The problem:
Many of the patients that come to us with foot problems also are in the unfortunate position of having cardiac disease. Almost all of these patients have been told by the cardiologist or family practitioner to get regular exercise. The exercise most commonly recommended is walking. Pain in the feet, ankles, and legs sometimes make walking intolerable or at least uncomfortable. If the patient with cardiac disease is unable to exercise their future prognosis is severely worsened. These patients are literally fighting for their lives.
Some ways cardiac disease contributes to foot pain:
1) Swelling: Limited cardiac function and can lead to fluid retention that collects in the feet and ankles. This puts pressure on the nerves and muscles causing “congestion” in the foot generally causing pain his pain can be burning or tingling or just an uncomfortable sensation.
2) Increased weight: A major risk factor for heart disease is elevated body mass index. The same kind of diet and activity that causes heart disease also cause us to gain weight. This places a much greater strain on the foot and ankle. Generally, with each step the foot takes about 1.5-2 times per body weight. That means if you are 30 pounds overweight, each step is about 60 pounds increased load on your foot. If you walk a mile each day (that’s a rough average of how many steps we take in any normal day) that means about 2000 steps. 60 pounds x2000 steps means 120,000 pounds more each day that your foot carries. That’s 60 tons. This results in pain in the heel, on the Achilles tendon, and on the ball of the foot. Also collapsed arches are common.
3) Nerve compression: Chronic swelling and decreased cardiac output causes some decrease in oxygen delivery to the tissues and decreases her ability to heal. This results in fibrosis and swelling INSIDE the nerve and nerve tunnels. This compresses the nerve.
4) Neuropathy: Neuropathy is a disease of the nerve itself with pain and damage caused by poor oxygen. This results in oxidative stress on the tissues and they become painful and somewhat chronically inflamed. This affects the nerves more than other systems.
Where to turn?
At Next Step Foot and Ankle Clinic, we can address all of these problems and get you walking with significantly less pain and discomfort usually in one or two visit. Remember if you have cardiac disease and have been told to exercise you are literally walking to live. We can provide solutions that make your live much more comfortable and help you walk to live. For more information or to set up an appointment call us at 210.375.3318 or use our online form.
