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Geriatrics and Podiatry

Bone density loss, dry skin, poor circulation, and rough and brittle nails are some of the common problems that can occur as people age. The effect that these problems has on foot health should be of particular concern in comprehensive geriatric care.

Feet that are diseased or injured have a negative effect on overall health and safety. Painful feet limit a person’s willingness and ability to stay active. Poor foot health can also cause gait change, which can lead to falls and accidents. Even though recovery time from health problems naturally slows as we age, many foot problems can be avoided altogether with regular prophylactic care.

Feet should be thoroughly washed in warm water daily. Care must be taken to dry the feet well, making sure to dry between and under the toes. Any left-over moisture can cause problems like foot fungus. After cleaning feet carefully check for problems such as cracked skin, bruises, swelling, cuts, corns, or other irregularities.

Examine toenails for ingrown, jagged, or split nails. Long toenails should be cut straight across. Never cut toenails at an angle or down the side as this may lead to ingrown nails.

Cracked and dry feet should be treated once or twice a day with a non-greasy moisturizer. Rub the moisturizer into the skin and allow it to dry before putting on socks and shoes. Sweaty feet can be dusted with a small amount of talcum powder. Avoid putting talcum directly into shoes as this may make feet slip within the shoe and cause a serious fall.

Wear clean dry socks each day. Not only do clean socks feel better on the feet, but socks worn for longer periods may harbor disease and odor-causing bacteria. Socks should not be tight around the top as they can leave marks on the leg. Socks that are too small can bring about bruising caused by pressure against the toes.

Wear comfortable and well-fitting shoes. If possible, consult a professional footwear specialist when purchasing shoes. Do not walk around barefoot as this exposes the feet to possible injury and bacteria.

Good foot health allows a more active lifestyle, which improves blood flow. Good circulation aids in recovery from injury or illness. It is also important for maintaining overall health.

Serious health problems can manifest themselves as symptoms in the feet. The elderly should seek professional help from a podiatrist if experiencing foot problems like tingling, numbness, pain, infection, or a sore that does not heal. Taking care of these problems right away can prevent the development of severe cases.

Heel Pain

Have you ever gotten up from a chair or out of bed in the morning, and upon taking that first step, feel like your heel has stepped on a tack? Many people experience a feeling of sharp pain which radiates into their arch from their heel and which does not allow them to put their heel on the floor. Sometimes they need to sit back down, stand only on their toes and use the wall for balance. If you can take a few steps, it seems to go away and lessen, allowing you to then resume your activity. Later, throughout your day and after a period of rest, it can happen again. If this sounds familiar you may be suffering from your first attack of heel pain.

Heel pain is a debilitating condition that affects day to day activities. Running and walking both causes stress on the heel because the heel is the part of the foot that hits the ground first. This means that the heel is taking on your entire weight. Diagnosis and treatments for heel pain can be easily found through your podiatrist.

Plantar Fasciitis

One of the main causes of heel pain is a condition known as plantar fasciitis. The plantar fascia is a band of tissue that extends along the bottom of the foot, from the toe to the bottom of the heel. A rip or tear in this ligament can cause inflammation of these tissues, resulting in heel pain. People who do not wear proper fitting shoes are often at risk of developing problems such as plantar fasciitis. Unnecessary stress from ill-fitting shoes, weight change, excessive running, and wearing non-supportive shoes on hard surfaces are all causes of plantar fasciitis.

Achilles Tendonitis

Achilles tendonitis is another cause of heel pain. Similar to plantar fasciitis, inflammation of the Achilles tendon will cause heel pain due to stress fractures and muscle tearing. A lack of flexibility of the ankle and heel is an indicator of Achilles tendonitis. If left untreated, this condition can lead to plantar fasciitis and cause even more pain on your heel.

Heel Spur

A third cause of heel pain is a heel spur. A heel spur occurs when the tissues of the plantar fascia undergo a great deal of stress, leading to a separation of the ligament from the heel bone entirely. This results in a pointed fragment of bone on the ball of the foot, known as a heel spur.

Heel Spurs

Heel spurs are the result of calcium deposits that cause bony protrusions on the underside of the heel. Heel spurs are usually painless, but they have the potential to cause heel pain. Heel spurs tend to be associated with plantar fasciitis, which is a condition that causes inflammation of the band of connective tissue that runs along the bottom of the foot. They most often occur to athletes whose sports involve a lot of running and jumping.

Some risk factors for developing heel spurs include running and jogging on hard surfaces, being obese, wearing poorly fitting shoes, or having walking gait abnormalities.

It is possible to have a heel spur without showing signs of any symptoms. However, if inflammation develops at the point of the spur’s formation, you may have pain while walking or running. In terms of diagnosis, sometimes all a doctor needs to know is that the patient is experiencing a sharp pain localized to the heel to diagnose a heel spur. Other times, an x-ray may be needed to confirm the presence of a heel spur.

Heel spurs can be prevented by wearing well-fitting shoes that have shock-absorbent soles. You should also be sure that you are choosing the right shoe for the activity you want to partake in; for example, do not wear walking shoes when you want to go on a run. Additionally, maintaining a healthy weight can be beneficial toward preventing heel spurs, as it will prevent an excess amount of pressure being placed on the ligaments.

There are a variety of treatment options for people with heel spurs. Some of these include stretching exercises, physical therapy, shoe inserts, or taping and strapping to rest stressed muscles and tendons. If you have heel pain that lasts longer than a month, don’t hesitate to seek help from a podiatrist. Your doctor can help you determine which treatment option is best for you.

Ingrown Toenail Care

An ingrown toenail is a toenail that grows sideways into the nail bed, causing pain and swelling. Ingrown toenails can worsen and cause drainage, turning into a serious infection.

Several factors affect whether a person is at risk from an ingrown toenail. The many causes include being overweight, diabetes, participating in sports, having a fungal infection of the toe, and cutting your nails too short. Ingrown toenails also have a genetic predisposition, causing some people to be more prone to receive the condition than others. Other causes include improperly fitting shoes and shoes that keep the feet damp.

Ingrown toenails can be preventable with certain measures. For starters, allowing your toe nails to grow slightly longer in length will help prevent them from becoming ingrown. If you have already developed an ingrown toenail, soak the affected toe in warm water. This will alleviate the pain and help prevent an infection from forming. Antibiotic soap or Epsom salts may be added to further help the relieving process and avoid infection. Placing cotton beneath the affected area is also suggested, as this may help the toenail grow upwards and not into the nail bed. Swelling and redness can be reduced by resting with your feet elevated.

A podiatrist should be seen if the pain becomes so serious that it prevents you from doing your everyday activities. If a red streak running up your leg appears or if you suspect your infection has spread, contact a podiatrist immediately. Fast treatments can be undertaken to lessen your pain and have you walking comfortably.

An ingrown toenail can be easily treated with a Band-Aid. Simply wrap the affected toe with a Band-Aid to prevent infection and keep the nail from growing out at a painful angle.

In more serious cases, your podiatrist may decide to make a small incision to remove a portion of your toenail. To prevent the nail from growing back, medication will be placed directly into the nail bed. This procedure would be performed under local anesthesia and is a faster method to alleviate discomfort from an ingrown toenail. Post-procedure directions will have you stay off the affected foot for a day. Afterwards, normal activities can be resumed.  

Solutions for Cracked Heels

Cracked heels can make life very frustrating and embarrassing when displaying the bare feet. Aside from being unpleasing to the eye, they can also tear stockings and socks and wear out shoes at a faster rate. When severe, cracked heels may cause pain or infection.

Cracked heels are a problem for those who are athletic, those who may walk a lot, and those who have especially dry skin. Those who use medication that dry the skin, those who swim often, wearing certain types of shoes, and those who are diabetic may have trouble with cracked heels. Seniors whose skin produces less oil may also have trouble with cracked feet. There is no one way to develop cracked feet, and there is no cure.

Today, the market consists of numerous products that have a variety of ingredients to promote healing. Some of these are over-the-counter. Others are prescribed by a doctor, especially for those who have chronic dry feet and heels.

Some doctors recommend wearing socks at night for those with rough skin. This helps further healing, and helps creams stay on longer and better absorb into the skin.

One way to alleviate dryness that causes cracked heels is by using moisturizers both day and night. Another way is to make sure the skin is clean and dry at all times. Using a pumice stone to buff away dead skin before putting on moisturizer can also help. Cracked heels will not respond to the cream unless the outer layer of skin is first removed through exfoliation. After exfoliation, lotion or ointment will be absorbed by the skin more easily.

Foods that produce healing and balance can also help the skin from within. Everything that is put into the body can either help it or hurt it. Taking supplements of omega-3 fatty acids and zinc can also be very beneficial.

Nevertheless, not all products are guaranteed to help treat cracked feet. Seeing a professional is best if other treatments options were unsuccessful. A podiatrist should be able to give the best advice to help with this problem.

Falls Prevention

Elderly Americans are very susceptible to falls as they get older. Everyone experiences decreases in flexibility, balance, strength, and the senses as they age. This correlates to some eye-opening statistics. 1 in 4 Americans aged 65 and older fall each year. An elderly American is being treated for a fall in an emergency room every 11 seconds, and every 19 minutes, an older person dies from falling. In light of these striking statistics, one can see the importance of taking steps to prevent falls.

Finding an exercise program for the elderly is an excellent way to reduce the likelihood of falls. Look for an exercise program that improves strength and balance. Elderly people who live a more sedentary lifestyle, with little physical activity, are at an increased risk of falling. Wearing well-fitted footwear that provides good foot support and cushion will help prevent falls from poorly fitted shoes. Talking to a podiatrist about your susceptibility to falls and about inspecting your prescriptions will help to avoid any medication that could make falls more likely. Due to a decline in the senses among the elderly, having your eyes and hearing checked is recommended.

Around half of all falls occur in the household. Removing tripping hazards in the home and making it more accommodating to older persons can significantly reduce falls. Some notable household changes include increasing lighting around the house, installing grab bars in the shower and bathroom, and making sure the floor is clear of clutter. Other smart options include installing a shower chair, using rubber-bottomed rugs, and placing railings on both sides of stairwells.  

Finally, discuss with a doctor and your family about your fear of falling. This will help to increase awareness among the population on the need for fall prevention. A lack of awareness on the matter, and a downplaying of importance are what increase the risks of falling. Following these tips can help to reduce the risk for yourself and your loved ones.

 

Ankle Sprains

Although ankle sprains may not be as serious as a broken ankle, they should be given immediate attention and care. An ankle sprain can lead to a significant amount of pain, as well as limited mobility. They are often characterized by the swelling and discoloration of the skin. This occurs when the ligaments are stretched beyond their limits.

The simple act of walking can sometimes cause a sprain, which makes ankle sprains a very common injury that can happen to anyone. They occur when the ankle twists in an awkward way or rolls over itself, causing a pop or snap in the tendons around the ankle. Some people are more at risk than others. These include athletes who continually push their bodies to the limits and also people who have previously suffered accidents to the feet, ankles, or lower legs.

Most of the time, an ankle sprain is not severe enough for hospital attention. There are many at-home treatment options available, including propping the leg up above your head to reduce blood flow and inflammation, applying ice packs to the affected area as needed, taking over-the-counter pain relievers and anti-inflammatory medication, using an ACE bandage to wrap and support the injured ankle, and most importantly, remaining off your feet until the ankle has fully healed.

Despite this, an ankle sprain can turn into a severe injury that might require hospitalization. If the ankle ligaments or muscles are damaged from a tear or rip, that is one sign that the sprain is severe enough for hospital attention and possibly for surgery. Even after the surgery, the recovery process can be long. You may need to have rehabilitation sessions administered by your podiatrist to get your ankle back to full health.

The severity of your sprain might become apparent if you are unable to stand or walk, consistent pain occurs over a prolonged period of time, swelling is much more severe than initially present, or if you start to experience tingling or numbness. These signs may indicate that your ankle sprain might actually be a broken ankle, an injury that requires immediate medical attention.

Although they are not completely avoidable, ankle sprains can be curbed with some preventative treatment measures. These include wearing appropriate-fitting shoes that not only provide a comfortable fit, but also ankle support. It is also recommended to stretch before doing any kind of physical activity, as this will help lower your body’s chance for an injury.

How to Care for Diabetic Foot

Millions of people are affected by diabetes each year. Diabetes damages blood vessels in all parts of the body, especially the feet. The legs and feet may develop slow blood flow, which causes neuropathy, or nerve damage. Once a diabetic patient develops neuropathy, it is important that the feet are well taken care of. Otherwise, the lower limbs may have to be amputated. This only happens in drastic cases, but it shows how seriously diabetic foot care should be taken.

It is very important to always wash and dry the feet thoroughly, especially in between the toes, if you’re a diabetic. Secondly, examining your feet and toes for redness or sores must be done, even if you do not feel pain.  You may also want to examine your feet from the bottom. Try to avoid wearing colored socks to prevent infections that may occur from the dye. Well-fitting socks are also highly recommended.

A diabetic’s physician should always monitor their blood levels to test how well blood sugars are being maintained. In addition to giving advice about everyday eating habits and foot care, a physician may prescribe medicine to help with the diabetic patient’s neuropathy. It is also advised to see a podiatrist if experiencing any feet conditions. Toenails may also need to be taken care of by a podiatrist. This prevents patients from cutting too deeply around their cuticles, which can lead to infection.

A person can take care of their feet at home by following the instructions of their physician. Using creams on one’s feet is also an effective way to heal dryness. Proceed with caution when using tools to remove calluses, as severe diabetics may not be able to feel pain on their feet. If any complications arise do not hesitate to contact a podiatrist.

On a daily basis, diabetic feet must be checked. If you are ever concerned about something, contact your health care professional. You never want to wait until a wound becomes too severe to treat. If left untreated, gangrene may develop. Gangrene is a serious infection that can lead to sepsis or amputation. It is also important for diabetics to be on the lookout for ulcers. Ulcers are sores that develop from tissue loss on the skin. They can be quite painful and require intensive treatment. Early treatment and everyday inspection are imperative to staying healthy.

Flip Flops and Feet

Flip flops are often a popular choice of footwear for many people. Flip flops allow your feet to breathe and give your toes the freedom of movement. They are easy to slip on and can be worn with virtually any style of clothing. Flip flops, however, despite their many benefits, can be detrimental for your foot health.

Despite their comfortableness, frequently wearing flip flops can create problems in the lower body over time. Issues mainly stem from the fact that people walk differently in flip flops compared to other footwear, such as sneakers. This is due to a change in one’s natural gait, which therefore creates stress in different parts of the body while hindering the body’s natural posture. Problems can also arise in the arches and balls of the feet. Flip flops provide little to no support to these areas.

Aside from long-term problems, flip-fops can also create short-term issues as well, such as ankle sprains and blisters. Weak materials that are flexible and bendable are generally used to manufacture flip flops. These materials make its wearers prone to both tripping and injuring their ankles. Flip flops can create blisters as the material rubs against the foot. People are much more at risk for infection while wearing flip flops due to their openness. This also makes it easier to scrape and cut the foot since there is a lack of protection. If these cuts are left untreated and uncovered, the risk then becomes greater.

To prevent the aforementioned occurrences, purchase a pair of flip flops that offer significant protection. The soles of the flip flops should not be floppy, but sturdy and firm, and should not significantly bend or wiggle when lifted from the floor. Flip flops made of high-quality materials will not be affected by this problem. While higher quality flip flops may be more expensive, they will last longer and provide better protection compared to a cheaper pair. Brand name flip flops sold from a quality manufacturer are a dependable option.

There is no problem in wearing your favorite pair of flip flops so as long as you do not wear them daily or for extended periods of time. Flip flops should be replaced every 3-4 months to ensure that they provide your feet with the best protection.

Flat Feet

Flatfoot is a condition that occurs when the arches on the foot are flattened, which allows the soles of the feet to touch the floor. Flatfoot is a common condition and it is usually painless.

Throughout childhood, most people begin to develop arches in their feet, however, some do not. Those who do not develop arches are left with flatfoot. The pain associated with flat feet is usually at its worse when engaging in activity. Another symptom that may occur with those who have this condition is swelling along the inside of the ankle.

It is also possible to have flexible flatfoot. Flexible flatfoot occurs when the arch is visible while sitting or standing on the tiptoes, but it disappears when standing. People who have flexible flatfoot are often children and most outgrow it without any problems.

There are some risk factors that may make you more likely to develop flatfoot. Those who have diabetes and rheumatoid arthritis have an increased risk of flatfoot development. Other factors include aging and obesity.

Diagnosis for flat feet is usually done by a series of tests by your podiatrist. Your podiatrist will typically try an x-ray, CT scan, ultrasound, or MRI on the feet. Treatment is usually not necessary for flat foot unless it causes pain. However, therapy is often used for those who experience pain in their flat feet. Some other suggested treatment options are arch supports, stretching exercises, and supportive shoes. 

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