Happy feet

Posted on 19 Feb 2009 at 9:49am
By David Taffet

Proper foot care is essential to overall good health


THE RIGHT FOOT FORWARD: Podiatrist Michael Saginaw says everything from shoe choice to hygiene can affect foot health. PHOTO BY ARNOLD WAYNE JONES

Even the most athletic and active of body-conscious men and women probably think far too little about one of the most important parts of their bodies. And we’re not talking about the abs.

It’s feet.

We stand on them, walk on them, run on them and lift weights with them, but the human foot is often overlooked — at least until it causes problems.

That’s where Dr. Michael Saginaw of Advanced Foot Care steps in.

Saginaw too often sees patients who have waited too long to pay attention to their feet. "If a problem arises, don’t put it off for six months," he says. "Delayed treatment leads to problems."

Keeping your feet healthy doesn’t have to be complicated, but may require diligence. Here is some of Saginaw’s advice about how to keep your feet happy.

Shoes
Will wearing improper shoes cause foot problems?

"Are we talking about drag queens?" Saginaw asks back. He laughs, but then notes that he actually sees fewer lesbians, and wonders if it’s the sensible shoes. But he does insist that choosing the proper shoes can make a big difference in foot health.

 "I hate flip-flops. Flip-flops are not shoes," he maintains, noting that they offer "no support, no protection — they are not what shoes were designed to be." The only place they should be worn, he says, are in the shower at the gym to prevent fungus.

For athletics, he recommends the right shoe for the right sport.

"There’s a difference in shoes in flexibility, weight and the density of the material used," he says. In tennis and soccer, there is a lot of lateral motion. The right shoe provides stability so you don’t twist your ankle. "A marathon runner’s shoe is almost like going barefoot."

Among his athletic patients, Saginaw primarily treats runners with heel issues and shin splints, both of which he says are treatable. "Typically we put them in an orthotic for running to change what sequence the muscles fire," he says.

But shoes are not the main cause of foot problems Saginaw treats. The three most common ailments involve toenails, heel pain and warts. And his best advice is to practice good hygiene by properly washing and drying your feet and then check them regularly.

Hygiene
Hygiene is one of the best preventative steps in foot care. Dry feet help prevent fungus, and anti-fungal powders may alleviate hyperhidrosis. Even socks offer additional protection from friction inside the shoe and can help prevent cuts and blisters. (Cotton socks are more absorbent than nylon although some nylon in the blend helps them keep their shape and hug the foot better.)

Nails
Ingrown nails can be painful; some people are just prone to them. Saginaw says you can help prevent them by letting the nail grow longer and cutting it straight across, but a foot care specialist can be used to prevent some of the symptoms if the problem recurs.

Fungus — including athlete’s foot — can be picked up anywhere but must be diagnosed. Some symptoms, like a trauma to the nail, may mimic a fungus but requires a different treatment. Current treatment includes topical and oral medication, but Saginaw hopes Texas will becomes the first in the state to offer a new laser treatment for fungus (which is waiting for Food and Drug Administration approval).

Warts
No, they don’t come from touching toads, but warts provide a challenge to foot care. (People with HIV are more prone to wart growth.)

"The problem with warts is that they are viral," Saginaw says. "Before putting on a home remedy, it needs to be diagnosed properly. You have to know what you’re treating. Warts can be confused with calluses."

Over-the-counter remedies work well for children’s softer skin, but adult dermis presents more difficulties. The problem with using a product like Compound W on the foot is the tougher skin that it won’t penetrate, requiring more aggressive treatment.

Heel pain
Plantar fasciitis, the most common heel pain, is caused by inflammation of the tissue that connects the heel to the toes. Orthotics are most commonly used in the treatment of this condition, and surgery is needed only rarely to treat the condition. Saginaw says early diagnosis is important.

Bony growths usually on the front of the heel are known as heel spurs. Many patients with plantar fasciitis also have these formations. Treatments for heal pain usually involve ice packs, exercise designed to relax the tissues, anti-inflammatory medication and orthotics.

Breaks
"It’s not true that you can’t do anything for a broken toe," Saginaw says of a common myth about broken bones in the foot. Self-treatment can cause more harm than good. Toes flex independently of each other and taping one to the other is not proper treatment. Instead, broken toes should be splinted separately.

Neuropathy
Numbness or tingling in the feet is known as neuropathy, something common in people with diabetes or taking HIV medications. With the feet insensitive to pain, you are less likely to notice cuts, blisters, calluses and warts that can lead to infection if left untreated. Self-inspection is the best prevention for smaller problems developing into bigger ones.

Ultimately, Saginaw keeps his advice simple: "Listen to your body. If it hurts, don’t do it. You can’t work through an injury."

This article appeared in the Dallas Voice print edition February 20, 2009.

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