Written by: Michele Meyer  |  Updated: May 17, 2012

Once upon a time, this little piggy went to market—all pink, pudgy and perfect. Then we grew up—and feet became another dreaded four-letter word.

Even the most perfectly sculpted, unblemished human specimens among us may dread summer’s big reveal, since no amount of dieting, extreme workouts or makeup can restore our feet to their newly minted loveliness. Knobby claws, gnarly nails, bumps, veins, blisters and scales are proof that we walk this earth as mere mortals.

It’s time the body part we loathe gained respect.

“Feet are the foundation of the body,” says David S. Wolf, DPM, podiatrist at The University of Texas Health Science Center (UTHealth) School of Nursing’s UT Health Services. “If your foundation is out of whack, your whole body is out of whack. When your feet hurt, you hurt all over.”

Wolf says four out of five Americans suffer foot pain in their lifetime, most of it self-inflicted.

Repeat Offenders

Here are seven of the most common foot issues today and how to avoid them:

Offense: “Sexy Shoe Syndrome”
Culprit: Sky-high stilettos with pointy toes.
Fix: Can paws howl? They certainly do, when crammed into tight spaces. Two-inch-plus heels force your Achilles tendons (the cord at the heel that runs up the back of your leg) to clench as your weight shifts to the balls of the feet. In time, this erodes the fat pads where you most need cushioning and creates a slew of ailments: bunions, corns, hammertoes (inflamed toe joints) and neuromas (irritated, trapped nerves usually between the third and fourth toes).

Burning, numbness, stabbing, throbbing and raw skin abrasion can result from any of these afflictions.

You can put your podiatrist on speed dial and ice your feet twice daily. Or, limit the torturous footbinding to two hours at a time. Better yet, quit the stilts. 

“High heels are good for our business—but we don’t want it,” Wolf says. “That old song, ‘The foot bone is connected to the ankle bone,’ tells the story. If one joint is out of place, your entire skeleton is affected. You change your gait and wind up with lower-back pain and headaches.”

So, avoid stratospheric shoes or risk eventual injury and surgery. Luckily, “sensible shoes” no longer need to look…sensible. Stylish yet forgiving footwear is sold everywhere nowadays. Even certain designer footwear brands have partnered with orthopedic experts or athletic footwear companies. 

Offense: Plantar Fasciitis
Culprit: Bands of connective tissue that run along the bottom of your feet (the arch) beg for mercy. Symptoms include stiffness and sharp or dull pain at the base of the heel, with the worst pain of the day often coming in the early morning.
Fix: Treat feet right by exercising regularly, losing weight and wearing shoes with the proper wiggle room at the toe box.

Keep in mind that one in 10 cases of plantar fasciitis becomes chronic, while the other nine can be treated with massage of the plantar fascia and simple exercises, Wolf says. For example, upon waking or retiring, roll your arches for two minutes over a frozen 16-ounce bottled water on a towel. Stretch the ligaments in the foot by scrunching the towel with your toes.

A night splint—sold at pharmacies—can keep feet at 90 degrees from legs overnight (to lengthen tendons). If store-bought arch supports fail, your podiatrist can custom-make an insole, also known as an orthotic. This balances and controls the foot and takes stress off the plantar fascia. Other treatments for more severe, stubborn inflammation include cortisone injections and oral anti-inflammatory medication.

Offense: Nighttime foot and leg cramps
Culprit: Body mechanics from switching between high-to-low heels; electrolyte imbalances; and certain vascular conditions.
Fix: If nighttime toe, foot or leg cramps torment you, especially a few hours after you’ve been wearing heels and have switched to flats or bare feet, Wolf suggests trying exercises after the cramp has passed. “While lying in bed, draw the alphabet on the sheets with your feet to strengthen the intrinsic muscles in your feet,” Wolf says.

“Cramps can occur when the body isn’t receiving or retaining a good potassium level,” Wolf adds. “Stay hydrated and consume potassium-rich foods such as bananas and orange juice, but don’t self-medicate with potassium supplements. Too much is as dangerous as too little when it comes to the delicate balance of electrolytes the body needs.”

If you continue to be plagued with leg cramps that wake you from a dead sleep, visit your health care provider. You may have an underlying vascular condition that needs attention.

If all else fails, you can try your grandmother’s cure: the bar of soap at the foot of the bed between the sheets. The theory goes that potassium ions are transferred to the feet from the soap. “I must admit that I have patients who swear by it,” Wolf says, though the evidence is purely anecdotal.

Offense: Black Toe
Culprit: Micro-trauma from distance running, rock climbing, basketball and repetitive sports cause blood to collect under nails.
Fix: Be a “good sport.” Stop running barefoot or in barely-there toe shoes, which lack support. Make sure your athletic shoes have a wide enough and long enough toe box. “Most of us put our weight on the inside or outside of our feet, and that causes injuries,” says Wolf, who has run in five marathons.

Switch shoes and socks midway through long (10-20K) walks and long (20-30K) runs, he suggests. The pounding, which is at three times your body weight with each step, “makes your feet swell and sweat, so you need shoes a half-size bigger. You also should trim nails or they hit the shoe, become black and can fall out.”

Cut callus-causing friction by wearing absorbent, thick socks. Some athletes wear two pairs of absorbent thin socks, allowing the socks to slide against each other instead of your skin. Replace athletic shoes every 350-500 miles—whether those miles are covered on a street or a treadmill.

Offense: Thick, Yellow, Crumbly, Ragged (Gross) Nails and Athlete’s Foot
Culprit: Stubbed, cramped, wet toes and fungus damage the nail beds, creating the condition onychomycosis. “The same fungus that will eventually lead to athlete’s foot originally resides in the nail bed,” Wolf says, solving the chicken-egg debate of which came first. “Walking barefoot in gyms, showers and airport security lines can lead to onychomycosis and athlete’s foot.”

Fungus grows in moist, dark, alkaline atmospheres—like shoes—and “can even spread to your finger nails from handling your feet, if you aren’t careful,” Wolf adds. Nail bed fungus often presents as a white or yellow patch under the nail, which, over time, distorts the nail, making it thick, ragged, crumbly and discolored. Since bacteria, psoriasis and trauma can all affect the toenail, you should visit your podiatrist and not try to self-diagnose.

Athlete’s foot starts with flaking skin and progresses to swelling and blisters between toes.

Fix:  Wear flip-flops in gym showers, socks in airports and always dry feet thoroughly. For athlete’s foot, topical anti-fungal creams and sprays work well—and quickly—if you’re consistent with the application.

For nail fungus, you’ve got to have commitment, because the fungus has moved in and plans to stick around.  Wolf says there is a laser treatment that patients often request, but he advises against it. “It’s experimental, expensive and not approved by the FDA,” Wolf says, adding that it also must be repeated 2-3 times. Wolf instead recommends a compound topical lacquer that contains tea tree oil, terbinafine (anti-fungal medication) and DMSO (dimethyl sulfoxide).  He also recommends the oral fluconazole (Diflucan) regimen, though the treatment takes three months with possible side effects and lifestyle restrictions, such as no alcohol.

Offense: Stinky, Sweaty Feet (Hyperhydrosis)
Culprit: If odor is pulling rank, blame the dark, dank environment of your shoes.
Fix: Dry out with antiperspirant, specialized sprays or powders. Change socks daily and alternate shoes day-to-day. For soggy athletic shoes, purchase a special shoe dryer. Many styles of casual walking shoes and/or the insoles are machine washable. For people with severe sweating of the feet, Botox injections have proved effective.

Offense: Wounded Feet
Culprit:  Coral, jagged glass, sea shells, beer caps, nails, rocks, dog bites…
Fix: Protect and defend your feet! If you’re nowhere near a first-aid kit, cleaning cuts with saline-rich eye or nose solutions cleanse and dry the wound. Vinegar, meat tenderizer or baking soda will take down swelling and stinging if stung by sea life. Once wounded, avoid lake, river or sea water. They are awash in micro-organisms that can cause severe infection.

See a foot specialist within 24 hours of any puncture wound to remove foreign objects and monitor your recovery. If swelling, smelling, oozing and pain linger, start with RICE (rest, ice, compression and elevation) and contact your doctor immediately.  Then, get vaccinated against tetanus every decade.

“I’m a big believer in trying the simple things first,” Wolf says. “The adage ‘Keep it simple’ is actually smart.”

If you would like to make an appointment at UT Health Services to see Dr. Wolf, please call 713-500-3267 or visit the UT Health Services website.