After ballet dancing my way through my childhood and teenage years, spending two decades of office life in uncomfortable heels and discovering longer-distance running in middle age, my feet have taken a bit of a pounding. At 54, I’m relentlessly plagued by cracked heels. I have a tenacious corn that resists all attempts at permanent removal. And while I haven’t been officially diagnosed, I’m pretty sure I suffer from plantar fasciitis, a condition that causes a shooting pain in the sole. Sadly, I’m far from alone. A recent survey suggested that up to a third of British adults suffer from foot-related problems – many of which recur time and again. But what can we do about it – and what clues could the state of your feet give to your overall health? We asked an expert for the answers.
What to do about… bunions
About 20% of us will develop a bunion as we age – but children can get them too (and if you have arthritis, you’re a woman or have a family history of bunions, you’re more likely to suffer). Bunions occur when the big toe moves toward the smaller toes, causing the joint at the base to protrude.
‘There’s no exact reason why bunions form,’ says The Royal College of Podiatry’s chief clinical advisor Dr Helen Branthwaite. ‘Some people get them because of the shape or length of the bones in their foot, or the way their foot moves when walking. Others get them if there’s a lot of movement in the joints of the foot.’ There's also no standard length of time a bunion takes to develop – many can take years, adds Dr Branthwaite.
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What they say about your health: Pain in your big toe, like bunions, can be a sign of arthritis. Menopause can also prompt foot shape changes, thanks to the change in collagen levels in your body. ‘This means the soft tissues loose their elasticity,’ says Dr Branthwaite. If a bunion suddenly appears, or there’s a noticeable change in the joint, see a podiatrist.
‘The first thing your podiatrist will do is check your footwear is appropriate for your activity types and they may recommend changes to the style or structure of your shoes to improve your foot function,’ says Dr Branthwaite. In the short term, bring out the trainers – shoes with a wide toe box, low heel and soft sole all help avoid pressure on the joint. Bunion pads can be helpful. If necessary, a podiatric surgeon or orthopaedic surgeon can recommend surgery to alleviate pain in the joint and improve movement.
What to do about… corns
Corns are hard, painful lumps with a distinct centre that form in areas of high pressure on the feet, often on toes or soles. Your footwear has a big part to play – shoes that are too tight, too loose or have a narrow toe box can lead to corns. As I can attest, corns can be very painful to press. They’re also horribly common – a recent US study suggested that up to 48% of the population are suffering.
What they say about your health: Corns are caused by the way you walk and the shoes you wear – and they don’t indicate any wider health concern. ‘They’re slightly more common as we age and lose some of the fatty padding in the feet,’ says Dr Branthwaite. ‘Activities like prolonged standing or walking, especially in inappropriate footwear, can also lead to excessive pressure and corn formation.’
To treat corns, visit a podiatrist to have them safely removed – and steer clear of corn plasters. ‘These contain high levels of acid and can quickly damage the skin and cause a wound, even in a healthy foot,’ warns Dr Branthwaite.
What to do about… cracked heels
From dusty white lines on your feet to deeper fissures, cracked heels are a common – and painful – complaint. ‘The skin is the largest organ in the body and requires care and maintenance to keep it supple,’ says Dr Branthwaite. ‘When you walk, the skin in your heel will need to stretch, and a build-up of callus (dead skin) and skin that’s low on moisture content can result in fissures in the skin to accommodate this.’ Cracked heels are more likely to strike in summer – according to Dr Branthwaite, ‘Wearing backless shoes, walking barefoot and having drier skin in the feet can all increase the chances of them occurring.’
What they say about your health: Cracked heels are more common if you suffer from other skin conditions, such as psoriasis and eczema. ‘They can also appear as a result of longer-term health conditions that affect the quality of the blood supply and nerve function in the feet, such as diabetes and circulatory issues, or conditions that affect breathing, such as chronic asthma and COPD, which can all make the skin in the feet drier,’ says Dr Branthwaite.
While footwear changes can help, the majority of cracked heels can be managed with appropriate (and assiduous) moisturising regimes using a urea-based cream from the chemist.
What to do about… plantar fasciitis
Shooting pain across the sole of your foot on standing? It could be a case of plantar fasciitis – the most common type of heel pain, caused by damage to the fascia band connecting the heel bone to the base of the toes. ‘This condition can be caused in various ways, including extensive running, walking or standing for long periods of time, especially when you have a sedentary lifestyle,’ says Dr Branthwaite. ‘In particular, a change of surface for exercising (e.g. road to track), poor shoe support, being overweight, overuse or sudden stretching of your sole, as well as a tight Achilles tendon, can lead to this condition.’ It’s most prevalent between the ages 40 and 60, although it also affects around 10% of younger people.
What it says about your health: ‘There are studies that show there’s a higher rate of plantar fasciitis in people who are obese and in people who have underactive thyroids,’ says Dr Branthwaite. ‘It could also be a sign of rheumatological disease, especially hypermobility, and inflammatory arthritis – and it’s also a known complication of menopause.’ Rest, ice and specific exercises to stretch the plantar fascia and Achilles tendon are first steps to take – or see a podiatrist for a treatment plan.
What to do about… swollen feet
Feet can puff up for several reasons, but this is more common in high temperatures, when fluid is released into the tissues as blood vessels dilate to release heat. Prolonged standing or sitting, pregnancy hormones and some medications can also cause fluid to leak.
What it says about your health: Longer-term swelling may be linked to other health conditions, says Dr Branthwaite; swelling of the feet, particularly when accompanied by other symptoms, such as shortness of breath or fatigue, can be a sign of heart failure, where the heart isn’t pumping blood effectively.
If you’ve noticed a recent change in your feet and ankles such as pronounced swelling or a mottled colouring, or if the swelling is accompanied by other symptoms, this could be a sign of circulatory issues, so make an appointment with your GP or podiatrist. If you notice a sudden change accompanied by pain, temperature change or signs of infection, seek urgent professional advice.
How to see a podiatrist: Your GP surgery can tell you whether you qualify for NHS podiatry. To find an HCPC registered private podiatrist, visit rcpod.org.uk/find-a-podiatrist.
