Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

The feet are the most abused part of the skeleton. Some of their insults include frequent trauma, unmerciful chilling, improper footwear, and maintenance of the same posture for many hours, to the point that calluses and corns develop from excessive pressure and sustained reduction in blood supply. A bit of study and a reformation of habits of foot care can bring a great deal of reduction in physical and emotional tension, as very few parts of the body have greater potential for such widespread distress as the feet.

The skin of the foot is very sensitive because it is so well protected by shoes or stockings. Nevertheless, we generally do not protect the feet as well as we should by stockings or shoes. Stockings should be substantial so that the rubbing against the shoes will not be so easily transmitted to the skin to cause corns or blisters.

There are nerve endings in the feet that cause much tickling when pressed or scratched. The reason for this is that the sensation of tickling is a double first cousin to pain, and the nerve endings are quite sensitive. We have powerful reflexes that react to painful stimuli on the feet, protecting them from serious injury. The feet are often made tired by walking in stiff shoes. Streets and sidewalks, hard floors, and hard surfaces and corners are hard on the feet. If we could walk barefoot occasionally on the ground, especially if there were plenty of pebbles to walk on that would massage the deeper structures of the feet, we would find that the foot health would be much better. If one does not have this kind of blessing available, an exercise program may be just what is needed to keep the feet feeling good. One does not need any kind of special or expensive equipment for foot exercises. You should try some of these for their wonderful relaxing ability:

• Sit with the legs stretched out in front, toes pointed toward the floor and simply bend the toes up toward the knees and back down toward the floor. If you make a circle with the toes of each foot, you can have a complete range of motion of the ankle bones in this way.
• Remove your shoes and walk on the edges of your feet, first on the outer borders, and next on the inner borders. Then walk around on your heels, and last walk around on your tiptoes. In this way you will have walked on all the four edges of your feet.
• Take a bottle, such as a soft drink bottle, and place it on the floor; roll it across your large arch. Then take your great toe and try to thread it into the neck of the bottle. Try to pick up the bottle by grasping it with your toes.

When drying from the shower, putting on stockings, or tying shoes, always do these operations while balancing on one foot. It is good for the balance as well as for the foot. Anytime you find yourself barefoot and without an occupation for the mind, take the time to pick up any object that you see - pebbles, tennis balls, pieces of paper, or any other thing that happens to drop.

It is a good thing to walk barefoot also. The backyard is a good place, where there are no dangerous objects to step on, and one does not need to feel undignified. Walking barefoot strengthens the muscles of the feet and keeps the skin in good condition.

The wearing of high heels is injurious to the feet. A podiatrist I know tells me that high heels should not be worn more than four hours per week. Pick your hours with care, and do not go over the limit. Buy dress shoes with low heels. It is actually tiring to wear high heels.

One should be as careful with the skin of the feet as with the skin of the face. If a moist, not very clean condition arises in the feet, it is quite easy to promote the growth of a fungus such as athlete's foot, which can become entrenched in the skin and become difficult to eliminate. Stockings or socks should be absorbent. If one will scrub the feet with a soft hand brush every day to remove all particles of dead skin, it will be quite easy, with proper drying, and use of a little starch or baking soda on the feet, to keep the skin dry and free from odor and fungus diseases.

Toenails should be kept in a healthy condition by keeping them scrubbed with a fingernail brush and the use of an orange stick to remove any kind of dirt that may accumulate under the nails. The cuticles should be worked with faithfully to assure that there is not unhealthfulness of the toenails. Toenails should be kept trimmed close, as long toenails promote many problems from fungus infection to excessive pressure from shoes and bed-clothing. Pressure on the toenails squeezes blood out of the tissue for a sufficient length of time to weaken it against infection and a fungus may attack the nail and eventually destroy it. Once a fungus gets entrenched in a toenail, it is almost impossible to restore the life to the nail, and one can almost count on saying goodbye forever to that toenail. How much better to keep the toenails trimmed nicely, the cuticles cleaned to discourage the growth of fungus, and the nail soft and pliable by proper cleansing and massaging.

Foot care in diabetics and the elderly assumes greater importance, especially in the treatment of corns. A corn medication can be obtained from the drugstore and used according to directions. It is quite safe. Elderly individuals with fragile skin may find the salicylic acid which is the usual ingredient of these preparations capable of causing irritation if any of the material gets on the normal skin. A good method for dealing with corns begins with a 30-minute soak in warm water to which has been added enough dish detergent to make the water soapy. Then use your fingernail to find a good cleavage plane for the corn and lift it off by inching the fingernail under it. Fingernail scissors or a razor blade may be used. Of course, you will use care not to cut yourself, but if you should, treat it promptly by cleansing well with alcohol and applying a square of adhesive tape directly on the skin to seal off the cut.

To treat an ingrown toenail, cut a V in the middle of the nail edge as deep as possible, almost down to the quick. A second thing is to take a few fibers of cotton and work them under the edge of the offending ingrown toenail. The third part of the treatment is hot and cold soaks. Put the foot up to the ankle in hot water, as hot as can be tolerated (unless one is a diabetic in which case only warm water at about 102° or 103° F should be used). After three minutes, put the foot to the same depth in the cold for about 30 seconds. Repeat the 3 minutes in the hot, and 30 seconds in the cold for about four or five changes, then dry carefully. Repeat the treatment every 2 to 4 hours until the swelling and pain have gone down.