Foot Care for Muslim Patients

Islam is the fastest growing religion in the United States and the world, and the number of Muslim patients who foot and ankle specialists will encounter is expected to increase as a result. Therefore, it is important to understand the Muslim patients' emphasis on modesty to ensure comfort during the patient encounter. The provider should understand the permissibility of animal-derived products, especially as it relates to lower-extremity wound care and surgical products. Specific rituals that are pillars of Islam, such as prayer, fasting in Ramadan, and Hajj pilgrimage, all have direct relationships with foot health that providers should be cognizant of. Ritual purification or ablution before prayer is associated with fungal infections, and specific prayer positions may aggravate foot pain. Providers must understand that it is not enough to only treat fungal infections that affect Muslim patients, but they also need to understand the unique circumstances of Muslim worshipers that increase their risk of fungal infections and recurrence. Consequently, educational and preventative measures for managing tinea pedis in the Muslim population are critical. Muslims fast from sunrise to sunset during the month of Ramadan and pray during the night for an extended time, which has potential effects on the lower extremity. Hajj is the major pilgrimage that Muslims are required to complete once in a lifetime, and there are smaller, optional, pilgrimages that Muslims perform as well. There is a high risk of foot, ankle, and leg complications during these pilgrimages, and therefore it is paramount that providers understand the risk factors for lower-extremity complications during Hajj. Although Muslim patients participate in many rituals that have the potential to affect their foot health and overall well-being, the provider should understand that concessions exist for all situations, and the well-being of the patient supersedes any ritualistic obligation.