For senior citizens, mobility can mean independence. Several groups in the area are helping seniors retain their mobility by helping them get their feet healthy.

Dr. Dan Conrad, a podiatrist, leads a monthly foot care clinic for the staff and residents at Westhills Village. He stresses the importance of mobility for a senior citizen's continued independence.

"If you have open sores or pain that keeps you from being able to walk, that limits your mobility and ultimately it limits your independence," Conrad said. "I can't tell you how often I have seniors tell me, 'All I want to do is go out and go for a walk.'"

At the clinics, Conrad helps seniors gain and retain their mobility by fielding questions about foot care.

"A lot of senior citizens have questions about nails and why painful corns or calluses are reoccurring," Conrad said.

According to Conrad, thick brittle nails are hard to care for, and although fungal infections can cause such a condition, often the cause is just age.

"As we age, nails will thicken and become more brittle even with no infection," Conrad said.

For older people, fungal infections are difficult to combat because some of the more effective treatments, such as oral anti-fungals, aren't viable.

"A lot of seniors aren't good candidates for oral anti-fungals because (anti-fungals) don't play well with other medications," Conrad said. "And very often, seniors are on a lot of other medications."

Fungal infection is very common, according to Conrad, and can affect people of all ages.

"I've seen infants with fungal infections," he said.

Conrad is also frequently asked about the reoccurrence of calluses or corns, which are a thickening of the skin caused by wear in the area.

"The body initially produces it as a protective barrier," Conrad said. "But it can thicken to the point that it is painful."

Conrad deals with these issues at his private practice, as well.

"I'd say about 45 percent of our patients are probably senior citizens," he said. "A lot of older people have a hard time caring for their feet because they can't reach their feet."

He also stressed that many people have problems with their feet due to poor circulation.

"I would recommend range of motion exercises - flexion and extension of toes, ankles - these types of exercises help with circulation," he said. "But they are not going to reduce the stricture or deformity a person may have as the result of a stroke."

For some, Conrad said, physical therapy may be needed, depending on how limited their motion is or how damaged their muscles.

How often do you think about your feet?

According to Conrad, most people don't think about their feet enough, and frequently, by the time people are thinking about their feet, it's because they are in pain - and it may be too late.

There are ways to prevent foot problems and they are surprisingly simple.

"The best preventative care for your feet is probably good shoes - not too tight or restrictive and no high heels," Conrad said.

He also said that it is important that footwear be made of leather or another type of breathable material that allows moisture to escape.

It also turns out mom was right when she said you had to wash between your toes. Conrad recommends washing feet thoroughly each day.

"Some people just wash their body and whatever flows down to their feet is all the cleaning their feet get," Conrad said. "But you really need to pay attention to your feet. Spend 30 seconds really cleaning them thoroughly. Wash between toes and dry them thoroughly."

For winter foot care, Conrad said to be sure to keep the skin hydrated.

"You don't need to use anything fancy," Conrad said. "Simple lotion is good and once a day is optimal."

My feet don't hurt

"I think feet are the most neglected part of the body," Conrad said.

He recommends seniors have their feet inspected twice a year by a podiatrist.

"Diabetics have them checked once every 61 days," Conrad said. "Diabetes is the No. 1 cause of amputations of lower extremities in 'civilized' countries."

Conrad also said that even if you aren't experiencing pain, you may have a foot problem that you should see a doctor about.

Extremely cracked and callused skin can be a sign of problems beyond simple dryness. "Maybe it's not painful," Conrad said, "but if it snags on socks, it's an issue to discuss with a doctor."

Various kinds of nail problems also should be addressed with a doctor. "If you treat nail problems at early stages, it can be treated more easily and less invasively," Conrad said. In cases of ingrown or injured nails, surgery or removal of a nail can be the result if left untreated.

Abnormalities of the skin, like warts or growths, warrant the attention of a doctor, as well. "For some, these can manifest with no pain or discomfort," Conrad said. "But it is a virus and it is very contagious." Furthermore, studies show a low incidence of warts becoming cancerous if left untreated.

Vascular changes can be a sign of a larger problem that a doctor needs to deal with. "Purplish or uneven coloring of the skin can be signs of vascular problems," Conrad said. "These need to be checked out for proper referral to vascular specialists."

But my doctor doesn't look at my feet

"Unless the patient specifically states that he or she has a problem, a general practitioner will not examine their feet during a routine checkup," Conrad said.

Conrad said this may be because family doctors assume that if you have a problem with your feet, you will tell them. General practitioners also may assume that you see a specialist for your foot problems. Furthermore, general wellness checks usually focus on health concerns that affect the longevity of life, rather than the quality of it.

"I've had patients come in with major problems who say, 'I've been to my family doctor three times and he didn't check my feet,'" Conrad said. "There are quite a few dermatological conditions - fungal, etc., that a primary care physician can easily catch, and even treat if they see it."

If your yearly general wellness checkup is the only time you see a doctor, be sure to have him check everything - including your feet," Conrad said. "They check your ears, they check your nose, they check your blood. Have them check your feet, too. Or set up an appointment to see a podiatrist."

Take care of your feet it's the only pair you have

According to Conrad, most foot problems are pretty treatable unless linked to a larger problem like diabetes or a circulation issue. He also said that certain people need to pay special attention to their feet.

"If you run remember to replace your shoes regularly," Conrad said, "they can look fine on the outside, but be so torn up on the inside that they aren't providing you any kind of support. The more often you run, the more often you will have to replace your shoes."

Ladies who wear nail polish also have to be extra careful.

"Nail polish doesn't increase a person's chance of getting a fungal infection, but it can greatly increase the effects if a person is seeded," Conrad said. "It works like a greenhouse. Go without nail polish as often as possible."

Contact Crystal Hohenthaner at 394-8329 or crystal.hohenthaner@rapidcityjournal.com.