Something's afoot — Ill-fitting shoes, obesity contribute to problems with your feet

ACFAS says kids suffer from shoes that don't fit well, too. The college publishes a guide to fitting shoes for kids, whose feet can grow up to two sizes in six months. Don't buy shoes that are too big. That can cause the foot to slide forward and put excessive pressure on the toes, it says. You need about a finger's width from big toe to shoe's end.

Tight shoes cause blisters, corns and calluses or worse. Shoes that are too flexible can lead to a pinched nerve between the toes that causes pain, numbness or burning in the ball of the foot, the guide says.

Shoes must offer proper cushioning and arch support, and any wear around the soles on kids' shoes means it's time to toss them. It's important that the toe box flexes easily and the shoes do not bend in the middle of the sole.

Worn-out shoes increase the risk for heel pain, Achilles tendonitis and even sprains and stress fractures.

People of all ages with flat feet need a wide toe box, strong arch support and shock absorption. Lace-up shoes that have room for an orthotic insert if it's needed are best.

One of the finest developments in foot care, Royall says, is specialized shoes. There are shoes designed for runners and others such as those who play basketball, for instance.

There are very good surgeries that can correct some foot ailments, but the podiatrists say they generally first try to resolve them in other ways. That includes antiinflammatory medications, orthotics and, in some cases, an injection "to calm things down," says Martin. Cortisone may be injected into inflamed tendons and joints. For nerves, Martin injects alcohol. Often, those treatments provide a cure. Putting a particular anti-cancer cream on warts makes them go away.

Besides wearing good-quality shoes that fit well, they recommend not going barefoot on hard floors. If feet sweat a lot, it's important to use powder in shoes to absorb it and cut down on athlete's foot or nail fungus. Dry feet need lotion. Socks should be changed daily. Martin counsels stepping out of the shower onto a towel. "No matter what household you're in, there is fungus on the floors in bathrooms and kitchens."

Fungal toenails are a big issue, especially for older patients, Royall says. The pain can be debilitating. He treats them with topical or oral medications. Sometimes the nails are removed or ground back.

While anything that has changed significantly or causes pain should be checked out by a foot specialist, people with diabetes should see a podiatrist at least annually and always wear shoes. Those shoes should fit well, Martin says. If they're too loose, the result is a friction blister. Too tight and there's a possibility of nail trauma that leads to fungal infection.

Diabetics often lose sensation in their feet and don't know when they've got an injury that requires treatment unless they're vigilant in watching for it. They tend to heal more slowly than others. And even seemingly minor injuries that are not cared for can lead to serious problems, even amputation.

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