Feet

Apart from its ubiquitous presence in common colloquialisms the human foot is a biological masterpiece strong flexible functional and complex. Our feet contain a total of 52 bones making up a quarter of all the bones in our body; 33 joints a network of more than 100 tendons muscles and ligaments; and 250 000 sweat glands!

But when it comes right down to it most people do not pay enough attention to their feet.

“Our feet are what connect us to the earth; yet they are the farthest thing from our brain and we think about them the least ” says Dr. Edwin Martin a local Wilmington podiatrist who exhorts people not to ignore foot problems. “If your feet hurt youre going to hurt all over.”

An average day of walking somewhere between 8 000 and 10 000 steps brings a force equal to several hundred tons to bear on your feet explaining why your feet are more subject to injury than any other part of your body.

According to the American Podiatric Medical Association (APMA the premier professional organization representing the nations podiatrists) 47 percent of Americans suffer from a foot ailment but only 26 percent of them have actually seen a podiatrist. With more than 300 different foot ailments some the result of heredity some due to normal wear and tear and others the result of neglect or abuse it is likely that most people will experience foot problems of a greater or lesser degree of seriousness at some time in their lives.

Podiatry 101

Podiatrists or doctors of podiatric medicine (DPM) diagnose and treat disorders diseases and injuries of the foot and lower leg. Their training is extensive involving a college premedical degree four years of podiatric medical school and usually a three-year residency program. There are several areas in which a podiatrist can specialize including foot and ankle surgery orthopedics primary care sports medicine pediatrics radiology geriatrics or diabetic foot care.

According to the APMA there are more than 15 000 podiatrists in this country. Of those 6 000 are members of the American College of Foot and Ankle Surgeons (ACFAS) which is a specialty board for those who have achieved certification by the American Board of Podiatric Surgery (ABPS).

Podiatrists treat several common foot problems such as athletes foot blisters bunions corns and calluses foot odor hammertoe heel pain heel spurs ingrown toenails swollen feet and warts. They also treat more serious foot problems associated with diabetes and arthritis fractures deformities and infections. In fact doctors of podiatric medicine are often the first doctors to see signs of such systemic conditions as diabetes arthritis and circulatory disease.

Helpful Advice from Locals

Wrightsville Beach is home to two podiatrists who have practices in the Wilmington area. Dr. Robert OMalley who lives on Channel Walk with his wife Kat and their two children opened OMalley Foot & Ankle ten years ago. In addition to his regular practice on Medical Center Drive Dr. OMalley volunteers his services once a month at Tileston Outreach Health Clinic in Wilmington.

During his residency Dr. OMalley specialized in Plantar Fasciitis (see sidebar) and heel pain. “Heel pain is the number one reason most people come to see me ” says OMalley. “After that are diabetic issues ingrown toenails bunions and deformed toes.”

Dr. OMalley believes many foot problems can be prevented with appropriate shoe fit. “Buy a good pair of sneakers first and start with across-the-counter insoles such as Spenco ” he says. “Once you find a pair of sneakers that fit with a good arch support you need to wear them often especially on weekends.”

While there are new treatments in podiatric medicine such as Sound Wave Therapy (a non-invasive procedure that subjects body parts to specific sound frequencies) that is proven to reduce inflammation increase blood circulation and relieve muscle pain) Dr. OMalley says he likes to try the most conservative routes first. “One of the areas where Ive seen a lot of positive changes over the past 10 years is in the treatment of diabetic ulcers. There are a lot of new-wound care products out there including graft materials creams and others.”

Dr. OMalley is a member of the ACFAS and highly recommends their patient Web site www.FootPhysicians.com for information on all types of foot-related issues.

On any given late summer afternoon youre likely to catch another local podiatrist surfing the waves in front of his home on the south end of Wrightsville Beach. Dr. Edwin Martin moved to Wrightsville Beach in August 2006 with his wife Beth after completing his residency in foot and ankle surgery at Temple University in Philadelphia.

Dr. Martins practice is located on the campus of Cape Fear Hospital on Wrightsville Avenue. Since Cape Fear is the designated orthopedic hospital center in the area most orthopedic surgery including foot and ankle surgeries takes place there.

Having recently completed his residency Dr. Martin believes podiatrists coming out of school in the last five years are better trained in arthroscopic surgery which has been used extensively in knee surgery but is becoming more and more common for ankle-related procedures.

“The techniques and instrumentation for minimally invasive surgical procedures for deformities such as hammertoes and bunions are also far more advanced today ” says Martin.

In his practice he sees more women than men. He believes this is probably due to two factors: women have more bunions related to shoe wear and they tend to be more health conscious going to see a doctor before a man will.

And when should you see a podiatrist? “If its a traumatic injury like a twisted ankle or a fall seek medical attention immediately ” says Dr. Martin. “But for most foot problems like heel pain give it three or four days. Put ice on it take an anti-inflammatory drug and rest it. If it doesnt improve then seek medical attention.”

Technology is beginning to play a major role in testing diagnosing and aiding foot related ailments. One Wilmington company exploring new technological innovations is Bodies in Balance. This physical therapy center uses a patented computer system called the SMART Balance Master to better understand and treat clients.

The SMART Balance Master is a large piece of equipment that uses a movable standing platform and three walls to gain personalized data through interactive programs. There are two specific tests done on the machine to obtain this information says Dr. Michelle DuPree Zumbro of Bodies in Balance. A Sensory Organization Test (SOT) measures how a person uses his lower extremities the visual input and the inner ear equilibrium systems to maintain his balance and a Limits of Stability Test measures a persons ability to shift his weight in eight various positions. Dr. Zumbro says that this data is very specific and informative about any type of ankle or foot injury. From the data physical therapists can design treatment and exercise programs specific to a patients needs.

Prevention

Most podiatrists agree that selecting the right shoe can prevent many foot problems. Women tend to inflict more punishment on their feet from improper footwear especially high-heeled shoes. In a recent survey conducted by the APMA 82 percent of women say they are willing to sacrifice the health of their feet for fashion.

Now that the hot weather is here sandals are both a necessity and a fashion statement. For tips on selecting sandals that are both sensible and stylish visit the APMAs Web site www.apma.org go to “Foot Health Brochures ” select “Beauty & Your Feet ” then select “Sandal Scandal.”

When shopping for any type of shoe APMA recommends the “three-step test.” First the shoe should bend where your foot bends naturally at the ball of the foot. Second the shoe should not twist from side to side. Finally squeeze the back of the heel to ensure that it will firmly hold your heel.

Older adults especially need to take care of their feet so they can remain mobile. According to the US National Center for Health Statistics impairment of the lower extremities is a leading cause of activity limitation in older people. Foot problems can also lead to knee hip and lower back pain that undermine mobility.

The moral? Be kind to your feet. Practice good foot care and if you are experiencing a problem if your dogs are barking see your family doctor or a podiatrist before it gets serious.