If you think of the body as a structure, the feet are the foundation on which everything else rests. Pounds of force are placed upon the feet with every step we take. The delicate bones, tendons and tissues usually bear this load cheerfully enough, but the condition of your feet can provide clues to overall health and affect the condition of the rest of the musculoskeletal system.

“Biomechanically, pathology of the foot, such as over-pronation (an excessive flattening of the foot), may be responsible for a variety of postural symptoms, including foot, ankle, knee, hip and low back pain,” says Dr. David Amarnek, a podiatrist with The Foot and Ankle Center. “It’s not uncommon in runners with knee problems to have foot pathology as a primary cause.”

The connection between feet and other joints, such as the knees, has been assumed for years but only recently studied carefully. “This subject is relatively new to podiatry and orthopedics in this country,” says Dr. Michael Horwitz, a podiatrist with Feet for Life Podiatry Centers. “More and more, people are discovering that over-supportive footwear and orthotics are actually causing more problems than they're helping. Hence, the minimalist-shoe movement.”

In fact, the knee’s relationship to the foot and vice-versa is being recognized as increasingly important. In a small study published in a recent issue of the journal, Arthritis & Rheumatism, special ‘mobility shoes,’ which are flat and flexible, designed to mimic walking barefoot, were shown to benefit people who have arthritis of the knee. Researchers suggest that wearing the shoes for at least six hours per day may help arthritis patients adapt their gait and reduce the force placed on the knees, although they note that further study is needed to replicate the initial findings.

Horwitz adds that the potential disorders, physical conditions and musculoskeletal problems tied directly to the feet are “too many to count.” Diabetes, kidney disease, heart disease and high blood pressure all have symptoms related to the condition of the feet. Pain, numbness, swelling and skin ulcers are clues to some of these systemic problems.

“In diabetics or those with peripheral vascular disease, infections or ulcerations of the foot may progress into more systemic manifestations, such as bacteria in the blood, ascending infections beyond the foot, etc., which may require hospitalization,” Amarnek notes.

Symptoms of poor circulation in the feet and legs—which may indicate high blood pressure or peripheral artery disease—include leg or foot cramps, particularly during exercise, skin ulcers that do not readily heal, swelling and changes in skin color.

“Even neuropathy is treated today with more attention on existing flow and function,” Horwitz says. “I believe that preservation of blood flow and nerve function is best done with touch therapies and footwear choices.”

Podiatrists can assess foot health and help you choose appropriate footwear or orthotics to ensure that your feet will serve as a firm foundation for years to come. Take care of your feet, and they’ll help take care of you.

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