A heel-to-toe guide to keeping your feet and ankles in perfect working order.
Getty ImagesYour feet are two tough tootsies. They spend their days shoved into stilettos, pounding pavements, and supporting your weight while you bounce around on the treadmill or take a Zumba class. It's no wonder that one out of six people in this country complain of foot problems.
The biggest reason women in particular limp in to see their doctor? Improper footwear. In fact, nine out of 10 women's foot issues can be attributed to too-tight shoes, according to the American Academy of Orthopedic Surgeons (AAOS).
But no need to stay seated in sneakers all day. "If you just tweak your footwear and give your feet some TLC, you should be able to stave off most problems," says Hillary Brenner, DPM, a New York City podiatrist and spokeswoman for the American Podiatric Medical Association. Here, the key moves that'll keep you striding strong for years to come.
Culprit # 1: Ankle sprains
The lowdown. If you've had one recently, you're in good company: An estimated 25,000 ankle sprains take place every day, according to the AAOS. They occur when your foot twists, rolls, or stretches beyond its normal range of motion, causing a possible tear in the ligaments there. This can happen during a run or even from something as innocuous as tripping over a curbor stumbling in a pair of stilettos.
What it feels like. A sprain can range from grade 1 (you've got some tenderness and swelling, but can still walk) to grade 3, with swelling and pain so severe you can't put weight on your foot even after several days. If it's the latter, you'll need to see a doctor for a splint, possibly crutches, and even physical therapy. Although you may be tempted to blow off a sprain and just hobble around on it, don't: About 40 percent of all ankle sprains can lead to chronic pain, often because they don't heal properly.
The Rx. First 72 hours: Follow the RICE protocolrest (keep off the sprain as much as you can and, if you must walk, use crutches), ice (for 20 minutes, four times a day), compression (use a bandage or an ACE wrap, available at drugstores, to immobilize and support your ankle), and elevation (keep your ankle propped up above your heart level as much as possible to minimize swelling).
After 72 hours: If swelling has gone down and you're putting weight on your foot again, you can do some light at-home strengthening exercises, provided they don't cause you any pain, says John Kennedy, MD, an orthopedic surgeon at the Hospital for Special Surgery in New York City. Try ankle circles: Gently rotate the affected ankle in one direction, then in the other. Perform 10 reps, three to four times a day. On the other hand, "if there's no improvement within about three days, see your doctor for an exam and possibly an MRI," Dr. Kennedy says. A more severe sprain can damage the cartilage or lining of the joint, or bone can chip off, which, if untreated, can lead to early-stage arthritis."
After a week: You should be pain free and back to your normal activity if you had a mild (grade 1) sprain, Dr. Kennedy says. If you're still limping, though, do get in to see your doctor. You may have a grade 2 sprainor worseand will most likely need physical therapy to retrain those torn ligaments. "Otherwise, sprains will keep happening," Dr. Kennedy explains.
Next Page: Culprit # 2: Plantar fasciitis [ pagebreak ] Culprit # 2: Plantar fasciitis
The lowdown. The plantar fascia is a long, thin ligament that connects your heel to the front of your foot, providing arch support. But when too much pressure is put on the footfrom improperly fitting shoes, weight gain, or a recent uptick in activitythe tissue can become swollen. This condition, known as plantar fasciitis, is the most common cause of pain on the bottom of the heel. "The plantar fascia is like a violin bowit's tight, and if it gets stretched too much, it may tear," says Carol L. Otis, MD, a sports medicine doctor in Portland, Oregon.
What it feels like. You'll notice pain on the bottom of your foot near your heel that's especially bad after a long period of restlike when you get out of bed in the morning or stand up from sitting at your desksince the ligament stiffens up when it's not being used. It should improve after a few minutes of walking. The pain may also worsen after exercise, due to the stress working out puts on your feet.
The Rx. Luckily, more than 90 percent of people with plantar fasciitis improve within 10 months of starting treatment, according to the AAOS. Start with stretches that'll loosen up your calves and feet. If the plantar fasciitis is caused by a mechanical problem like overpronation (when your foot rolls inward), custom-made orthotics can help take tension off the fascia.
If your pain is really severe, your doc may give you a cortisone shot to help reduce inflammation, and also prescribe physical therapy. As a last resortespecially if you don't get better after a year of treatmenthe may recommend a surgical procedure like a plantar fascia release, in which the ligament is cut to relieve tension.
Culprit #3: Neuroma
The lowdown. A neuroma is a thickening of nerve tissue in between the metatarsal bonesthe long bones between your toes. The usual cause: "Tight, narrow shoes that squeeze the toe bones and forefoot together, pinching the nerve," says Jackie Sutera, DPM, a podiatrist in New York City.
What it feels like. Burning pain in the ball of the foot and/or between your toes.
The Rx. Switching to flatter, roomier shoes; taking anti-inflammatories; wearing custom-made foot pads; and getting cortisone injections all relieve symptoms in about 80 percent of sufferers. If you're in the other 20 percent, you'll probably need surgery to shrink or remove the nerve, says Sutera. If this is the case, ask your doc whether an MRI might be necessary. "Neuromas can be misdiagnosed as stress fractures," Dr. Otis notes, "and vice versa, and neither condition can be seen on an X-ray."
Next Page: Culprit # 4: Bunions and hammertoes [ pagebreak ] Culprit # 4: Bunions and hammertoes
The lowdown. More than half of all women have a buniona red, swollen bump on the joint that connects the big toe to the foot. "Women tend to have narrower heels and broader forefeet than men," Dr. Otis notesand some shoe designers don't compensate for that. The result: A lot of us are wearing shoes that are too wide in the heel and too tight in the forefoot, creating bunions and also hammertoes, the name for toes that become bent at the middle joint.
What it feels like. Bunions tend to hurt when you're walking. Hammertoes may cause pain when you put on your shoes.
The Rx. If your shoes are pinching, get your feet measured, so you can buy footwear in a larger size if necessary. "Women often don't realize that their foot size can change due to weight gain, injury, or pregnancy," Dr. Otis says. "If you have one foot that's bigger than the otherwhich is fairly commonbuy the correct fit for the larger foot." Try over-the-counter protective pads for relief, too. If none of this helps, you'll need minor surgery: Left untreated, bunions can get bigger and even lead to arthritis.
Culprit # 5: Achilles tendinitis
The lowdown. An inflammation of the Achilles tendon, which connects your calf muscles to your heel bone, tendinitis is most often seen in women who work out a lotor wear high heels regularly. "After a number of years, your Achilles tendon ends up chronically shortened," Dr. Otis explains, so it's easily stressed when you exercise or walk on it.
What it feels like. Pain, stiffness, and/or swelling along the Achilles tendon when you wake up in the morning or after exercising.
The Rx. First-line treatments include rest (if you're a runner, switch to a low-impact activity such as swimming), icing for 20 minutes several times a day, and OTC anti-inflammatories such as ibuprofen. Dr. Otis also has patients tap their toes while they're sitting, three times a day for about 50 reps, to build strength in the front of the leg and balance out tightness in the Achilles tendon.
Wearing heel lifts can take the stress off of it, but if your doctor feels your footwear is making the problem worse, she may recommend switching shoes entirely. If pain doesn't lessen after a week or two, you may need a course of physical therapy and possibly custom-made orthotics.