By: Michael Zapf, DPM, MPH, FACFAOM

I was thrilled to be invited by the publisher of Today’s Health, Randy Strong, to write a series of articles about podiatric care. I have known Randy for several years and have found his health care publications to be honorable, reliable and accurate. With the first two issues of this magazine already published I can see that he is only adding to his reputation. I hope Today’s Health enjoys the success it deserves.

Probably the most frequently asked question of a podiatrist is, "Why would someone want to treat feet?" The answer is both simple and complex. The simple answer is "I don’t. I treat people who happen to have feet that have problems." I assume that this is the same answer given by other doctors, like gynecologists, ear, nose and throat specialists or urologists, who treat a specific region of the body. Nobody can know everything about the body so it is kind of nice that people have chosen to get to know just one part in excruciating detail. I chose feet.

The more involved answer involves the challenge of mastering the exquisite details of the foot and the joy of using that knowledge in making people better. Few of us will get through life without foot problems. When problems happen, there is comfort in knowing that someone is dedicating his or her life to helping you and your foot problem.

The foot is an incredible machine, in some ways more advanced than the hand. The lower primates use their foot like a hand. Notice the feet of primates next time you are at the zoo. With an opposable thumb the primate can grasp objects, throw things and groom each other. The only thing they cannot do with a foot is walk on it. Even gorillas cannot spend much time on their feet. Only human beings have the foot so adapted that we have a flat surface to walk on and all the toes out in front.

The foot has to accomplish two opposite activities every walking step. When the foot lands on the ground it becomes loose and flexible to adapt to changes in the terrain. This magic process is called pronation and is seen as a flattening of the arch. Every foot pronates to some degree at foot strike. The trick in efficient walking is to have the foot transform itself into a rigid lever by the time it pushes off the ground. This transformation is called supination and results in an increase in the arch height. Walking is nothing more than a series of pronation-supination motions.

While efficient walking is impossible without some pronation and supination, problems occur when either is done to excess. Too much pronation leads to hip and knee pain, shin splints, tendonitis, bunions, hammertoes and the very common heel and arch pain. Too much supination can also lead to hip and knee pain, heel pain, hammertoes and even a type of bunion.

The purpose of my series of articles is to discuss each of these foot maladies, and more, in what I hope is an interesting manner. I will use examples of actual patients to illustrate the various things that go wrong with feet. You will learn about bunions in adults and children, ingrown nails and how to prevent them permanently and the latest techniques in treating warts and fungal nails. I will tell you about my monthly trips to Mexico to treat childhood foot deformities. I will even tell you how to prevent a variety of athletic injuries and purchase the right athletic shoes.