Running on empty

Author: KEITH AUSTIN
Date: 19/06/2003
Words: 776 Publication: Sydney Morning Herald
Section: Health And Science
Page: 2

There is a classic television moment from the 1970s when the British comedian Ernie Wise bounds onto the stage and demands theatrically, ``What's afoot?", to which his partner, Eric Morecambe , replies, ``It's the funny-shaped thing on the end of your leg."

This humour in the English music hall tradition illustrates well the ambivalent attitude that most of us have to those ``funny-shaped" things. Stuffed into sweaty sneakers, squeezed into fashionable shoes then made to walk an average of 128,000 kilometres in a lifetime, our feet do an amazing job and don't they pay for it.

According to the Australasian Podiatry Council there are more than 300 identified foot ailments and more than 60 per cent of people experience foot pain in their lives. But less than half of them (two out of five) seek professional help. So even when our feet do start to kick up a fuss, we ignore them. One such person was 56-year-old printing consultant Jim Cryer, from Chatswood, who found out the hard way. An enthusiastic runner for more than 20 years, about a year ago Cryer joined the Sydney Striders , one of the city's oldest running clubs, and this year found himself at the top of the age-adjusted handicap rankings.

``Then about three weeks ago I felt a slight swelling in my right foot," he says. ``I thought it was a harmless mosquito bite but, being male, I totally ignored it for a couple of days. Then went for a run on it. That was OK, but the swelling was getting worse. I went for another run; still OK. By the Sunday it was really starting to become more and more inflamed around the right ankle area."
Hobbling painfully into work on the Monday, Cryer went to a medical centre, his own doctor, then ended up at the Sydney Adventist Hospital in Wahroonga.

He was on an antibiotic drip for eight days, his foot from mid-shin down resembling ``a frankfurter sausage", according to his wife.
How the infection happened is a bit of a mystery, although a four-hour run through the bush the weekend before may hold a clue.
``It was through soggy, wet bush tracks with mud and slosh and slush and all sorts of things. Then there were many, many runs in the previous weeks when it was so wet and I had been running for hours on end in wet, soggy running shoes. And, yes, I had got a few little cracks under the toes," he says.``That all contributed for sure. Also, when you get adjusted to your running shoes they're like your own favourite slippers and I remember it's a bit silly that I hadn't been taking them off after a run. So there's another hour of incubation of all sorts of horrible things."

A Bondi Junction podiatrist, Andrew Bull, explains that bacterial infections as severe as Cryer's usually start with friction on untreated tinea. ``When this becomes an issue it's because the tinea has broken the skin's barrier down. Once the skin is opened, then the bacteria can get in. "Tinea, or dermatophytosis , is a fungal infection of the skin. When present on the feet it's known as tinea pedis or, most commonly, athelete's foot . Highly contagious, once it starts eating into living skin symptoms include itching , reddening , a scaly rash , cracking , splitting and peeling . Chronic conditions resulting from tinea are rare but include cellulitis (an infection of subcutaneous tissue) and lymph gland infection as bacteria spreads through the bloodstream. Treating tinea pedis (with creams or oral antibiotics), says Bull, isn't a large part of his job but it does increase during the summer months.

``Fungus loves heat and moisture. I get a lot of backpackers in here. They really suffer through the Australian summer," he says.
The most common advice Bull gives patients is not to wear the same shoes every day, change their socks and get their feet out in the sun at lunch.

Bull recommends a separate wash for socks if you have tinea so the bacteria doesn't get on underpants, resulting in ``jock rot" or athlete's groin. Surprisingly, that little bit of flaky skin between the toes can kill you if left untreated and the infection gets into your bloodstream.

Some experts say tinea is more common among men. Bull puts it down to hygiene. ``Guys are less hygiene conscious; girls would be more likely to wear thongs around the showers at the gyms, for instance. Girls also wear open shoes a lot more than guys do."

Tinea symptoms:

• Itching and burning feet.
• Cracked, scaling and peeling skin particularly in the toe webs and sometimes spreading to the soles of the feet. In severe cases, bleeding may occur.
• Scaling or peeling of the soles.
• Blisters.

In advanced stages, some of the following symptoms may occur:

• White, soggy skin in the toe webs.
• Unpleasant odour.
• Oozing from the blisters.
• A white thickening of the toenails if left untreated.
• Pain in the affected areas.