Putting your feet first

Looking after them is vitally important, yet we rarely give them any attention. We asked an expert about common foot problems and how to cure them
We rarely think about our feet unless there's something wrong with them. While we can get quite obsessed with the health and appearance of our hair, skin and fingernails, we tend to forget about our 'plates of meat' until we get the first twinge of an ingrowing toenail or a dose of athlete's foot. But looking after them is just as important, particularly as we grow older.

We asked Emma McConnachie from the Royal College of Podiatry to tell us about the many sorts of foot problems and the best ways to show them the TLC they deserve.

Which foot problems do you most commonly encounter?
Podiatrists see a wide range of foot and lower-limb issues. The most serious range from inherited musculoskeletal problems that affect the structure of the foot, to ulcers caused by poor blood supply, which particularly affect people with diabetes.

In general practice we see a lot of ingrown toenails, corns, calluses, bunions, verrucae and fungal infections.

Can your shoes help you to diagnose problems with your feet?
Yes. You might notice holes appearing in one particular area of the shoe, or the sole wearing down unevenly on one side. You should take notice of any pain or discomfort when wearing a particular pair of shoes.

The feet are complex, and no two are a perfect pair. Each one has 26 bones, 33 joints and over 100 muscles, ligaments and tendons, so there are plenty of issues that can occur. If you notice that one side of a single shoe is wearing down more quickly than the other, this is an obvious sign that the weight on that foot is not being equally distributed. A podiatrist can help to assess your individual foot needs and advise on what interventions can help prevent future issues - or treat the ones you are experiencing.

Other common issues are corns and calluses caused by shoes that are too tight in particular areas. If the shoe is too short your toes will push against the leather or material, which can damage the nails or cause an ingrown toenail.

When should we seek professional advice about a foot problem?
Podiatrists are happy to advise about any foot and lower-limb issue you are having, as well as providing general advice. If you have experienced a problem in your foot for two weeks or more that isn't easing, you should contact a podiatrist.

If you have underlying health conditions that might affect healing, circulation or sensation (such as diabetes) then you should seek help as soon as you can.

Podiatrists (who were previously known as chiropodists) are trained to degree level and are regulated by the Health and Care Professions Council. To see one on the NHS, check with your GP. Private podiatrists can be seen without a referral. You can search for one in your local area using the Find a Podiatrist service on our website, rcpod.org.uk.

How often should we cut our toenails and what is the best way to do it?
When you cut them, make sure you go straight across. Cutting down the sides can result in ingrown toenails and infections, as the nail is more likely to pierce the flesh. Filing your toenails twice a week is a quick and easy way to keep them short and comfortable.

Our magazine is mostly read by older people. Are foot problems more likely to occur as we age?
Unfortunately, yes. This is simply because your feet have had more wear and tear than those of younger people. The skin becomes thinner, less elastic and more fragile as we age, which can make common problems such as fungal infections worse.

The best way to look after your feet in later life is to follow the general guidelines for staying healthy - keep active, exercise regularly, eat healthily and slim down if you are overweight.

What should a good general foot care regime involve?
Wash your feet daily with warm soapy water and gently dry between the toes. You should apply a moisturiser at least once a week, or more if needed, avoiding the area between the toes. You can use a urea cream if you have particularly dry skin.

Remember not to cut your toenails down the sides. Filing them twice a week is a safer way to manage them.

Check your feet daily for any changes, such as cuts or abrasions, and seek professional help if you notice anything. If you are unable to examine your feet because of mobility or flexibility issues, ask a family member for help or try using a mirror.

Ensure that your shoes fit your foot shape and do not cause rubbing or pinching in any areas.

If you have pain or a problem with your feet that has lasted for two weeks or more, see a podiatrist. People with diabetes should see one as soon as they notice any changes.

What are the most common mistakes people make when caring for their feet?
We often see people at our clinics who say their problem has persisted for months or even years, but that they were too embarrassed to ask a professional to have a look. Don't be afraid of seeking help. Podiatrists have seen it all, and are best placed to help assist you with whatever foot issue you have.

What are the best ways that people can prevent foot problems from developing?
Make good choices with your footwear and self-care. Also, listen to your body. If you have a pain or problem in your feet that is refusing to go away then seek assistance from a podiatrist. Taking regular care of your feet by applying moisturiser to them a couple of times a week and checking them regularly will help to keep them in good condition.

Are there any common foot problems that we can safely treat at home?
It depends on the individual and whether you have any other health conditions. If your feet have compromised sensation, circulation or skin quality, there is a higher risk that you could damage them if you try treating yourself.

Basic footcare, such as filing your toenails, using a pumice stone or emery- style foot file and applying moisturising cream regularly are generally safe. But acid-based treatments, such as corn plasters, should only be used with the advice of a podiatrist, as they can create wounds in the healthiest of people. Blades, sharp implements and cheese grater-style devices are best avoided, especially for those with diabetes.

Which foot problems should never be treated at home by people with circulatory problems or diabetes? What are the risks if they do?
Corn and callus removal are the most common issue that people attempt to self-treat, often with sharp implements or acid-based treatments. These can quickly cause wounds in otherwise healthy people, which can lead to infection. People with diabetes are at much greater risk of this because of the restricted blood circulation in their feet.

Any problem that has broken the skin, such as an ingrown toenail, should be seen by a podiatrist. Verrucae can also be hard to self-manage for people with diabetes, as many over-the-counter treatments contain acids or freeze the tissue - they should not be used by people with this condition.

Pictures: Adobe Stock
Find Health advice in every issue of The Lady, in shops on the first Friday of every month!