute of Orthopedics, Gleneagles Global Health City, Chennai