BY Sandra Chambers

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.


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.

Plantar Fasciitis

If your heels are achy and sore when you first step out of bed in the morning you may be experiencing plantar fasciitis. Often mistakenly referred to as heel spurs plantar fasciitis most likely develops due to small tears to the plantar fascia the ligament connecting your heel to the base of your toes. This occurs through repeated stress from activity and exercise on your feet. The ailment is more likely to develop in women overweight individuals or active persons such as athletes or soldiers. Rarely does plantar fasciitis affect people under the age of 25.

The classic symptom of plantar fasciitis is heel pain especially during your first steps in the morning or directly after long periods of sitting. Though heel spurs may develop small calcium deposits on the bottom of your heel they do not cause pain.

The most effective methods for treating plantar fasciitis are rest and ice which allow the plantar fascia to relax and heal and stretching the Achilles tendon and calf muscles. One helpful stretch includes the use of a bath towel. First roll a bath towel into a long tube. Then sitting with one leg extended place the rolled towel below the ball of your foot and hold its ends in either hand. Gently pull the towel towards you bending your foot backwards. Hold relax and repeat. The towel stretch is most effective in the morning or after extensive time off of your feet. Patricia Brown

Orthotics: a support system for your feet

Chasing kids running around the office hitting the gym your feet could use a bit of support couldnt they? The question is: Which orthotic will most soothe your sole?

Orthotics are shoe inserts that aid in comfort and support during walking or exercise. People of all ages use these devices for numerous reasons. According to Mike Floyd of Floyd Braces and Limbs orthotics provide “total contact support” for ailments including but not limited to “foot pain stresses bunions or fractures.”

There are three main types of orthotics: rigid soft and semi-rigid. Each type is made of different material and designed to serve specific purposes. Rigid orthotics control foot motion and function in order to help aches and strains. They are constructed of firm materials are extremely durable and are usually made by a plaster mold specific to an individuals foot. Soft orthotics relieve uncomfortable or sore spots during movement acting as an extra protective layer for feet. They are made of flexible moldable material and often need to be replaced or restored. Semi-rigid orthotics are a combination of the two made of both soft and rigid materials and are usually prescribed for athletes.

If you are experiencing “any kind of foot or joint pain ” Floyd advises “contact a doctor and have the situation evaluated.” An orthotic insert could be your most comfortable solution. Patricia Brown