A person travels an average of 185,000 kilometers during walking. That is four times around the world! Logical that our feet start to squeak and crack with age. Fortunately, foot complaints are often easy to remedy and prevent.
1. How many people have foot complaints?
According to the Dutch Association of Podotherapists, 57 percent of Dutch people suffer from foot problems one or more times during their lifetime. Because we age on average and remain active for longer, the number of foot complaints increases in old age.
2. What are the causes of the problems among the over-50s? And which complaints are included?
Slack muscles and tendons. The 107 ligaments and 19 muscles and tendons in the feet become slacker during the course of our lives. They then have to work harder to keep the body in balance, which can give a tired feeling.
Too tight footwear. The more everything stretches, the more space is created between the 26 foot bones. The foot is somewhat longer and especially wider, also called a ‘sagging foot’. Shoes that always fit well, suddenly become (too) tight. Result: painful, burning and tired feet, excessive calluses, corns, ingrown toenails or lumps on the big toes.
Thinner fat pads. The fat pads under the ball of the foot and the heel also become thinner with aging, sometimes resulting in pain. People then feel that they are walking on stones or directly on their bones.
Wear cartilage. The cartilage between the foot joints wear, causing stiffness, pain and deformities.
Deviating foot position. An incorrect standing foot – for example, too far in or out – can also cause overload and pain or even inflammation. Sometimes also for complaints in the ankle, knee, hips, back or neck.
Reduced blood flow. Less blood flow in legs and feet provides a drier skin and thus more chance of chapping (cracks) and wounds. Moreover, they do not heal as quickly. The same applies to any fungal infections in the skin or nail.
3. Who is at extra risk?
Diabetic patients often have poorly perfused feet, with all the consequences (see question 2). In addition, the nerves in their feet are affected, so they do not feel pain well anymore. An unnoticed wound can easily get worse and become inflamed. That is why diabetics have to check their feet daily and have them taken care of.
Rheumatism patients often have pain in a foot due to inflammation, deformities and changes in position. A podotherapist can make special insoles to relieve the pressure on the foot.
People with dementia often walk a lot in confused situations, which can lead to foot complaints. Or they are just bedridden, which can cause bedsores on the heel. An additional problem is that demented patients are not always able to express pain. For example, their foot complaints can sometimes remain untreated or worsen unnoticed.
Women generally have four (!) Times more foot problems than men. This is mainly due to the high heels they wear. The higher the heel, the more the bones, muscles, ligaments and tendons in the forefoot and the toes are pushed together. This extra pressure can, for example, bend the big toe inwards, possibly resulting in pain, an ingrowing toenail or a toe lump (extra bone formation). The friction between the skin and shoe increases the chance of thick calluses and corns. Nerves are also pinched. That can cause tingling or numbness.
4. Are high heels completely out of the question?
As long as you wear them for a few hours now and then, high heels are no problem. But preferably not too often.
5. What is a ‘well-fitting’ shoe?
It is sturdy – the sole must be flexible but not foldable – and leave enough space (one centimeter) in front of the toes. You should, as it were, be able to ‘play the piano’ in your shoe. On the side, at the small toes, there must also be some play space. For both men and women, a heel of up to three centimeters is the best. Furthermore, it is important that the shoe fits well on the instep. If not, the foot will slide and you will constantly have to strain your muscles so as not to slip out of the shoe. All this also applies to slippers. Always buy shoes at the end of the afternoon, when feet are at their greatest. In a specialist shop you can have both the length and the width of your foot measured and find the right size. Do not always choose the same size automatically; the size may differ per manufacturer and model. Do not be tempted by the well-known sales pitch that a tight shoe ‘runs out’. Your foot forms more to your shoe than the other way around.
6. You often hear that a small heel is better than no heel at all. Is that right?
This is especially true for people with knee or back complaints. A small heel can then provide relief and relief from the pain.
7. Which complaints can you treat yourself and when should you seek professional help?
Callus originates as a natural reaction to excessive pressure and friction on the skin. You can gently remove a small amount of calluses yourself with a sandpaper calligraphy file. Do not take too much away and do not use an iron ‘rasp’. This will damage the skin quickly, with the risk of wounds and infection. For all other foot problems it is wise to seek professional help. This also applies to corns. At the drug store you can get various remedies against corns, but it usually does not work to remove the deeper ‘kernel’ of the corn and the chance of damaging healthy skin is greater.
8. Is it possible to go through with foot complaints for a long time?
Healthy feet are essential to remain independent and mobile. If nothing is done about the cause, most foot problems are worsening. A bit of callus is not bad, but very thick calluses can stand and give extra pressure and therefore become painful. In addition, moisture can accumulate underneath, with the risk of infection. Untreated corns can also ignite. Stand problems of the foot affect the posture of the whole body and can eventually cause problems in other places (ankle, knee, back, neck). In general, the longer you walk with pain in the foot, the more time it takes to recover. For fungal infections, moreover, they are very contagious. You can easily transfer them to for example housemates or people at the sports club.
9. When do you go to a pedicure?
With calluses (thick calluses, corns), nail problems (ingrown toenail, fungal nail) and skin problems (dry skin, fissures, fungus) you can go to a pedicure. She also gives advice on, for example, footwear, personal hygiene and skin care. Some pedicures have a note ‘foot care for diabetics’ and / or ‘foot care for rheumatic patients’. This means that they have followed further training in these subjects after completing their MBO training. There are also special medical pedicures. They have a broader education and can handle all risk factors (rheumatism, diabetes, dementia, etc.). In addition, they measure, for example, nail braces (orthonyxia) to adjust the shape of a nail and / or prevent ingrowth. Pedicure is not a protected profession. That means that everyone can call themselves that way. For example, there are more and more nail studios that offer pedicure treatments without being trained.
10. What does a podiatrist do?
A podotherapist is a legally recognized paramedic (someone who works on a doctor’s referral) with a college degree. He diagnoses and treats foot complaints (or complaints in other places in the body) that are the result of an inadequate foot. Usually these are pain or fatigue complaints, deformities and / or skin and nail disorders. Diabetes and rheumatic patients with serious complaints also end up at a podiatrist. A podotherapist has various options for treating foot complaints, such as fitting custom-made soles, silicone toe pieces or nail braces. The tasks of a podiatrist and a medical pedicure partly overlap. If a problem is too complicated for a medical pedicure, a patient comes to a podiatrist. Apart from being treated, a podiatrist also gives advice on how to prevent complaints in the future, for example by wearing other footwear. There are about six hundred podotherapists in the Netherlands.
11. What are the latest developments?
More and more podiatrists use a digital pressure measurement system to analyze a patient’s walking pattern. In this way, they know exactly where the problem is and if insoles give the correct correction. Another development is the ‘cad-cam system’, which makes two- or three-dimensional photographs of the underside of the foot. Based on this, a computer then mills a perfectly customized inlay sole.
12. Is treatment by a pedicure or podotherapist reimbursed by the health insurer?
Treatment by a podotherapist is included in the supplementary package with most insurers. Some health insurers reimburse treatment by a pedicure or podotherapist in diabetic patients under the basic insurance, while others have included it in their supplementary insurance. Rheumatoid patients must always claim supplementary insurance for reimbursement. Other patients do not receive any reimbursement for a visit to a pedicure.
13. What can you do yourself to prevent foot complaints?
- Wear appropriate shoes with sufficient space for the toes and not too high heels.
- Cut toenails straight and not too short (also no round corners); this prevents in growth. A real nail scissors (instead of a nail clipper) leaves fewer strokes behind.
- Always dry the feet well, especially between the toes.
- Lubricate your feet regularly with a foot cream to prevent dry skin, splits and calluses.
- Limit a foot bath to five minutes. If you remain in the water longer, the skin will soften, making it extra vulnerable to wounds or infections.
- Walking barefoot is not a problem as long as you have no complaints. With stand problems it is better to wear a sturdy shoe.
- If you wear slippers, the muscles in the foot must work hard to keep the slipper in place. With frequent use this can lead to complaints. Too small slippers cause calluses on the heels.