As told by J. Speight Grimes, M.D.
Sunburns on the foot can lead to severe skin cancer, most often due to a delay in diagnosis.
With the arrival of warm weather, we begin to think of summer activities. We imagine walks on the beach, cool dips in the local swimming hole, or lazy days lying in the sun. We kick off our boots and run barefoot in the grass. After a year spent confined in the dark, grass or cool water feels good on your feet. But, that freedom comes with risk of injury.
The obvious risks are from sharp objects or hot surfaces. Less obvious risks come from the sun and our activities themselves. Protecting your feet while still enjoying outdoor activities only takes a little planning.
Let the Shoe Fit
We can start by selecting appropriate shoes for our activities. Flip-flops or thongs have gone from beachwear to everyday wear. We see them with business suits instead of swimsuits. People wear them year round for almost any kind of activity. These shoes, while comfortable and convenient, offer poor protection for our feet and little support. They should never be used while operating machinery or traversing loose, slippery ground. In particular, they should never be used around lawn mowers.
For those who will be around water, sandals that strap around the ankle or water shoes that tie are available. These shoes are great for swimming or wading activities. Any time you are not in a pool or water park, you should assume the bottom will have broken glass or other sharp objects. It only takes an instant to turn a fun weekend into an emergency room visit. Shoes for lake or river swimming are recommended. If you are injured, you should seek medical attention for all injuries except for the less severe. Superficial wounds should be cleaned with fresh water and treated with antibiotic ointment for two days. Any sign of infection should be taken seriously as unusual bacteria exist in both fresh and salt water that can be difficult to treat.
When people make the transition from enclosed supportive shoes to lighter summer shoes, existing problems with feet may become more apparent. Some of the conditions that may need medical attention are:
- Tendon problems, especially around the arch and ankle
- Hammer or crossover toes
- Unstable ankles with repeated sprains
- Big toe spurs or arthritis
These problems can often be addressed with specialized shoes or inserts. An evaluation by a foot specialist will help direct you to appropriate care.
A recent development we see more of in the summer is barefoot running. This activity includes both true barefoot and wearing low profile shoes like those with individual toes. This activity has been popularized by the book, “Born to Run.” While many runners have made the transition without injury, serious injuries can occur. Anyone who wants change from traditional running to low profile running should consult an experienced running coach. This is not a simple change of shoes, but requires learning a new running technique. You also need to condition the bones and soft tissues of your feet for their new role. It often takes months to work up to long distances. Not everyone will be able to make the transition, so pay attention to signals from your feet and don’t push too hard.
Lather, Inspect, Repeat
The most under appreciated risk to your foot is from the sun. Sunburns are not uncommon when barefoot or in sandals. A non-greasy sunscreen is recommended when going barefoot or wearing sandals for everyone. The obvious painful episode is unpleasant but the real concern from long-term exposure is skin cancer. This association is surprising to many, but skin cancer can occur on the foot. When skin cancer occurs on the foot, the results are poorer than other locations on the body. This is often because of a delay in diagnosis. Everyone should inspect their feet monthly for unusual moles or any colored areas that have changed. Any wounds that will not heal, spots that bleed or moles that are changing, should be evaluated. Your family physician or dermatologist can help determine the appropriate action.
Summer is a fantastic time to enjoy all your favorite outdoor activities. Taking care of your feet now will keep them in good shape for summers to come.