Your feet take you everywhere

When boot season rolls around, your feet might be out of sight, but they shouldn’t be out of mind.

Good foot care is essential all year. It’s especially important for people with diabetes, neuropathy (nerve damage) and circulation issues.

Debby Coulthard, RN, a certified foot care nurse at PeaceHealth in Cottage Grove, Oregon, relates a story that sparked her passion for foot care. Coulthard saw a gentleman who had lost so much feeling in his feet that he didn’t notice his set of car keys had slipped into one of his shoes during a long hike. After the hike, he found the keys only after he had taken off his shoe and found they had ravaged his foot. “I was dumbfounded,” she said. “I’ve always known foot care was important, but until then I didn’t realize the severity of possible damage.”

As Coulthard’s example shows, what you don’t feel can hurt you. Without being able to feel your feet, it’s easy to mis-step, twist an ankle or take a tumble. Injuries from a fall as well as harm to the skin or tissue of your feet can take a very long time to heal.

It isn’t only risky to lose feeling in your feet. The opposite is also true. PeaceHealth’s Hilary Gerber, DO, in Vancouver, Washington, once saw a patient who had trouble walking because of severe foot pain. After seeing a television commercial about shooting nerve pain, he thought he might have diabetes. Gerber took a closer look and discovered that several of the man’s nails had simply grown much too long. Fortunately, she caught and fixed the problem before it could cause further damage. He was back to walking pain-free.

You might be surprised to know that foot health isn’t only about your feet. Your feet are the foundation for the rest of your health. Other parts of your body are affected by how you treat your feet. That’s why your doctor might explore changes related to your feet when you complain of knee pain or backaches.

“Having healthy, functional feet affects the overall health of the body in many ways,” said Geoff Bain, RN, a foot care specialist for PeaceHealth’s senior wellness clinic in Eugene, Oregon.

Put yourself in another’s shoes

Except during the summer or in warm vacation spots when we want sandal-worthy toes, we might not think about foot care until there’s a problem. Gerber says, “When we’re young and healthy, we take it for granted.” When you’re in prime health, you’re flexible enough to bend or bring your feet up to where you can look more closely. Your eyesight is clear. And your hands are usually strong and agile enough to still work a pair of nail clippers.

As we get older, foot care can be a much tougher task.

“People don't realize how hard it is to care for your own feet when you get to be a certain age,” said Gerber. “One of the simplest and most gratifying things we, as healthcare professionals, can do to help older patients is just simple foot care.”

Foot care checklist

If you’re relatively healthy, you can manage your own foot care with these simple tips

• Check your feet regularly.
• Wear shoes that fit well, are suited to your activity and aren’t too worn down.
  • Shoes that are too big can cause blisters.
  • Shoes that are too tight or pointy (or high heels) can aggravate bunions. They can also cause ingrown nails and painful corns.
• Trim your toenails regularly. Clip straight across and don’t go too short. Angled cuts can cause painful ingrown nails.

As you get older or if you have any conditions that require extra attention to your feet, follow the same guidelines above but

• Check your feet DAILY. If you can’t, ask a loved one for help.
• Review your insurance to see if your benefits cover foot care. Some might also pay for custom inserts or specialty socks and shoes.

Professional help is available 

PeaceHealth offers foot care in primary care offices (including senior health) as well as special foot care services with a referral from a patient’s primary care doctor.

Medicare and other standard insurance plans usually cover at least one diabetic foot check per year. Some plans cover more frequent visits if your condition (diabetes, neuropathy or circulation issues) puts you at risk for developing complications.

“Our ultimate goal is to help people keep their feet intact,” said Bain. He describes what to expect in a routine foot care visit. First, the nurse will briefly assess the skin, circulation and sensation of the feet. Then, the nurse will trim and possibly thin nails to reduce the chance of injury and pain.

Callus removal is often next. Calluses are patches of thick skin that can lead to neuropathic or diabetic ulcers (wounds or breaks in the skin). According to Bain, “calluses can act like a foreign object and can ultimately lead to potential infections.”

The last few steps in the visit include applying an emollient or strong moisturizer to keep the skin from drying out and forming calluses. Finally, the nurse will evaluate the condition of a patient’s shoes and socks.

“Compared to a pedicure at a nail salon, our focus is on comfort, safety and education rather than cosmetics,” he said.

Still…while the focus of foot care isn’t about looks, foot care specialists can help patients feel better about their feet.

“Some people feel bad about the way their feet look and they don’t want to come in. I say, don’t worry,” said Coulthard. “I’ve seen dramatic changes that foot care can make. I had one new patient come in, really uncomfortable about how his feet looked. After a visit or two the patient said ‘are those my feet? I can’t believe those are my feet!’ When people feel better about their feet, they usually feel better overall.”

Helping people keep their feet in top condition isn’t the only benefit of foot care, according to Coulthard. “Because we have eyes on our foot-care patients every eight to 12 weeks, we can also see when they have other medical issues that need follow-up,” she said.

Bottom line — good foot care all year round can prevent or solve a variety of health concerns. It pays to pay attention. Regardless of your age or condition, doctors encourage everyone to make foot care a priority.

If you have concerns about your feet, let your primary care provider know. “We’re here to help care for you, from head to toe — literally,” said Gerber.