Proper foot care


By age 50, the average person will have walked 75,000 miles, according to the American Podiatric Medical Association. That’s a lot of steps, even without the Fitbit tracker.

However, when those “miles” include walking in improperly fitting or high-heeled shoes, coupled with the natural changes to our feet as we age, it’s a recipe for foot pain.

Even more, the foot and ankle have 26 bones (accounting for one-quarter of the bones in the human body), 33 joints and more than 100 muscles, tendons and ligaments. It means there are a lot of places where things can go wrong — and that’s just on the inside.

Nails, bunions, callouses and other things can cause pain and problems on the outside of our feet.

Podiatrists can work with older adults before or after a foot problem develops to create a care plan and work within the guidelines of what preventive treatments will be paid by Medicare and Medicaid.

“People might be surprised to know that if they are in the groups that Medicare/Medicaid considers to be ‘at risk’ that they can get foot treatments paid for, even such basic things as nail trimming,” says Dr. Melisa Monson, a podiatrist who has practiced in Eugene for more than 20 years. “General foot care for the older person looks at the nails, do they have fungus or ingrown toenails, heel pain, callouses, bunions, those types of things. If a person is at risk due to something like diabetes or peripheral neuropathy that decreases sensation in their feet, things like that can lead to ulcers or even amputation.”

Yes, problems with the feet can be serious enough to lead to amputation.

Because the foot is an extremity, blood flow there is often not sufficient for wound healing. Infections can be hard to treat.

Because of this, Medicare will pay for regular foot care for at-risk patients having diabetes, peripheral neuropathy, poor blood flow for any reason, arteriosclerosis, peripheral vascular disease, swelling, lymphedema, decreased sensation or numbness.

If you’re not sure you have a problem, or you fear that one is developing, it pays to check in with a podiatrist.

Medicare considers many treatments to be preventative, so even if you’re not having a problem now, a doctor could still help you with callouses, nail trimming and shoe orthotics at no charge.

Nails, which curve and thicken over time, cause the most common problems that older adults have with their feet.

Fungus infections, which are very common, thicken the nail, making it harder to trim. Older folks may have loss of movement or they can’t see well enough to properly trim their nails. If the person’s shoe is too small, that can put pressure on the nail, which can lead to an infection.

If you are having a problem, a foot doctor will look most importantly at the type of shoes you wear and how they fit. ☸

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