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Source: Australian Podiatry Association, US National Institutes of Health (National Institute on Aging), US Dept of Health and Human Services (US Food and Drug Administration), US National Library of Medicine.

Like the foundation of a tall building, problems in your feet can have far-reaching effects throughout the body and sometimes are the first sign of more serious medical conditions such as arthritis, diabetes, and nerve or circulatory disorders.

a) Fascinating Foot Facts

The foot contains 26 bones, 33 joints, 107 ligaments and 19 muscles. A quarter of all the body’s bones are in the feet.
There are 250,000 sweat glands in a pair of feet. Sweat glands in the feet excrete as much as a half-pint (0.24 litres) of moisture a day.
The average person will walk around 128,000kms (79,535 miles) in a life time. That’s more than three times around the earth.
When walking, each time your heel lifts off the ground it forces the toes to cary one half of your body weight.
Only small percentage of the population is born with foot problems
Women have about four times as many foot problems as men. High heels are partly to blame.
It’s rare that two feet are exactly the same, on of them is often larger than the other.
Around 40% of Australians and 75% of Americans will experience some form of foot problems in their lifetime.
About 60-70% of people with diabetes have mild to severe forms of diabetic nerve damage, which in severe forms may lead to lower limb amputations.
Foot disorders in the elderly are extremely common and are the cause of much pain and disability, and consequently loss of mobility and independence.

b) Prevention

The following steps can prevent foot problems and foot pain:

Wear comfortable, properly fitting shoes. They should have good arch support and cushioning.
Wear shoes with adequate room around the ball of your foot and toe.
Wear sneakers as often as possible, especially when walking.
Avoid narrow-toed shoes and high heels.
Replace running shoes frequently.
Warm up before exercise, cool down after exercise, and stretch adequately.
Increase your amount of exercise SLOWLY over time to avoid putting excessive strain on your feet.
Lose weight if you need to.
Learn exercises to strengthen your feet and avoid pain. This can help flat feet and other potential foot problems.
Keep feet dry to avoid friction. This may help prevent corns and calluses.
Avoid alcohol to prevent attacks of gout.

c) Foot Hygiene

The foot has more than 250,000 sweat glands. It's the mixture of sweat and bacteria in our shoes and socks that makes feet smelly. Clean, dry feet can lower the risk of both foot odor and fungus infections.

Feet should be washed every day with soap and lukewarm water, especially between the toes, and then dried completely with a soft towel. Any mild soap or antibacterial hand soap works fine.

People spend a lot of time shampooing and conditioning their hair and applying soaps and lotions to their body, but then probably don't spend 10 seconds washing their feet. Washing the feet with a wash cloth or similarly abrasive product is important because it helps remove the dead skin, bacteria, and fungus.

People who want to soak their feet should use warm, soapy water. Soaking feet in Epsom salt can cause excessive drying of skin. This is an important consideration for diabetics or with those who have existing dry or fragile skin. Consider soaking feet in warm water with a small amount of liquid dishwashing solution that has skin softeners. There is no benefit in soaking feet in Epsom salt compared to regular table salt.

Applying moisturizing lotion on the feet after bathing can alleviate dry skin. During dry winter months, apply a small amount of lotion a few times per day.

Toenails should be trimmed straight across and not too short. Many people incorrectly cut the corners, leaving a small point of nail that then grows into the skin or they accidentally cut the skin.

People who pamper themselves with a salon pedicure also need to make sure that proper cutting and safety measures are followed. In the last few years, there have been reports of infections linked to nail salon whirlpool footbaths that hadn't been properly cleaned or disinfected.

d) Something Afoot: Common Problems

Fungal Infections, such as athlete's foot, happen because our feet are in shoes most of the time. Shoes are warm, dark, and moist—the perfect place for fungus to grow. A fungus can cause dry skin, redness, blisters, itching, and peeling. It can be hard to cure.

To prevent infections:

Keep your feet clean and dry. Be sure to dry the area between your toes.
Change your shoes and socks or stockings often to help keep your feet dry.
Don’t buy tight shoes.
Try dusting your feet every day with foot powder.

Dry skin can cause itching and burning feet. Use mild soap in small amounts and a cream or lotion on your legs and feet every day. Be careful about adding oils to bath water since they can make your feet and bathtub very slippery.

Corns and calluses are caused by pressure when the bony parts of your feet rub against your shoes. Wearing shoes that fit better or using special pads may help. See your doctor, especially if you have diabetes or circulation problems.

Warts are skin growths caused by viruses. They are sometimes painful and may spread if not treated.

Bunions develop when the joints in your big toe no longer fit together. They become swollen and tender. Bunions tend to run in families. If a bunion is not too painful, wearing shoes cut wide at the toes and instep (middle part of the foot), taping the foot, or wearing pads that cushion the bunion may help.

Ingrown toenails are caused by a piece of the nail breaking the skin. This can happen if you don't cut your toenails straight across so the corner of the nail can be seen above the skin. Use clippers made to cut toenails. Ingrown toenails are very common in the large toes.

Hammertoe is caused by a shortening of the tendons that control toe movements. The toe knuckle grows and pulls the toe back. Over time, the joint gets bigger and stiffens as it rubs against shoes. This can affect your balance. More space in the shoe or stocking can help. In very serious cases, surgery may be needed.

Plantar Fasciitis; Stretching or tearing of the plantar fascia, which runs along the bottom of the foot and supports the arch of the foot. Heel pads, pain medicines, or cortisone injections may help. Other conservative care includes splinting, stretching, avoiding walking barefoot, and physical therapy. Shock wave treatments use shock wave energy to relieve inflammation and are an alternative to surgery.

Neuroma; Enlarged benign growths of nerves, most commonly between the third and fourth toes. This nerve condition is caused by bones rubbing against and irritating the nerves. It is also caused by abnormal bone structure or pressure from poorly fitting shoes. It may cause pain, burning, or numbness between toes and in the ball of the foot. Treatment includes padding, taping, orthotic devices, and cortisone injections. Sometimes, surgical removal is required.

Spurs are calcium bumps that grow on bones of your feet. They are caused by stress on the feet. Standing for long periods of time, wearing badly fitting shoes, or being overweight can make spurs worse. Sometimes spurs are painless. At other times, they can hurt. Treatments for spurs are foot supports, heel pads, and heel cups. Sometimes surgery is needed.

Swollen feet may be a sign of more serious health problems. If you continue to have swollen feet and ankles, see your doctor.

e) Exercise Right

Wearing inadequate and worn-out shoes is a common mistake for athletes, says James Losito, D.P.M., team podiatrist for the Miami Heat basketball team and professor of podiatric biomechanics at Barry University in Miami Shores, Fla.

"Running shoes should be discarded after 200 miles to 400 miles of use and they should fit correctly," Losito says. "There should be a thumb-width of length between the longest toe and the end of a shoe. Failure to wear the correct shoe size can result in runner's toe, calluses, ingrown nails, fungal nail infections, and hammertoe deformities."

People also should purchase the right shoe for the sport. "Many injuries occur because someone is wearing a running shoe while playing basketball," Losito says.

Another common cause of athletic injuries is doing too much too soon. "Both overuse training habits and worn-out shoes could result in stress fractures, heel pain or heel spur (plantar fasciitis) or shin splints," he says. "It is important to start out slowly and increase distance, duration, and pace gradually. For runners, I recommend no more than a 10 percent increase per week."

Walking or jumping on hard surfaces and failing to stretch and do warm-ups may also cause shin splints, plantar fasciitis, and heel spurs. Losito says, "There is no solid evidence to confirm that stretching actually decreases the likelihood of injuries, but it makes sense to maintain flexibility through gentle stretching, especially following exercise."

According to the American Academy of Podiatric Sports Medicine, the most common pain associated with jogging is runner's knee, which can be caused by rolling in or down on the foot. With aerobics, rising on the toes can cause an inflamed Achilles tendon. Stress fractures can be caused by running and other repetitive strain. Sharp pain, bruising, or swelling after a foot injury warrants medical attention. Contrary to popular belief, it's possible to walk, even if a foot bone is broken.

f) Treatment

Treatment for foot problems should be directed at the underlying cause. Most foot problems can be handled conservatively, without drug treatment or surgery. However, if not properly managed, some foot problems, such as infections related to diabetes, can lead to hospitalization and amputation.

Many problems can be corrected by simply modifying your shoes. This may mean stretching your current shoes, buying more comfortable shoes, wearing orthotics, or having shoes specially made to help your specific foot abnormalities. Treatment of corns with corn pads or plasters may reduce pressure on the affected area. Pain relievers (eg, acetaminophen, aspirin, ibuprofen) are often helpful, and those with anti-inflammatory properties are especially useful for minor swelling and redness. Sometimes, weight-bearing activities must be stopped for a few days to control symptoms, but non—weight-bearing exercises (eg, swimming or cycling) should still be done to maintain strength and movement.

Sometimes, surgery is needed to correct foot problems, but this is usually a last resort. Surgery can involve quite a bit of discomfort and limit standing and walking for weeks to months. People who undergo foot surgery must be sure to keep up their muscle strength during the recovery period.

g) Podiatry

Podiatrists provide comprehensive foot care, diagnosing, treating and preventing foot and ankle problems. They are qualified to treat problems with all parts of the foot and ankle, including toes, heels, balls, nails, skin, veins, nerves and bones and joints and to deal with foot problems caused by injury, infection, disease, footwear and the environment as well as structural problems and biomechanical disorders.

Podiatrists also perform foot surgery. All podiatrists are qualified to perform minor foot surgery, such as nail surgery. Some podiatrists do further study to quality as podiatric surgeons, undertaking more complex foot surgeries in a hospital sitting.

h) Orthotic Devices

Orthotic devices are intended to make the feet more comfortable, minimize stress on the foot, or improve an abnormal or irregular walking pattern. An orthotic device could be a conservative approach to a foot problem, a preventive measure to avoid problems, or a useful support after foot surgery.

According to the American Academy of Orthopaedic Surgeons, orthotic devices commonly used include bunion shield pads, arch pads for people with a flat foot, and heel inserts for people with plantar fasciitis. They can be custom made and also sold by podiatrists, physical therapists, or orthotic companies via retail and online stores.

Consumers might do well to try a less expensive OTC orthotic device first. "But if the problem doesn't go away after six weeks, you may need to seek a professional consultation and a custom orthotic may be indicated," says Eddy Gosschalk of Southern California Orthotics and Prosthetics. "People who are at risk for developing wounds or who have an unusual foot shape tend to need a custom orthotic." To create a custom orthotic, a plaster cast is taken of your foot and sent to a laboratory.

To avoid or overcome a foot or ankle problem you may need to learn some new habits or modify your current level of activity. Obviously, the goal is to return to normal activity as quickly as possible, empowered with the knowledge to prevent recurring pain, re-injury or disability.

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