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WHAT IS IT?
Most people in the United States walk about 10,000 steps a day. Small wonder, then, that one in six complains of aching feet, most often from overexercise, ill-fitting shoes, years of daily wear and tear, or aging. Women are more likely than men to have foot problems-mostly from tight or high-heeled shoes.Four of the most common foot problems are: Achilles tendinitis-condition when the Achilles tendon, just above your heel bone, is strained or inflamed. It’s a common sports injury.
Bunions-bony lumps that form on the side of the joint that connects the big toe to the foot. These lumps are often harmless, but they may become inflamed and painful.
Hammertoes-condition when tendons in a toe, most often the second toe, contract so that the toe bends and you can’t straighten it out. This makes walking or standing hard for some people.
Plantar fasciitis-a common problem for runners and other people who overuse their feet. Stress on the plantar fascia, a ligament along the bottom of the foot that links heel and toe bones, causes pain.
Left untreated, foot injuries may change your walk or posture, or cause pain in the hips, knees, ankles, or lower back. You can do a lot to prevent foot problems by making sure you wear shoes that fit well and by exercising the right way. If you already have a foot problem, you and your doctor can take steps to heal your foot and stop the pain. Keep in mind that foot pain is not normal, and it shouldn’t be ignored.
WHAT IS HAPPENING?
Here’s how foot problems develop:
Achilles tendinitis: A tendon is a tough band of tissue that links a muscle to a bone. One section of the Achilles tendon-an inch or two or three above the heel bone-gets a lot less blood and is weaker than the rest. It’s here that the tendon may be strained. Swelling and pain may build over many months. Scar tissue can form that leaves the tendon in more pain than before. It’s easily injured again.

Bunions: A bunion slowly forces the big toe to point inward or outward. Ill-fitting shoes can press on the bunion, making it swell and hurt. Long-term pressure can inflame a small sac nearby that cushions the toe bone, called a bursa-a problem known as bursitis.

Hammertoes: With a hammertoe, the tendon in the toe slowly contracts, making the toe stiff and hard to move. The joint of the hammertoe rubbing against a shoe can form a painful corn.

Plantar fasciitis: When strain pulls or tears the fibers of the plantar fascia, pain results. White blood cells repair the area, but the rush of fluid also creates swelling and pain. Unless you fix the problem that caused it, you can further damage the ligament and end up with scar tissue. The damage sometimes even spreads to the ankle or to the heel, which can lead to heel spurs. It may take up to a year to heal.
WHAT CAUSES IT?
No one can say exactly why one person has foot problems and another doesn’t, but certain factors increase your risk. Some-such as your age and genes-are outside your control. Others are things you can change.

THINGS YOU CAN’T CHANGE

Age
As we age, the skin on our feet thins and ligaments and tendons weaken. We’re more likely to injure our feet when we overuse them or cram them into shoes that don’t fit.

Genes
Some people inherit a problem called hallux valgus, or weakness in the toe joints. They get bunions when they injure their toes or wear poorly fitting shoes. Other problems such as high arches or feet that turn in too much, which can make them prone to injury, may also run in your family.

Illness
Health problems such as arthritis and diabetes increase the risk of serious foot ailments. Arthritis weakens bones and muscles. Diabetes can damage nerves and cut blood flow. Because they can’t feel pain in their feet, people with nerve damage from diabetes sometimes let foot injuries go until they’re severe.

THINGS YOU CAN CHANGE

Wearing ill-fitting shoes
Shoes that are too tight, short, pointed, overly worn, or high in the heel squeeze your feet and increase your risk.

Being overweight
If you gain as little as ten extra pounds, you add to any activity’s impact on your feet-whether you’re standing, walking, or running. Weight gain can change your gait, or how you walk, which puts stress on your legs and feet. If you’re overweight or obese you’re at greater risk of inflamed heels and stressed arches. Shoe size can also change if you put on extra pounds.

Sudden increase in activity
If you step up your exercise all of a sudden, you may stretch or tear the plantar fasciae or other tissues.

Working out on hard surfaces
When you switch from working out on a soft surface such as grass to a hard one such as concrete, your plantar fasciae take more of a pounding.

Overuse
People who have to work on their feet or who play strenuous sports are more likely to injure their plantar fasciae by overusing their feet. For instance, running has three times the impact that walking has on your feet, especially on the plantar fasciae.

Moving the wrong way
People who walk or exercise with their feet turned in may get plantar fasciitis.
WHAT YOU CAN DO FOR YOURSELF
You can help prevent foot injuries by making smart choices about your shoes and exercise. If you already have a foot problem, home remedies may help. You should also see your doctor.

Take medicine
Over-the-counter medicines are good for pain. For swelling, try ibuprofen (Advil or Motrin), aspirin, or naproxen (Aleve). These drugs work to help relieve pain.

Use ice and more ice
Ice reduces the pain and swelling of Achilles tendinitis. Collect pieces of ice in a cup and rub them one by one on the part of the foot that hurts. Repeat for 5 or 10 minutes or until the area is numb. Or apply an ice pack, sold in drugstores, or a package of frozen peas for 10 to 15 minutes at a time. Repeat often, stopping for half an hour or so between applications.

Wrap your foot
If you have plantar fasciitis, taping your foot with a sports bandage when you exercise or using a night splint when you sleep helps support your arch, stretches out the plantar fascia, and speeds healing. The wrapping helps prevent the fascia from tightening up. That way, it heals in a stretched position, which cuts down on your pain.

Rest
If you’ve strained a ligament or tendon, try resting your foot for at least a week. If the injury is from some type of exercise, such as jogging, try something else that doesn’t put stress on the injured area. Swimming and bicycling are often good choices.

Change your shoes
Store-bought shoe inserts may relieve pain. For bunions, try doughnut-shaped toe cushions or pieces of moleskin cut to size; they take the pressure off the toe joint. Products with gel in them also help cushion tender spots. If you have a hammertoe, use a cap or padded sleeve that fits over the joint to protect the toe tip from the end of the shoe. Shoe lifts that support the arch and raise the heel take the pressure off an injured plantar fascia.

Choose the right shoes
Shoes that fit are vital for preventing foot injuries. Always pick shoes that are sturdy and feel good, with enough room to wiggle your toes. Here are some other tips:

When you shop, make sure you try on both shoes. Fit new shoes to your larger foot. Many people’s feet aren’t the same size.
Make sure your heel fits snugly and doesn’t slip out of the shoe when you walk.
Try on new shoes at the end of the day, and sports shoes after a workout. Your feet swell after you stand or sit all day and after exercise.
Don’t wear heels higher than about two inches. They lead to injuries.
Walk or run a few steps in new shoes before buying.
Look for stiff heels on workout shoes. They help keep your foot from twisting too much, which can lead to aching leg muscles and tendons. You shouldn’t be able to hold the shoe and squish the heel down or compress it from the sides.
Don’t overexercise
When you’re all fired up about starting a new routine, it’s easy to overdo it. Don’t jump into a new sport without learning how to do it right. Always increase your activity slowly. Adding ten minutes per workout is a good rule. And be sure to take rest days.

Exercise in the right places
Soft surfaces are much more forgiving than concrete or wood. Try running on a dirt path or track rather than the concrete floor at the high school gym or on sidewalks.

Lose weight
Losing weight is one of the best things you can do for your feet. Cutting calories and exercising often is the best way to drop pounds. Here are some tips:

Cut fats in your diet by choosing low-fat foods. Eat more vegetables, fruits, and grains, which are healthy and low in fat and calories. Prepare them without adding fat. A serving of steamed vegetables has no fat grams, while the same amount of vegetables sauteed in butter or oil has 14 grams of fat.
Use less sugar, alcohol, and salt.
Get your exercise up to 20 to 30 minutes, three times a week. A brisk half-hour walk not only strengthens muscles and protects joints, it burns about 150 calories.
WHAT YOUR DOCTOR CAN DO FOR YOU
Your doctor can treat all kinds of foot problems with drugs, special custom-made inserts, or surgery, or may send you to a physical therapist.

Drugs
Your doctor may prescribe special drugs to relieve inflammation and pain, or may suggest that you take large doses of ibuprofen for a short time. In severe cases, he or she will inject a corticosteroid drug to control swelling and pain. Corticosteroids should not be used more than a few times. They can cause serious side effects such as osteoporosis, diabetes, or cataracts. Too many injections can also weaken or rupture the plantar fascia or shrink tissue pads around your heel bones.

Shoe inserts
Your doctor may fit you for custom-made molded plastic inserts to support your arches or heels. These take pressure off the part that hurts, support the foot, and help realign it to the correct position.

Surgery
Only extreme cases need surgery. A bad bunion can be surgically removed and the joint realigned. Surgery can also realign a hammertoe. A tight plantar fascia can be cut to relieve pain. And inflamed tissues caused by Achilles tendinitis can be removed so that the tendon heals and moves better.

Endoscopic surgery helps some people with plantar fasciitis. With this method, the surgeon makes a tiny cut-only a fraction of an inch-in the foot. Then he or she inserts a viewing scope with a tiny camera on the end. The scope is connected to a viewing monitor so the surgeon can see the tissues inside the foot. Through another small cut, with tiny instruments, the surgeon operates on the plantar fascia. Recovery time is a week or two.

Physical therapy
A physical therapist can ice, massage, and stretch the tissues that hurt. He or she can also teach you exercises to strengthen your tissues and restore movement. A physical therapist can also treat you with ultrasound, sound waves that pass through your skin to your bones and tissues. The treatment increases blood flow and aids healing.