Top tips for foot health
Tip No. 1
Our feet go through a significant amount of loads and stress during various activities that we do during the day. The pressures that go through the joints of the feet vary from as low at 5,000 kgforce/m2 to around 36,000 kgforce/m2 whilst running and even higher in top athletes. No wonder that our feet are designed and biomechanically capable to withstand such loads and deal with the demands of our day to day life!
When the balance between load and biomechanical stability is upset, either by way of injuries (severe ones or repeated low grade), or changes in our lifestyle, we start seeing persisting problems, including pain, deformities and degenerative changes in joints etc. Remedial action is needed when we start seeing patterns in our activity status which are not normal or routine.
During National Foot Week, pay more attention to the niggling foot or ankle problems that you’ve been putting up with. My top tip for people who sprain their ankle/foot while running or indulging in sport is to get it assessed by a specialist as early as possible. This can make a big difference in the recovery and rehab and save a huge amount of time whereby one could have returned to their routine much earlier.
Mr Suresh Chandrashekar, Consultant Foot & Ankle Surgeon
National Foot Week is an ideal time to remind ourselves that inflammatory arthritis can attack the feet of people with inflammatory arthritis such as those with Rheumatoid arthritis (RA), Ankylosing Spondylitis, Gout and Psoriatic Arthritis.
9 out of every 10 people with RA will complain of foot problems at some point in their disease. Symptoms include pain, swelling, warmth, and with longer disease duration it’s possible to develop progressive deformity of the foot’s shape.
The good news is that early specialist treatment can help prevent the latter while treating the acute symptoms effectively so if patients develop any of these symptoms please seek advice from a Rheumatologist as soon as possible.
In addition to the above symptoms, patients often report the impact of foot symptoms on their work, lifestyle, sports and hobbies. Judicious use of medications, steroid injections, insoles, corrective footwear, multidisciplinary therapy and if needed, surgery, can help slow down or prevent permanent damage and keep our patients doing what they want to.
All the joints of the foot and ankle can become inflamed but most commonly the metatarsophalangeal joints are affected. Some people with RA develop nodules over bony prominences which can rub against (e.g. ill-fitting footwear) and this friction can cause corns and calluses which in turn may ulcerate and become infected. Some patients develop inflamed fluid filled sacs (bursitis) which can be intensely painful. Other people with inflammatory arthritis can develop impaired circulation to the toes due to blood vessel spasm (Raynaud’s), furring up of blood vessels (atherosclerosis) or inflammation of blood vessels (vasculitis). Even the nerves can be affected in RA and this can cause loss of sensation or very unpleasant painful sensations.
The key point to take away is that inflammatory arthritis can attack not just joints, but also the skin, blood vessels, nerves and other tissues and early recognition and specialist treatment helps, so it’s advisable to seek advice from a Rheumatologist as soon as possible to help limit permanent damage and disability.
Dr Simon Paul, Consultant Rheumatologist
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11 March 2020–