THE HEART OF THE MATTER
a special program of the National Emergency Medicine Association (NEMA) 

Week: 528.2 Guest: Dr. David Lieb, Podiatrist Topic: Feet on the Beach - One Part Host: Steve Girard Producer: Ed Graham

NEMA: Ah, the poor foot...shoes can squeeze and blister, toes are stubbed in the middle of the night...and most of the time, the foot is socked away in shoes and, well, socks. Then, it's vacation...freedom for you, and for your foot. But hitting the beach has its hazards...we're with Dr. Dave Lieb, a podiatrist...who says the first step in not messing up your vacation is treating the skin on your feet as you would the rest of your skin....

LIEB: Well, important thing to remember is to use sunblock on the top of your feet, because it can burn just like the rest of your body. There's not very much on the top of your foot, there's one muscle and the bones are right under it, so there's not very much there, and its important to use sunblock there as well. In relation to the bottom of your feet, the bottom of the feet do have an extra layer of skin, compared to the rest of the body, so they're a little bit thicker, but they can burn walking on the hot sand. So its important to keep them a little bit wet. You might have heard of the fire walkers, who walk on hot coals, and they found that the reason they're able to do that is because they walk on a thin layer of vapor, or steam, their perspiration...it turns to steam, and that's how they're able to avoid burning their feet. So, if you want to avoid burning the bottom of your feet on the sand, be sure to keep em wet or wear beach shoes.

NEMA: The unprotected foot can be damaged in lots of ways at the beach....

LIEB: Things like shells or coral, they need to be cleaned with either peroxide and washed with alcohol, because they can become infected very easily. If you're in an area that has coral, it can be cut very easy with that and it can become infected very quickly...cause you know that coral is a living creature. And you may not even know it because it's so sharp.

NEMA: One area beach goers should be wary of, is the common showers you may use there....

LIEB: In the shower, or the shower area you have to watch out for warts...they're very common in the summer time...they can, just by walking down a rough area of concrete, can be injected up into the foot...and once you get them they can spread to different areas of your foot...and they're caused by a virus...and they can spread not only to your foot but other parts of your body, your hands, etc...

NEMA: I've heard of a parasite that lives in the sand at the shoreline, what is that?

LIEB: The North American version is called Nacotera Americanus, which is a hookworm found primarily along the Atlantic seaboard. And you get what's called cutaneal larval migrans, where the worm burrows up through the skin and crawls up underneath the skin...and that's usually not too hard to find because it'll itch a lot and you'll actually see the shape of the worm underneath the skin. And that can be treated, there's different drugs they can use, such as mebendezol, that can be used to treat that and get rid of it.

NEMA: There's nothing like getting up early and getting some exercise on the beach....

LIEB: A lot of people like to run at the beach...you should always run with shoes on at the beach, I've tried running without in the sand...it's nice, but it'll probably only last about 30 to 45 minutes, and start to blister a little bit...plus, if you're running along where the waves break up, there's a little bit of a cant to the beach there, and you may get some muscle strain on one side of your leg from running on that cant.. So try and run, if you're running at the beach, on a level surface, that's not sloped too much.

NEMA: Your feet carry the weight of your world, day in and day out. On your beach vacation...take care of them with a few precautions...I'll never forget when I burned the soles of my feet so badly on the sand, that it took two days before I could get around without pain...and it seems the thin skin on the top of the foot is the easiest place to forget the sunblock. I'm SG.