veNTIlATIoN - Green Cross Publishing

46
poster series
Foot care and footwear
Do you feel that you’re under pressure every day
of the week, every week of the month and every
month of the year? Well your feet are! Just imagine
that there was between 65 and 80 kilos of weight
pressing down on you every day and you’ve
got an idea of how those metatarsals are feeling every day.
That’s before we even mention high heels or the fact that we
squeeze our feet into ill-fitting shoes and that we don’t let our
feet breath. Each of these practices leads to a whole host of
problems and our feet suffer the consequences. Skeletal shock,
produced by walking, can be the cause of back, foot, ankle,
knee and hip pain, as well as other joint ailments (Johnson J.,
1994). Even as we drive we are putting pressure on our feet
without realising it; a pressure that they were not designed to
cope with.
However, we often do not pay our feet any attention until
they start to cause us trouble, despite the abundance of advice
available regarding foot care, (Dhara et al., 2001; Bansal et al.
2006, McGuire, J.B., 2006; Rosen, J. 2007). “The most common
foot problems are calluses, corns, fungal infections, toenail
conditions and foot injuries. Conditions such as diabetes and
peripheral vascular disease increases the risk of more serious
foot problems.” (Maher, C. 2002) As well as certain health
conditions, lifestyle choices can often be the cause of foot
problems, such as blisters, cracked heels, sweaty and aching
feet, ingrown toenails and bunions. Many holistic treatments
are being promoted in relation to the feet, with reflexology
now being provided as part of patient care.
With this in mind, the aim of this poster was to provide
professionals with a clear and concise visual aid to highlight to
patients the problems arising from inadequate and unsuitable
foot care and footwear. A brief description of the above
mentioned foot problems and treatments available was listed.
Hallux Valgus Bunion
This is a painful enlargement of the joint of the big toe. The
skin overlying the joint becomes tender and swollen. In severe
cases the joint itself often becomes deformed and the big toe
deviates laterally either under or over the second toe. Poorly fitting
shoes are often a causitative factor. Treatment include wearing
shoes that conform to the shape of the foot thereby relieving pressure
and reducing pain .Surgery is also an option to improve
appearance and reduce pain.
Ingrown Toenail
This condition is more often seen on the big toe. The
edges of the nail become painfully embedded into the
skin. This may happen due to incorrect nail cutting or
from shoe or sock pressure within the shoe. Cutting the toe
nail straight across and relieving pressure on the foot with wide toe
box footwear may prevent the problem. Untreated ingrown toenails
often become infected and painful requiring antibiotic treatment.
Removal of the toenail under local anaesthetic is some times
required to relieve pain.
Hammer Toe
This toe deformity results in a sideways
bend in the middle toe joint often as a
result of narrow tipped shoes. It is a painful
condition especially on the bony prominence on the
top and end of the toe. Corns often develop over this bony prominence.
Sized footwear may prevent this problem.
Morton’s Neuroma
This condition is caused by a nerve between the third and forth toes
becoming pinched as a result of tight fitting shoes resulting in pain.
The nerve responds by forming a neuroma, this is a build up of tissue
in the nerve. This extra tissue results in pain often radiating into
the toes. Wearing correctly fitted wide footwear will relieve pain and
oral medication to reduce the inflamination around the nerve.
Planter Fascilitis
This condition is the inflammation of the connective tissue of the
sole of the foot where it attaches to the heel bone resulting in pain.
This may happen without injury but often as a result of unsupportative
light weight footwear causing pain and swelling in the area.
Medication to reduce pain and swelling along with supportative
shoes are recommended.
references
Bansal, M.K., Kadambande, S.; Khurana, A.; Debnath, U.; Hariharan, K. (2006). Comparative
anthropometric analysis of shod and unshod feet. Foot; 16(4): 188-91.
Dhara, P.,Manna, I.; Pradhan, D.; Ghosh, S.; Kar, S.K. (2001).A comparative study of foot dimension
between adult male and female and evaluation of foot hazards due to using footwear. Journal of
Physiological Anthropological Applied Human Science. 20; 241-6.
Johnson, J. (1994) Footwear alleviates aches, fatigue through better fit, shock absorption. Occup
Health Saf 63(3),68-9.
Maher, C. (2002). A Step in Time… The World of Irish Nursing. June 2002. (25).
McGuire, J.B. (2006). Pressure redistribution strategies for the diabetic or at-risk foot. Advances in Skin
& Wound Care; 19 (5): 270-9.
Rosen, J. 2007. Health matters. Soothe sandal sores. Alternative Medicine Magazine 98, 20.
Abstract submitted by Ann Casey, IPNA Cork Branch. This was an entry for the branch poster award 2007.
Corns
A corn is a circular painful area of traumatised
hyperkeratotic skin. Common sites for
digital or hard corns are the big and fifth toes
as a result of pressure on the skin from incorrect
fitting stockings or footwear. Soft corns occur between the toes,
often corns on opposing toes resulting from sweaty feet can
become painful and develop secondary infections. Professional
advise regarding paring, filing or over the counter treatments is
advised.
Calluses
These are caused by friction and or exact
pressure on the skin over laying the
metatarsal heads of the feet. The skin becomes
thickened and hard resulting in further pressure
and pain when walking. Calluses are the result of inappropriate
footwear, unusual gait (walking pattern) or a foot bone deformity.
Treatment includes identifying the underlying problem, advice
on thick soled footwear or padding and skin care to relieve pressure
and provide shock absorption from underfoot.
Onychomycosis
Fungal nail infections resulting in thickened
painful and difficult to trim nails. The unsightly
appearance of the nail rather than pain is the reason
for seeking treatment. This condition is difficult and slow to
treat requiring compliance with antifungal treatment to prevent
reinfection. A sample of nail clipping is often requested for analysis
prior to treatment.
Tinea Pedis
Commonly known as Athletes foot a scaly,
itchy skin rash occurs between the fourth and
fifth toes firstly then developing onto the sole of
the foot. The skin between the toes becomes
inflamed, swollen and smelly. This is a contagious infection, easily
spread through shower and pool areas or shared footwear. Tinea
pedis initially may develop from the exclusive use of synthetic type
(plastic) footwear and (nylon) stockings resulting in hot sweaty feet.
Good skin hygiene especially between the toes, compliance with prescribed
treatments and wearing leather shoes or sandals with cotton
socks will keep the feet cool.
Copy of original poster