When choosing your winter footwear, it may be tempting to choose form over function or whichever you feel is the most stylish, but would that still be the case if you knew the risks you were taking?
Here are a few commonly known winter foot conditions that you may wish to avoid.
If any shoes you’ve chosen are giving you blisters, it’s a clear cut sign that they’re the wrong choice for your feet. With properly fitted shoes, there should be no ‘breaking in’ period to have to go through.
Blisters are a result of friction or repeating rubbing, often when wearing brand new shoes that don’t fit properly.
Common remedies include soap and water, letting blisters heal with time and topical antiseptic on open wounds; however, a visit to the podiatrist’s clinic is always recommended.
Usually related to poor circulation, chilblains appear when the skin has been exposed to a cold, humid environment before being quickly moved to the warm.
The cold air causes the skin’s small blood vessels to constrict, which doesn’t give them enough time to react to the warm air. As a result, the blood may leak, leading to red, swollen, itchy skin.
These patches may turn into ulcers or lead to infection as the skin becomes dry or cracked.
Chilblains are most commonly found on the toes, especially if the feet already have bunions and/or callouses.
To avoid them, ensure your feet are kept warm throughout the winter and avoid direct heat. Allow your feet to warm up at a steady pace to allow your circulation to catch up.
Morton’s neuroma is a result of footwear that’s too tight, causing the bones and tissues to become squeezed against the nerves of the feet.
These pinched nerves will lead to feelings of numbness, tingling or burning and is most commonly felt around the toes.
As your feet may get wider with age, ensure you update your shoes width accordingly. If you think you may be experiencing a Morton’s Neuroma, get in touch with your podiatrist at the first possible opportunity.
This condition is named after the French doctor, Raynaud, and is also caused by cold weather and its effects on blood vessels.
As with chilblains, the blood vessels in the feet will tighten when exposed to very cold temperatures, causing limited circulation to the hands and feet.
Due to this lack of oxygen and blood flow to the feet, an individual may experience blistering, redness, discolouration or pain. These are the effects of Raynaud’s Phenomenon.
If you’ve found yourself experiencing a black toenail, it may be a case of Skier’s toe. This dark shade is due to bleeding underneath the nail, which may also cause you to experience a painful ‘pulsing’ sensation due to the blood pressure.
Skier’s toe may be brought on by shoes that are too tight and often Ski boots – hence its name! Ensure that the shoes you wear this winter are roomy enough for your toes, even when you’re wearing socks.
By wearing shoes that fit well and also keep you warm throughout the winter, you should be all set to avoid these painful conditions. Remember, for the best advice, always visit your podiatrist!
Rwanda is a small ambitious country known as the land of 1000 hills with a population around 12 million and a rapidly growing economy. It has rolling hills for as far as you can see, a rain forest, gorillas and volcanoes, making for quite the site to any visitor. However, it is also known for the 1994 genocide in which over 1 million people were killed in 100 days across the country.
This tragic event has led to some very big health issues, which the country still faces, but thanks to a range of donor funding and strong political leadership, the country is on its way to quickly becoming a middle-income country.
As countries shift from low incomes to middle income economies, health issues become complex, where the country can face a mix of communicable disease (ie. malaria, HIV, TB) and the introduction of non-communicable disease (ie. diabetes, high BP, cholesterol) with changes in lifestyles.
Now you are probably wondering what this has to do with podiatry?
Well, as clinicians we play a role in the overall wellbeing of every patient that walks through our door for treatment and we become advocates for a number public health issues. While our specialist area is focused on the foot and ankle, an understanding of the bodily systems is imperative for understanding the impacts on the lower limb. This allows us to transition from clinical practice to other work streams such as health policy, public health programmes, service management and research.
As a podiatrist with a public health background, the increase of diabetes and chronic conditions in developing nations has become of personal interest. In many of these countries, diabetes is poorly understood and without proper prevention and care, can lead to a large economic burdens on the healthcare system. In 2012, the UK alone spent a whopping £639 million on foot ulcers and £662 on lower limb amputations, so the prevention and monitoring of these conditions is of paramount importance in the developing world.
The quality of life for individuals with diabetes is also drastically affected if not controlled, impacting mobility, footwear and overall lifestyle. Additionally, chronic ulceration and limb amputation, creates an increases risk (approximately 80%) of mortality within the first 5 years post amputation.
How did all this lead me to Africa, I hear you say?
In April of 2016, I (sadly) departed from the Betafeet clinic to implement an mhealth project in Rwanda in partnership with the Ministry of Health. This project, allows patients across the country to speak with a doctor and receive a prescription via SMS through their mobile phone, reducing the travel time, wait time and expense of receiving care from one of the local physical hospitals. The system is also working on monitoring both communicable and non-communicable disease using artificial intelligence, engaging patients to take ownership of their health.
This could be a major milestone for a country with stretched resources. To put things into perspective, over 80% of the population lives in remote areas of the country and works in the ‘in-formal’ sector as subsistence farmers with an average income of 2-3 dollars per day, which is not very much. To receive care, a patient may travel over an hour to reach their nearest hospital where a doctor is present and then wait anywhere from a few hours to a few days to receive the care they need. However almost 80% of the population already has a mobile phone.
Appropriate access to clinical care is a large part of the prevention and management of many conditions and undertaking this project has been a great experience. As a clinician, I have had the opportunity to utilise my knowledge to develop operational pathways and input into the technology development to shape the way patients receive their care.
It is with
this experience I now look to move on to my next adventure focusing on Aboriginals
and the utilisation of technology in the prevention of major non communicable
disease such as diabetes.
Final comment from Reggie Simpson and Betafeet Podiatry
We wish Andre the very best in his future and thank him for this interesting blog account. We look forward to his next blog focused on his work with the Aboriginal population.