Mind Your Feet

What are the primary causes of fungal infections in the feet?

Fungal infections thrive in warm, moist conditions. Feet are particularly vulnerable when they remain sweaty or are not dried properly, especially between the toes. People with diabetes, low immunity, or those undergoing treatments like chemotherapy are at higher risk. Infections can also spread through contaminated surfaces such as swimming pools, gyms, shared bathrooms, and wet carpets.

What kind of footwear do you recommend for men and women?

Footwear should always prioritise comfort and support. I recommend shoes that are extra wide, have adequate depth, and are well-cushioned. Avoid narrow, pointed shoes that compress the toes. It's also important to wear activity-specific footwear — running shoes for running, sports shoes for sports — rather than using one pair for everything.

Do you recommend any specific footwear brands?

Rather than focusing on brands, it's better to look for essential features such as shock absorption, stability, motion control, and cushioning. The footwear should also be lightweight and suited to your foot's length and width. A good fit matters more than a popular brand name.

Are there enough qualified podiatrists in India?

Unfortunately, no. Podiatry is still an emerging field in India, and there are limited formal training programs, degrees, or diplomas available. This leads to a shortage of qualified specialists compared to global standards.

What is the training and qualification of a podiatrist?

A podiatrist is a medical professional specialising in foot and ankle care. Like other doctors, they undergo medical training followed by specialised education in areas such as diabetic foot care, sports medicine, gait analysis, and biomechanics. In many countries, podiatrists focus exclusively on foot-related conditions.

It is common for people to soak their feet in warm salt water. What is your view?

For a healthy individual, soaking feet in warm salt water can be beneficial. However, people with diabetes should avoid it. Due to neuropathy, they may not feel heat properly, increasing the risk of burns. Even using hot water bottles or heaters near the feet can be dangerous.

What first aid do you recommend for foot injuries?

For internal injuries like sprains, follow the RICE protocol: Rest, Ice, Compression, and Elevation. If you suspect a fracture, immobilise the area with a splint and seek medical help. For external wounds, apply firm pressure with a clean cloth or bandage to stop bleeding, keep the foot elevated, and consult a doctor.

Can foot sores be treated at home?

It's always best to seek medical advice. If immediate care isn't possible, clean the wound with an antiseptic solution and apply a topical antibiotic dressing. Avoid contamination, especially from unclean water. If healing is delayed, consult a doctor without delay.

What types of foot-related problems do you commonly see?

About 50% of my patients have diabetic foot issues, including neuropathy and non-healing ulcers. Other common problems include heel pain, corns, calluses, fungal infections, ingrown toenails, flat feet, high arches, and sports-related injuries.

How can one maintain healthy feet?

Wash feet daily with lukewarm water; dry thoroughly, especially between toes; wear well-fitted, cushioned footwear; cut nails straight across; moisturise dry skin (avoid between toes); use powder for sweaty feet; wear clean cotton or wool socks; and avoid self-treating corns or calluses — consult a doctor for any persistent issue.

Why is foot care still neglected in India despite the rising burden of diabetes and lifestyle diseases?

Podiatry is still neglected in India despite the rising burden of diabetes because of a lack of awareness and education among healthcare providers about the basics of diabetic foot care, and because there is no formal training program in medical colleges and universities to teach podiatry as a specialty.

How can podiatry be integrated into primary healthcare in India to reduce preventable complications?

Starting Preventive Podiatry Training Programs at the district level, and dissemination of Diabetic Foot Education, is very important. Diabetic foot screening for neuropathy and vasculopathy with biomechanical assessment should be an integral part of diabetic care. Diabetic foot education should be a must for all diabetic patients. Prevention by preventive podiatry care is the best way to avoid diabetic foot complications.