March 2015

During your lifetime, you will probably walk about 75,000 miles, which is quite a lot of stress to put on your feet. As you get older, the 26 bones and 30 joints in your body will lose flexibility and elasticity, and your foot’s natural shock absorbers will wear down too. Having arthritis added to this mix only makes matters worse because your joints will become distorted and inflame, which is why arthritic foot care needs to be something you think about every day.

When dealing with arthritis, having additional foot complications, such as bunions, hammertoes, or neuroma, can be a serious detriment. To avoid these, buying well-fitting shoes with a lower heel and good support are a must. Arthritis causes you to lose your arch, so having shoes with good arch support is also highly recommended.

Aside from getting good arch support, the shoes need to fit comfortably and properly as well. A good place to start is by leaving a finger width between the back of the shoe and your foot to gauge proper size. It is also helpful to have a square or rounded toe box in the front to provide even more comfort. Another thing to look for is a rubber sole that can provide a cushion and absorb shock as you walk. This adds flexibility to the ball of your foot when you push off your heel to walk.

Exercise is another key aspect of arthritic foot care, not only strengthening and stretching your muscles and joints, but helping to prevent further injury and pain as well. Stretching the Achilles tendon for example, the tendon located in the back of your heel, will give you added mobility and reduce pain due to stress. Another thing you can do is massage your feet, kneading the ball of your foot as well as your toes from top to bottom.

Stretching the Achilles tendon is a simple exercise that you can do at home anytime. Lean against the wall with your palms flat against the surface while placing one foot forward, towards the wall, and one foot behind you. Bend your forward knee towards the wall while keeping your back knee locked straight, and make sure both your heels are completely touching the ground at all times. This will stretch your Achilles tendon and calf muscles as well, and you will feel the stretch almost immediately. You can also stretch your toes in a couple ways. One involves taking a rubber band and wrapping it around both your big toes while your heels remain together, then pull them apart to stretch your big toe. You can also place a rubber band around all the toes of one of your feet and then try to separate each individual toe, stretching them all.

A final step you can take to help your arthritis is taking non-steroid, non-inflammatory drugs or topical medicines with capsaicin. Unfortunately there is no complete way to remove all of your arthritic pain, but following some of this advice can go a long way in staying as pain free as possible.

Ankle/foot Orthotics (AFOs) are custom-made devices, molded to fit inside a shoe, and designed to correct an abnormal or irregular walking gait. Orthotics come in both customized and over the counter models. Custom made Orthotics should be prescribed through a podiatrist, who specializes in foot pathology, as well as performing surgery if required, or a pedorthist, who specializes in customized footwear and orthotics management and design. AFOs are commonly used by athletes, such as professional track and field runners, cyclists, hockey players, professional dancers, ice skaters and golfers. Athletes benefit greatly from custom made AFOs, both when recovering from an injury and to help prevent future problems from occurring. These devices keep the foot aligned to allow the bones, ligaments and muscles to heal, restoring the patient to optimum performance. AFOs are designed for shock absorption to help release the pressure and stress from painful parts of the foot and ankle, and to allow for the correct positioning of the feet. Custom-made AFOs relieve pain in the hip and lower back, while restoring balance and improving an athlete’s performance. The AFO controls the motion of the ankle and foot, which helps in alleviating pain. The brace comes in various heights and profiles, for high and low top shoes and boots. Braces are fabric lined and are made of light weight material to easily embrace the ankle, for a better fit inside the footwear. With this type of orthotic, athletes can continue to play in comfort and stability. A custom made ankle/foot orthotic is designed by a podiatrist or an orthotic specialist, to help treat ailments, i.e., tendon maladies, flat foot problems, spurs, arthritis of the ankle and/or foot, ankle sprains, ankle weakness and drop foot (a patient cannot raise their foot at the ankle joint or at the least, has limited ability to raise their foot). An orthotics specialist will put a patient through a complete muscular workup, using digital or ultrasound equipment, followed by the ankle and foot being cast and fitted for the proper orthotics. Depending upon the final evaluation, a stretching treatment is designed, with specific shoe fitting discussions. In a couple of weeks, after the AFOs are fitted to the shoes that the patient was required to bring, any needed adjustments are made to ensure a perfect fit. Following the fittings, evaluations are set up for the patient over the following weeks. AFOs are also available over the counter for improving basic comfort. If an athlete has general low aches or pains in the ankle/foot or lower back, an over-the-counter orthotic arch support, which slips inside the shoes, can be purchased without a prescription. The arch supports help to spread an athlete’s weight evenly throughout the bottom of the foot. But when a medical condition occurs, i.e., an injury, arthritis, problems with an illness, or poor circulation, then a specialist's prescription will be required. Over-the-counter arch supports can be purchased in local retail or sport stores, as well as in drug store pharmacies.  In all cases, a skilled podiatrist will offer the best recommendation on which medical device is suited to handle the patient’s particular needs.