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FOOTNOTES ON THE FEET

'Taken for granted' is the phrase when it comes to the feet. Now what's wrong with that? A matter of priority, for one. We go places because of the feet, in more than the literal sense. Without them stranded becomes the word, and the world.

So, today, we take a walk with Dr Amer Khan, orthopaedic and trauma surgeon, Zulekha Hospital, Sharjah, and get an idea on the importance of the feet, and on how to ensure that they remain in shape and place to give each one of us the best mileage possible, in a manner of speaking.

"People have to change their attitude to the feet. They are as important as other body parts. People should be sensitive to problems afflicting the feet. If they experience pain or discomfort when standing, walking or running, find it discomforting wearing shoes, they should consult an orthopaedic surgeon immediately so that the doctor can evaluate the problem early enough to take remedial action," says Dr Amer Khan.

Ignore the pain or discomfort, or deformity, and it will lead to more problems. Take the problem late to the doctor and it would become that much more difficult to treat. The weight distribution on the feet could be all wrong for a number of reasons, the problem could be a secondary one, caused by problems originating in the hip, knee or ankle. For example arthritis that gradually progresses and leads to deformities of the foot, like bent toes.

"The patient needs to see an Ortho with special interest in the feet," says Dr Khan, who has that "special interest", and comes armed with vast and relevant experience, 15 years of treating and correcting problems of the bones and the feet, first in the United Kingdom, and then in New Zealand.

What will the 'Ortho' do? "To begin with, he will take a proper history of the problem, then he will thoroughly examine the problem, assess the afflicted foot, see if it is a secondary affliction, take a look at the gait, the pressure areas, et al," says Dr Khan.

There are special equipment to take care of the "looking and assessing the foot" chore. Like the "foot pad", which is a computerised "mobile pad" that gives a "complete picture" of the foot with all the "pressure areas" - a detailed footprint of the shape it is in.

"These equipment are making their way into the UAE," smiles Dr Khan, "But even without them doctors can make a fair and correct assessment of the shape in which a foot is." There's a special warning from him to diabetics, they are at a greater risk. It is very important for diabetics to look after their feet because diabetes damages nerves, leaving the feet without sensation, handicap the victim when it comes to discerning weight distribution and pain.

There are simple measures that a doctor could suggest, says Dr Khan. First and foremost, proper hygiene. Two, on the use of proper and comfortable footwear. Three, advice on the different types of supports in shoes, some people may need special footwear. The doctor will also educate people on their walking and sporting activities. And, if required, recommend surgery.

"People are afraid of surgeries but they are actually very safe these days," says Dr Khan, who hails from Lahore in Pakistan, and shares an interest in Cricket with legions others in the subcontinent. He has a special warning for diabetics, and those with neurological disorders. Also those in any profession which needs standing at a place for extended periods, like the friendly neighbourhood policeman and the largely ignored factory worker in the suburbs, the industrial outskirts. These people need to walk the extra mile, to find relief. To wind up, men and women should do more than just think on their feet. They should think about the feet. Give the feet more than a walking chance. That should be an everyday feat.

HALLUX VALGUS

The big toe. We take it as a common Joe. Just one of two. But sometimes the big toe does a Hallux Valgus. And then it could deviate us from leading a life comfortable. For that's what Hallux Valgus is, a deviation of the big toe, very discomfortable, even painful.

Dr Khan says it's more common in women than in men. And normally occurs due to wearing tight shoes, though this is not a proven fact. Some grey area there. But the mechanics of how this happens, is the toe deviates to one side and a bunion (a swelling) is formed on the inside margin of the toe, the toe becomes like a bowstring with a tendon pulling it to one side and the front part of the foot gets wider, look very ugly, and with time the big toe rubs against the second toe and cause problems to it, too.

Hallux Valgus can cause stiffness in the joints, and is not necessarily an old age affliction, can also hit the young. The gold standard surgery for Hallux Valgus is the "scarf". The surgeon will assess the foot and cut the bone and rejoin it so that the alignment gets corrected. It is an hour-long operation and "very stable". There's no need to plaster the foot. The patient will walk "much better" in six weeks time, and the operation wound heals within 8 to 12 weeks. It is a relatively new procedure to relieve pain, discomfort and give the foot a far more normal shape.