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Footwear & Foot Care Footwear & Foot Care

Footwear & Foot Care - PowerPoint Presentation

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Uploaded On 2022-08-03

Footwear & Foot Care - PPT Presentation

Joanna Hammond Specialist Podiatrist Housekeeping Fire alarms Mobiles Toilets Aims How Diabetes and Vascular problems can affect the feet Nail conditions Foot conditions Correct Footwear ID: 933253

footwear nail skin foot nail footwear foot skin toes feet toe pressure nails small shoes corns areas callus incorrect

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Presentation Transcript

Slide1

Footwear & Foot Care

Joanna Hammond

Specialist Podiatrist

Slide2

Housekeeping:

Fire alarms

Mobiles

Toilets

Slide3

Aims

How Diabetes and Vascular problems can affect the feet

Nail conditions

Foot conditions

Correct Footwear

Why correct footwear is so important

Slide4

Pressure Points

An area which receives a high amount of pressure either whilst walking or from footwear.

Often occurs over bony areas.

If pressure continues, the skin could

- Form hard skin / corns.

- Break down, creating an ulcer.

- Blisters.

Slide5

Pressure Points Contd

Bunions

Soles of the feet

Tops of the toes

Heels

Slide6

Diabetes

Slide7

Diabetes

Diabetes affects approximately 5% of the UK population (2.6 million diagnosed and estimated half a million undiagnosed)

90% of those are type 2 diabetics and 10% type 1.

Peripheral Arterial Disease affects 19% of those aged over 70.

Slide8

Diabetes and the Feet

Skin Changes

Blood Supply

Neuropathy

Ulceration

Slide9

Skin Changes

Dryness, peeling and cracking can occur due to the natural function that provides moisture to the skin not being as efficient.

Slide10

Blood supply to the feet

Poor circulation due to the narrowing and hardening of blood vessels to the lower limb, which can lead to poor healing and difficulty fighting infection.

Slide11

Neuropathy

A lack of feeling within the feet, means that diabetics will not be aware of any injury unless they check their feet regularly.

Can be felt as tingling, burning, pricking, squeezing, “asleep”.

Can be worse at night

Slide12

Ulceration

Ulceration can be neuropathic or ischaemic or both.

12 – 25 % (

cavanagh

et al) of diabetics will develop an ulcer

85% of amputations start with an ulcer

Slide13

Neuropathic ulcers – tend to be pain free found in areas of adequate blood flow, often surrounded by callus, commonly seen at the bottom of the feet and the tips of the toes

Ischaemic

ulcers can be painful, are found in areas where there is a diminished pulse, often at the ends of the toes

Diabetic ulcers are usually a combination of these 2 types

Slide14

Ulcers

Slide15

Ulcer prevention

Moisturise

.

Check feet daily.

Don’t walk barefoot.

Ensure footwear is not rubbing or squeezing at any point.

If a wound is not healing normally contact a medical professional.

Slide16

The Nail

Slide17

Nail Anatomy

The nail is produced by cells in the nail matrix. If damage occurs to the cells, then a deformed nail will result.

Slide18

Thickened Nails

Usually as a result of damage to the nail bed.

These nails can look imposing.

File the surface in one direction, making sure you regularly check how much you have removed.

Slide19

Fungal Nails

These nails are often crumbly and flake off in small chunks.

Cut a small section of the nail at a time and file all the rough edges.

Slide20

Fungal Nails

Slide21

Involuted Nails

The nail curls round, pushing on the

sulcus

(skin at the sides of the nail).

Many people, incorrectly, call these in growing toenails.

Gently cut a small section of the nail at a time following the line of the end of the toe.

Do NOT be tempted to dig down the side to remove the curled area.

Slide22

Involuted Nail

Slide23

In growing Toenail

A small slither of nail pierces the skin.

It feels very sharp if the end of the toe is pressed.

Can become red, inflamed and infected.

Slide24

Ingrowing Toenails

This occurs when a small spicule of nail pierces the skin surrounding the nail and grows into the flesh. It is extremely painful. Although any resultant infection can be initially managed with antibiotic cover, unless the spicule is removed, reinfection will occur

Slide25

Black Nails

More commonly caused by trauma.

Colour caused by a bleed under the nail (bruise).

Will grow out as the nail grows.

Can take 9 – 12 months to grow out.

Slide26

Black Nails

Slide27

Foot Conditions

Slide28

Callus

A build up of skin that occurs over areas of High Pressure.

Can be naturally

occuring

or footwear induced

It is often yellow in colour.

Gently file the area.

Moisturise Regularly.

Slide29

Callus

Slide30

Corns

Small areas of very hard skin.

Caused by Pressure.

Have NO root.

Can be between the toes.

Do NOT use medicated corn preparations.

Slide31

Corns

Slide32

Corns

Severe untreated corns

Slide33

Verrucae

This is a virus that infects one of the middle layers of the skin.

There are over 50 different types of

verruca

.

Management usually involves leaving asymptomatic VP’s, as they do resolve themselves naturally.

NB The black dots are not the virus!!!!!!!

Slide34

Verrucae

Slide35

Interdigital Maceration

White waterlogged skin between the toes.

Make sure you dry properly between the toes.

If necessary, apply a small amount of surgical spirit until the condition clears up.

Slide36

Interdigital Maceration

Slide37

Athletes Foot

A Fungal Infection (there are 5 common types)

Can be between the toes, or anywhere on the foot.

The most common type gives the foot a distinctive demarcated redness called the moccasin affect.

Change socks daily, give shoes a day of rest.

Keep feet clean and dry

.

Slide38

Fungal Infections

Slide39

Athletes Foot

Slide40

Fissures

Usually as a result of dry skin and tensile pressure

File the area

Apply moisturiser regularly

If necessary apply a dressing and monitor for signs of infection

May require Podiatric intervention of a large amount of callus is present within the fissure

Slide41

Fissures

Slide42

FOOTWEAR

Slide43

Footwear is one of the main causes of foot problems.

Slide44

Correct Size

Many people wear the incorrect size of shoe.

Foot measurement is only a guide.

One study found that 35.5% of women wearing shoes too small reported foot pain (the figure was 9.5% for those wearing the correct fit)

Slide45

Why?

Too big and shoes become a trip hazard, too tight and they cramp the foot making it unstable.

Slide46

Heel Height

This is the part that most people are aware of!

Shoes should be no more than half an inch.

Slide47

Why?

Too high and stability is reduced with the reduced foot / floor contact.

The Centre of gravity is also altered!

Slide48

Toe width

The shoe should be rounded to accommodate the shape of the toes.

Even slightly tapered toe boxes are not ideal.

Slide49

Toe Depth

The depth of the toe box should accommodate the toes.

If the toes are bent / deformed then a deeper toe box will be required.

Slide50

Why?

A shallow toe box will rub on the tops of the toes causing corns, callus and discomfort.

Slide51

Sole

The sole should provide cushioning (without being too thick)

There should be some grip on the sole.

Slide52

Why?

Too thin and every lump and bump can be felt on the ground potentially leading to instability.

Slide53

Fastening

All shoes should be held on the foot.

There should be a heel cup.

At the front there should be laces, a strap, buckle, velcro.

A slip-on shoe HAS to be too tight to stay on the foot!

Slide54

Incorrect Footwear

Incorrect Footwear can be uncomfortable.

It creates excessive Pressure Points.

It can lead to callus, corns or ulcers.

Slide55

Footwear and Falls

Incorrect footwear is often a factor that contributes to instability and leads to falls.

Slide56

Correct Footwear is one of the few areas in which you as individuals can improve your health outcomes.

Incorrect footwear is implicated in many falls.

Knowing the difference between good and bad footwear can reduce your risk of falling and ulceration.

Slide57

Slippers

Exactly the same “rules” that apply for shoes apply for slippers.

Indoor shoes are as good as slippers.

Remember that if someone spends a lot of time indoors, then their slippers are their most important pair of “shoes”.

Slide58

Thank You for Listening