Happy Fourth of July! I hope everyone is able to get outside and enjoy time with family and friends today. Holidays, especially in the summer, are a common time for foot and ankle injuries to occur and I often see these several conditions come into my practice throughout the summer. Below I’ve included some common conditions I see shortly after the Fourth of July, as well as ways to prevent them.
Blisters
A blister is a reaction of the skin to friction, which creates a raised “bubble,” the skin’s way to protect itself from what is causing the friction. Blisters occur anywhere on the foot that friction may occur; this might be on the back of the heel, between or on toes, or on the bottom of the foot.
Ways to protect yourself: Prevent the friction. Avoid thong sandals, as these can often cause rubbing between the toes over time. You can try to prevent friction getting worse by applying a band-aid or a similar type of padding when you start to feel a blister coming on. If you are able, a good option to preventing blisters is to change your shoes when you start to feel one coming on. If a blister does occur, it is best to leave it alone, as removing the skin may cause it to get worse, or even infected.
Sunburn
Sunburn is a reaction of the skin to the sun. The most common type of burn that I see is first degree sunburn. A first degree sunburn is quite painful and can cause blistering on the skin. You should seek medical attention sooner rather than later, as blistering indicates problems below the skin. Often I hear of patients falling asleep in the sun which leads to significant burns with loss of skin if damage is severe enough. Sunburns can also cause skin infection, which will require medical attention.
Ways to protect yourself: Wear sunscreen. Use higher SPF (50-70 SPF) on the top of the foot. Top of feet are often worst burns because skin there is very thin. I would also recommend using sunscreen on the bottom of the foot if you plan on exposing the bottom of your feet directly to the sun. If you do get a sunburn on your feet, you can try soaking it in baking soda and cool water, then apply aloe to the burnt area. Do not use alcohol or peroxide to the areas as it will burn the tissue more.
Fungus
Fungus is an infection of the skin caused by a yeast or contaminant that invades the skin’s surface when the right conditions are met. This is what we would call an “opportunistic infection,” because it will occur when the conditions are just right. Often high humidity, sweat, and lack of air circulation between toes, on the sides or bottoms of feet make the perfect conditions to cause fungus.
Ways to protect yourself: Keep air circulating to feet. As soon as you see small water blisters, start treating with an over-the-counter anti-fungal agent. The itchy, blistery patches that form are usually an indication that it is an acute infection. Sometimes you’ll need both topical and oral therapy that only your doctor can prescribe.
Foreign Bodies
Foreign bodies are often caused by walking barefoot, and can potentially lodge deeply into the foot, making it painful and difficult to remove. I often see small pieces of sand, stone, wood, metal, or glass that patients come in with. Foreign bodies can cause pain and may lead to infection if it is not removed and treated appropriately. Infections are common, as the foreign body can be carrying contaminants. Diabetic patients and neuropathy or nerve-damaged patients are at high risk for infection, as they cannot feel the pain that occurs with foreign bodies and may not get the medical attention as quickly as needed.
Ways to protect yourself: Wear shoes. Though it is tempting, walking barefoot can end in disaster if something does get under your skin. Shoes can help prevent small pieces of debris from getting into your skin, avoiding pain and possible infection. It is helpful to inspect between your toes and the bottom of your foot daily, even if you need to ask someone for help.
Plantar Fasciitis
Plantar fasciitis is a strain of the supporting long ligament of the bottom of the foot called the plantar fascia that extends from the bottom of the heel to the underside of the toes. There are three bands of this ligament. The most common to be pulled is the medial band, as it is self-supporting. If you wear shoes that have little support (like flip-flops), it will strain the ligament as you walk because there’s no support to that ligament. Once strained, it will initially give you acute pain, which will then lead to chronic daily footstep pain. This ligament is prone to small tears and in extreme cases, will rupture. This will require medical attention and appropriate mobilization. Sometimes plantar fasciitis is not even foot-related, but can be caused by a misalignment in knees, hips, or back.
Ways to protect yourself: Wear supportive shoes. Although tempting throughout the summer months, going barefoot can cause pain and agony the longer you are without shoes. There are orthotic sandals that are now available, such as those you would find with NAOT, Bionics, and Clark’s. Be careful that the sandals you purchase have orthotics built into them. Your feet should be measured before purchasing shoes, more toward evening as feet and legs have a tendency to swell, and your shoe size will change. As we age, our shoe sizes change as well, and that’s important to keep in mind to make sure you have the right fitting shoes.
If you believe you have any of the above conditions or are having any foot, ankle, or lower leg pain, please do not hesitate to request an appointment! I want to make sure everyone has a pain-free rest of the summer, so get any foot conditions taken care of as soon as possible.
Wishing everyone a safe and happy Fourth of July!
Dr. Rosemarie Rynkiewicz, DPM 