Foot care every paraplegic needs to know

Reading time: 4 minutes

This is a textual expansion on from my YouTube video.

For most people in a wheelchair, feet become something ignored and a vulnerable point for injury.

There are a few things that sum to make foot care so important.

Sitting down and not walking means that the feet don’t move much and get poor circulation, if you can’t move your feet, then it’s even worse. And to add to that, if you can’t feel temperature and you’re out in the cold, you could get frostbite without knowing.

Here are some of my experiences and quick tips concerning foot health.

Stinky feet – as a guy, I just let the shower water wash my feet, but once I was in a wheelchair, I noticed that I was getting runners foot or whatever it’s called. Tennis toes? Basically, they were getting ugly and bad. I found out that the solution was to wash my feet, scrub hard and get the dead skin off and always wash between the toes. This vastly improved the hygiene health of my feet.

Toe nails – with my Greek feet, my toe nails grow out kind of weird, and with not being able to feel exactly how each of my toes are doing, I could have a nail too long and that could get messed up in a shoe, or I could get an ingrown toenail and be hurting without knowing it. I make sure to keep my toenails at a rather short length.

Pressure sores – it’s very possible to get a pressure sore or something like that in between your toes! When I first came home from rehab, I slept on my side, always my left side and this in turn had my left foot with some weight on it and pushed my pinky toe into the toe next to it. On that toe is now a purple spot, which to me seems like I just need to drain some blood out of it and less of a pressure sore. Anyway, if your shoes are too tight or you don’t sleep with padded boots on, then be very aware of your foot position. If this does happen or anything alike, you can buy toe spacers and put those on. The only thing is to make sure you let your toes breathe and that the toe spacers don’t give you a pressure sore.

Toasty toes – What I’ve found to be true is that my legs, and mostly my feet, just don’t keep warm. I have the warmest boots and the warmest socks, but really, they’re not active. A jacket is not warm, a good jacket is just a good insulator – it keeps your body heat from escaping and from the cold air getting in. It doesn’t matter how good Ugg boots or Smartwool socks are. To be effective, my feet still have to produce the heat. As it is right now, I can be in a 70F (21C) and my feet will be cold.

What’s good is that if I’m out in the cold, I at least know that my feet won’t get colder than normal because the boot’s insulation keeps the cold out.

There are a few ways I warm up my feet, and some caveats that ensue.

  • Hair dryer – this is a good way to blow some warm air on your feet. It takes a little while to warm up more than just the surface. Make sure it’s not too hot! Keep a good distance and always, always make sure your METAL footplate doesn’t get too hot. Once when I was doing this, I got a heat blister on my toe from the metal getting hot.

  • Warm water – make sure this is only warm and not above 105F (40C). You can do this in the shower or put warm water in a bag and put it on your feet. You could also take a little bucket of warm water and dip your feet into it while on the couch.

  • Lie down – when I lay down, my circulation improves, and raising my feet up helps as well. Adding a blanket or some thick fuzzy socks will help. Using your hands to move your feet around can help – movement always helps.

  • Warm towel – this is a trick I adopted when learning massage therapy. Take a wet rag that isn’t dripping and put it in the microwave. Now, it’s a warm rag. Put it up against the inside of your wrist (a sensitive skin area) to check if the temperature is too hot. Use the necessary judgement to determine if your feet will be okay and then wrap the towel around your feet/foot.

  • Move – move to norther Australia if you want it to always be warm and then you should be mostly fine for keeping hot.

As briefly mentioned above, massage therapy can be good not only for your feet but for all of you.

The final footcare advice is to just be generally aware of what you’re doing. If you have a lack of feeling in your feet, then you need to be aware of where your feet are. Because of the design of the wheelchair I use, the footplate has gotten very sharp on one of the corners and I have cut my ankle many times. Luckily, I’ve healed fast.

The final thing I have to say is an all-enveloping disclaimer that this is just good intentioned advice, and I don’t allow you to sue me for anything. The actions you take are your own. I say this because you could burn yourself with hot water. Make sure you’re being safe.

Immediate actionable items: Optimize yourself for being warm, take care of yourself, and don’t forget to be present in the moment.

Summary: Many things to consider when it comes to footcare. Clip your toenails, keep your feet warm, wash your feet, and a few more things.

Overdeliver:  If you’re in a wheelchair, don’t be naïve. There are people who will sexualize your feet. Nothing against fetishes, to each their own, but don’t get me involved – as the saying goes.

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