MEDICAL SURFARI: FOOT CARE IMPORTANT PART OF HEALTH

What has 52 bones, 66 joints, 214 ligaments and 38 muscles (saying nothing of the nerves and blood vessels) that mirrors your overall health, especially with systemic conditions such as diabetes, arthritis and circulatory disease? Your feet!

The average person takes them for granted during each of the 8,000 to 10,000 steps taken in any given day. This adds up to more than 115,000 miles in a lifetime and that is more than four times the circumference of the earth.

Our feet bear remarkable forces with walking and running, yet they literally stand up to these forces thousands of times every day without problems if they are well cared for.

Our feet are biomechanical masterpieces that are, of course, important when it comes to walking, but they also play a very important role in balance.

Foot problems are among the most common health problems. In some cases, the problems of deformity or a tendency toward degeneration may be hereditary, but in most cases they result from the cumulative effects of abuse and neglect. Some studies have shown that as many as 75 percent of Americans experience foot problems at some time in their lives, but nowhere near that many seek medical treatment.

Foot problems are four times more likely in women than in men. As you might guess, this has been attributed to the difference in shoe design, especially the wearing of "high heels." Ever since ancient Egyptian times, footwear has been designed to provide protection, support, comfort, sturdiness and, last but not least, stylishness.

Choosing proper footwear can reduce foot problems and, of course, there is no more important time to pay attention to this fact than during childhood when children's feet grow and develop. Shoes are generally not necessary when children begin to walk and by allowing them to go barefooted indoors or to wear only a pair of socks, their feet will develop unrestricted.

Children's feet grow quickly, and once the need for shoes becomes apparent, they may, more frequently than parents would like, require changing shoe size to allow room for growth.

Although there is a litany of conditions that affect the feet including arthritis, bunions, athlete's feet, nail fungus, warts, infections, heel pain and foot and ankle injuries, one of the most serious and pervasive problems is diabetes. Diabetes mellitus is a chronic disease affecting about 16 million people in the United States.

People with this condition are prone to many complications of the disease, and about 15 percent of those will develop an open wound or ulceration on the foot during their lifetime.

Twenty percent of these ulcerations lead to amputations and, it nearly goes without saying an amputation often ends a working career and restricts social life and independence. For more than 50 percent of those who experience an amputation of one limb resulting from the effects of diabetes, the loss of the other limb will occur within three to five years.

The key to amputation prevention is good blood glucose control and early recognition of foot problems. Warning signs include color changes of the skin, increased skin temperature, swelling of the foot or ankle, pain in the legs when at rest or while walking, open sores with or without drainage that are slow to heal and ingrown and fungus infected toenails.

Ulceration is not uncommon in patients with diabetes, and often poorly fitting shoes or socks may cause the initial sore.

Your family physician is trained to recognize and treat many of these conditions. Doctors of podiatric medicine are specialists that exclusively provide foot care and they are especially skilled in recognizing and treating the many conditions that plague our poor feet.

World Wide Web Resources American Podiatric Medical Association http://www.apma.org This Web site provides excellent information on more than 30 topics related to foot problems and foot care/ Center for Podiatric Information http://www.infowest.com/sites/p/podiatry/ On this Web site you can access information on various foot disorders, with accompanying pictures of the various disorders that are quite detailed.