Every Step of the Way

Imagine yourself walking. How many steps do you think you take every day? The average person takes between 8,000 and 10,000. In a normal lifetime that adds up to about 115,000 miles ­or four walking trips around the globe. With each step, you place two to five times your body weight on your feet and ankles. No wonder they often hurt at the end of a long day!

Here's something else to consider: One quarter of the bones in the entire body are in the feet. Each foot has 26 bones, 33 joints, 170 ligaments and an intricate network of muscles, nerves and blood vessels. "A masterpiece of engineering and a work of art," stated Leonardo da Vinci."

A masterpiece that is vulnerable to a host of conditions, injuries and illnesses.

Common foot and ankle problems

  • Ankle sprains and breaks
  • Heel pain
  • Flat feet
  • Bumps on the feet
  • Diabetic issues
  • Improper foot care

Walking, by itself, overworks our feet and ankles and a number of other things can increase the burden. For instance, the dictates of fashion may be the overwhelming reason why so many people complain of aching feet. At least 80 percent of all foot problems occur in women — the main culprits are shoes that don't fit well and high heels. The issues for men are usually being overweight or not wearing proper athletic shoes.

What can hurt our feet

  • Standing for long periods on a regular basis
  • Being overweight
  • Playing sports
  • Shoes that don't fit well
  • High heels
  • Diabetes

Ankle sprains and fractures

The most common ankle problems are sprains and fractures. A sprained ankle happens when you twist your foot beyond where it normally moves. It may be more apt to occur if you're doing something physical, but it can also happen by simply stepping on an uneven surface or downward on an angle. Ever trip on the stairs or when stepping off a curb?

Treating a sprained ankle ranges from rest (longer than you may think) to wearing a brace or a cast and doing a course of physical rehab. Unfortunately, about one-third of sprained ankles will become a recurrent problem.

A fractured or broken ankle can involve one or all three of the bones that make up the ankle joint — the tibia (shinbone), fibula (smaller bone of lower leg) or talus (a small bone that sits between the tibia, fibula and calcaneus (heel bone). A severe ankle sprain can feel like a broken ankle, so it's important to have it evaluated. Most fractures can be treated with a cast, but if the bones are out of place, surgery may be necessary.

Achilles tendon

The Achilles tendon, which connects the calf muscles to the heel, is the largest tendon in the body. It goes into action every time you walk, run and jump. It's tough, but it's also vulnerable to injury and prone to tendinitis or inflammation. Achilles tendinitis usually happens because of repeated stress to the tendon and causes pain and stiffness. A sudden pop in the back of the calf or heel may mean the tendon has ruptured or torn. Rest, ice and stretching generally ease tendinitis symptoms, but in severe cases, surgery may be necessary.

Plantar fasciitis

The most common cause of pain on the bottom of the heel is plantar fasciitis, which develops when the thick band of tissue that runs across the bottom of the foot and connects the heel bone to the toes, becomes irritated and inflamed.

  • Pain usually begins in the morning or at the start of a run
  • Worsens as the day progresses

Risk factors

  • Repetitive stress
  • Obesity
  • High arch or instep
  • Heel spurs

Treatment

  • Pain medication
  • Rest
  • Heel cups/cushions
  • Stretching exercises
  • Night splints
  • Cortisone injections
  • Physical therapy
  • Surgery if conservative measures don't relieve the problem

Flat feet

A person can be born with flat feet or they can develop later in life. No matter what the cause, they can usually be treated with orthotics and braces or surgery, if necessary. A common sign of a flat foot is "too many toes." If you look at a foot from the back, normally you would only see the fourth and fifth toes. The heel bone also tends to sag toward the outside, contributing to the loss of the arch.

Toenail disorders

A number of disorders can cause pain and other problems in the toes. Some of the more common include:

  • Fungal infection
  • Ingrown toenail
  • Hammertoe
  • Neuroma
  • Bunion
  • Bunionette

Diabetic foot

Diabetes is a huge problem around the globe. In the United States, it's estimated that 18.2 million people are diabetics — that's 6.3 percent of the population. The number one reason why someone with diabetes ends up in the hospital is because of complications involving the lower legs and feet. Fifteen percent of diabetics develop a serious infection and every year 82,000 undergo an amputation.

There are three basic reasons why someone with diabetes is at increased risk of developing a serious foot condition, particularly an infection or an ulcer.

  • Loss of sensation (neuropathy)
  • Caused by nerve damage
  • Makes it difficult to feel a cut, blister or sore
  • Lack of circulation (angiopathy)
  • Caused by damage to blood vessels
  • Makes it harder for an infection or an ulcer to heal
  • Lowered ability to fight infection (immunopathy)

Most diabetes-related problems could be prevented with proper foot care and regular medical checkups. An annual foot assessment can decrease complications by as much as 200 percent. A team approach is generally the best way to care for a diabetic foot.

  • Endocrine specialist or internist
  • Orthopaedic specialist
  • Vascular surgeon
  • Podiatrist
  • Wound Center

It's easy to take our feet for granted, but ignoring what might seem like a minor problem could lead to serious consequences. Our feet and ankles carry a heavy load — every step of the way. With regular care and, if necessary, some lifestyle changes, you're much more likely to avoid major problems.

  • Wear shoes that fit properly
  • Don't wear more than a two-inch heel
  • Do strengthening exercises and stretches
  • If you're overweight, lose the extra pounds
  • If diabetic, have feet checked regularly