April 11. 2005

AMARILLO - The leg bone's connected to the ankle bone and the ankle bone's connected to the foot bone. And that's where care really counts, especially as people get older.

"Wear and tear on your feet starts when you first learn to walk and continues until you cannot walk anymore," said Andrew B. Crocker, Texas Cooperative Extension gerontology specialist.

"We should all remember to pay close attention to our feet," Crocker said. "They may be the first sign of problems in our bodies, including serious diseases."

People who have certain conditions should be especially concerned with the care of their feet, he said.

Diabetics and those with other nerve and circulatory disorders should be sure their feet are receiving proper blood flow and do not have any injuries, Crocker said.

Cold feet may be a sign of circulation problems, he said. Another sign of decreased blood flow is the loss of hair growth on the toes or feet. Lack of blood flow to the feet and toes is common for those with diabetes and can make it difficult to heal sores or infections.

"If you suffer from diabetes, you should check your feet every day," Crocker said. "Look for areas of redness, areas of swelling or any other changes to the feet. Often, people with diabetes lose their sensation and cannot feel an abnormality on their foot, so a daily inspection becomes very important."

He suggested those unable to check their own feet should ask a friend or family member to help.

Keeping toenails trimmed is an important task, Crocker said, but can also be a dangerous one for people who have circulatory or nerve problems in their feet. Toenails should be trimmed straight across but not cut too short, especially in the corners. This may lead to ingrown toenails.

Also, he said, be careful when trimming not to cut the toe itself. Those with diabetes, circulation problems, nerve problems and those prone to infection should not cut their own toenails, Crocker said.

Medicare will pay for toenail trimming by a trained medical professional if certain conditions, such as diabetes, exist, he said. Health providers should be able to determine if an individual qualifies for this service.

Another step in proper foot care, Crocker said, is to make sure shoes fit properly. Remember the following:

– Foot size changes with age. Be sure to measure before each new shoe purchase.

– One foot is normally larger than the other, so be sure to fit your new shoes to the larger foot.

– Make sure that the ball of your foot fits comfortably into the widest part of the shoe.

– Your heel should fit comfortably with little or no slipping when you walk.

– Most importantly, walk in the shoes before buying them to make sure they do not hurt your feet.

"Our feet do more work than a lot of other parts of the body. Remember to take care of your feet and remind your health provider to take a look at your feet the next time you go in for an appointment," Crocker said.

For more information, contact the local Extension office or the American Podiatric Medical Association at 1-800-FOOTCARE (1-800-366-8223) or www.apma.org .

INFORMATION BOX:

Common conditions associated with feet include

– Fungal and Bacterial Conditions: Fungal and bacterial growth on feet is caused by the feet being in a warm, dark, damp place; namely, shoes. One of the most common fungal conditions is athlete's foot. Fungus and bacteria may cause dry skin, redness, blisters, itching and infection. To help prevent this condition, change shoes and socks often to help keep feet dry. Also, try dusting with foot powder to reduce moisture.

– Corns and Calluses: Friction and pressure are the main culprits for corns and calluses. When bony foot parts rub against shoes, hard, dry knots may form on the feet. Sometimes corns and calluses may be treated by wearing shoes that fit differently or cushioning the bony parts with special pads. Any form of treatment that involves cutting or scraping corns and calluses should only be performed by a health professional.

– Bunions: Big toes may become swollen and tender. If the bunion is not severe, pain and pressure may be relieved by wearing wider shoes, taping the foot or wearing pads to cushion the bunion. Physical therapy, special shoe inserts or surgery may be necessary to treat the bunion. Unfortunately, bunions tend to run in families.

– Hammertoe: Shortening of the tendons that control toe movements is a condition known as hammertoe. The toe knuckle is usually enlarged, drawing the toe back. As the toe rubs against the shoe, it may become stiff and enlarge even more. Without the large toe resting against the walking surface, individuals may lose their balance. Treatment includes wearing socks and shoes with plenty of room for the toe. Surgery may be needed to correct hammertoe.

– Bone spurs: Calcium deposits on the bones may cause spurs – prickly rock-like formations that may cause great pain. Spurs are caused by muscle strain in the feet from standing long periods or wearing ill-fitting shoes. Treatment for spurs includes using foot supports, heel pads and heel cups. In some cases, surgery may be necessary to remove spurs.