Self-Assessment Quiz |
1. | How much time do you spend on your feet each day? | ||
a. | less than 2 hours | 0 | |
b. | 2 - 4 hours | 1 | |
c. | 5 - 7 hours | 2 | |
d. | 8 hours or more | 3 | |
2. | How old are you? | ||
a. | under 40 | 0 | |
b. | between 40 and 59 | 1 | |
c. | 60 and over | 2 | |
3. | How would you describe your weight? | ||
a. | less than 20 pounds overweight or at ideal weight | 0 | |
b. | 20 - 39 pounds overweight | 2 | |
c. | 40 or more pounds overweight | 3 | |
4. | Have problems with your feet or ankles ever prevented you from participating in: | ||
a. | leisure/sports activities? | ||
yes | 2 | ||
no | 0 | ||
b. | work activities? | ||
yes | 3 | ||
no | 0 | ||
5. | Have you ever received medical treatment for problems with your feet and/or ankles? | ||
a. | yes | 3 | |
b. | no | 0 | |
6. | Do you regularly wear heels two inches or higher? | ||
a. | yes | 2 | |
b. | no | 0 | |
7. | What types of exercise do you engage in or plan to engage in? (check all that apply) | ||
a. | walking | 1 | |
b. | field sports (e.g., softball, golf) | 2 | |
c. | winter sports (e.g., skiing, ice skating) | 2 | |
d. | court sports (e.g., tennis, basketball) | 3 | |
e. | aerobics | 3 | |
f. | running | 3 | |
g. | none (if you chose answer g, skip to question 11) | 0 | |
8. | Do you have the appropriate shoes for your sport or sports? | ||
a. | yes | 0 | |
b. | no | 3 | |
9. | Do you experience foot or ankle pain when walking or exercising? | ||
a. | rarely | 1 | |
b. | sometimes | 2 | |
c. | often | 3 | |
d. | never | 0 | |
10. | Do you: | ||
a. | exercise in footwear that is more than one year old or in hand-me-down footwear? | ||
yes | 3 | ||
b. | stretch properly before and after exercising? | ||
yes | 0 | ||
no | 3 | ||
11. | Do you: | ||
a. | have diabetes? | ||
yes | 3 | ||
no | 0 | ||
b. | experience numbness and/or burning in your feet? | ||
yes | 3 | ||
no | 0 | ||
c. | have a family history of diabetes? | ||
yes | 2 | ||
no | 0 | ||
12. | Do you: (check all that apply) | ||
a. | sprain your ankles frequently (once a year or more) or are your ankles weak? | ||
yes | 2 | ||
no | 0 | ||
b. | have flat feet or excessively high arches? | ||
yes | 2 | ||
no | 0 | ||
c. | experience pain in the achilles tendon or heel or have shin splints (pain in the front lower leg)? | ||
yes | 2 | ||
no | 0 | ||
d. | have corns, calluses, bunions or hammertoes? | ||
yes | 3 | ||
no | 0 | ||
e. | have arthritis or joint pain in your feet? | ||
yes | 3 | ||
no | 0 | ||
f. | have poor circulation or cramping in your legs? | ||
yes | 3 | ||
no | 0 | ||
The Foot Health Foundation of America
A National Health Initiative of the American Podiatric Medical Association