Dealing with Pain Part 5: Keeping Feet and Ankles Healthy

September 21, 2019

"Pain and discomfort in the feet, especially as we age, is a huge problem that we probably don’t focus enough attention on."

Over the course of a lifetime, our feet and ankles really take a pounding. The resulting pain and discomfort many of us experience as we get older in our feet and ankles, including plantar fasciitis, shin splints, swelling in the lower legs, and other issues, are unique to our lower extremities. The good news, as we’ll learn in Dr. Nancy’s live show today, is that most of these conditions are preventable with a few simple tips and the right lifestyle choices!

Video Highlights

  • 01:36: Facts About Feet
  • 07:00: Why Foot Health is Important
  • 11:51: Most Common Toe, Foot, and Ankle Issues
  • 35:14: Ways to Keep the Feet and Ankles Healthy
  • 39:07: Foot and Ankle Stretches
  • 42:50: Yoga Poses for Foot and Ankle Strength
  • 51:23: Nutrition for Feet, Ankles, and Toes
  • 52:40: Wrap-Up

So far, in this series, we’ve talked about different conditions, aches, and pains in our joints, bones, ligaments, and muscles throughout the body, including our wrists and hands, knees, shoulders, and hips. Today, we are going to finish by talking about several conditions that can really do a number on your lower extremities — specifically the ankles, feet, and toes.

Facts About Feet

Let’s take a moment to consider how much actual wear and tear our muscles and joints in our lower extremities are actually exposed to. With every step, each foot absorbs the equivalent of 1.5 times of our bodyweight, and that becomes 5 times our bodyweight when we run. Over the course of a day, that means your feet absorb the equivalent of over 200 tons of force!

Here are a few more interesting foot facts to consider:

  • The human foot and ankle contains 26 bones, 33 joints, and more than 100 muscles, tendons, and ligaments.
  • The 52 bones in your feet make up ¼ of all the bones in your body.
  • There are also more than 8,000 nerves in your feet — oh and ticklish feet are a good sign by the way, as reduced sensitivity could be a symptom of neuropathy, a medical condition that is often linked to diabetes
  • Your two feet have 250,000 sweat glands — that’s a quarter of a million — that are capable of producing half a pint of sweat in a single day! 
  • The average person walks roughly 110,000 miles over their lifetime. To put that in perspective, the earth has a circumference of 24,000 miles. So, over the course of our life, that’s like walking around the earth 4 ½ times!

Why Foot Health is Important

The health of your feet is often a pretty accurate reflection of your overall general health. Abnormalities or pain in your feet can often be a sign of a more serious health condition, and pain and discomfort in the feet, especially as we age, is a huge problem that we probably don’t focus enough attention on. 

In fact, over 80% of us will experience some type of foot pain over the course of our lives, yet only 20% of people report paying regular attention to the health of their feet. And while foot pain can affect any of us, women are actually four times more likely than men to have foot pain.

Everyone has had a minor problem with a toe, foot, or ankle from time to time. Most of the time our daily movements do not cause problems, but it's not surprising that over time, symptoms develop from everyday wear and tear or overuse. Toe, foot, or ankle problems can also occur from injuries and most often as a natural process of aging.

Some pain is inevitable, and just a natural part of aging. Some age-related pain, including burning, numb, or tingly muscles, stiff or painful joints, or just general fatigue and aches, comes with the years.  Your feet and lower legs are no exception — you’ll feel the same type of pain and discomfort in your ankles and feet as you will in other joints and muscles in your body.

However, when it comes to feet, you might also experience pain and discomforts unique to your lower extremities, including plantar fasciitis, shin splints, or swelling in your lower legs, ankles and feet. Most of the pain, swelling, and discomfort people experience in their lower legs, ankles, and feet are either caused by, or made worse by, preventable lifestyle choices — how we treat our feet, and the steps we take (no pun intended) or don’t take to keep our feet, ankles, and lower legs healthy.

Most Common Toe, Foot, and Ankle Issues

Let’s start with the skin. Most skin problems that affect your feet tend to be less serious, short-term, and more of a discomfort or distraction: 

  • If you have the feeling of walking on pebbles, you may have plantar warts on the bottom of your feet.
  • Patches of thick and tough skin on the heel or ball of your foot is usually caused by a callous, corn, or blister
  • Red, peeling, cracking, burning, and itchy skin between your toes or on the bottom of your feet is likely caused by a fungus such as  athlete's foot.
  • Red, swollen, and painful skin around a toenail could be an ingrown nail or an infection around the nail.

All of these are treatable with natural home treatment methods or by seeing your podiatrist.  For example, you can use an apple cider vinegar foot soak to kill the fungus that causes athlete's foot.  Apple cider vinegar can also be used to kill plantar warts.

There are literally hundreds of other issues that come up causing pain and discomfort in your feet and toes, including:

  • Bunions, or bumps or swelling on your big toe
  • Stress fractures resulting from wear and tear
  • Heel spurs, which are tine bone spurs under your heel 
  • Joint pain, stiffness, and swelling are common when you have conditions such as bursitis, arthritis, lupus, or gout.
  • Shin splints, which is pain or soreness along the inner side of your tibia, or shinbone and often result from overuse and increased activity — but also common with aging.
  • Hammer toe, resulting from an abnormal bend in the joint of one or more of your toes, typically caused by the wearing of narrow shoes or high heels.

Okay, let’s switch gears a little and talk about some of the more common chronic issues seen in your lower legs, ankles, and feet as we age. The big four are:  

  • Plantar fasciitis
  • Swollen Legs, Ankles and Feet
  • Arthritis
  • Neuropathy

Plantar Fasciitis

You’ve probably heard of plantar fasciitis, a condition that causes pain in the heel and bottom of the foot, and affects over two million people each year. The plantar fascia is a ligament found at the bottom of the foot. It’s actually the largest ligament in the body. Plantar fasciitis results from inflammation of the thick fascia tissues of the heels.

The most common symptoms of plantar fasciitis include:

  • Pain in the heel, especially when waking up and taking the first few steps of the day
  • Worsening bone and joint pain after walking, exercising or carrying heavy objects
  • Tenderness and sometimes swelling throughout the feet
  • Trouble walking normally and completing everyday tasks without pain
  • Reduced pain when stopping repetitive movements or exercising for a period of time

As we age, or as we expose the ligament to stress, maybe from overuse or from pressure caused by excess weight, tiny micro tears develop throughout the plantar fascia, and especially where the ligament attaches to the heel bone or on the sole of the foot. This leads to inflammation, pain, and fluid build-up called perifascial edema.

Fortunately, the condition is treatable and even preventable — it’s a slow recovery, but more than 90% of people with plantar fasciitis will fully recover within months of starting simple treatment that you can do right at home.

We’re going to show you several of these stretches and exercises in just a few minutes, so don’t go anywhere!

Swollen Legs, Ankles and Feet

Next, let’s talk about something that can occur as we age where you start to experience swelling in your lower legs and your ankles. While this is not unusual with age, it can be a really important warning sign of a much more significant and even life threatening health condition.

Your legs swell as a result of fluid buildup, which is commonly referred to as edema, and  happens when the tissues or blood vessels in your legs retain more fluid than they should.

This can happen if you simply spend a long day on your feet or sit for too long. But it may also be a sign that you need to lose weight or are not getting enough exercise, or it could be the beginning of a more serious medical condition, such as:

  • Congestive heart failure, which happens when your heart is too weak to pump the blood your body needs — this results in fluid retention, most often in your legs.
  • Varicose veins, which occur when the valves in the veins in your legs fail to keep blood flowing toward your heart, causing it to back up and pool, resulting in the common appearance of clustered veins most often associated with varicose veins. This can also cause your lower legs to swell.
  • Kidney problems that prevent the normal function of filtering water and waste material from your blood can often cause excess fluid to collect in your body and results in swelling in your legs. 

If you are noticing swelling in your legs and ankles, even slight swelling, you really need to see your doctor as it could be a sign of a more serious health condition — especially if you are also experiencing leg pain or increased fatigue — don’t ignore these symptoms.

After seeing your doctor, there are a few things you can do to reduce or even prevent the swelling in your lower legs, including

  • Cutting way back on salty and proceed foods
  • Wear compression stockings.
  • Exercise on a regular basis
  • Avoid sitting for long periods of time, make sure you move around frequently.  If you are flying, make sure you walk the aisles at least every hour or on long car rides, stop every few hours and stretch your legs and get your blood flowing down there. This is really, really important.
  • This will sound strange, but if you are experiencing swelling in your legs and ankles, raise your legs above the level of your heart for at least 30 minutes, twice a day — at least to start. As you start exercising and eating better, your heart will get stronger and your circulation will improve, and you will need to do this less and less.

Arthritis

Arthritis is another of the most common causes of ankle and foot pain. Dr. Nancy has spent a lot of time talking about the painful effects resulting from the loss of cartilage and inflammation of the joints as we age in many of her other episodes. Arthritis is one of the most common contributors to foot and ankle pain, and inflammation leading to joint pain, swelling, and stiffness can result. 

It’s also important to point out that there are two distinctly different main forms of arthritis: osteoarthritis, or arthritis caused by general wear and tear as we age; and rheumatoid arthritis, which can occur in your feet when the immune system attacks healthy joint cartilage; both have similar symptoms and can lead to joints becoming deformed and immobile if not treated early on. 

Neuropathy

The last condition that causes pain, weakness, and discomfort in your feet that we want to discuss today is neuropathy, and specifically peripheral neuropathy, which is damage to your nerves that results in pain, numbness, or tingling in the affected area, most often in your hands and feet. 

Specific symptoms of peripheral neuropathy include: gradual onset of numbness; prickling or tingling in your feet which can spread upward into your legs; sharp, jabbing, throbbing or burning pain; extreme sensitivity to touch; and pain during activities that shouldn't cause pain, such as putting weight on the feet, or when they're under a blanket.

The most common cause of peripheral neuropathy in your feet is diabetes, but other causes include autoimmune disorders, infections, trauma, alcoholism, frequent exposure to toxins, and vitamin and nutritional deficiencies.

Ways to Keep the Feet and Ankles Healthy

As you can see, during aging, the health of our legs and feet often boils down to lifestyle issues — mainly nutrition and exercise.

In our last episode, when we talked about ways to prevent hip pain, we demonstrated a number of stretches and exercises that strengthen the ankles, feet, and toes. These are also great for treating or preventing plantar fasciitis, helping to ease peripheral neuropathy discomfort, and can help stretch and improve your range of motion which is often limited as a result of arthritis. Let’s review a few of those again.  

Heel Raises 

Hold onto a chair or wall for support and raise up on the balls of your feet for 10 to 20 reps.

Ankle Rotations

From a sitting position, lift one leg off the ground and rotate the foot clockwise about 10 times and then counterclockwise about 10 times before doing the same on the other leg.

Ball Steps

Place a tennis or lacrosse ball underneath the ball of the foot and place all your weight on it by pushing down. Move your foot around in various directions, giving yourself a little massage.

Toe Trotting 

Walk around the room on tiptoes. Reminder: you can do it while your vacuuming or doing laundry or cooking dinner.

Toe Curls

All you have to do is curl your toes in and out, in and out, over and over again. Make it a game by trying to pick items up off the floor with your toes, which helps to make them stronger. 

Foot and Ankle Stretches

Here are a few more stretches and exercises to try to help keep our feet, ankles and toes healthy and strong:

Sand Walking 

This is a great way to stretch and strengthen the muscles, tendons, ligaments and joints in your feet and toes ankles, and even calves.

The beach is the best option for this, but if you are in a pinch, a sandbox or an outdoor volleyball court will also work. Remove shoes and socks and walk for as long as possible. If you haven’t ever done this, make sure you start off slow and increase these distances slowly over time, to avoid overexerting muscles in the feet and calves. This is a simple, but really effective way to build strong muscles, ligaments, and tendons in your feet, ankles, and toes — plus, you are on the beach! Be careful with running barefoot on the beach if you are prone to plantar fasciitis, as the pounding of barefoot running will aggravate it. 

Arch Lifts

  • Stand with your feet directly underneath your hips.
  • Making sure to keep your toes in contact with the floor the entire time, roll your weight to the outer edges of your feet as you lift your arches up as far as you can. Pretend there’s an angry bee under the arches of your feet!
  • Then release your feet back down. You’ll work the muscles that help to lift and support your arches.
  • Do 2–3 sets of 10–15 repetitions.

Yoga Poses for Foot and Ankle Strength

There are also a few yoga poses that are important for improving the health, strength, and flexibility of your feet and ankles:  

Down Dog Foot Pedal

This pose relieves tension in the hamstrings, calves, ankles, and the plantar fascia. 

  • Start on hands and knees, then push your tailbone up to a standard downward facing dog pose, which is an inverted V shape.
  • Bend your knees one at a time, pedaling the feet.

Tree Pose 

This pose helps to strengthen the stabilizing muscles and ligaments around the ankles and feet. 

  • Stand up tall, grounding through both feet
  • Bring one knee up, and place the foot on the inner thigh, or calf (never on the knee)
  • You can place your hands on your hips or over your heart, whatever you prefer

  • If you feel good about that pose, raise your arms and wave them like the branches of your tree.

Toe Pose

This pose helps to release tension in the ankles and the plantar fascia.

  • Begin in a tabletop position on your hands and knees. Bring your legs all the way together, then tuck your toes under.
  • Keeping your toes tucked under, slowly walk your hands towards your thighs and sit your hips back on your heels.
  • Walk your hands up onto your thighs to lift your chest up and hold for 8 breaths. You should feel the plantar fascia release. Hold for 1-2 minutes.
  • This pose can feel intense if you have tight feet and ankles. While it should feel slightly uncomfortable as you go into this deep stretch, it should never feel painful. If it becomes painful, come out of the pose.

  • If this is too hard on your knees, take a rolled up towel and put it underneath your sit bones.

Nutrition for Feet, Ankles, and Toes

We already mentioned the importance of nutrition in keeping your feet, ankles, and toes pain-free.  We know how important it is to eat healthy, avoiding processed foods, excess sodium, sugar, and unhealthy fats as a way to reduce chronic inflammation and other chronic health issues, including diabetes. In addition to eating foods that help prevent inflammation and help ward off diseases and conditions that target your joints, you can also start taking a nutrient support supplement for your joints, like Smarter Nutrition’s Smarter Joint Food. Whether your diet is great or needs improvement, it’s important supplement to support collagen production for the critical cartilage in your joints, among other benefits.

Wrap-Up

This wraps up Dr. Nancy’s five-part series on pain and aging. Your joints are prone to a lot of wear and tear, especially as we age — and as millions of you know, the result is often pain, stiffness, discomfort, and loss of mobility. 

After watching today’s show about ankles, feet, and toes, as well as the rest of this series, we hope you understand that, while some changes in our joints and muscles are unavoidable, the majority of age-related conditions we discussed are able to be managed, reduced, and in some cases even prevented. Make an effort to stretch and exercise as Dr. Nancy demonstrated, and make smart diet and lifestyle choices.

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