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4 Common Conditions Associated with Aging Feet (and How a Canadian Certified Pedorthist Can Help)

Estimates suggest that, on average, if you live to the age of 80 years old you will have taken enough steps to walk the Trans-Canada Highway between Victoria, British Columbia and St. John’s, Newfoundland over 20 times! That is a lot of ground covered on a pair of feet that must get us through a lifetime.

If you knew how many steps you would be taking in your life, would you care for your feet a little better than you are now? Maybe you already have a concern about your feet? While issues with our feet do not discriminate against age, there are a few conditions that become more common among older adults. Read on to learn more about them and how Canadian Certified Pedorthists – C. Ped (C)- can help.

Fat Pad Atrophy

We are all born with large fat pads in our feet. It is why babies’ feet are so cute and plump. When we learn to walk, these fat pads serve the purpose of cushion and shock absorption, reducing the amount of stress on the other soft tissues and bones of the feet. Unfortunately, as we get older, the fat pads begin to break down, thin out, and stop doing their job so well, otherwise known as atrophy. When this atrophy occurs, clients will often describe it as the sensation like they are walking directly on the bones of their feet, most commonly at the heel or ball of the foot. Not only is the sensation unnerving, it can also lead to other complications such as ulceration.

Treatment: To treat fat pad atrophy, a Canadian Certified Pedorthist may recommend supportive footwear with cushion in the areas where thinning has occurred. They may also design custom foot orthotics with extra padding applied to the areas that feel most like they are lacking natural cushion. The foot orthotic may also include features such as a deep heel cup to contain the fat pad under the heel or a metatarsal pad to take some pressure away from the ball of the foot.

Corns & Calluses

Corns and calluses are regularly grouped together; however, they are two unique changes that can happen to the skin of our feet. A corn is a dry thickening on the outer layers of skin with a hard, central core, about 1cm or less in diameter, and commonly found on the side of the 5th (baby) toe, on top of or between the other small toes, and on the bottom of the foot. The most common cause of corns is ill-fitting footwear. Similarly, calluses are formed by a thickening of the skin. However, calluses often appear in areas of high friction and pressure. They can range in size, even covering the entire bottom of the ball of the foot.

Treatment: To treat corns or calluses, a Canadian Certified Pedorthist may recommend better fitting footwear and can help you to choose shoes with a toe box that matches the shape (including depth and width) of the foot. If footwear isn’t the cause they may introduce pre-made or custom spacers to keep the areas separated. Custom foot orthotics can help to positively alter the mechanics of the feet such that pressure and friction can be reduced. Your C. Ped (C) can excavate or dig material out of the shoe or foot orthotic to accommodate a corn or thick callus.

Hammer, Claw & Mallet Toes

Hammer, claw, and mallet toe deformities each refer to a different orientation of the small joints in the lesser toes (toes two through five). They are often the result of an imbalance between the muscles that point the toes down and those that pull the toes up. They are exacerbated by footwear that is too tight and there is a higher occurrence of lesser toe deformities in women than men. Our small toes are meant to help stabilize the foot, and when this function is compromised it increases the risk of falling. This is especially the case among older adults, who have other risk factors for falls as well. Toe deformities are best treated early on when range of motion is still available in the joint.

Treatment: Because ill-fitting footwear is associated with toe deformities, a Canadian Certified Pedorthist will first make recommendations on features and fit to look for. In most cases, extra depth will be required in the toe box of the shoe. Neoprene or mesh can allow for more stretch over the toes compared to a leather or vinyl. Something as simple as having your shoes stretched can also be a big help. If you have a hammer, claw or mallet toe that is due to another problem with your foot your C. Ped (C) may modify an off-the-shelf device or make custom foot orthotics for you. An off-the-shelf or custom toe prop or crest can also be used to offload the tips of the toes in question; this is particularly useful if a painful callus has formed. (For more on conditions of the toes read https://www.pedorthic.ca/foot-health/toe-conditions/)

Osteoarthritis

While changes to the surfaces of our joints, also known as osteoarthritis (OA), can occur as naturally as getting wrinkles on our skin, people over the age of 55 are four times more likely to experience the effects of OA than those in younger age groups. OA can also be brought on by a history of injury and generally poor alignment of the joint. The most common areas of OA in the feet occur at the big toe joint, the ankle, subtalar joint, and midfoot. (For arthritis myths debunked read https://www.pedorthic.ca/pedorthics-arthritis-debunking-common-myths/)

Treatment: Those who are living with OA in their feet or other joints are encouraged to remain active with low impact activities. Depending on the affected joint, your Certified Canadian Pedorthist may recommend footwear features such as a stiff rocker to help reduce painful range of motion and quickly propel the foot during the gait cycle. Custom or off-the-shelf foot orthotics are a conservative treatment that can be used to alter motion and loading of the joints. Selection of the materials a C. Ped (C) might use for someone experience pain due to OA in the foot or ankle will be dependent on what is found during the assessment and could be anything from soft foams to rigid plastics.

To learn more about foot conditions that could be affecting you and your mobility, visit our website to find a Canadian Certified Pedorthist near you visit https://www.pedorthic.ca/find-a-pedorthist/

By Jaime Nickerson, C. Ped (C)


June: A Focus on Seniors

June is Seniors’ Month and Canadian Certified Pedorthists – C. Ped (C) – across Canada are ready to deliver top tips and advice on how to help your feet age gracefully. Here are some facts about seniors and footcare to start off the month:

  • According to the 2016 Census the population of seniors now outnumber children in Canada 5.9 million to 5.8 million. It is anticipated that the scale will continue to be tipped for years to come.
  • Though frequency of health problems rises with increase in age, over half of seniors report they are in “good health”, defined by the World Health Organization as “a state of complete physical, mental and social well-being.”
  • As such, seniors are maintaining an active lifestyle for longer and they’re remaining in the workforce longer.
  • Age-related foot problems include fat pad atrophy (breakdown), boney deformities such as hallux valgus and bunions, hammer, claw or mallet toes, neuromas, corns, callouses, nail disorders, arthritis, reduced circulation, and peripheral neuropathy. These problems can lead to discomfort or pain.
  • Canadian Certified Pedorthists – C. Ped (C) – can help to determine helpful approaches to alleviate the discomfort associated with these conditions through assessment and implementing a treatment plan that could involve thorough shoe fitting, off-the-shelf or custom orthopaedic shoes, off-the-shelf or custom foot orthotics, compression socks, bracing, toe props or spacers, and more.

Quick tips for footcare:

  • Develop a habit of checking your feet daily. If you have trouble seeing your feet, it’s important to get someone to look at them for you or use a mirror.
  • When possible, choose footwear that has an adjustable fit instead of slip-ons. Laces, buckles, and Velcro straps can accommodate conditions such as painful boney prominences, swelling, and toe deformities.
  • Consult your health care provider if the texture, colour or temperature of any part of your feet change.

Be sure to check back frequently this month as we share more tips and facts about aging and footcare!


Foot Health Awareness Month: A Recap

 In case you missed it, May was Foot Health Awareness Month here at the Pedorthic Association of Canada! This month we shared information on the topic of footcare and health. Here’s a recap of the information we shared this month:

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Foot orthotics and orthopaedic shoes are widely available – you have probably noticed signs for them in stores in your community or on online shopping sites. To make sure you are getting the best care possible for your feet and lower limbs ask your family doctor for a referral to a Canadian Certified Pedorthist. Read our blog article for more on finding the best care possible for your feet and lower limbs.

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How do you know when your shoes need to be replaced? Take a close look at each pair of your shoes. If you see signs of wear, including worn out treads, creases in the midsole, indents inside the shoe or asymmetrical wear patterns it is time to purchase a new pair. Read the full post here

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Did you know that it’s completely normal for young children to have flat feet? Babies are born with a fat pad where the arch normally is, making their feet appear flat. Young children also have very flexible feet, which causes them to flatten more when standing. Keep reading

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From an early age we’re taught the importance of keeping our shoelaces tied, and if we didn’t listen to this advice, we quickly learned why it is not safe to run around with untied laces. Tripping hazard aside, tying your shoelaces is very important as it affects how your footwear fits and functions. Different lacing techniques benefit different foot types. In Why Lacing Matters, we present some guidelines to help you determine which technique is best for you.

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Foot problems are the leading cause of hospitalization for Canadians living with diabetes. Canadian Certified Pedorthists – C. Ped (C) – are integral members of a person’s health care team. They offer a unique skill set to help manage and prevent potential foot complications from diabetes. Read more in our blog article on what role a Pedorthist can play in help people manage their diabetes.

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What is an orthotic, you ask? Watch one of our most-viewed videos with the answer: What is an Orthotic?

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Canadian Certified Pedorthists regularly work with a variety of health care providers including nurses, who specialize in foot and wound care, and physiotherapists, to develop a treatment plan best suited for the individual patient and to provide you with the best care possible! See full post here

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One thing that sets Canadian Certified Pedorthists apart from other providers is our skillset for modifying footwear. This video explains! The Magic Behind Modified Shoes

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Although arthritis is common, affecting about 20 percent of Canadians over age 12, it is not a generally well understood condition. Many myths about arthritis exist, but it’s important to set the record straight so patients can be well informed about their health. Read Pedorthics & Arthritis: Debunking Common Myths for more on this topic.

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Even though May is coming to a close, it is important to continue to make foot health a part of your overall health care plan going forward. Make a Pedorthist part of your foot health care plan—find a local Pedorthist here.


Managing your Diabetes: What Role Can a Pedorthist Play?

It is estimated that around 11 million Canadians currently live with diabetes or prediabetes. This is a significant percentage of the population, which means that chances are, you likely know someone affected by the disease. 

Long-term complications in people with diabetes frequently manifest in foot problems such as infections and ulcerations. In fact, foot problems are the leading cause of hospitalization for Canadians living with diabetes. Between 14 and 24 per cent of those living with diabetes are at risk of developing a foot ulcer that could result in the amputation of a foot or leg.

Education is Key

If you are living with diabetes or are prediabetic, it is crucial to educate yourself on the disease, and find ways to better manage your own health. Staying on top of things will help you avoid complications in the long run.

One way to educate yourself is by visiting your local diabetes education centre. These centres are located in communities across the country and provide education on healthy eating and physical activity for people living with diabetes. A quick Google search will help you locate one in your area. Centres are usually comprised of registered nurses and registered dietitians who will teach you how to monitor your blood glucose levels, how to safely take insulin and diabetes medication, how to manage your stress, and how to prevent complications. They will also help direct you to other local health care professionals such as Pedorthists, chiropodists, foot care nurses, eye doctors, psychologists and physical therapists.

How Can a Pedorthist Help?

Living with diabetes can be a daunting task, and education is only one component of managing your diabetes. The other key part of the puzzle is to utilize health care professionals who are on your team and who will help you live a healthy active lifestyle while reducing you chances of complications from diabetes.

Canadian Certified Pedorthists – C. Ped (C) – are integral members of a person’s health care team. They offer a unique skill set to help manage and prevent potential foot complications from diabetes, considering the majority of foot problems diagnosed in people with diabetes could be avoided through daily footcare and proper shoe selection.

Foot Examinations

To avoid the development of wounds or ulcers, it is vital that people living with diabetes visually examine their own feet daily, and, when purchasing shoes, have them professionally fitted rather than relying on how their feet ‘feel’. A Pedorthist can help with this by giving you a proper foot examination at least once per year and providing patient education on footwear and other foot care tips. Pedorthists can also specifically design custom orthotics and provide footwear modifications and custom-made orthopedic footwear. A foot examination by your local Pedorthist will include: an assessment of any structural abnormalities of the foot, such as feet that lean excessively to one side, causing friction between the side of the foot and the shoe; signs of neuropathy and vascular disease; and evidence of any ulcerations and/or infections.

Treating Ulcers

Because many people with diabetes have reduced circulation or sensation in their feet and are not able to feel if something in their shoe or the shoe itself is irritating their foot, they often develop wounds and/or ulcers. Pedorthists can work in conjunction with other foot care specialists when treating diabetic foot ulcers. They can use specific materials and/or devices to reduce pressure and friction on the foot at the spot of the ulcer. Seeing a Pedorthist on a regular basis is important so they can adjust and change the padding and support based on how the ulcer is healing.

Once an ulcer is healed, Pedorthists can play an important role preventing recurrence by helping people transition back to appropriate footwear. They can design and build custom foot orthotics to protect and prevent future skin breakdown.

Seeing your Pedorthist on a regular basis is important; they will help you to stay active and on your feet while monitoring and identify warning signs of complications. To locate a Pedorthist near you, click here.

It’s not easy living with a chronic condition like diabetes. Remember to educate yourself and seek out help when you need it. That way your symptoms will be more manageable in the long run.

By Derek Gilmer, C. Ped (C)

 

Related Links:

Pedorthic Association of Canada – Diabetic Foot Care https://www.pedorthic.ca/foot-health/diabetes/

Canadian Journal of Diabetes, https://www.canadianjournalofdiabetes.com/

Journal of Vascular Surgery, www.jvascsurg.org

Diabetes Canada, https://www.diabetes.ca/


Pedorthics and Arthritis: Debunking Common Myths

As Pedorthists, we see patients with all types of medical issues that affect the foot and ankle. Arthritis is one such condition that can create chronic pain and cause problems with walking, standing and balance. Although arthritis is common, affecting about 20 percent of Canadians over age 12, it is not a generally well understood condition. Many myths about arthritis exist, but it’s important to set the record straight so patients can be well informed about their health.

Here are some common myths that many Pedorthists have encountered in our clinics:

Myth #1: Arthritis is an “Old People” Disease

There is a common misconception out there that arthritis only affects older adults. While it is true that people aged 55 and over are four times more likely to have arthritis than younger people, arthritis can affect people of all ages. In fact, arthritis affects three of every 1,000 Canadian children, and three out of five Canadians diagnosed with arthritis are of working age.

Myth #2: There’s Only One Kind of Arthritis

This is simply not true. The term Arthritis is an umbrella term for more than 100 related diseases affecting joints, tissues, or even the entire body. Common forms of arthritis like osteoarthritis and rheumatoid arthritis are what most people think of when they hear of arthritis, but other common conditions such as gout and lupus are forms of arthritis that might not come to mind as often. Carpal tunnel syndrome is another condition related to arthritis, and can be caused by the stress of repetitive motion.

Myth #3: Arthritis Only Affects the Joints

Arthritis can affect much more than just the joints: muscles, tendons, connective tissue, bones and bursa (the fluid-filled sacs around joints). Lupus can also affect organ functioning. Living with the chronic pain of arthritis can also have a profound impact on one’s mental health, and can contribute to depression, anger, disrupted sleep, fever, unexplained weight loss, weakness as well as fatigue. See our blog article for more on Pedorthists and chronic pain.

Myth #4: Exercise Makes Arthritis Worse

Thanks to recent studies, it is now recognized that exercise is essential to manage chronic pain, including arthritis. It may seem counterintuitive, but lifting weights and performing weight-bearing activities on your arthritic joints can actually help. This is because these activities can build muscles, which supports and protects joints in the long run. The best way to exercise with arthritis is by participating in low-impact exercises that encourage range of motion like walking, yoga, tai chi or water aerobics. Talk to a health care professional about joint-friendly activities that suit your interests and abilities.

Myth #5: Arthritis Can’t be Prevented

We may not know everything about arthritis, but we do know that healthy lifestyle choices like proper diets, exercise and maintaining a healthy weight can help reduce the risk. Studies have shown that among women, having excess weight increases the risk of arthritis in the hips and hands, while in men it increases the risk of gout.

If you work behind a desk all day, or have a job that requires repetitive motions, you can take simple steps to avoid pain and inflammation in your joints, which could lead to arthritis. Take frequent breaks, get up and move around, use proper form when lifting or moving items, and make sure your workspace is set up in an ergonomic way. It is also important to wear proper footwear to improve shock absorption and reduce impact on the joints.

Myth #6: Medication is the Only Treatment for Arthritis

Many people suffering from osteoarthritis may take acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation, but this isn’t the only way to manage one’s symptoms. Some try physical and occupational therapy, while others may have surgery to remove some or all of an affected joint.

When it comes to arthritis in the feet, ankles, knees and hips, Pedorthists can offer alternatives to medication to help improve mobility and flexibility in lower limb joints through the use of custom-made orthotics and footwear. Custom orthotics can improve the alignment of the lower body, reducing abnormal stresses on the joints. They can also provide optimal cushioning to improve shock absorption and reduce pressure on any painful areas of the feet. Footwear with a firm forefoot rocker sole is particularly beneficial for people with painful arthritis in the forefoot and toes, as it promotes forward motion during gait while limiting toe flexion and pressure on the forefoot.

If you suffer from arthritis, it is important to educate yourself on the condition and the myths surrounding it so you can manage your condition and live your life to the fullest. Talk to your health care provider and visit your local Pedorthist to discuss ways to improve your mobility and range of motion by using custom-made orthotics and footwear. Click here to locate a Pedorthist near you today.

By Heather Orosz, BSc, C. Ped (C)

 

References:

Delzell, E. (n.d.). Feet Hurt? Slip in Some Relief With Shoe Inserts [Blog post]. Retrieved from https://www.arthritis.org/living-with-arthritis/pain-management/joint-protection/foot-pain-shoe-inserts.php 

Dostal, E. (2012, March 9). 8 Myths About Arthritis—Busted! [Blog post]. Retrieved from https://www.prevention.com/health/g20482654/8-myths-about-arthritis-busted/

Loranger, L. (2014, September 1). 7 Common Arthritis Myths Busted [Blog post]. Retrieved from https://www.physiotherapyalberta.ca/public_and_patients/the_you_movement_blog/7_common_arthritis_myths_busted

Rogers, E. (2018, September 5). 8 Myths About Arthritis Debunked [Blog post]. Retrieved from http://www.everythingzoomer.com/health/longevity/2018/09/05/8-myths-about-arthritis/

Statistics Canada. (2017). Table 13-10-0096-06, Arthritis, by age group. Retrieved from https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310009606


Foot Health Awareness Month

May is our favourite month as it is Foot Health Awareness Month!  

A 2014 study revealed that nearly 75% of people over the age of 18 have experienced foot pain. Nearly half of those surveyed said they would be more active if they could get rid of the foot pain, yet only a third of them said they had talked to a healthcare professional about their pain.

Canadian Certified Pedorthists hear again and again from patients that they delayed booking an appointment because they thought the pain was something they had to live with. To help you avoid months of unnecessary foot and lower limb pain, this month, we’re going to be sharing many tips on how to keep your feet healthy as well as how to relieve different types of pain.

But first we want to make sure you know what Canadian Certified Pedorthists do and how they can help you.

What is a Pedorthist?

Canadian Certified Pedorthists – C. Ped (C) – are foot orthotic and orthopaedic footwear experts. They are trained in the assessment of lower limb anatomy and muscle and joint function. They help reduce foot and lower limb pain through the use of footwear selection and modification and by designing, fitting and modifying custom foot orthotics. In short, they improve your mobility so you can continue to live a healthy active life.

Canadian Certified Pedorthists work alongside physicians, nurse practitioners and other healthcare providers. To find a Canadian Certified Pedorthist in your community visit www.pedorthic.ca/find-a-pedorthist/

Come back frequently this month to find out more about pedorthists and learn foot health tips.


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