Footcare for the elderly

As an elderly patient, it is important that you pay special attention to your feet with regard to foot hygiene, the cutting of nails, the type of socks/hosiery worn and the type of shoe. Older feet naturally can develop more problems because the skin tends to thin and lose its elasticity. Healing can take longer and wear and tear will take its toll on the joints over the years and may cause swelling or some degree of arthritis. Uncomfortable and painful feet are not necessarily a natural progression of ageing. Following basic guidelines may improve comfort, relieve pain and maintain mobility.

Keeping Warm

Try to keep your feet as warm as possible. Exercise is the best way and warm hosiery or socks can help. Wearing an extra pair of socks in cold weather can help, but care must be taken that when worn with shoes, the feet are not tight in the shoes. Avoid anything too tight which may restrict circulation or squeeze your toes.
Follow the guidelines set out in the ‘General Foot Care‘ page.

Footwear:

As we get holder, it becomes more important to wear a shoe that holds the foot in place and gives adequate support.

Buy shoes that fit you in the shop. Do not expect tight shoes to stretch.
The upper part of the shoe should be soft and flexible, and the lining should be smooth and where possible free of ridges.
The toe box should allow all the toes to wiggle freely without rubbing against the front or the top of the shoe.
The instep should cushion the arch comfortably without causing irritation.
The heel should fit snugly without slipping, pressure or pinching.
The sole should flex easily at the ball of the foot.

Footcare for children

As children’s feet grow, the cartilage changes into bone. Growth does not take place at a steady pace and during the first year the foot reaches almost half of adult size. The foot is fully developed towards the late teens.

As the feet are soft, it is very important that they be allowed to develop naturally, without being constricted in any way. It is important not to force children into walking sooner than they are ready, as this can have a long term effect upon the feet and the formation of the bones in the leg.

It is not always necessary to have children wearing shoes in the early stages. Whilst indoors, barefoot is preferable as it allows the foot to develop and strengthen the muscles without being constricted. When children start walking, that is the time to get them good shoes. Ensure that the feet have been measured using the right gauge and that the shoe fits properly. Correct measurement is only a guide as to which shoe will fit best. Regular fit checks are recommended to ensure that the shoes are not constricting the feet.

After 7-8 years the foot has developed considerably and it is not so easy to correct any structural abnormality. In these cases exercises or corrective appliances may be required to aid foot function.

If you have any concerns about the way your child is walking, early examination by a registered Chiropodist should detect any underlying defects. As children grow and their feet continue to develop, check the shoe and sock sizes every few weeks in the early stages to every 3-4 months after the age of 2-3, to ensure that they have not outgrown their shoes.

At the age of five, the foot has its full count of 26 bones, however it has not fully formed. It is only around the age of eight that the arch is properly developed and the foot growth rate will begin to slow down.

Footcare for diabetics

Diabetes, or Diabetes Mellitus to give it its proper name is a chronic disease that affects millions of people around the world. It is classified as a set of related diseases that occur when the body cannot regulate the amount of sugar or glucose in the blood stream. Glucose or sugar provides the blood with energy. It is produced by the liver from the food that we eat.
For those with a healthy system, the blood glucose level is regulated by several hormones, one of which is insulin. This essential chemical allows glucose to move from the blood to the liver, muscle and fat tissue, providing energy for the body. Insulin is produced by the pancreas, which also secretes enzymes important for proper digestion.
Diabetes is the resulting condition when the body does not produce adequate amounts of insulin properly in the system. The glucose therefore cannot move into the cells and convert into energy, but rather builds up in the bloodstream. This build-up harms both the cells seeking fuel as well as the organs and tissues exposed to the higher glucose levels.

Diabetes can be divided into two types:

Type 1 Diabetes

In this type the body stops producing insulin or produces so little that the body cannot regulate its blood sugar level on its own. This type is most commonly identified during childhood or in young adults and was previously known as ‘juvenile diabetes’. Type 1 diabetes can occur in adults and older persons as well. Type 1 diabetes normally requires daily insulin treatments to stay healthy.

Type 2 Diabetes

In this type, the pancreas secretes insulin as expected and sometimes at the proper levels, but the body cannot process the insulin completely. The body tries to overcome the rejection by producing more insulin. This is commonly referred to as ‘insulin resistance’ and is normally recognised in adulthood. Type 2 diabetes is controlled with proper diet, weight loss if required and oral medications.
Diabetes can lead to poor blood supply, loss of sensitivity (peripheral neuropathy) and greater risk of infection to the feet. It is therefore more important, if you have diabetes to look after your feet.