Put Your Best Foot Forward

By Miranda Bednar, DPT

The average person will walk 115,000 miles in their lifetime. That’s four trips around the Earth! From the time we are toddlers learning to walk until we are older adults possibly using a cane for assistance, our feet are very important to our quality of life. The feet affect our health from our first days to our last.

The foot and ankle together are a fascinating and complex body region made up of 26 bones, 33 joints and over 100 muscles, tendons and ligaments. Of the many jobs the foot and ankle complex have, some of the most important are standing balance, absorbing the shock sent into the body from the ground when we walk and forming a rigid lever to propel us forward as we move. To complete these tasks properly the foot and ankle complex has the unique ability to be, at times, mobile and adaptable and then rigid and powerful. By the time we have moved through a single day our feet have endured hundreds of tons of force.

One of the best ways for us to stay healthy is to continue moving. If our feet hurt, we do not feel like walking or may even be afraid to do so. There are multiple research studies that have determined that painful feet can disrupt ability to balance, change the way one walks, and decrease one’s desire to move. Impaired balance can lead to falls. Changes in walking pattern can lead to abnormal stress on other parts of the body causing injury or arthritis. Decreased movement can lead to or exacerbate other disease processes (such as diabetes or obesity), decrease cardiovascular health, lead to weight gain and decrease quality of life.

75% of Americans will have a foot problem at some point in their life. Obvious problems include fractures, either traumatic or stress-related, ligament sprains when you “roll” your ankle and muscle tears. Less obvious ones include plantar fasciitis which causes heel pain, and tendonitis anywhere around the ankle. Furthermore, irritation of the nerves and/or blood vessels at the foot and ankle can become tarsal tunnel syndrome which causes pain and tingling throughout the foot and metatarsalgia, or Morton’s Neuroma, which causes pain or numbness at the balls of the foot and toes. While these injuries and inflammations create unhealthy feet, sometimes the foot alone causes the problem.

We all have different foot shapes and sizes. These differences include “flat feet”, high arches, bunions, hammer toes, extra toes, and calluses. While these variances are natural and not uncommon, they will affect how the foot and ankle complex functions creating excessive stresses on some of the joints, ligaments and tendons.

While the list of possible foot and ankle problems may be unnerving, rest assured there are actions you can take to remedy those foot problems and regain your quality of life. After fractures, sprains or surgery, the foot and ankle often demonstrate strength and motion deficits that can make you limp. These deficits can be addressed via joint mobilizations and soft tissues massage done by a physical therapist and with instruction in a self-stretching and strengthening program. Muscle strains and tendonitis cause swelling and pain. They often get better with icing, resting and gradual return to or modification of your activity.  Pain in the bottom of the feet, balls of the feet and toes may be caused by excessive or abnormal pressure on those areas. These pains can be addressed by being fit with shoe wear that is appropriate for your foot shape and size, using custom or over the counter orthotics and by having potential joint or motion restrictions treated by a physical therapist. Toe deformities which may cause balance difficulties can be supported, and progression of the deformity and disability can be halted with various in-shoe padding and proper shoe wear.

Diabetes and vascular disease can cause neuropathy (numbness) in the feet. In these instances, it is important to be properly fitted with shoes for foot protection and to regularly check the skin of the feet for cuts or blisters. If you do see cuts or blisters you should make an appointment with your doctor to be checked for infection and to begin healing measures.

No matter how slight or severe the problem may be, don’t sacrifice your function, safety and health on painful feet. Seek medical advice now and avoid running the risk of further injury and dysfunction. Maintain your health by “putting your best foot forward.”