Foot care
There's blood on the courtyard floor, and Karim can't feel a thing. That is exactly the problem.
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Friday morning. Karim crosses the courtyard in his hawai chappal, as he has every day for thirty years.
“Abbu, stop! You're leaving blood on the floor!”
“Me? I don't feel anything.”
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The main risk factors for a foot ulcer are loss of protective sensation (numbness), poor circulation to the feet (peripheral artery disease) and a foot deformity. A foot that cannot feel pain or pressure can be hurt without you noticing.
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There is a small cut on his sole, and a sharp stone still stuck in the chappal.
What should they do about the cut?
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ASoak the foot in warm water and let it heal.
What happens instead
The guideline advises washing the feet daily but not soaking them in a bath, and drying carefully between the toes.
BCall a trained healthcare professional today.
✓ The right step
Contact a trained healthcare professional straight away, on the same day if you can. Do not wait for your next appointment.
CPut a corn plaster on it and carry on.
What happens instead
Not with chemical corn removers or corn plasters; the guideline lists avoiding them as part of home foot care. Hard skin is better treated by a trained professional.
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“Your feet have lost some of their feeling. That's why the stone never hurt.”
Have your feet examined at least once a year. If you have numbness or poor circulation in the feet, every 6–12 months or more often.
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“So what do we do every day?”
- Look at both feet, including the soles and between the toes. If you cannot see your soles, use a mirror or ask someone to look.
- Wash your feet daily but do not soak them in a bath, and dry them carefully, especially between the toes. If you make wudu, the washing is done; what needs care is the drying.
- Use a moisturiser on dry skin.
- Cut toenails straight across.
- Do not use chemical corn removers or corn plasters on hard skin. Have it treated by a trained professional.
- Avoid tight socks, and avoid exposing your feet to a lot of heat or cold.
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“And my chappal?”
If you are at risk, the guideline says to avoid walking barefoot, in socks without shoes, or in thin-soled slippers, whether indoors or outdoors. It also warns against other open footwear that leaves the skin exposed to sharp objects; a hawai chappal is an example.
- Choose shoes that fit the shape of your foot, with enough length, width and depth. Have the fit checked standing up, preferably at the end of the day, because numb feet cannot judge a tight shoe.
- Look inside your shoes for stones or other objects every time before you put them on.
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“Thirty years of hawai chappal…”
“…and from today, proper shoes, even at home. I'll look inside them every morning.”
For people at low or moderate risk (numbness or poor circulation, without a past ulcer, amputation or kidney failure), the guideline says that walking an extra 1000 steps a day is likely safe for the feet.
What to remember
- Have your feet examined at least once a year. If you have numbness or poor circulation in the feet, every 6–12 months or more often.
- If you are at risk, do not walk barefoot, in socks without shoes, or in thin-soled slippers, at home or outside.
- Look at your feet every day. Wash them without soaking, dry carefully between the toes, moisturise dry skin and cut toenails straight across.
- Wear shoes that fit, and check inside them for anything sharp before you put them on.
- A blister, cut, crack or bleeding under hard skin needs a call to a trained healthcare professional straight away.