The Importance of Foot Care

Treat your feet right and give pain the boot



ILLUSTRATION BY benjamin hjelm

Robert Kraft, 73-year-old billionaire, business magnate, and owner of the New England Patriots football team, has made a splash in recent months as he attended red-carpet events such as the Tony Awards and Grammys with a young actress on his black-suited arm and sneakers on his feet. You might suspect that Kraft is trying to send a message that he’s hip and young at heart, but he has stated in interviews that his primary motive for wearing custom-made orthopedic kicks is to soothe and support his aching feet.

Alas, foot ailments know no boundaries; they affect the rich, poor, young and old. Diabetics are at particular risk of foot trouble and need to treat their feet with very special care, but in general, people don’t show their feet much love — until they have a problem. “People absolutely undervalue their feet until they have an issue, and then they feel it every step of every day,” says Peter Kasyjanski, DPM, FACFAS, a podiatrist at Granite State Podiatry Associates in Manchester.

Sole concern

Foot woes can result from a variety of factors, but many of the conditions that podiatrists frequently see share a common denominator: they involve footwear that provided inadequate support. Bunions, curled “hammer toes,” painful plantar fasciitis, fungal infections that cause nails to become thick, brittle and discolored — the list of foot maladies linked with insufficiently supportive footwear goes on, Kasyjanski says, which is why choosing the right kind of shoe can make all the difference.

“From a podiatric or foot-health standpoint, better support is always one of the first things I recommend,” Kasyjanski says, “and by better support I mean a good athletic sneaker or orthotics or insoles in the shoes.” As a preventive step, “everybody should have a good pair of sneakers in their wardrobe and wear them when they’re active,” he says. Shoes that are soft and malleable might be tempting because they feel good on our feet, but they provide little support, Kasyjanski says. Slippers and the like can cause our feet to compensate for the lacking structure, making abnormalities and dysfunction within the feet more likely, whereas firmer shoes will prevent the compensation from occurring.

Are pedicures harmful?

Although our disregard for our feet can create trouble, as evidenced by the times when we wear impractical or poorly fitting shoes and later suffer blisters or worse, sometimes problems arise when we lavish too much attention on our feet. In particular, pedicures — like soft, squishy shoes that feel good — can be damaging. To avoid trouble, stick with a reputable salon where employees properly clean their instruments or bring your own pedicure tools, says James H. Dolan, DPM, a podiatrist at Core Podiatry in Exeter.

Why bother? Fungal toenails and other widespread toenail ailments often result from pedicures, Kasyjanski says. “A lot of people think they get fungal nail because of hygiene issues. That’s not true at all,” he says. The fungus that affects toenails grows naturally in our skin, he says, but can create trouble if the skin gets damaged in any way, including via a pedicure. Fungal nails are “very, very common and very difficult to treat,” he says.

And if you do go to the salon, remember that cuticles are not the enemy. Pedicurists often cut back the cuticles that grow around nails, but cuticles are part of our body’s defense against infection and bacteria, Kasyjanski says, so pushing and clipping them is not a good idea. Ask your pedicurist to skip the cuticle treatment, he says.

Also just say “no” to constant coats of nail polish. “It seems to me the trend is now for women to get pedicures year-round,” rather than indulge in pedicures only for special events or summertime, Dolan says. “Leaving toenail polish on month after month puts you at risk for developing a fungus,” he says, so consider going au naturel more often.

It’s not happy news for those of us who enjoy a splash of color on our nails, but we need to give our toenails a break — a good kind of break, that is. “Many women come to see me after the summer,” Kasyjanski says. “They’ve been wearing nail polish all summer long and now their nails are damaged. Oftentimes the nails can grow out afterwards, but sometimes they don’t. Sometimes they get secondarily infected by fungus and then we have to treat it, and again, it’s not the simplest thing in the world to treat.” 


Choose your shoes wisely

Behold the lowly foot. Around these parts, it stays under wraps for much of the year, lest our piggies get frostbite. Some of us should probably keep our feet hidden for the entire year. But what they lack in beauty they make up for in function, which is why we should make an effort to take care of them. Start by smartly choosing your footwear.

Go for support

A supportive shoe will bend only at the toes, says Peter Kasyjanski, DPM, FACFAS, a podiatrist at Granite State Podiatry Associates in Manchester. If you can bend a shoe in half at the arch, if it feels like a slipper or if it’s very loose, then it’s an unsupportive shoe, Kasyjanski says.

Watch the heel

No one was designed to walk around in high heels, says James H. Dolan, DPM, a podiatrist at Core Podiatry in Exeter. Go for an inch-and-a-half or lower.

Embrace your true size

Don’t be in denial about your shoe size. Like it or not, our feet get bigger and wider with time. “Whatever size shoe you wear, it’s probably inaccurate,” Dolan says. Get measured, preferably late in the day when feet are largest, “by someone who actually knows what they’re doing.”

Forego the flip-flops

“Flip-flops are probably the number-one generator of patients for me in the summer,” Dolan says. “Flip-flops are designed to wear from the shower to the bedroom, not to be used as a shoe for the day,” he says.

Be realistic

Match what you wear on your feet with your activity level. “If you’re going shopping at the mall for a few hours or sightseeing or traveling, you should wear a supportive sneaker or at least a shoe that can have an orthotic or an insole in it,” Kasyjanski says.

Enjoy, a little

If your shoes aren’t causing you pain, you don’t have foot trouble and you’re not going to walk much, short stints in impractical footwear can be OK, Kasyjanski says. Use common sense, though. Don’t go dancing in stilettos, he says, “because then you’ll probably be in my office on Monday morning.”

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