The average American walks 8,000 to 10,000 steps a day.

During a lifetime, that's roughly the equivalent of walking five times around the earth.

An estimated three-quarters of all Americans will experience foot health problems at some point during their lives, and the importance of foot health care is even greater for the 21 million Americans with diabetes.

"Many people living with diabetes have some form of diabetic nerve damage that impairs the sensation of feeling in their feet," says Dr. David Strom, an orthopaedic surgeon with Pinehurst Surgical and medical director of the FirstHealth Wound Care and Hyperbaric Center at FirstHealth Moore Regional Hospital. "About one in 10 people with diabetes will develop a foot ulcer at some stage. Of those, many will develop a chronic wound that, if not properly treated, could lead, in the most severe cases, to amputation."

In recognition of April as National Foot Health Awareness Month, the staff of the FirstHealth Wound Care and Hyperbaric Center offers these health care tips for putting your best foot forward:

- Because running puts three to four times more pressure on your feet than walking, joggers should buy new running shoes about every 400 miles. Daily walkers need to change shoes every six to nine months.

- Your feet contain a quarter of a million sweat glands, so you should always wear socks with shoes. Change your socks daily and buy seamless socks made out of synthetic fibers that move moisture away from the foot.

Thanks to fashionable shoes and high heels, women have four times as many foot problems as men. Buy shoes that fit comfortably in the store without expecting them to stretch to fit your feet.

- Feet swell during the day, so shop for shoes in the afternoon when your feet are at their maximum length and width.

The left foot and the right foot are almost always different sizes, so it is important to have both measured while standing up for an accurate reading.

- If you use custom-made inserts, don't buy more than one at any given time. The size and shape of your feet may change, and you should be fitted every four months.

- Cut toenails straight across at a length slightly longer than the tips of your toes. Use an emery board to smooth the corners.

- Let a professional fit you if you have a bunion, hammer toes or another foot health problem. Medicare will reimburse a certain amount of money for one pair of prescription shoes each year and up to three pairs of custom inserts annually.

If you have other insurance, you should check with your provider for specifics.

- People with diabetes should never go barefoot and need to inspect the inside of their shoes daily for torn linings and foreign objects. They should also examine their feet each day for blisters, cuts and scratches, using a mirror to see the bottoms of their feet.

Additionally, diabetic patients should have their feet examined during regular health care visits or at least four times a year.

In addition to Strom, physicians providing care at the Wound Care and Hyperbaric Center at Moore Regional Hospital are Dr. Noel McDevitt, a plastic surgeon; Dr. Clinton Atkinson, a vascular surgeon, Dr. Robert Albrecht, a vascular surgeon; Dr. Willy Chu, a general surgeon; Dr. David DuBois, an emergency medicine physician; and Dr. Clayton Steiner, a general surgeon.

For more information about chronic foot wounds and diabetes disease management, contact the FirstHealth Wound Care and Hyperbaric Center in Pinehurst at (910) 715-5901.

The center, which is located in the Specialty Centers Building on the campus of FirstHealth Moore Regional Hospital, specializes in the treatment of chronic wounds and non-responsive conditions and offers hospital-based outpatient wound care and hyperbaric (pure oxygen) therapy, as well as disease management.