AARP Smart Guide to Healthy Feet

GET A PROPER SHOE FIT

13. Try new shoes on in the middle of the day

Badly fitting shoes contribute to all sorts of foot problems, from corns and toe deformities to plantar fasciitis. It’s important to try on new shoes after you’ve been on your feet for a while. That’s because feet expand up to 8 percent over the course of a day due to swelling. “You shouldn’t go the first thing in the morning,” says Vlahovic. However, if you wait until the end of the day, the shoes you buy might be too large. So midday may be best. Never buy tight shoes hoping that they’ll stretch or that you can break them in — they should be comfortable right out of the box.

14. Try new shoes with your orthotics or insoles

If you use orthotics or insoles to ease pain or correct other problems, be sure to try them in the footwear you’re thinking of buying. If the shoe you’re trying on has removable insoles, like most athletic shoes, take those out first. You may need a half-size-larger shoe to accommodate the extra material.

15. Have both feet measured regularly

Feet get longer and wider as you get older, and can also get larger if you were pregnant or gained weight. “I have many patients who don’t realize how much their feet have changed,” says Vlahovic. “They’re trying to stuff their foot into a shoe that’s just too narrow, and wondering why they have pain.” Another thing to keep in mind is that most people have one foot that’s larger than the other. Always fit shoes to your larger foot.

16. Don’t assume every pair of shoes your size will fit your feet

As with clothing, sizes vary among shoe brands and styles. Assess the shoe by how it fits on your foot, not the number on the box. If you’ve ordered shoes online, be prepared to return those that don’t fit well.

17. Stand during the fitting process

For the best fit, Schaeffer says, “I use the two-finger rule to check for room in the toe box. This will prevent your foot and toes from jamming into the front of the shoe, and prevent the shoe from being too large, which can also cause your toes to jam and slide.” There should be one finger’s width of space between your long toe and the end of the shoe, and one finger’s width of space between your heel and the back of your shoe. If your shoes are too tight, they can create pressure in the ball of your foot, Schaeffer adds.

18. Take a walk

Make sure the new shoes fit and feel right when you are moving. “Some stores will allow you to walk or even run around the store to be sure they feel comfortable,” says Vlahovic. Shoes should stay snug on your feet and not slip or pinch when you walk.

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TREATING FUNGUS

19. Wear shower shoes or flip-flops in certain public areas

Wearing protective footwear in spas and gym locker rooms can help you avoid contracting athlete’s foot and toenail fungus. It’s also a good practice to dry your feet thoroughly after such exposure, and avoid putting damp feet into closed-toe footwear. Athlete’s foot, a fungal infection that tends to start between the toes, causes an itchy, scaly rash and is common among people with sweaty feet who wear tight shoes. Toenail fungus causes the nails to become thick and yellowed and to crumble or flake.

20. Rotate your shoes

Shoes absorb moisture from the feet, promoting the growth of fungus. To keep dampness to a minimum, alternate your shoes every day so that the pair you wear one day dries out completely before you wear it again. Or use a UV shoe sanitizer — available on Amazon and retailers including Walmart — between wears. “These devices are the only evidence-based intervention that helps to decrease the fungal burden in shoes so that you’re not reinfecting yourself,” says Vlahovic.

21. Wear the right type of socks

Choose socks made of wool or synthetic fiber, such as nylon or polyester, which are designed to wick moisture away from your feet. Vlahovic recommends socks that are infused with copper, which is naturally antimicrobial. Stash an extra pair at work or in your purse.

22. Try OTC preparations and other home care

Over-the-counter antifungal creams, gels and sprays are effective at relieving athlete’s foot, but it can take many weeks to get rid of the infection completely, Vlahovic says. Research suggests that terbinafine (Lamisil) is more effective and works more quickly than other preparations. To resolve toenail fungus, try soaking your feet daily in a mixture of one part white vinegar to two parts warm water for 15 to 20 minutes. More severe cases may respond to ciclopirox topical solution, 8 percent (a nail lacquer). But that, too, can take time. (Consider oral prescription options if the properly used OTC is not effective or the disease is widespread.)

23. Consider remedies for plantar hyperhidrosis

This sometimes embarrassing and bothersome condition causes the soles to sweat excessively. Try aluminum chloride hexahydrate, an antiperspirant for the feet, Vlahovic suggests. A process called Iontophoresis may also provide relief: Patients place their feet in a shallow tub of water, and a special device that emits a low-voltage electrical current through the water blocks sweat glands. 

Botox injections can also prevent extreme perspiration, research shows. And in severe cases, a minimally invasive procedure called endoscopic thoracic sympathectomy (ETS) uses small incisions to block the excessive nerve activity that leads to severe sweating.

ARTHRITIS FOOT CARE

24. Know when to call the doc

Both rheumatoid arthritis (RA), an autoimmune condition, and osteoarthritis (OA), the more common wear-and-tear arthritis, can affect the structure and function of the feet. It is important to see a podiatrist or rheumatologist if any of these symptoms occur in the feet: swelling in one or more joints; persistent joint pain or tenderness; redness or heat in a joint; limited joint movement; morning stiffness; or skin changes like rashes and growths. 

RA attacks the joints at the base of the toes, causing erosions in the bones, while OA can cause hammertoes, particularly in the second or third toes. Gout, a form of arthritis caused by excessive uric acid in the blood, causes pain and swelling primarily in the big toe, says Stuart D. Kaplan, M.D., chief of rheumatology at Mount Sinai South Nassau in Oceanside, New York. 

25. Try sneakers with rocker soles

Shoes with rocker soles have a thicker than normal sole and a curved heel. “The design helps spread the shock of a footstep out over the entire foot to offload pressure points,” says Christine Seaworth, a foot and ankle surgeon at the Knoxville Orthopaedic Clinic in Knoxville, Tennessee. “By rolling through their steps, it leads to a more natural gait and less stiffness.” In people with OA, rocker shoes reduce pain and pressure under the big toe joint, research shows. In a recent study, pain relief in those who wore rocker-sole shoes improved by 22 points on a commonly used scale of foot pain. They can also reduce pain and disability, and increase activity in patients with rheumatoid foot pain, research suggests.

26. Eat an anti-inflammatory diet

Foods containing omega-3 fatty acids — nuts, seeds, legumes, vegetables, olive oil and fish — may reduce arthritis-related foot pain. If they sound familiar, these foods are the stars of the healthful Mediterranean diet. Consuming less red meat, game, organ meat, alcohol, sweets and sugary drinks can reduce pain and swelling if you experience gout.

27. Use ice — and heat

Both can help, but for different reasons. “Heat — like a warm towel or heating pad — relaxes tight joints and improves blood flow, making it great for morning stiffness,” says Ormond. “Cold therapy — like an ice pack — helps calm inflammation and numb pain, so it’s perfect after a long day on your feet.” A good rule of thumb: Use heat when you feel stiff, and ice when you’re swollen or sore, he says. To avoid injuring your skin, be sure to put a barrier, such as a towel, between the skin and heat/cold source, Seaworth adds.

28. Move more

It may sound counterintuitive to exercise painful joints. But the benefits of exercise for arthritis are clear: Research shows that regular activity helps maintain joint function while reducing pain and other symptoms. “Activities that increase motion to the joint can help relieve stiffness, especially those that are low-impact, like biking and swimming,” says Seaworth. Strengthening the muscles around the joints affected by arthritis can improve stability and joint pain while also improving balance and decreasing the likelihood of a fall, she adds.

29. Use the right painkillers

Oral and topical painkillers should be part of your tool kit. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can relieve the pain and inflammation of arthritis. (Avoid them if you take blood thinners or have uncontrolled high blood pressure, heart failure or a history of ulcers or liver or kidney disease.) An alternative for joint pain is an over-the-counter NSAID called diclofenac sodium topical gel, 1 percent. Ask your doctor about steroid injections. Surgery to replace damaged joints may be a last resort.

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DIABETIC FOOT CARE

30. Watch for diabetes warning signs 

Diabetes is a serious metabolic condition that has wide-ranging effects throughout the body — feet included. An early diagnosis is critical, so tell your doctor if you have any of these symptoms: a change in the color and temperature of your feet; dry, cracked skin on your feet; thick, yellow toenails; loss of hair on your toes, feet and lower legs; a fungus infection, such as athlete’s foot, between your toes; an ingrown toenail or a sore, such as a blister, ulcer or infected corn; a cut that is not healing as quickly as expected; or tingling, burning, or pain or loss of feeling or the ability to sense heat or cold. Those are symptoms of neuropathy. According to the American Diabetes Association, 60 to 70 percent of people with diabetes will develop one or some of these conditions.

31. Keep your blood sugar under control

Managing blood sugar levels is “the number one aspect of avoiding diabetic foot problems,” says podiatrist Marlene Reid of Naperville, Illinois. High blood sugar levels can damage the nerves responsible for sensation, leading to neuropathy and problems with all the body’s systems. Reduced blood flow from diabetes can make it harder for your feet to heal from an injury or to resist infection, which increases the likelihood of wounds, or the necessity of lower-limb amputation and other complications. To stay on top of your diabetes, monitor your A1C levels — a measure of your blood sugar over time. Try to exercise at least 30 minutes most days of the week, watch your weight, eat a balanced diet with lots of fiber, get plenty of sleep and don’t smoke.

32. Check your feet every day

It’s important for diabetics to pay extra close attention. To avoid complications due to infection or poor wound healing, it’s best to catch problems early. “You want to see if there are any areas of bleeding or irritation or actual openings or ulcerations, because people with diabetes may not be able to feel as well as someone who doesn’t have diabetes,” Vlahovic explains. “Wounds can become portals of entry for bacteria, leading to skin or bone infections and possibly amputation.”

33. Wear the right socks

People with diabetes should look for special socks made of sweat-wicking materials such as wool and various acrylics, and without seams in order to reduce friction between the feet and shoes, and to reduce the risk of blisters, which can lead to ulcers. Otherwise, socks should not “bunch or constrict any areas of the feet and ankle,” says Reid.

34. Outsource care for your toes and soles

Don’t try to remove corns and calluses yourself, due to the risk, as a diabetic, of creating a wound that may be hard to heal. It’s safer to let a podiatrist care for these common foot complaints.