Top Five Foot Problems to Avoid
Howard E. Friedman DPM


A 59 year old man complained to his podiatrist about pain in the right heel that began during a recent camping trip. The patient was hiking, camping and fishing for several days. He was also portaging a canoe with his camping buddy. The combination of poor arch support in his wading boot and carrying a heavy canoe both contributed to an acute foot condition. Now, this hiker is sidelined until the pain and inflammation of his foot subsides.

His condition could have been avoided with some preventive care. Many sports injuries can be prevented, or, their effects diminished, if treated early.

Five Preventable Foot Conditions

A stress fracture is an incomplete break of a bone that occurs in response to a repetitive action, such as running, jumping or even walking, Symptoms include an ache and some swelling in the affected area. The metatarsals, the area directly in front of the toes, is commonly affected in the foot. The lower leg can also develop a stress fracture of the tibia or fibula.  Preventing this injury includes maintaining adequate calcium and vitamin D in the diet, early detection of osteoporosis and treating a stubborn ache or pain before it develops further. Accurate diagnosis sometimes requires an MRI.

A foot problem more visible than a stress fracture is a painful infected ingrown toenail. Pain in the corner of the nail along with redness and swelling are the early warning signs. Home treatment can include soaking the toe in warm salt water and applying a topical antibiotic. Usually, however, the ingrown nail needs to be removed with the help of local anesthesia in the toe.  If the condition is recurrent, the ingrown nail border can be permanently removed. Trimming nails straight across, avoiding a tight shoe or boot and early treatment can prevent this condition from requiring antibiotics.

No other part of the body is routinely and completely ‘double-wrapped’ in clothing as is the foot. The warm, damp shoe or boot environment can lead to a fungus infection or an inflammation of the skin. The inflammation, or, dermatitis results in red, itchy skin.  This can be an allergic response to wool, for example, or a reaction to moisture, poisonous plants or insects. Treatment requires a steroid cream.  A chronic skin fungus, or, athletes foot, requires an anti-fungal cream, often applied daily for up to six weeks. Maintaining dry feet and changing into dry socks can help prevent these conditions. Removing boots at the end of a hike and changing in to sandals or moccasins is also helpful.

Tendonitis is the fourth preventable condition. Stretching prior to beginning a long hike out can help prevent this tendon injury. Avoiding this injury is important, because injury to the Achilles tendon, for example, can last months.

Leaning against a wall, or tree, with the feet flat on the ground, one foot in front of the other and switching between leaning forward and standing straight is one way to gently stretch and warm-up the Achilles prior to beginning the day’s hike. In addition, rising up on the toes for five to ten seconds several times in a row can also help strengthen and condition tendons and muscles in the calf and foot. For better results perform this exercise with one foot raised off the ground. Prompt treatment will keep a mild injury from becoming severe.

One of the most frequent causes of foot pain is plantar fasciitis. This condition is often associated with a heel spur, or, growth of bone on the undersurface of the heel bone, or, calcaneus. Regardless of whether a bone spur is present or absent, the pain in this condition comes from an inflammation at the junction of a ligament deep in the foot, and its attachment to the calcaneal bone.

Early symptoms of this sometimes debilitating problem include a pain or dull ache in the bottom of the heel bone usually with the first step when getting up from bed or even a chair. The pain sometimes diminishes as the day progresses. If left untreated, patients may resort to limping and can be sidelined from hiking, running or even walking a treadmill, for months. Hikers carrying a heavy back-pack on a long trail are susceptible to this condition.

Early intervention includes wearing appropriately fitting shoes with a supportive footbed, or, arch support. Resting the heel on an ice pack for five-to-ten minutes a few times a day is helpful, as is performing the stretching exercises described above for the Achilles tendon. Use of anti-inflammatory medication such as ibuprofen is also helpful. Prescription medication may be needed. Other treatments include a stretching splint, custom made arch supports, called orthotics and, sometimes, a cortisone injection.

With some common sense a person’s feet should hold up well during years of hiking, walking, and, staying physically active. Early diagnosis and treatment, however, are very important in keeping patients on their feet.

Howard E. Friedman DPM is a podiatrist and board certified foot surgeon. He treats hikers and non-hikers in his office in Suffern, New York.

Howard E. Friedman