There aren’t many professions more taxing on the feet than that of a nurse or midwife. Long shifts, concrete floors and the demands of the job can take a significant toll, but you can remedy the abuse with a little self-care according to podiatrists.
Podiatrist Daniel Fitzpatrick said nurses and midwives are the most prevalent patient he sees at his podiatry clinic.
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“I think we all underestimate how taxing the role of these caregivers is on the lower limb and their bodies in general. I know after fifteen years of seeing the same types of conditions in nurses and midwives we now realise that their feet cop a battering,” said Mr Fitzpatrick.
It is vital for nurses and midwives to be proactive with their foot health if they want to continue in their profession, explained Mr Fitzpatrick.
“Unfortunately, we all tend to put off treatment, but nurses and midwives have such a physical job that they don’t have the leeway that the rest of us do.”
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Nurses and midwives spend the majority of their time at work on their feet, so painful conditions become chronic quickly, said Mr Fitzpatrick, and once these issues get to that stage, they become costlier to fix and may require surgery or pain-relieving injections.
A study published in the International Journal of Nursing Practice, investigating foot health and impact on work wellbeing in Finnish nurses, found that nurses had a variety of foot problems, with dry skin, foot pain, and corns and calluses being the most prevalent.
The study concluded that foot problems were common among nurses and were associated with individual and work-related factors. The incidence of long-term diseases, the need for specialist appointments and related impact on work performance were all associated with foot health, and as such prevention of foot problems should be prioritised.
The research paper highlighted the importance of regular assessment and self‐care by nurses, and in severe cases, professional podiatric care. Also, health care organisations need to develop work ergonomics and occupational health care programs to support foot health and work wellbeing in this profession.
7 tips on keeping feet tiptop.
Daniel Fitzpatrick recommends the following self-care tips for nurses and midwives.
1. Do calf stretches
Stretching the calves (the back of the bottom part of your leg) is vital to foot function. The calves can tighten the muscles at the bottom of the feet and as a result increase minor tears and pain.
“I’m sure patients in our clinic think all I do is talk about calves, but they are vital and cause so many knee and foot problems. They are particularly relevant when you stand up for a living.”
How to stretch your calves
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Find a wall and place the palms of your hands on it at around shoulder height.
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Place one foot in front of the other so that toes are pointing in the same direction and feet are parallel to each other. The back heel should touch the ground.
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For the first stretch, bend the front knee and keep your back knee straight.
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Hold for 30 seconds.
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For the second stretch, bend the back knee of the back leg.
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Hold for 30 seconds.
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Repeat on opposite leg.
How often?
Mr Fitzpatrick advises that calf stretches be performed four times a day, ensuring stretches are held for 30 seconds and continued for three weeks. If there is not a significant improvement in symptoms, book an appointment with a podiatrist.
2. Tennis ball exercise
This exercise is excellent for loosening soft tissues and getting the natural lubricant back into the joints. It can help everything from plantar fasciitis to osteoarthritis. It’s great as an exercise for nurses and midwives at the end of a day.
How to do this exercise
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Sit on the edge of a chair with the tennis ball under your toes.
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Roll the tennis ball from your toes to your heel, applying as much pressure as you can tolerate.
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Roll the ball around in small circles on your forefoot (from your toes to under the ball of your foot).
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Now roll the ball around in small circles on your arch (from the end of the ball of your foot to the beginning of your heel).
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Then roll the ball around in small circles on your heel.
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Repeat the above process on the other foot.
3. If you have pain get assessed!
If pain lasts longer than three weeks, it can lead to chronic inflammation. This is particularly important when the point of pain is in an area that is heavily used in a work capacity, said Mr Fitzpatrick, who strongly suggests seeing a podiatrist.
“So often I take a history and nurses, and midwives have been in chronic pain for over six months! As a result, the problem is much harder to fix. We can usually still fix it, but it costs more and takes longer to heal while the poor patient is in pain.”
Podiatrist Sarah Sweeney adds the following essential tips on foot health for nurses and midwives.
4. Custom orthotics.
“I cannot stress how important it is to have proper arch support in your shoes which only a custom orthotic can offer.
“A lot of my nurse patients present with plantar fasciitis (heel pain). This is due to the way they walk and stand, the fascia or arch is not supported and can become stretched and strained and extremely sore!
“This is a common complaint in the nursing profession. Book in with your local podiatrist, get an assessment and see if custom orthotics will help you.”
5. Footwear!
“It is imperative that nurses and midwives wear supportive shoes. The best part about this job is that they are allowed to wear joggers to work.
“I recommend New Balance black leather joggers, Brookes or Asics. Always make sure that the foot is not squeezed into a shoe, as huge problems can occur if the shoe is ill-fitting.”
6. Regular callus and corn debridement.
“Callus and corns are common due to the amount of time nurses and midwives are on their feet, and are extremely painful if left untreated. It’s important to see a podiatrist regularly to manage these conditions.”
At home treatment – use a pumice stone and foot file to remove excess callus (hard skin), moisturise the feet regularly, wear cotton socks to prevent sweating, and shoe deodoriser to avoid smelly feet and shoes.
7. Avoid nail salons!
“Most of these places do not sterilise. This makes you susceptible to a fungal infection in your toenails. Fungal infections are tough to get rid of. Make an appointment with a podiatrist for a medi-pedi instead. We use sterile instruments and are trained to remove ingrown toenails, corns and callus.
“I cannot stress how debilitating it is to be in agony with every step you take, how scary it is to realise that you can't walk without pain and to wonder if you will ever be pain-free again.
“If nurses don't make the right choices for their feet, they could end up with so much pain that they have no choice but to stop working," said Ms Sweeney.
Ms Sweeney said she recently treated a nurse who had a stress fracture so severe that she had to wear a moon boot for six weeks, and because moon boots are a health and safety hazard in a hospital, she had to take six weeks of unpaid leave.
“The stress fracture was not from trauma – just from the way she walked around all day with no support.
“Feet can look ugly after a lifetime of neglect, so it is important to treat them well. It’s important for a nurse’s health, quality of life and livelihood. Prevention is always better than cure!” said Ms Sweeney.