WorkingFeetA practical guide to lookingafter your feet at work

The Society of Chiropodists and Podiatristswww.feetforlife.org

ContentsFeet at work ...................................... 3

Foot pain........................................... 4

Common problems ............................. 5

Protect your feet at work ..................... 6

The right shoe for the job.................... 8

Choosing the best safety shoes ............ 11

Health and safety legislation................ 12

Podiatry............................................. 14

Further advice and contacts................. 16

Your feetbear thebrunt ofyour dailyworking life

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Feet at work

Working Feet • 3

Not only do feet face the hazards of highheels, steel toe-caps or ill fitting footwear,but also get to work in occupations andenvironments that can really put them atrisk when the right advice isn’t followed.

The average person walks the equivalentof five times around the earth in alifetime, and in simple walking, each stepcan exert up to two times your bodyweight in ground reaction force throughyour lower limb; so a trim 10 stoneperson will have between 15 and 20stone of impact going through the heelon heel-strike. Considering the distancecovered, and the hazards feet areexposed to during a working lifetime, it isno wonder that working feet need careand attention if they are going to survive.

Your feet bear the brunt of your dailyworking life. Prolonged standing, walking,operating machinery, high heels, fallingobjects and slippery surfaces are justsome of the dangers we expose our feetto in the workplace.

Every year, 2 million sick days are lostdue to lower limb disorders, and many ofthese sick days could be prevented bysimply:

• wearing the right shoe for the job;

• following an appropriate daily foot careroutine.

ELAINE worked in a supermarket in thefresh fruit and vegetable display area.Some grapes had fallen out of thepackaging and were loose on the floor.Elaine slipped and fell, spraining herankle, which resulted in her having twoweeks off work. If she had worn safetyfootwear with a slip resistant sole, thisaccident may have been prevented.

CAROLE normally worked in an office of acompany, but was asked to participate in anexhibition at the NEC for a week promotingthe company. She continued to wear herusual high heel court shoe, but by the endof the week she was experiencing severepain in the ball of her right foot. After a visitto her local hospital and an x-ray, she wasdiagnosed with a stress fracture of ametatarsal bone in the foot.

Foot pain

4 • Working Feet

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In the UK, it is thought that 75 to 80 per centof the adult population has some form of footproblem, and over 90 per cent will suffer froma foot problem at some point in their lives.Many people put up with foot pain believing itto be normal.

We have all heard the excuses… “I’m breakingthe shoes in”, “I’m on them all day, what doyou expect,” to name but a few. However,persistent pain should not be an every dayoccurrence, and is the body’s warning systemthat something is wrong. Don’t ignore it.

The environment in which we work can alsoimpact on foot comfort, such as the type offloor we stand on. Wooden floors, for example,tend to have some ‘give’, which is much moreforgiving than tiled, concrete or marble floorsthat have very little or no ‘give’ at all. It is notunusual for problems to arise within the foot,lower leg and back as a result of working onhard unyielding surfaces for long periods –especially if you are also wearing a hard soledshoe with no shock absorption.

Dangers for working feetWorking feet can be exposed to many dangers.To avoid painful conditions, you need to followfootwear and foot care advice that is suited toyour needs. Pain and discomfort ultimatelyaffect how well you perform in terms of workand play; affecting mobility and performance,and may prevent you from walking, playingsport, and leading a normal, active life. Notprotecting feet at work may also lead to seriousinjury and loss of livelihood.

Work related foot problemsWe all know that regular maintenance and ayearly MOT is vital to keep a car runningsmoothly, yet most of us overlook howimportant it is to care for our feet. Hiddenaway in shoes, we don’t give them muchthought.

Standing for long periods may cause pain ordiscomfort to the feet, ankles, knees and hips,as well as to the back and neck. Also, standingfor long periods in unsuitable footwear mayexacerbate any underlying problem you mayhave with your joints, increasing the rate atwhich arthritic changes take place.

Accidents at workIn an at-risk environment, unprotected feet areat risk from accident and injury such aspuncture wounds, crushing and laceration,sprained ankles, chemical burns, fractures andeven amputations.

Common problems

Working Feet • 5

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Your occupation can contribute to footproblems, and working feet are particularlyprone to the following problems:

• Aches or pains in the heel, arch, ball of thefoot or legs.

• Itching and/or discolouration in the legscaused by varicose veins.

• Numbness, tingling in the foot, changes tothe colour of the skin, caused by poorcirculation.

• Swelling in the feet, ankle or leg.

• Injuries such a crushing, punctures,amputations and lacerations caused byheavy objects falling and crushing the footor toes; treading on pointed or sharpobjects such as nails or broken glass; feettrapped between objects, such as betweena conveyor belt and roller.

• Sprained ankles, fractures or broken bonesresulting from slips, trips and falls. Causesinclude slippery floors, long stride lengthwith the wrong heel, cluttered walkways,incorrect footwear and poor lighting.

• Constant walking on hard, inflexiblesurfaces can exacerbate joint damage, andwearing shoes that are a poor fit, or havetoo high a heel.

• Knee, hip, back and neck pain.

• Corns and hard skin.

• Sweaty and smelly feet.

• Athlete’s foot.

Members of the Society of Chiropodists andPodiatrists are experts in footcare. To find apodiatrist* near you, see page 15.

* The terms podiatrist and chiropodist are interchangeable.

6 • Working Feet

Protect yourfeet at work

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The good news is thatit’s never too late to startlooking after your feet,and there is a lot youcan do to help yourself.

Tips for working feet• Wear shoes that are appropriate for your

job and suitable for your work conditions. • Different occupations have different

footwear requirements. Caterers andnurses, for example, may simply need a good-fitting, supportive shoe with an enclosed toe for protection, but abuilder will require safety footwear with a steel toecap.

• Wear safety footwear if the job requires orrecommends it.

• Wear shoes that fit properly, allowing yourtoes wiggle room (about 1cm gap betweenlongest toe and end of shoe). This alsoapplies to footwear with steel toecaps –toes are vulnerable if they’re beingsquashed against steel!

• For women who want to wear heels, stickto a heel height of around 4cm foreveryday footwear, and do daily calfstretching exercises to keep calf and heelmuscles supple. If you’re on your feetconstantly, reduce heel height to 2cm.

• Vary heel height from day to day.

• Wear shoes with a strap or lace over theinstep rather than slip-ons. This will stopyour foot sliding forward, a bit like aseatbelt does in a car.

• Always have two pairs of shoes on the go,alternating on a daily basis so that sweatcan dry out properly. Damp shoes eachmorning are the perfect environments forathlete’s foot and the bacteria that causessmelly feet.

• Safety footwear such as protective toecapscan prevent toes being crushed. They’renot all ugly; some high profile brands nowmake good-looking safety boots.

• Where slips can occur – wear slip resistantsoles.

• If there is a danger from nails or sharpobjects – wear puncture resistant soles.

• Adopt a regular foot care regime to keepyour feet in tip-top condition.

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* The terms podiatrist and chiropodist are interchangeable.

Don’t ignore foot pain Resolve foot problems by seeking specialist helpfrom a podiatrist*. See a member of the Society of Chiropodists and Podiatrists who can help tokeep your feet comfortable and functioning well.The podiatrist can advise and treat foot problemsthat may affect your well-being at work, and also advise on footwear style and fit. [See pages14-15 for more information.]

Visit The Society of Chiropodists and Podiatrists’website at www.feetforlife.org or telephone 0845 450 3720 to find your nearest podiatrist.

Tips for healthy feet• To keep your feet fit and flexible and

exercise them:

• circle your feet 10 times in eachdirection, keeping your leg as still as possible.

• Try circling the alphabet with your feet.

• Pick up pencils or marbles and putthem down next to your other foot– ready to do the same thing againwith that one.

• At home, walk about bare-footed onsafe flooring to exercise them. (Please do a foot check afterwards if you have diabetes, or anothersystemic condition that may affecthealing).

• If standing all day, try to move aboutor flex the feet up and down to helpmove the circulation. Once at home,elevate the feet and legs above thehead and heart for 15 minutes or so.

The right shoefor the job

8 • Working Feet

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FootwearIf you are on your feet at work, you shouldwear the right shoe for the job, choosingfootwear that is appropriate for youroccupation, working environment and feet.

Following a risk assessment, safety footwearmay be required or recommended. If it isrequired or recommended, make sure youwear it. If safety footwear is not worn whenrequired, you may receive no compensation for injury.

Also, any footwear that doesn’t fit properly cancause life-long foot problems. Problems couldbe easily avoided or reduced by following theright advice.

Shoe fitRegardless of your workplace: warehouse,airport, shop, office or even at home –comfortable, properly fitted footwear is essentialto maintaining good foot health. Many minor footailments can be relieved with properly fitted andcarefully selected shoes. In many workplaces,safety shoes are necessary to protect againstenvironmental risks, but they also need to becomfortable and correctly fitted. There is amisconception that safety shoes, especiallyprotective toecaps, will be uncomfortable, but ifthe shoes are padded and fitted correctly, youshould not be able to feel the toecaps at all.Women should take note that court shoe stylesteel toecaps are difficult to fit accurately.

Tips on getting the right fit• Always have both feet measured because

they may not be the same size. Whenchoosing shoes, the length, width anddepth of the shoes are important.

• Always try on both shoes.

• Ensure there is enough room at the front of the shoes to allow for the naturalmovement of your toes when walking –your toes should be able to wiggle.

• Make sure there is around 1cm spacebetween your longest toe and the end of the shoe.

• When choosing new shoes, take time to test them out, walk around to ensuremaximum comfort.

• Don’t break in new shoes. Shoes that fitwell should feel comfortable.

• As you get older, your feet tend to get larger,so get them measured periodically.

• Good fit doesn’t necessarily mean expensive.

Photograph: ARCO

Working Feet • 11

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What to look for• Upper – made from natural materials such

as leather or a breathable man-made fabric.Some leather has a plastic coating to repelwater and allow the shoe to be wiped clean.

• Lining – breathable material keeps the foot fresh; they need to be smooth andseam-free.

• Toe area – should be foot-shaped and deepenough to prevent rubbing and allow thetoes to wiggle. This is especially importantwith protective toecaps. If the shoes arepadded and fitted properly, you should notbe able to feel the toecaps at all.

• Insole – preferably removable to allow easyinsertion of padding or orthoses.

• Heel fit – the heel should fit snugly on the foot, stopping the heel slipping out of the shoe and stabilising the foot uponground contact.

• Heel – should have a broad base, no higherthan 4cm. If worn for long stretches, shouldbe no more than 2cm in height.

• Sole – Should be strong and flexible withshock absorption to cushion the jolts ofwalking on hard surfaces. Material shouldbe slip resistant, such as rubber,polyurethane or PVC.

• Fastenings – laces, buckles or Velcro help tosecure the foot in the shoe.

Choosing thebest safety shoes

Photographs: ARCO

Health andsafety legislation

12 • Working Feet

The Health and Safety Executive has acampaign running until 2010 to reduce slips,trips and falls by 30 per cent. As well ascreating a safe environment by house-keepingand good building design, a focal point of thecampaign is workers and their footwear.

Health and Safety legislation includes footwearin the workplace. The basic legislativerequirement is that all reasonable efforts mustbe made to eliminate or reduce the likelihood ofinjury occurring in the first place. An employermay need to issue safety or protective footwearto reduce the severity of an injury.

Risk assessments are used to decide whetheran employee needs special footwear for work.

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Working Feet • 13

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Employer and employee’s duties Health and Safety legislation includes workplace footwear:

Health and Safety at Work Act 1974The general duty:

• section 2 outlines the need of the employer to provide a safeworking environment

• section 7 outlines the general duties of employees at work to takereasonable care of his own health and safety and co-operate withhis employer to enable him to discharge his legal duties.

The Personal Protective Equipment at Work Regulations 1992 (as amended)

Personal Protective Equipment (including special workplace footwear)must be:

• provided where risks have been identified and cannot be controlledin any other way;

• properly assessed before use to ensure it is suitable;• maintained and stored properly;• provided with instructions on how to use it safely;• used correctly by employees.

The Management of Health and Safety at Work Regulations 1999

This requires that:

• a ‘suitable and sufficient’ assessment of the risk to the health and safety of persons at work and of those not in his employment be made.

• a hierarchy of risks is set out.

For further information see www.hse.gov.uk

Podiatry

14 • Working Feet

What is a podiatrist?Podiatrists (the name chiropodist is familiar tomany, and means the same as podiatrist) arehighly skilled professionals trained to prevent,diagnose, treat and rehabilitate abnormalconditions of the feet and lower limbs. Theyprevent and correct deformity, keep peoplemobile and active, relieve pain and treatinfections. General treatments include skin,such as corn and callus removal, nail-care,soft tissue and connective tissue problems,and advice on footwear. Podiatrists carry outspecialised work such as nail surgery andmusculoskeletal assessments. They can alsodiagnose and treat conditions that threaten thefeet of patients liable to injury or pressurerelated problems, as a result of medicaldisorders such as diabetes, rheumatoid arthritisor impaired circulation.

Podiatric surgerySome podiatrists known as podiatric surgeonsspecialise in surgery to the foot and ankle,performing surgery to manage conditions suchas bunions, hammer toes, removal of neuromas,to name but a few procedures they carry out.

BiomechanicsSome podiatrists specialise in biomechanics –looking at the relationship between the bones,muscles and soft tissue in the foot and lowerlimb, and its effects on other parts of the bodysuch as the back and knee.

How to find a podiatristTo find a local podiatrist, you can eitherapproach your GP practice for information on NHS referral, or, for a private consultation,you can visit www.feetforlife.org or telephone0845 450 3720.

www.feetforlife.org

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Health Professions CouncilSince July 2005, only those who havesatisfied the criteria for registration with theHPC can call themselves a chiropodist orpodiatrist. The HPC is a UK-wide regulatorybody, which regulates 13 health professions.All members of the Society of Chiropodists and Podiatrists are members of the HPC.

Some letters to look out for after the name ofthe chiropodist or podiatrist are:

HPC Registered

MChS/FChS – Member/Fellow of the Society ofChiropodists and Podiatrists

Other qualifications they may display are:

DPodM – Diploma in Podiatric Medicine

FCPodS – Podiatric Surgeon

BSc/BSc (Hons) – Bachelor of Science degreein Podiatric Medicine

A word of caution, only the titles chiropodistand podiatrist are protected in law. There aresome people who call themselves other foot-related titles, who are unregulated by the HPC.Attending an HPC registered chiropodist orpodiatrist helps ensures safety and proficiency.

Further foot health information The Society of Chiropodists and Podiatrists provides a number of foot healthinformation leaflets for you to either download in PDF form from the Society’s website,www.feetforlife.org, or to send for in hard copy from the address at the bottom of thepage. Current leaflets include Children’s Feet, Sporty Feet, Heel Pain, Footwear andFootcare for People with Diabetes. More will be published soon.

With the compliments of:

The Society of Chiropodists and Podiatrists, 1 Fellmongers Path, Tower Bridge Road, London, SE1 3LY. Tel: 0845 450 3720 • Fax: 0845 450 3721 • Email: enq@scpod.org • www.feetforlife.orgCopyright © 2007 The Society of Chiropodists and Podiatrists

Written by: The Society of Chiropodists and Podiatrists, PR Committee, External Relations DepartmentDesigned and printed by: Harvest Digital Imaging Ltd

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