Foot, Heel & Toe

Anatomy of the Foot

An inside look at the structure of the foot.

Each foot is made up of 28 bones, 30 joints and more than 100 muscles, tendons and ligaments, all of which work together to provide support, balance and mobility. Here's a look at the main structures of the feet. 

Bones

Nearly one-fourth of the body's bones are in our feet. The bones of the feet are:

• Talus – the bone on top of the foot that forms a joint with the two bones of the lower leg, the tibia and fibula.
• Calcaneus – the largest bone of the foot, which lies beneath the talus to form the heel bone. 
• Tarsals – five irregularly shaped bones of the midfoot that form the foot's arch. The tarsal bones are the cuboid, navicular and medial, intermediate and lateral cuneiforms.
• Metatarsals – five bones (labeled one through five, starting with the big toe) that make up the forefoot.
• Phalanges (singular: phalanx) – the 14 bones that make up the toes. The big toe consists of two phalanges – the distal and proximal. The other toes have three.
• Sesamoids – two small, pea-shaped bones that lie beneath the head of the first metatarsal in the ball of the foot.

Joints

Joints in the feet are formed wherever two or more of these bones meet. Except for the big toe, each of the toes has three joints, which include:

• metatarsophalangeal joint (MCP) – the joint at the base of the toe
• proximal interphalangeal joint (PIP) – the joint in the middle of the toe
• distal phalangeal joint (DP) – the joint closest to the tip of the toe.

Each big toe has two joints:

• metatarsophalangeal joint
• interphalangeal joint

The surfaces of the bones where they meet to form joints are covered with a layer of cartilage, which allows them to glide smoothly against one another as they move. The joints are enclosed by a fibrous capsule that is lined with a thin membrane called the synovium, which secretes a fluid to lubricate the joints.

Muscles

Twenty muscles give the foot its shape, support and the ability to move. The main muscles of the foot are:

• the tibilias posterior, which supports the foot's arch
• the tibilias anterior, which allows the foot to move upward
• the tibilias peroneal, which controls movement on the outside of the ankle
• the extensors, which help raise the toes, making it possible to take a step
• the flexors, which help stabilize the toes.

Tendons and Ligaments

Many tendons attach these muscles to the bones and ligaments that hold the bones together to maintain the foot's arch.

The main tendon of the foot is the Achilles tendon, which runs from the calf muscle to the heel. The Achilles tendon makes it possible to run, jump, climb stairs and stand on your toes.

The main ligaments of the foot are:

• plantar fascia – the longest ligament of the foot. The ligament, which runs along the sole of the foot, from the heel to the toes, forms the arch. By stretching and contracting, the plantar fascia helps us balance and gives the foot strength for walking.
• plantar calcaneonavicular ligament – a ligament of the sole of the foot that connects the calcaneus and navicular and supports the head of the talus.
• calcaneocuboid ligament – the ligament that connects the calcaneus and the tarsal bones and helps the plantar fascia support the arch of the foot.

Foot Heel & Toe Pain Causes

Arthritis & Diseases that Affect the Foot

From joint inflammation and narrowed blood vessels to compressed nerves, problems that may be to blame for painful feet.

Many forms of arthritis and related conditions that affect the joints, muscles and/or bones can cause problems like pain, stiffness and swelling in the joints of the feet. Other conditions can cause additional problems, such as numbness and tingling, pitted nails, painful ulcers or thickened skin. Here are some possible disease-related problems that affect the hands and wrists.

• Osteoarthritis (OA). The most common form of arthritis, osteoarthritis is a chronic condition characterized by the breakdown of the cartilage that cushions the ends of the bones where they meet to form joints. This breakdown causes the bones to rub against each other, causing stiffness, pain and loss of movement in the joint. In the foot, osteoarthritis most commonly affects the big toe, but it can also affect the midfoot.

• Rheumatoid arthritis (RA). Rheumatoid arthritis is a chronic inflammatory disease of the joints that occurs when the body’s immune system – which normally protects us from infection – mistakenly attacks the synovium, the thin membrane that lines the joints. The result can be joint damage, pain, swelling, inflammation, loss of function and disability. Rheumatoid arthritis commonly affects the small joints of the feet, often causing symptoms in several joints of both feet. This can lead to the development of corns and bunions, and the curling and stiffening of the toes into positions such as claw toe or hammer toe.

• Juvenile arthritis (JA). Juvenile arthritis is the term used to describe arthritis when it begins before age 16. There are several different types of juvenile arthritis that can cause pain and swelling in the joints of the feet.

• Gout. Gout is a form of arthritis that occurs when excess uric acid, a bodily waste product circulating in the bloodstream, is deposited as needle-shaped monosodium urate crystals in tissues of the body, including the joints. For many people, the first symptom of gout is excruciating pain and swelling in the big toe – often following a trauma, such as an illness or injury. Subsequent attacks may occur off and on in other joints. After years with the disease, lumps of uric acid, called tophi, may form beneath the skin in different parts of the body, including the feet. 

• Reactive arthritis. Reactive arthritis is a chronic form of arthritis that often occurs following an infection of the genital, urinary or gastrointestinal system. Features of reactive arthritis include inflammation and swelling of the joints, eyes and structures within the gastrointestinal or genitourinary tracts, such as intestines, kidneys or bladder. A small percentage of people with the disease develop a rash or hard nodules on the soles of their feet or on the palms of their hands.

• Lupus. Lupus is a chronic autoimmune disease, meaning the body's immune system creates antibodies that attack healthy tissues, including the joints. The wrist and small joints of the feet are among those most commonly affected by lupus. Lupus also can cause inflammation in many organs, including the skin, heart, lungs and kidneys.

• Psoriatic arthritis. Psoriatic arthritis is a form of arthritis accompanied by the skin disease psoriasis. The skin disease often precedes the arthritis; in a small percentage the joint disease develops before the skin disease. Psoriatic arthritis can affect the toes. The associated skin disease can affect the skin of the feet and cause the toenails to thicken, develop pits and separate from the nail bed.

• Infectious arthritis. Also called septic arthritis, infectious arthritis refers to arthritis that is caused by an infection within the joint. Infectious arthritis is often caused by bacteria, which spread through the bloodstream to the joint. Sometimes it is caused by viruses or fungi and can affect the joints of the feet.

• Raynaud's phenomenon. Raynaud’s phenomenon is a condition characterized by a narrowing of the blood vessels to the extremities, usually in the hands and feet, in response to cold temperatures or stress. When blood vessels close down, toes become cold and white, then blue, and numb or painful. When the vessels open up again, the toes become red or purple. Raynaud’s is often associated with connective tissue diseases, notably scleroderma.

• Osteoporosis. Osteoporosis is a condition in which the bones lose enough mass that they become brittle and prone to breaking with slight trauma. In people with osteoporosis in bones of the foot, just stepping off of a curb can cause a stress fracture. The condition can occur with aging, inflammatory disease (such as rheumatoid arthritis) inactivity, a low-calcium diet or use of corticosteroid medications.

• Scleroderma. Literally translated &quothard skin,&quot scleroderma is an umbrella term for disorders that involve the abnormal growth of the connective tissue supporting the skin and internal organs. Although there are several different forms of scleroderma, all forms can cause thickening and tightening of the skin on the fingers called sclerodactyly. Skin thickening can also affect the backs of the feet, but it is usually less disabling than skin tightening on the hands.

Foot Injuries and Other Problems

Common and some not-so-common injuries and other problems that affect the feet.

The bones, connective tissue and small joints of the feet are prone to several types of injuries. Injuries can happen in otherwise healthy joints; however, arthritis and related disease processes can make some more likely. For example, foot bones weakened by osteoporosis are prone to fracture and toes affected by rheumatoid arthritis are more prone to certain deformities, such as hammer toe or claw toe. The following are some of the more common foot injuries and foot problems associated with arthritis and related conditions.

• Fractures. Any of the foot's 28 bones can be broken. Here's how each of the three sections of the foot – the heel, or hind foot; midfoot; and forefoot – can be affected.
  • Calcaneus. A fracture of the heel bone, or calcaneus, can be disabling. Most breaks for the calcaneus are due to a high-energy collision, such as a fall from a high ladder or an automobile accident.
  • Midfoot. Another common site of fractures is the midfoot, where bones held together by connective tissue form an arch on top of the foot between the ankle and toes. Dropping something heavy on the foot can break one or more of the bones. Falling or twisting the foot can break or move the bones out of place.
  • Forefoot. A fracture to one of the bones in the forefoot (metatarsals) or toes (phalanges) is painful, but is usually not disabling. Fractures in the forefoot may be stress fractures, tiny cracks in the bone surface caused by stress to the bone, such as running long distances or increasing an exercise program too quickly. Others may extend through the bone and be the result of dropping something heavy on the foot or twisting the foot.

• Claw toe. In this common deformity of the foot, the toes are bent upward from the joint at the ball of the foot and then downward at the middle joint, causing the toes to dig down into the soles of the shoes. Corns may develop over the top of the toe or under the ball of the foot. Poorly fitting footwear is often blamed for claw toe, however the condition also can result from rheumatoid arthritis or nerve damage from diabetes.

• Hammer toe. In this foot deformity, the second third or fourth toe is bent at the middle joint, giving it the appearance of a hammer. At first, the toes are flexible, but over time they become fixed and can be painful. Corns and calluses can form on the top of the middle joint or at the tip of the toe. The deformity can occur from wearing narrow-toed shoes or from a disease process, such as rheumatoid arthritis.

• Tarsal tunnel syndrome. Tarsal tunnel syndrome is a compression of the posterior tibial nerve – which supplies sensation to the bottom of the foot and enables the muscle of the foot to move – as it passes from the lower leg to the foot through the tarsal tunnel. The tarsal tunnel is a narrow passageway inside the ankle through which arteries, veins, tendons and nerves, including posterior tibial nerve, run. Anything that strains the nerve or causes swelling or inflammation of the tunnel or the structures that pass through it can compress the nerve. The result is often pain, tingling, burning, and numbness, usually on the inside of the ankle or bottom of the foot.

• Charcot Foot. This serious condition occurs when significant nerve damage causes weakening of the bones, which can lead to fractures. As the problem progresses, the joints can collapse, leading to deformity, disability and in some cases, the need for amputation.

• Bunions. A bunion is a common deformity in which the base of the big toe is enlarged. The skin over the enlarged joint may be red and tender. As the bunion gets larger, you may find it difficult to find comfortable shoes. Walking may be painful. Your big toe may angle toward or move under your second toe. The second toe, in turn, may overlap your third toe, causing pain and deformity of the entire foot. Nine out of 10 bunions occur in women. Bunions are often caused by wearing tight, narrow shoes or high heels.

• Plantar fasciitis. Plantar fasciitis is inflammation of a thick ligament called the plantar fascia, which runs along the sole of the foot, from the bottom of the heel bone to the toes. It can feel like the arch of the foot is tearing. People with inflammatory forms of arthritis, such as rheumatoid arthritis, ankylosing spondylitis or reactive arthritis, as well as those with fibromyalgia, are more likely to develop plantar fasciitis. Other causes include being overweight, standing too long, having arches that are either too high or too flat, or wearing unsupportive, hard-soled shoes.

• Heel spurs. When plantar fasciitis continues for a long time, a calcium deposit called a heel spur may form where the fascia tissue band connects to the heel bone. In some cases heel spurs cause pain when walking.

• Morton's neuroma. A thickening of the tissue that surrounds the nerve that leads to the toes, Morton's neuroma often causes pain on the ball of the foot or the sensation of walking on a marble. The condition usually develops between the third and fourth toes, often in response to irritation, trauma or excessive pressure. High-heeled or tight, narrow shoes can make the condition worse.

Foot, Heel & Toe Pain Diagnosis

Diagnosing Foot Problems

From blood work to X-rays, tests your doctor uses to find the cause of foot pain.

Diagnosing a foot problem will begin with a physical exam and assessment of your medical history. During the medical history your doctor will ask you questions such as:

• What symptoms are you experiencing?
• When did you first start noticing them? Were they the result of an injury?
• Are your symptoms worse after activity or rest? Are there certain activities that make them worse – or better?
• Do you recall having an illness or accident around the time your symptoms began?
• Are you experiencing symptoms in any joints besides the joints of feet?
• Do any of your family members have arthritis or other foot problems?
• Do you have other medical problems that could be causing your symptoms?

During the physical exam your doctor will look at and touch your feet and any other joints you may be experiencing problems with. Your doctor will be looking for areas that have tenderness, pain or swelling, as well as indications the joint may be damaged. Depending on the findings of the history and exam, your doctor may order lab tests and imaging tests to help make or confirm a diagnosis.

Imaging and Tests for Foot Pain

Noninvasive tests that allow your doctor to see inside your feet.

Imaging tests can allow your doctor to see the structures inside your foot noninvasively. The most common imaging tests to diagnose foot problems are:

X-ray (radiography). A standard X-ray is a simple test in which an X-ray beam (a form of electromagnetic radiation) is passed through the foot to create a two-dimensional picture of the bones that form the joint. A doctor can use X-rays to view:

• joint space. Narrowing of the space between the bones, which are normally covered by cartilage, can be a sign of arthritis and its severity.
• bone spurs. Bony overgrowths at the joint are a sign of osteoarthritis.
• fractures. Broken bones in feet and toes will show up on x-rays, however, small cracks in the bone may not. 

In some cases, a contrast dye is injected into the foot to enable the doctor to better see the joint on X-ray. This is called arthrography.

Computerized axial tomography (CAT) scan. Also called a computed tomography (or CT) scan, this noninvasive test combines X-ray equipment with sophisticated computers to produce multiple images, which are combined to depict cross-sectional slices of internal structures. CT scans may be used to diagnose foot problems that don't show up on X-ray. They also show soft tissues, such as ligaments and muscles, more clearly than traditional X-rays, so they are more useful for diagnosing certain foot problems.

Magnetic resonance imaging (MRI). This procedure uses a strong magnet linked to a computer to create a picture of the internal structures in black and white and shades of gray. Because an MRI shows the soft tissues, as well as the bones, it is particularly useful for diagnosing injuries to the cartilage, tendons and ligaments, as well as areas of swelling. The test may also be used to determine the severity of tarsal tunnel syndrome.

Video fluoroscopy. This test, using an X-ray and a fluorescent screen, allows a doctor to view the internal structures and movements of the foot instantly, and to create an "X-ray movie" that can be viewed repeatedly.

Bone scan. This technique can be used to view stress fractures caused by repetitive trauma. It involves injecting a small amount of radioactive material into the bloodstream. The material collects in the bones, particularly in areas of new bone growth where fractures are healing, enabling doctors to see those areas with a scanner.

Electrodiagnostic tests. For diagnosing problems, such as tarsal tunnel syndrome, where there is compression of the nerve, a doctor may use electrodiagnostic tests, such as nerve conduction studies and electromyography. For nerve conduction studies, the doctor fastens electrodes to the ankle and foot, then sends small electric shocks to the nerves in the lower leg, ankle, and toes, and measures the speed of conduction of nerve fibers. In the electromyography, the doctor inserts thin needles into the muscle to record electrical activity. The electrical signals are viewed on a screen.

Lab Tests for Foot Problems

Tests that tell what's going on inside your body.

Often a sample of blood or joint fluid can help you doctor confirm a diagnosis. For example, a blood test showing high blood levels of rheumatoid factor – an antibody that acts against the blood component gamma globulin – or an antibody called anti-cyclic citrullinated peptide antibody (anti-CCP), may suggest rheumatoid arthritis. High levels of antinuclear antibodies (ANAs), abnormal antibodies directed against the cells' nuclei, could suggest lupus or another inflammatory disease.

Tests of fluid drawn with a needle from the joint may reveal crystals of uric acid, confirming a diagnosis of gout; or a bacterium, suggesting that joint inflammation is caused by an infection.

Foot, Heel & Toe Pain Treatment

Medications to Treat Feet

What you need to know about the many medications used for foot problems.

Medications to ease pain, relieve inflammation, slow bone loss, modify the course of an inflammatory disease or prevent joint damage are an important part of treatment for many foot problems. The medications used to treat arthritis and other problems that affect the feet will depend largely on the form of arthritis or related condition that is diagnosed. The types of medications commonly used in arthritis treatment are:

Nonsteroidal anti-inflammatory drugs (NSAIDs). Including more than a dozen different drugs, some of which are available without a prescription, nonsteroidal anti-inflammatory drugs are used to help ease arthritis pain and inflammation. They are used for all forms of arthritis.

Corticosteroids. These quick-acting drugs, similar to the cortisone made by your own body, are used to control inflammation. If inflammation is due to a systemic inflammatory disease, your doctor may prescribe oral corticosteroids. If inflammation is limited to one or a few joints, your doctor may inject a corticosteroid preparation directly into the joint.

Analgesics. Analgesics are among the most common drugs for many forms of arthritis. They also may be used to relieve pain from foot problems and surgery. Unlike NSAIDs, which target both pain and inflammation, analgesics are designed purely for pain relief. For that reason, they may be safe for people who are unable to take NSAIDs due to allergies or stomach problems, for example. When used as prescribed, they’re also an appropriate, and possibly safer, choice for people whose arthritis causes pain but not inflammation.

If foot pain is in the soft tissues, you may find relief from an analgesic salve, rub or balm available over the counter under trade names such as Aspercreme, Ben-Gay, Capzasin-P, Eucalyptamint, Icy Hot,Voltaren Gel and Zostrix. These topical preparations work through a variety of active ingredients and may be helpful if you are unable to take oral medications, or if medications fail to relieve pain or reduce it to a manageable level.

Disease modifying anti-rheumatic drugs (DMARDs). Disease-modifying anti-rheumatic drugs are drugs that work slowly to modify the course of inflammatory disease. Different DMARDs may be useful for a number of different forms of arthritis including rheumatoid arthritis, lupus and psoriatic arthritis, all of which can affect the small joints of the feet. 

Gout medications. Some medications for gout are designed to reduce levels of uric acid in the blood to prevent future attacks of joint pain and inflammation. Others are designed to relieve the pain and inflammation of an acute attack. Many people with gout take both types of medication.

Biologic response modifiers. The newest category of medications used for rheumatoid arthritis and a few other inflammatory forms of arthritis are the biologic agents. There are currently eight such agents approved by the FDA. Each blocks a step in the inflammation process without suppressing the entire immune system. In addition to rheumatoid arthritis, certain biologic agents may be used in juvenile arthritis, ankylosing spondylitis and psoriatic arthritis.

Osteoporosis medications. Osteoporosis medications are those used to slow the loss of bone or help the body build new bone. Although they are not used specifically to treat foot problems, strong bones are less prone to fracture. In people with osteoporosis, even stepping off a curb can fracture bones in the foot.

Foot Surgery

Surgical options for arthritis and other problems that affect the feet.

If the feet are injured or arthritis in the toes and other joints causes constant pain, interferes with walking and makes it difficult to wear shoes, surgery may be an option – or a necessity. Here are some of the most commonly performed arthritis-related foot surgeries.

• Fracture repair. Although most fractures of the foot can heal with the use of a cast, rigid shoe or, in the case of broken toes, taping the broken toe to a healthy one, some breaks require surgery to repair. This is especially true if a bone is displaced, or broken in such as way that the broken ends don't line up and have changed position. In this case, surgery may involve repositioning the bone and placing hardware to hold it in place while it heals.

• Arthroscopic debridement. In the early stages of arthritis, arthroscopic surgery may be helpful for removing inflamed tissue or spurs that have formed on the joint. Arthroscopic surgery is performed using a lighted scope inserted through a small incision in the skin over the joint. The scope, which is fitted with a camera, illuminates the inside of the joint and projects images of the joint onto a television monitor. Guided by the pictures on the monitor, the doctor is able to insert small surgical instruments through additional incisions to make surgical repairs to the joint.

Read more about foot and ankle surgery from the American Academy of Orthopaedic Surgeons.  

• Joint fusion. Also called arthrodesis, joint fusion involves removing the ends of the bones where they meet to form joints and then joining the two ends with pins or screws until they fuse into one rigid unit. Joint fusion may be used on the big toe for bunions or damage caused by arthritis. On the smaller toes, it may be used to correct deformities such as hammer toe or claw toe. In most cases, however, less invasive surgeries are effective for correcting these deformities.

• Osteotomy. This procedure involves cutting bones to realign a joint. In the foot, the most common use of osteotomy is to correct bunions.

Help for Heel Pain

Fixes for America's top foot problem - plantar faciitis.

As anyone who has ever had foot pain can tell you, when your feet hurt, you hurt all over. “The feet are the foundation of our ‘building,’ or body,” says Craig Gastwirth, a podiatrist at Podiatry Examiners of Michigan in Detroit. “If there’s a problem with that foundation, everything else – knees, hips and back – is thrown off.”

Heel pain, typically caused by plantar fasciitis, is the No. 1 reason people visit a podiatrist, says Dr. Gastwirth.

Plantar fasciitis, inflammation of a thick band of connective tissue called the plantar fascia, which runs along the sole from the bottom of the heel bone to the toes, can feel like the arch of the foot is tearing.

 No Stranger to Heel Pain

Arthritis patients are prone to develop plantar fasciitis – particularly those with inflammatory forms of arthritis, such as ankylosing spondylitis and reactive arthritis, as well as in those with fibromyalgia.  Other causes include being overweight, standing too long, having arches that are either too high or too flat, or wearing unsupportive, hard-soled shoes.

One of the biggest problems associated with plantar fasciitis is that everyday walking can be painful, yet walking for exercise is one of the best therapies for it. There are ways to heal plantar fasciitis, so you can feel better all over and keep walking.

Begin by using ice and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) or naproxen (Aleve), if necessary, to reduce inflammation.

After a week or two of minimizing time on your feet, stretching the tissues (see below) and decreasing inflammation, you should be able to get out and walk comfortably at the end of each day, provided you wear a heel cushion in supportive, soft-soled shoes. After walking, stretch your feet.

You may not be able to walk as far or as fast as you did prior to developing plantar fasciitis, but continuing to walk will help you heal further. You can slowly work back to your regular pace and distance.

In 90 percent of people, heel pain improves significantly after two months of home treatment, according to the American Association of Orthopaedic Surgeons. If pain persists, talk to your doctor about wearing a night splint – a boot-like device that keeps your foot flexed while you sleep. If the pain is severe, a walking cast may be needed. Injections of inflammation-reducing corticosteroids can be considered, and surgery to release tension in the plantar fascia is an option of last resort for severe cases.

Heel-Healing Stretches

Before you get out of bed in the morning, and then periodically throughout the day, do the following exercises to increase flexibility and ease pain.

Slowly flex your foot and toes to stretch the tissue on the bottom of your sore foot. Hold the stretch for 10 counts. Relax and repeat.

Do gentle ankle rolls to keep the tissues around the ankle and on the back of the heel flexible.

Sit on the edge of your bed and roll your foot back and forth over a tennis ball.

Foot, Heel & Toe Care

Ways to Prevent Foot Pain and Get Around

Proper footwear, shoe inserts and other means to help manage foot pain and get around better.

In addition to medication and surgery, there are many things you can do on your own or with your doctor or physical therapist to relieve foot pain and maintain your daily activities. Here are some techniques and devices worth trying.

Hot and cold. When feet are swollen and painful from arthritis, cold packs can numb the painful joints and reduce swelling. Cold also is helpful for reducing swelling and inflammation from a new joint injury. For aching feet without acute inflammation, heat may provide relief. For Raynaud's phenomenon, keeping the feet warm is helpful.

Canes and crutches. If placing weight on your foot causes pain, your doctor or physical therapist may recommend a cane. There are many different types of canes. The most common type has a single tip, but if you have trouble balancing, your doctor may recommend a quad, or four-point cane. Your doctor can advise the best way to use your cane, but generally you should hold it in the hand opposite the painful foot.

For fractures and particularly painful foot problems, crutches may be used for a short time to take more pressure off of your foot. Speak to your doctor about how – and how long – to use crutches.

Proper footwear. Shoes that cramp the toes or high heels that thrust the foot forward can lead to foot problems, particularly for women, and aggravate the pain they cause. Conversely, selecting appropriate footwear with a wide toe box, ample arch support and low heels can help ease pain.

Orthotic devices. Orthotic devices include foot pads and heel inserts purchased at your local pharmacy or discount store as well as custom-designed and fitted shoe inserts or braces from your doctor or physical therapist.

These devices are often used for various foot problems including:

• heel pain
• bunions
• hammer toe or claw toe
• Morton's neuroma
• plantar fasciitis

Learn more about orthotic devices from the American Academy of Orthopaedic Surgeons.

Massage. Nothing feels quiet like a good foot rub. Massaging the feet can improve circulation, reduce tension and relieve pain. If you can't afford a spa pedicure or don't have a loved one to help, you can massage your own feet.

Here's how:

• Get comfortable. Sitting in a comfortable chair, raise and bend one leg and place foot on the opposite thigh.
• Use moisture and pressure. Pour lotion or oil into your hand and rub it gently to your foot and massage. Knead your entire foot as if you are kneading bread. Use your knuckles or thumbs to massage the skin and underlying tissue.
• Add gadgets. Rollers or other massagers from the drug store can help if your hands are also sore or you don't have time for a full massage. Another quick tip: roll your foot over a tennis ball.

Preventing Foot Problems

What you need to know to protect your feet from painful problems.

By giving your foot some well-deserved attention, you can help prevent painful problems.

Here are some important steps you can take to prevent problems with your feet.

Check out your feet. Paying attention to your feet can help prevent problems and prevent small problems from getting bigger. This is particularly important if you have diabetes, which can go along with arthritis.

• Examine your feet daily. Check for blisters, cuts, sores and/or cracked skin. If your nerves or blood flow is affected, even these small problems can become big.
• Keep your feet clean. Wash them in warm soap and water daily. Always wear clean socks.
• Keep your feet moisturized. If your feet are dry, rub lotion into dry areas. Dry, cracked skin can open your feet to infection.
• Keep your toenails trimmed. If they are hard to trim, try clipping them after a bath or shower when they are softer. Cut around the shape of the nail to help prevent ingrown toenails.
• Inspect your shoes. Before putting them on, run you hand through your shoe. Check for pebbles, rough seams or anything else that might irritate your foot.
• Wear socks. Always wear socks or hose with your shoes to help protect your feet and reduce friction, which can cause blisters. Look at your feet every day to check for problems.

Learn more about diabetes-related foot problems and how to prevent them from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Exercise. Although your feet will never look buff like well-exercised abs do, exercise will help keep them strong, flexible and pain-free. Below are several sets of exercises to keep your feet fit. Check with your doctor before embarking on any exercise regimen.

• Achilles stretch. Lean against a wall, palms flat on the wall, one foot forward, one foot back. Keep your heels on the floor and lean forward, feeling the pull in your Achilles tendon and calf. Do three times, holding for 10 seconds each time.

• Big-toe stretch. Loop one thick rubber band around your big toes and pull the big toes away from each other and toward your other toes. Hold for five seconds. Repeat 10 times.

• Toe pull. Put a rubber band around the toes of each foot and spread your toes. Hold for five seconds. Repeat 10 times.

Select proper footwear. Ill-fitting or unsupportive shoes and high heels that thrust the foot forward can lead to foot problems, particularly in women. Shoes with lower heels, a wide toe box and proper protection and support can reduce the risk of certain foot problems. When shopping for shoes, go at the end of the day when your feet are bigger. Break in new shoes slowly – say by wearing them an hour or two a day for the first couple of weeks.