Good foot hygiene is reliant upon keeping the feet dry and comfortable. Issues arise when the feet are kept in a moist environment for excessive periods enabling bacteria and fungus to propagate1. Furthermore, any pressure on loaded feet can result in the development of lesions such as blisters and ulcers. Pressure on the foot can result from restrictive, tight tops of socks and seams pressing into the foot. Feet that are compromised by disease such as diabetics are at greater risk of developing such lesions².

Clinical problems that can arise and be affected by the sock type worn include:

• Toenail damage and fungal infection manifestation,
• Friction blisters, hyperkeratoses, heloma dura/molle (corns),
• Dermatophyte, yeast, bacteria and viral (verruca) infections,
• Mechanical or shear induced injuries of subcutaneous tissue (capsulitis, bursitis, calcaneal fat pad atrophy)
• Mechanical or shear injuries against bone prominence (retrocalcaneal exostosis, sesamoiditis, hallux valgus, tailor’s bunion, accessory navicular, tibial crest periostitis, medial and lateral malleolar contusion)

Socks are relevant to good foot hygiene from the following points:

1) their ability to draw or ‘wick’ moisture away from the foot
2) air circulation around the foot
3) the cushioning/comfort they provide to the foot
4) minimization of seams to abrade the foot
5) not restrictive to the foot or leg

Extra care is also required with feet deemed at high risk such as diabetic feet. A densely padded sock (whether acrylic or cotton/wool or combined) that keeps the feet relatively dry is required in people at risk of developing ulcers through decreased pressure sensation².

For those who suffer from blisters, socks may be one of many contributing factors. Acrylic fibers have been show to cause less blisters and smaller blisters than cotton fiber socks3. The use of the fibre known as Coolmax has also been shown to significantly reduce blisters⁴

When choosing a sock, try to look for those with the above features which aid foot health through taking sweat away from the foot and allowing air flow to circulate to minimize moisture on the foot, providing comfort and minimizing the risk of lesions developing through seams and restrictive, tight tops. Socks, however, only one part of good foot health with well fitted quality foot wear and attention to foot hygiene (regular cleaning and inspection of feet by oneself) being integral components.

Speak to one of our podiatrists if you need help selecting socks to suit your feet and activities. At Eastern Foot Care we stock a range of locally made, high quality socks made with high quality fibres such as Coolmax, mercerized cotton, and wool designed for a diverse range of activities. Contact us for more information.

References:

1) Savage, EA, Adams, BB, 2006, “Skin Manifestations of Running”, Journal of American Academy of Dermatology, vol. 55, no.2, p. 290-301.

2) Feldman CB, Davis, ED, 2001, “Sockwear Recommendations for People with Diabetes”, Diabetes Spectrum, vol 14, no.2, p.59-61.

3) Herring, KM, Richie, DH, 1993, “Comparison of cotton and acrylic socks using a generic cushion sole design for runners”, Journal of American Podiatric Association, vol 83, no 9, p.515-522.

4) Knapik, JJ, Hamlet MP, Thompson KJ, Jones, BH, 1996, “Influence of boot-sock systems on frequency and severity of foot blisters”, Military Medicine, vol 161, no 10, p594-598.