2. FOOT CARE FACTS
•3 out of 4 people experience serious foot problems in their lifetime.
•The foot contains 26 bones, 33 joints, 107 ligaments and 19 muscles.
•1/4 of all the bones in the human body are down in your feet.
•When these bones are out of alignment, so is the rest of the body.
•Only a small percentage of the population is born with foot problems.
•It's neglect and a lack of awareness of proper care - including ill fitting shoes –
that bring on problems.
•Women have about four times as many foot problems as men.
•High heels are partly to blame.
•Walking is the best exercise for your feet.
•It also contributes to your general health by improving circulation, contributing
to weight control, and promoting all-around well being.
3. DIAGRAM OF THE BONES IN
A. distal phalanx of the hallux
B. proximal phalanx of the hallux
C. distal phalanges
D. intermediate phalanges
E. proximal phalanges
F. 1st metatarsal
G. lesser metatarsals
H. medial cuneiform
I. intermediate cuneiform
J. lateral cuneiform
K. styloid process
This view is from the bottom of the foot, a plantar view.
Ligaments attaching to the bones are also shown.
Phalanges: The bones in the toes are called
Metatarsals: The bones in the middle of
the foot are called metatarsal bones.
Cuneiforms: There are three bones in the
middle of the foot, towards the center of
the body called cuneiforms.
Cuboid: The bone sitting adjacent to the
cuneiforms on the outside of the foot is
called the cuboid.
Navicular: This bone sits behind the
Talus: Also called the ankle bone, the talus
sits directly behind the navicular.
Calcaneus: Also called the heel bone, the
calcaneus sits under the talus and behind
4. FOOT MIRROR - OUR
• Conditions such as arthritis, diabetes, nerve and circulatory disorders can show their
initial symptoms in the feet - so foot ailments can be your first sign of more serious
• Arthritis is the number one cause of disability. It limits everyday dressing, climbing
stairs, getting in and out of bed or walking.
• About 60-70% of people with diabetes have mild to severe forms of diabetic nerve
damage, which in severe forms can lead to lower limb amputations.
• Approximately 56,000 people a year lose their foot or leg to diabetes.
• There are 250,000 sweat glands in a pair of feet. Sweat glands in the feet excrete as
much as a half-pint of moisture a day.
• Walking barefoot can cause plantar warts. The virus enters through a cut.
• The average person takes 8,000 to 10,000 steps a day, which adds up to about
115,000 miles over a lifetime. That's enough to go around the circumference of the
earth four times.
• The two feet may be different sizes. Buy shoes for the larger one.
5. Plantar Fasciitis
• Plantar Fasciitis is one of
the most common
conditions resulting in
• This condition is an
the plantar fascia and is
common in all age groups.
• The plantar fascia is
longitudinal bands of
dense fibrous connective
tissue that originates at
the heel bone and runs
along the sole of the foot
(plantar surface) to its
attachment at the base of
• The plantar fascia act as a
bow string to keep the
arch of the foot from
•Pain usually felt along the underside of the heel, arch (MLA) and into the metatarsal
•Pain and/or stiffness in the morning or after periods of rest, relief after a few steps.
•Pain after excessive activity or at the end of the day, may be sudden with unknown
•Mechanical stress and/or direct micro-trauma placed on the plantar fascia.
•lLss of natural tissue for cushioning under the heel (“fat pad atrophy”).
•Excessive pronation lengthens the arch overstretching the plantar fascia results in micro-
tears of the fascia and increased pull on the calcaneus (heel bone), which may lead to the
development of a heel spur
6. Treatment Options:
• The treatment of Plantar Fasciitis is relatively simple, yet it may take several weeks or
more for the symptoms to go away completely, allowing you to resume normal
activity. Physician may prescribe one or more of the following treatment options
depending on the severity of situation.
• Stretching and icing: daily stretching of the heel cord and plantar fascia to help warm-
up the soft tissue. Icing is required after the stretching to reduce inflammation
• Rest and activity modification: decreasing distances and duration of activities such as
• Custom Orthotic Devices: if you have a foot dysfunction, a custom made orthosis can
be manufactured to redistibute pressure, control flexible mechanical abnormalities
(pronation/supination) and cushion under heel
• Proper Footwear: footwear should have features to control improper foot mechanics
and compliment the orthoses
• Other health care modalities: Physiotherapy and/or massage therapy
• Night splints: worn at night while you sleep, keeps tension on the plantar fascia so it
heals in a stretched position.
Corrective options from Relief:
• Is a non-specific diagnosis of pain
and/or inflammation in and
around the ball of the foot
• One or more of the metatarsal
joints may become painful or
inflamed due to the presence of
Any extra stress/pressure on the front of the foot can cause metatarsalgia, Common examples
•Improper fitting shoes (high heeled or pointed footwear)
•Hammer toe resulting in a more prominent metatarsal head fat pad thinning, Callouses or
pressure sensitivity may develop beneath the joints.
•Trauma (sports or other injuries) or exposure to hard surfaces for extended periods.
•Collapsing of the metatarsal transverse arch.
• Treatments consist of relieving the pressure on the ball of the foot.
• This may be achieved by one and/or a combination of the following depending on the
severity of the pain:
• Wear proper footwear: in mild cases simply changing to proper footwear (wide round
toe box) may be all that is required
• Shoe modifications:
• Addition of contoured pads, metatarsal bars/pads.
Corrective options from Relief:
Is a bony
enlargement on the
aspect of the first
metatarsal head that
irritated by improper
Bunions are more
in adults but they
can occur in
juveniles as well.
•Most often caused by an inherited faulty mechanical structure of the foot.
•It is not the bunion itself that is inherited, but certain foot types (flat feet) that make
a person prone to developing a bunion.
•Although wearing shoes that crowd the toes won’t actually cause bunions, they can
cause the deformity to get progressively worse.
•Bunions may be treated conservatively with changes in footwear such as round/wide/deep
toe boxes, soft leathers/avoidance of stitching over toes.
•Custom made orthoses to reduce pronation and pad the affected area.
Corrective options from Relief:
11. Foot Corns & Calluses?
• A callus is an area of hard, thickened skin that can occur across the ball of the foot, on
the heel, or on the outer side of the big toe.
• While many consider them a skin problem, they actually are systemic of a problem
with the bone.
• Calluses have painful nerves and bursal sacs (fluid-filled balloons that act as shock
absorbers) beneath them, causing symptoms ranging from sharp, shooting pain to
dull, aching soreness.
• Calluses form from repeated friction and pressure, as the shoe (or ground) rubs
against a bony prominence (bone spur) on the toe or foot.
• The skin thickens in response to this pressure.
• Small amounts of friction or pressure over long periods of time cause a corn or callus.
• A great deal of friction or pressure over shorter periods of time can cause blisters or
• Calluses typically develop under a metatarsal head (the long bone that forms the ball
of the foot) that is carrying more than its fair share of the body weight, usually due to
it being dropped down or due to its longer length.
A plantar calcaneal spur is an outgrowth from the bone at the back of the foot known as the
This outgrowth is the cause of severe discomfort on the sole of the foot (plantar surface) and
pain and is commonly known as heel spur pain.
These spurs may develop over a long period of time and are initially unidentifiable, even
upon x-ray, although the symptoms are present.
Calcaneal spurs may be mistaken for plantar fasciitis, which is the inflammation of the thin
fibrous layer between the skin on the sole of the foot and the bones of the foot.
12. Signs and Symptoms of a Calcaneal Heel Spur:
• Pain, particularly towards the back of the heel, is most often reported although some
patients with a calcaneal spur may not report any symptoms.
• The heel pain aggravates during walking or standing and may completely subside once
lying down or raising the legs off the ground.
• A tender protrusion may be at the back of the sole upon firm pressure.
• Sharp pains when walking on hard surfaces, especially when barefoot.
• Pain upon carrying a heavy object that may distort the pressure applied on the foot.
• Swelling of the foot without the heel spur may occur due to additional weight place
on the opposite foot when walking to prevent the heel pain caused by the spur.
How to prevent calluses:
• Switch to better shoes, or even an orthotic device.
Buy socks with double-thick toes and heels and nylon hose with a woven cotton
• sole on the bottom of the foot.
• Corns are calluses that form on the toes because the bones push up against the shoe
and put pressure on the skin.
• The surface layer of the skin thickens and builds up, irritating the tissues underneath.
• Hard corns are usually located on the top of the toe or on the side of the small toe.
• Soft corns resemble open sores and develop between the toes as they rub against
• Improperly fitting shoes are a leading cause of corns.
• Toe deformities, such as hammertoe or claw toe, also can lead to corns.
• A calcaneal spur is not easily treated and the patient needs to learn to live with the
condition by managing it conservatively.
• Special footwear, resting regularly when walking or running over long distances and
professional care by a podiatrist may assist.
• In severe cases, an anesthetic injection may be considered although this should only
be done when the patient cannot tolerate the pain that is persisting even when
resting the feet.
13. • Calluses can be treated with over-the-counter callus removers that have strong acids
that peel this excess skin away after repeated application.
• You should be careful with these products as they can cause chemical burns when not
• Begin by soaking your feet in warm soapy water and gently rubbing away any dead
skin that loosens.
• A pumice stone or emery board is then used to “file” this thickened skin.
• Apply a good moisturizer to the hardened areas to keep them softer and relieve pain.
• Non-medicated corn pads or moleskin (a thin fuzzy sheet of fabric with an adhesive
back) can relieve calluses, but should be removed carefully to avoid tearing the skin.
Corrective options from Relief:
(Silicone variant) (Variant with fabric)
14. Corrective options from Relief for Heel and Arch:
Achilles' tendonitis creates pain, tenderness and stiffness just above the heel bone.
• The most common cause of Achilles' Tendonitis is overuse of the tendon, such as during
excessive physical activity involving feet.
• Biomechanical abnormalities and wearing high-heeled shoes for prolonged periods can also
create this condition.
• To treat Achilles' tendonitis, remember the acronym "PRICE": protect, rest, ice, compress
• Protect: Protect the Achilles' tendon from further injury by immobilizing it. Wearing a brace
or splint and using crutches can encourage faster healing.
• Rest: Rest is vital for tissue healing. Avoid activities that increase pain or swelling to the
injury. After a few days of completely resting the affected area, gently move it through its
full range of motion a few times a day to maintain joint flexibility and prevent stiffness.
• Ice: Ice can help reduce pain or swelling. Apply it to the injured area for about five minutes a
few times daily.
• Compress: Compress the injury until the swelling is gone with a compression bandage or
• Elevate: Elevate your foot above the level of your heart to reduce swelling.
• Wearing proper footwear and shoe inserts, such as heel stabilizers and heel supports, can
take stress off of your Achilles' tendons, comfort feet and prevent injuries.
•Tendons are thick, fibrous cords that
attach muscle to bone.
•The Achilles' tendon, also called the
heel cord, connects muscles in the
back of the lower leg to the heel bone
(or the calcaneus).
•It helps the foot point downward,
rise up on the toes and push during
walking. Inflammation of a tendon is
called tendonitis. The area highlighted
in red in this illustration refers to
16. Corrective options from Relief:
17. Diabetes and Foot Issues
Diabetic Foot Problems?
• If a doctor has ever said you had an elevated blood sugar level – even just once when
you were pregnant – you are at risk for diabetes.
• Nervous system impairment (neuropathy) is a major complication that may cause you
to lose feeling in your feet or hands.
• This means you won’t know right away if you hurt yourself.
• The problem affects about 60 to 70 percent of people with diabetes.
• It is estimated that 15% of all diabetics will develop a serious foot condition at some
time in their lives.
• With proper education and tools one can prevent the likely hood of foot health
• Visit your local health care professional to get information on foot care, proper
footwear and preventative action.
• Poor circulation, neuropathy and decreased ability to fight infection create the
grounds for a high risk foot type.
18. Corrective options from Relief:
Diabetes and Foot Issues