Friday, April 25, 2014

Health and Wellness: Foot Care And Some Things In Between

Remember that scene in the film Boomerang where Eddie Murphy's character relates to his friends how he dumped Lela Rochon's character because her feet were hammertime? Just before that, one catches a glimpse of said hammertime; and it wasn't pretty, right? Well, in today's post we deal with matters of the feet. Once again, it has been an education for me because I just wasn't informed about some issues, others, however, like plantar fasciitis, I've known about since the time Dwayne Schintzius was playing in the NBA. In my quest to get answers to a plethora of questions, I reached out to the Podiatry Association of South Africa and they were gracious enough to engage and indulge me. So, without further ado, I'll hand it to Nadia Dembskey.

Hello Nadia and thank you very much for talking to us!


How important is foot care and does it get the attention it deserves?
As a Podiatrist foot care is very important to me, but it is evident in the number of patients we treat – especially diabetics – that the lower limbs do not receive the consideration and regard they deserve.
What happens to the foot when a shoe is too small or big?
Small shoes restrict growth and cause mostly lesser toe deformities (hammer toes, claw toes, etc.).  Footwear that is too narrow causes bunion formation – a real concern for the South African foot.  Shoes that are too big cause friction blisters and ultimately result in callus formation.
What is the cause for shoe heels to wear in this manner? Can it be remedied?
This is a normal walking pattern – lateral (outside) heel strike, progressing to midstance (middle part of foot) and ultimately hallux propulsion (pushing off with the big toe).
At what age do one’s feet stop growing and as one gets older can their feet become smaller?
Growth plates fuse by the age of 18, normally the end of the growth period.  Foot size is not dictated by age after this time, but more so by one’s weight (obesity results in an increased foot size and weight loss results in a reduced foot size).
This is a personal issue which makes buying footwear a challenge. With lace-up shoes, including sneakers, I take a size 11; however, with slip-on shoes I take a size 10. Why the difference?
This depends a lot on the shoe manufacturers, the country of origin and last formation.  Lace-ups are the better shoes as the lace provides grip on the foot which you can control whereas this is not the case with slip-ons, therefore you would generally take a smaller size to provide the same comfort (grip).
Educate us on the following common foot ailments, what they are? What causes them? How to treat them? And are they preventable?
Athlete's Foot - Also known as Tinea Pedis (TP).  This is a fungal infection of the skin on the feet.  Treatment usually involves washing all shoes and socks with an anti-fungal wash such as Fungisolve and topical anti-fungal cream application (Lamisil).  It can be prevented by wearing flip-flops whenever one gets into a communal shower.
Bunion - Also known as Hallux Abducto Valgus (HAV).  This is generally a malformation in the alignment of the first ray (length of the big toe).  In most cases it is genetic, but can also be caused by narrow tipped shoes and high heels.  The advised treatment for HAV is correct footwear (trainers, shoes with a deep heel cup and a broad and deep toe box) and custom insoles (orthotics – made by Podiatrists).  We rarely advise surgical intervention as this changes biomechanics (the way one walks), unless the pain is unbearable.
Corns -Also known as Heloma Durum (HD).  This is an increased area of pressure on top or underneath the foot.  It is characterised by callus formation overlying an increased pinpoint area of pressure that forms a root that grows into the skin.  Treatment involves going to a Podiatrist who is medically trained in using a blade to remove the excess hard skin and remove the root. 

Cracked heels - Also known as Fissures.  This is due to excess dry skin and is usually caused by wearing open shoes (sandals, flip-flops, etc.).  Using a good quality foot cream morning and night and wearing closed shoes and socks generally takes care of the problem.
Pain in the middle of the sole - Also known as Plantar Fasciitis.  This is generally an over-working of the plantar fascia (fibrous band in the middle of the foot).  An extensive treatment regime is necessary in this instance, starting by a biomechanical assessment with your Podiatrist, footwear advice, custom insoles (orthotics), stretching and anti-inflammatory methods.

Ingrown toe nails - Also known as Onychocryptosis (OC).  This is characterised by the nail bed growing in an involuted shape (overturned spoon).  Treatment involves a Nail Wedge Resection (NWR) whereby the toe is injected with Local Anaesthetic to numb the toe, and removal of the part of the offending nail piece right up to the nail bed.  The nail bed is then killed off with a strong chemical (Phenol) so as to ensure it never grows back.
Is popping a foot blister with a hot needle and thread the correct method of treating it?
No, all blisters should be left intact – this is a sterile wound environment with no chance of bacteria entering and causing infection.  If the blister pops for some reason, clean off with salt water and apply a dressing until the wound is completely healed.
Are my feet supposed to hurt when standing for a long time in a pair of good quality shoes?
Anyone’s feet will hurt when standing for too long a period.  If this becomes a problem, consult your Podiatrist for a proper biomechanical examination.
The month of May is known as foot care month. What does it entail?
Foot Care Month has been established to inform the public of how important their feet are and how to take care of them.  Every year is focussed on a different topic.  Follow our Facebook Page (Podiatry Association of South Africa) for more in the upcoming month of May.
What role does PASA play in South Africa?
PASA is an Association where most Podiatrists belong to.  It is an Association whom the public can contact with any foot queries and related questions and also our website ( provides information on Podiatrists and the work they do as well as a detailed list of where one can find a Podiatrist in their area.
What are the basics of proper foot care?
Cleaning the feet daily, wearing the correct footwear, applying a foot cream to the feet daily and consulting a Podiatrist whenever one is in pain or uncertain of what is happening to their feet.
Any tips on giving the perfect foot massage?
Unfortunately not, please contact the Somatology Association in this regard.  We are Medical Podiatrists, not Somatologists (Beauty Therapists).
Please recommend some products one can use for taking care of their feet.
Any good quality foot cream which contain ingredients such as Lanolin and Urea (Pedirelax, Epimax Plus, Eucerin, etc.).
Thank you very much for your time and talking to us Nadia, and the knowledge you have dispensed regarding foot care.
Nadia Dembskey is the National Secretary of the Podiatry Association of South Africa. In order to get in touch with PASA they can be reached at; and the number to call is 086 110 0249. For more information go their website

                                         PG: Man to man, generation to generation.


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Valgomed bei Hallux Valgus

daren sammy said...

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