Ask Dr Mel: Cracked heels and broken ribs

Ask Dr Mel: Dry, cracked heels and broken ribs.

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Every week we bring you expert advice from Woman's Weekly's health expert Dr Melanie Wynne-Jones. Mel is a GP with 26 years' experience, and is the senior partner in a busy surgery in Stockport. This week she answers your questions about sore, cracked heels, and broken ribs.

Q What can I do about the sore, cracked skin on my heels? I want to be able to wear sandals this summer.

A The skin on our heels thickens if feet are squashed or slide about in ill-fitting shoes or slippers.

Skin can also dry out in hot weather or if we go barefoot - but sweaty, moist feet are more prone to fungal infections, such as athlete's foot, and this can cause cracking, too.

Fungal infections also produce itching, redness and scaling, but will usually clear up with antifungal creams, such as miconazole or terbinafine (from your pharmacy).

You may need prescription antifungal tablets (or steroid cream) if these don't work. See your GP if you have diabetes or severe scaling, as this can sometimes be a sign of psoriasis, eczema or allergy.

However, if the problem seems to be just down to dryness, your skin simply needs rehydration. Soak your feet in warm water, then use a pumice stone to gently remove dead skin from the heels - stop if it hurts!

Be sure to dry your feet thoroughly and slather on a thick moisturising ointment - Vaseline is great, and creams containing urea, such as Calmurid, which you can get from the pharmacy, are also good. Moisturise your feet before bed and wear cotton socks overnight.

Q My ribs have been really sore since I fell over recently. Could they be broken?

A It's surprisingly easy to break a rib if you fall awkwardly, and you can break several if you fall hard enough. But it's more likely that you've bruised the bones or the muscles of your chest wall, as this can be very painful, too.

Rib fractures really hurt because the ribs move every time we breathe, and a fracture can often damage the delicate membranes (pleura) that line the chest, triggering a sharp pain with each breath. Very occasionally, the sharp ends of the broken bone can puncture the underlying lung. This can make breathing very difficult and needs urgent treatment as it's potentially serious.

So, if you're breathless or cough up blood after a chest injury, see a doctor and have an X-ray as soon as possible. It's definitely worth having a check-up for severe pain, too, but if your doctor doesn't suspect complications, you won't need an X-ray. The treatment will simply be painkillers and rest until the rib heals, which may take several weeks.

Advice given here is for general information only and is correct on date of publication 12/07/09 but may be subject to change. Please seek help from your own GP if you have a medical problem.

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By Dr Melanie Wynne-Jones

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