Healthy feet help people stay active

Appeared in: Cortez Journal

Now that the weather is warming up, that means it's time to start enjoying outdoor activities. If you're ready to go hiking, play a few rounds of golf, hit the tennis courts, get back to jogging, start working around your home and gardens, ranch or farm, you'll want to keep your feet healthy and pain-free in order to stay active this spring and summer.

"The old adage 'when your feet hurt, you hurt all over' is true," said Cortez podiatrist Terry Cook, DPM. "Foot problems present a special challenge. If your arm hurts you can just ease up on using it for a while until it heals, but it's hard to get around on just one foot."

The foot is one of the most complex of all the body parts. Each foot has 33 joints, 26 bones and 112 ligaments, all of which work together so that you can get around both during daily activities and when you engage in exercise and sports. A recent survey by the American Podiatric Medical Association ( revealed that 72 percent of Americans report not exercising due to foot pain. In this article, Dr. Cook shares his thoughts on how active people can prevent common foot conditions, and what can be done to treat problems when they do occur.

But first, here's a primer on the profession of podiatry. After four years of undergraduate college, and usually a major degree, podiatrists earn their DPM (doctor of podiatric medicine) by completing four years of podiatric medical school, followed by a hospital-based residency program that lasts another three to four years. Podiatrists are licensed by the state in which they practice, may be board certified in their specialty, and keep their skills and knowledge sharp by engaging in continuing medical education each year.

"Podiatrists treat foot and ankle problems like ingrown toenails, sprains, fractures, infections and inflammatory conditions, and bunions. And a big part of what we do is care for patients who have diabetes to help prevent amputations," Cook said.

Like MDs, DOs, and other licensed health care providers, DPMs send their patients for laboratory studies and X-rays, prescribe medications, order physical therapy treatments and perform surgery.

Here's a rundown of common foot and ankle problems that Dr. Cook treats regularly, many of which you can prevent by taking good care of your feet. What's good foot care? Cook said it's keeping your feet clean and dry, wearing clean socks with supportive shoes that fit well and keeping toenails trimmed properly.

Ankle sprains and strains, which are essentially the same thing, can often be prevented by wearing shoes that are designed for the activity you're engaging in.

"Many people are in inappropriate shoe gear when they get injured," Cook said.

He recommends, for example, that hikers wear high-top, properly laced up boots rather than sandals or running shoes.

A minor ankle sprain can often be treated at home with the RICE method: rest, ice, compression and elevation.

"Some people need an ankle brace or cast boot or end up on crutches," Cook said, adding that it's difficult to tell patients exactly how long a sprain will take to get better. "It can be three to six months before it's fully healed."

Interestingly, an ankle fracture, which seems like a more dramatic injury, usually heals faster than a sprain.

"Many times with a fracture a patient is on crutches for three to four weeks, then in a walking cast boot for another three to four," Cook said.

Surgery is sometimes indicated for an ankle fracture, but not always.

Small stress fractures in the bones of the foot are also fairly common and can be quite painful.

"The most frequent location for a stress fracture is the top middle part of the foot, behind the toes," Cook said.

This injury, caused by overuse, is sometimes called a "march fracture" in homage to soldiers in boot camp who fall prey to the condition because they're not used to stomping the ground in boots for hours on end.

Stress fractures can be avoided by wearing shoes with good padding and arch support, and not increasing a training program too quickly. Treatment when fractures do occur includes immobilization for four to six weeks in a cast boot and/or using crutches.

Plantar fasciitis is a painful condition involving inflammation of the fascia band that runs from the heel to the toe. This is most often the result of repetitive actions like walking and running, but it can be caused by an injury.

"Classically, patients will have heel pain when they first get out of bed that is relieved after a few minutes but then gets worse as the day goes on," Cook said.

Unfortunately, there's not much you can do to prevent this condition.

"Being overweight may play a factor, but I've treated a lot of skinny people with it," Cook said.

Treatment for plantar fasciitis includes stretching, ice, wearing shoes with good support, and taking anti-inflammatory medications like ibuprofen.

"I treat this condition conservatively and rarely do surgery for it," Cook said.

Tendonitis, like plantar fasciitis, is also usually the result of overuse.

"It's just the chronic build up from regular activities that causes something to become strained or swollen," Cook said.

The treatment is essentially the same as it is for plantar fasciitis.

Almost always a sports-related injury, a tear or rupture of the Achilles tendon can be extremely painful.

"Anyone can get this, but it's often the weekend warrior," Cook said.

The Achilles tendon starts above the heel and runs up the back of the lower calf. A tear may or may not require surgery. Whether treated conservatively or with an operation, it can take as long as nine months before a patient is healed enough to return to sporting activities following this injury.

Heel spurs also can limit physical activity, but it's not the spur itself that causes trouble.

"It's the inflammation around the spur that makes it painful," said Cook, who treats this condition conservatively with ice and anti-inflammatory medications. "The spur won't go away unless you take it out," said Cook, and this isn't usually necessary. "I see 200 to 300 spurs a year and take out maybe one or two."

Don't let foot pain keep you from engaging in the activities you enjoy. If you have any of the problems discussed in this article and they don't respond to home treatments in fairly short order, seek medical attention so that you get back to doing all the things you love to do here in the beautiful Four Corners.

Terry Cook, DPM, graduated from the California School of Podiatric Medicine (CSPM), formerly known as California College of Podiatric Medicine (CCPM), in 1995.


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