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Harvard Commentaries
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Put Your Best Foot Forward


July 09, 2013

By Paulette Chandler M.D.

Brigham and Women's Hospital


Does foot pain interfere with your ability to exercise? Take the right steps to protect your feet from pulled muscles, stress fractures and other foot woes. Don't let improperly fitting shoes, impaired circulation or incorrectly trimmed toenails deter you from staying active.

Choose the Right Shoes

Steps to ensure proper-fitting shoes include:

  • Fit shoes to the larger foot. Most people have one foot that is larger than the other. To ensure accurate measurement, always measure feet at the end of the day when feet are largest.
  • Check toe space. The ball of your foot should fit comfortably into the widest part of the shoe with ample wiggle room for toes. You should have about a half inch (about width of thumb) between longest toe and shoe tip. For people with foot deformities such as hammertoes, custom-made shoes may add extra depth with an enlarged toe box.
  • Make sure your heel fits comfortably in the shoe with minimal amount of slipping. The shoes should not ride up and down on your heels when walking.
  • Choose athletic shoes that bend in the area in which the toes bend and not at the arch. Shoes that bend in the midfoot area put more pressure on the heel and Achilles tendon, especially during high-pressure foot activities such as running and jumping.
  • Select shoes with upper material that is soft and flexible to match the shape of your foot.
  • Check the sole. Thick soles cushion feet when walking on hard surfaces. People with impaired circulation from conditions such as diabetes or peripheral vascular disease need extra protection.
  • Add insoles for additional cushion. Prefabricated gel-cushioned pads help absorb shock to reduce the risk of stress fractures and inflamed tendons that may contribute to forefoot pain. Over-the-counter pads protect areas of friction and pressure where the bony parts of your feet rub against your shoes, which can create corns and calluses.

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Take Care of Your Feet

Clip your toenails. Make sure they are not sticking out past the tips of your toes. Cut the toenails straight across to avoid developing an ingrown toenail.

Check your feet for blisters and cracks, especially if you have diabetes or peripheral arterial disease. Look between your toes for skin breakdown and athlete's foot infection.

Wear socks. Socks should have a smooth fit over the foot and not be too tight. High-moisture-absorbing acrylic socks can help to prevent blisters and keep the feet dry.

Dry your feet completely after baths and showers, particularly between the toes. Dry gently with a towel or a hair dryer on a medium heat setting.

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Stretch

Since poor flexibility can increase the risk of injuring feet, stretching is an important strategy for preventing foot pain. When exercising, warm up, cool down, and stretch before and after your activity.

Stretches that target specific areas of the feet can help to prevent foot pain. For example, the plantar fascia, an extension of the Achilles tendon, is a tough ligament-like sheet of tissue that extends from the heel bone to the base of the toes. The plantar fascia is highly susceptible to pain and inflammation. Try the Achilles-heel stretch to prevent injury to the plantar fascia. Stand on the bottom step of a flight of stairs, with the balls of feet on the step, lower heels until you feel a stretch in calves. Do this exercise three or four times a day, progressively holding the stretch for 30 to 60 seconds.

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Maintain Good Foot Circulation

Regular physical activity can improve circulation to the feet. If you have impaired circulation such as peripheral arterial disease, additional measures that may help include:

  • Not smoking
  • Avoiding exposing feet to cold temperatures
  • Not sitting for long periods of time (especially with legs crossed)

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Even minor foot pain can disrupt your walking and other exercise routines. By giving your feet a few minutes of attention each day, you can prevent injury and skin breakdown.

Paulette Chandler, M.D., M.P.H., is a clinical instructor of medicine at Harvard Medical School and an attending physician at Brigham and Women's Hospital.

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