A Help the Aged Advice leaflet Fitter Feet Endorsed by [INSERT LOGO] The Society of Chiropodists and Podiatrists This leaflet is endorsed by The Society of Chiropodists and Podiatrists. -------------------------------------------------------------------------------- Contents Section 1 Trouble with your feet? Section 2. Looking after your feet Section 3. Simple foot care Section 4. Exercise your feet Section 5. Common foot problems Section 6. How to contact a chiropodist Section 7. Useful contacts Looking after your feet is one of the most important aspects of personal health care, whatever your age. During your lifetime, your feet could walk the equivalent of four times around the world! To make sure that your feet stay fit, you need to look after them, keeping them clean, warm and well supported. In this leaflet, we use the term chiropodist to refer to both a chiropodist and podiatrist. -------------------------------------------------------------------------------- Section 1. Trouble with your feet? Generally our feet serve us well, but they are subjected to a lot of stress and strain. Wearing shoes which don’t fit properly, walking on hard pavements or even just standing still can all take their toll on your feet. Never ignore minor foot troubles. They may not seem to matter very much at the time, but can get worse unless you seek proper attention and treatment. Symptoms such as persistent pain, soreness or redness are warning signs. If, for example, you neglect a corn, it can develop and become more painful; in extreme cases, the corn may become infected and develop into an ulcer. You may then start to change your walking pattern to avoid the pain which can lead to more serious problems. It may also cause other problems such as a bad back. Always attend to foot problems quickly; this will save you discomfort in the future. -------------------------------------------------------------------------------- Section 2. Looking after your feet Buying new shoes It is very important when you buy shoes that they fit your feet properly. This can prevent problems developing as well giving you extra stability; wearing the correct footwear can help prevent falls if you are at all unsteady on your feet. For more information and practical advice on how to stay steady on your feet, see our free advice leaflet Staying Steady. When buying new footwear, it is important to bear in mind the following points. * It is essential that shoes, boots and slippers fit properly and allow your feet to breathe. * There should always be a halfinch gap between the ends of your toes and the ends of the shoes. They should fit snugly at both the heel and the instep. The shoes should have a fastening such as a strap or laces which will help to keep your heel to the back of the shoe and stop your toes getting squashed. * Make sure the shoes are wide enough. The widest part of your feet should rest in the widest part of the shoe. * As you get older, the size and shape of your feet may change so always have your feet measured when buying new shoes. If possible, stay standing while your feet are measured. When you try on a new pair of shoes, make sure you stand up and walk around in them. Try walking on a hard surface as well as on a carpet so you can check how well the shoes cushion your feet. * Make sure that you feel safe and secure when you walk, and that the shoes you choose protect and support your feet. * Look for footwear which has soft supple uppers of leather or fabric. Avoid shoes with a lot of decorative stitching which can stop the shoe from stretching over a bunion or raised toe. Feel around inside the shoes to make sure that there are no seams or stitching to rub your feet. * Make sure that you can get the shoes on and off by yourself. A shoe horn with a long handle could help. If you find tying the laces difficult you could try footwear with Velcro fastenings. * Choose slippers with high sides and firm soles which enclose the heel. A strap or flap fastening allows the slipper to be adjusted to fit your foot exactly. Wash your slippers regularly and try not to wear the same pair all the time. * When buying new shoes be sure to take the time you need to decide if they are suitable. Don't be rushed into buying shoes that you're not sure about, or ones you haven't tried on. More expensive shoes are not always better for your feet - choosing a pair of shoes is all about what is most suitable for you. * It is often a good idea to buy shoes in the afternoon, particularly if your feet swell during the day. Shoes that fit well in the morning may become too tight by the evening. You may find it easier to try on shoes in your own home and in your own time. There are many mail order companies which supply a wide range of footwear. Before ordering your shoes, check that you can exchange them or get a refund if they are uncomfortable. Socks, stockings and garters Make sure that socks and stockings fit you properly and aren't too tight. Don't wear two pairs of socks in shoes which already fit and avoid tight garters as these can reduce the circulation of blood to your ankles and feet. Change your socks and stockings every day. If you have varicose veins, you need to take special care of your legs. Support hosiery can relieve the symptoms of tired aching legs and prevent varicose veins from getting worse. Graduated support hosiery is made tighter at the ankle to encourage blood to flow back up the leg towards the heart. If your doctor feels that you would benefit from support stockings, you may be able to get them on prescription through the NHS. Before you buy support stockings, make sure you get advice from your doctor or chiropodist as to which grade (size) is most appropriate; this is particularly important if you have diabetes as you may have lost some feeling in your legs and could be wearing the wrong size stockings. A few simple tips to help varicose veins and relieve aching legs are given below. * Try to avoid knocks and grazes. * Keep your weight within normal limits. * Put your feet up when you can. * Whenever you get the opportunity (at least a few minutes every day) try circling your ankles and curling your toes. * Do not cross your legs while sitting. * Avoid popsocks or hold-ups with tight elastic. -------------------------------------------------------------------------------- Section 3. Simple foot care Keeping your feet clean is very important and is the main way of preventing infections. Wash your feet every day in warm soapy water. Rinse them well and dry them gently with a soft towel, taking particular care to dry between the toes. To stop patches of hard, dead skin building up, use a chiropody sponge or pumice stone now and again. You can get these from chemists' shops; ask your chemist for advice on which product to use, particularly if you have diabetes. Next, apply moisturising cream, especially if your feet are taut and dry. Massage the cream in upwards, from the toes towards the knees, to stimulate your circulation. But don’t apply cream between your toes. If your feet get very moist because of heavy perspiration, dab them with surgical spirit after washing. You could also try an antiperspirant spray for feet or a special shoe deodorant. Wearing cotton or woollen socks, rather than ones made of synthetic materials, can also help. Make sure that your feet are completely dry before putting on shoes and socks. Never wear wet shoes  you can dry them out by packing them with newspaper before drying them in gentle heat. Trim your toenails regularly. Always cut them straight across so that they are level with the ends of your toes and not too short. Don't try to cut around the corners of the nails as this can encourage ingrowing toenails. You can buy nail clippers to help you cut your toe nails correctly. Smooth nail edges with an emery board so that stockings or fine socks won't snag. Never poke anything down under the nail. If you can't bend down to cut your nails, ask a friend or relative to help you. Failing this, contact a chiropodist. Your doctor’s surgery may also offer this service. -------------------------------------------------------------------------------- Section 4. Exercise your feet Exercise can really help to keep feet healthy  it tones up muscles, helps to strengthen your arches and stimulates blood circulation. Try doing the following exercises regularly. 1. Rising on tiptoes Stand with feet parallel and, holding on to a steady piece of furniture for support, rise slowly up and down on your tiptoes. This exercises the leg muscles and helps strengthen the foot muscles. 2. Point your toes Sitting down, extend and stretch the foot in as straight a line with the leg as possible. 3. Rotate your feet Still sitting, extend feet one at a time and rotate slowly at the ankle, as if you are trying to draw the largest circle possible with your big toe. Do this first in one direction, then the other. 4. Wiggle your toes Remain sitting with feet resting on the floor. Move your toes up and down. -------------------------------------------------------------------------------- Section 5. Common foot problems Corns and calluses Corns and calluses are often a sign that your shoes don't fit properly. Corns are caused by pressure or friction over bony areas, particularly over the joints, the ends of the toes and under the feet. Soft corns appear between the toes where there is pressure and perspiration collects. If a corn presses down on a nerve it can cause pain. Calluses are also caused by pressure or friction, producing hard skin. Unlike a corn, though, a callus does not have a central core. It can grow over any bony area, usually on the ball of the foot. Calluses can give you a burning sensation on the soles of the feet. This is often caused by the friction of your foot moving back and forth in its shoe. Problems with your feet which are very painful or recur often should be treated by a chiropodist. Most corns and calluses, however, can be protected with products you can buy over the counter from chemists’ shops. Make sure you seek advice from your chemist or chiropodist before you buy any products over the counter. Do not cut corns yourself and only use corn and callus treatments when advised to do so by a chiropodist. Products that contain acid may burn the healthy skin around the corn. This can lead to serious problems such as infection. Consult your doctor or chiropodist for advice. Bunions Bunions are a deformity of the big toe joint. They produce an enlarged joint which can be painful and make walking difficult. Wearing shoes that fit comfortably, and that have thick soles and soft leather or fabric uppers can help to ease the discomfort, as can the use of a bunion shield which you can get from chemists' shops. These are short term solutions. Get the advice of a chiropodist on how to manage this condition in the long term. Heel fissures Heel fissures are torn or cracked skin which occur around the heel; they are commonly caused by hard, dry and flaky skin. If the fissures become deep, it can become painful to stand or walk. Sometimes they can bleed and in severe cases become infected. If you develop a heel fissure, go to your chiropodist who will remove the hard skin, and give you preventative advice for the future. Tired, aching feet Nearly everyone at times will experience tired or aching feet. For example, a long trip to the shops, gardening, housework; all sorts of exercise can make your feet ache. Here are a few tips for reviving tired, aching feet. * Wear the right shoe for the job. * When you sit down for a rest, get into the habit of putting your feet up. Aim to have your feet a few inches higher than your hips. * Watch your weight  the more you carry, the greater the strain on your feet. * To help cushion your feet, try using comfortable insoles, but only if there is enough room in your shoes for them. * Massage your feet to improve circulation. * If your heels ache in the morning from pressure on them during sleep, and continue to ache for several weeks, go to your doctor or chiropodist. These problems should not be ignored and there are treatments available. Ingrowing toenails Ingrowing toenails can be very painful; they are usually caused by illfitting, overtight footwear or by cutting the toenails too short. Rough edges of the toenail become embedded in the skin as the nail grows. The toe then becomes inflamed and swollen. Chiropody treatment is often required for this condition. Verrucae Verrucae are warts on the feet caused by a virus which can sometimes spread and get bigger if not treated. They mostly occur on the sole of the foot, but you can also get them elsewhere on the feet and on your hands. Verrucae tend to disappear of their own accord after a while. If you find that they are spreading or occur on a painful spot, you can contact your chiropodist who will be able to advise you on a suitable treatment. Athlete's foot Athlete's foot is a fungal infection and is very contagious  it can be spread by clothing, towels, and floor coverings of bathrooms, swimming pools and showers. Symptoms can include an itchy rash, splitting of the skin between the toes and blisters on the skin under the toes. Athlete's foot is particularly troublesome in hot weather when sweating feet create the ideal conditions of warmth and moisture for the fungus to spread. Athlete's foot can be treated by the regular use of an antifungal powder or cream. They work by getting rid of the fungus which causes athlete's foot. These products are available from chemists' shops. Chilblains Chilblains are the result of poor circulation in cold and damp weather. Symptoms are redness, tingling and an itching sensation, accompanied by inflammation and swelling. In cold weather, avoid heating your feet up too quickly in a hot bath, in front of a fire, or resting them on a hot water bottle. Wear long woolly socks, leg warmers or boots and make sure that footwear is not too tight. Regular foot exercises and bathing your feet alternately in warm and cold water will help to stimulate the circulation. If you have serious problems with chilblains or cold feet, always consult your chiropodist or doctor. Foot care for people with arthritis People with arthritis can experience a lot of pain and discomfort in their feet. This can sometimes be relieved by wearing well-cushioned footwear with lace-up fastenings and adjustable straps. Trainers are ideal as they provide a lot of support and protection to the foot. Ask your chiropodist for advice. Normal foam insoles for shoes don't give much relief, but your chiropodist may be able to give you some advice on special ‘shock absorbing’ insoles or custom-made inlays. If you have arthritis, it is important to speak to your doctor or chiropodist about any foot problems. Foot care for people with diabetes People with diabetes can often experience poor circulation and loss of sensation in their feet. This means you may not be aware of problems unless you examine your feet regularly. You should also feel inside all shoes for any seams or stitching or even small stones which could rub the foot and lead to problems. Even the smallest injury can lead to infection which, if not treated promptly, may lead to serious complications. When you go to buy new shoes, make sure you get your feet measured; this is particularly important if your shoes start to feel too big as this could be an early indication that you are losing feeling in your feet. Anyone with diabetes should receive regular foot advice or treatment; you are entitled to an annual foot check-up. If you have any foot problems, you should consult your doctor or chiropodist. -------------------------------------------------------------------------------- Section 6. How to contact a chiropodist If you think you need chiropody treatment you should discuss this with your doctor. In many cases your doctor will be able to arrange free treatment through the NHS. However, owing to the pressure on this service you may have to wait for some time before seeing an NHS chiropodist. If you would prefer to pay privately for chiropody treatment, you can contact The Society of Chiropodists and Podiatrists for details of Health Professions Council (HPC) registered chiropodists in your area. Make sure you ask about the cost before you agree to have any treatment done. Alternatively, you can ask your doctor to recommend a local HPC registered chiropodist doing private work. By making an appointment with a chiropodist who is registered with the HPC, you can be confident that you are seeing someone who is qualified. The Health Professions Council ensures that registered chiropodists are following standards of professional training, performance and conduct. -------------------------------------------------------------------------------- Section 7. Useful contacts Arthritis Care 18 Stephenson Way London NW1 2HD Tel: 020 7380 6500 Helpline: 0808 800 4050 Web: www.arthritiscare.org.uk Arthritis Care offers advice on arthritis, including foot problems and foot care. Diabetes UK Macleod House 10 Parkway London NW1 7AA Helpline: 0845 120 2960 Web: www.diabetes.org.uk Diabetes UK can offer further guidance and advice on looking after your feet if you have diabetes. The Disabled Living Foundation 380-384 Harrow Road London W9 2HU Helpline: 0845 130 9177 Web: www.dlf.org.uk The Disabled Living Foundation can provide advice on finding, adapting and putting on shoes. The Society of Chiropodists and Podiatrists 1 Fellmonger’s Path Tower Bridge Road London SE1 3LY Tel: 0845 450 3720 Web: www.feetforlife.org The Society of Chiropodists and Podiatrists can provide you with details of registered chiropodists in your area. Standard back page (LATEST VERSION) with list of Advice Leaflets