Fashion Forward or Foot Fiasco?

As a little girl I remember watching my grandma take off her knee-high nylon stockings at the end of the day. I marveled at the jagged curves, curled toes and bony protuberances that were her feet. They didn’t look like my feet at all. Mine were just long, narrow rectangles for the most part. The crazy outline was also absent on my mother’s feet. When I asked my mom about the twists and turns on Grandma’s feet, her diagnosis was a lifetime of denial, vanity and cheap shoes — meaning Grandma was really around a size 7 but thought that sounded way too big, so she squeezed her feet into synthetic size 6’s until the end. Ouch!

Reality check
At first I dismissed Grandma’s seemingly silly and illogical footwear choices as a “generational” thing. That was before I spent an evening in two-inch heels after months of a flats-only regimen. My arches ached; the balls of my feet screamed, and a blister had formed on my pinkie toe. Suddenly I remembered why I’d pushed those tall, pointy shoes to the back of my closet — they were evil (but at the time had really made my outfit uber fashionable)!

Tons of pressure
When you consider an average day of walking brings a force equal to several hundred tons to bear on the feet, it’s no wonder more than half of all Americans suffer from foot pain at some point in their lives. The human foot is complex; it has 26 bones, 33 joints, 107 ligaments, 19 muscles and numerous tendons. These parts all work together to allow the foot to move in a variety of ways while balancing your weight and propelling you forward or backward on even or uneven surfaces. The components of your feet work together, sharing the tremendous pressures of daily living, which often result in foot pain.

Common foot problems
Whether the sources are congenital problems, foot abuse, high heels, poorly fitting shoes or other maltreatment of the feet, women are especially subject to a number of afflictions involving the feet (most of which can also occur in men):
Achilles tendonitis—Inflammation of the Achilles tendon, the link between the calf muscle and heel bone, often happens to those who wear high heels regularly because over time their tendons become shortened. When a regular high-heel wearer switches to low heels for strenuous physical activity without appropriate warm-up exercises, it makes for an ideal scenario for Achilles tendonitis.

Bunions—Misaligned big toe joints, which become swollen and tender. The deformity causes the first joint of the big toe to slant outward, and the big toe to angle toward the other toes. Bunions tend to run in families, but the tendency can be aggravated by shoes that are too narrow in the forefoot and toe.

Hammertoe—A condition in which the toe is curled into a claw-like position. Although the condition usually stems from muscle imbalance, it is often aggravated by ill-fitting shoes, socks or hosiery that cramps the toes. Corns often accompany hammertoes because the toes rub against each other, the top or side of the shoe.
Metatarsalgia—General pain in the ball of the foot; often caused by wearing high heels.

Neuromas—Enlarged, benign growths of nerves, most commonly between the third and fourth toes. They may stem, in part, from ill-fitting shoes, resulting in pain, burning, tingling or numbness between the toes and in the ball of the foot.

Plantar fasciitis—Inflammation of the long band of connective tissue running from the heel to the ball of the foot, a main cause of rear-foot pain. Shoes that cramp the feet, especially in the arch area, sometimes cause this condition.

Pump bump (Haglund’s deformity)—A bone enlargement at the back of the heel bone, in the area where the Achilles tendon attaches to the bone. The deformity generally is the result of faulty biomechanics causing increased motion of the heel bone against the back of the shoe.

As you can see by the descriptions above, many of these conditions can be prevented or fixed by simply making better, more informed footwear choices. Which brings us to the high heel conundrum.

Hell on high heels: use and abuse
Even before women started to move into the U.S. work force in greater numbers, child rearing and homemaking responsibilities probably kept them on their feet a lot more than men before work outside the home beckoned. Those traditional roles remain, and women find themselves not only holding down a full-time salaried position, but still doing the laundry, grocery shopping, etc. Women’s feet are taking more punishment than ever, and the footwear that some feel obliged to wear in the work place may be playing a role. According to the American Podiatric Medical Association (APMA), the wearing of high-heeled shoes is a prime example of women inviting foot problems. Doctors of podiatric medicine see no value in high heels (generally defined as pumps with heels of more than two inches). They believe them to be biomechanically and orthopedically unsound, citing medical, postural and safety faults of such heels. High heels, Marlene Reid, DPM and past president of the American Association for Women Podiatrists, says, don’t just put temporary pressure on the ball of the foot — they change the makeup of your foot. “A 3-inch heel causes pressure seven times your body weight,” she explains. “This changes the pattern of (cushioning) fat on the bottom of your foot. This can happen to women in their 20s.”

High heels may contribute to knee and back problems, disabling injuries in falls, shortened calf muscles and an awkward, unnatural gait. In time, high heels may cause enough changes in the feet to impair their proper function. Most women admit high heels make their feet hurt, but they tolerate the discomfort in order to look taller, stylish and more professional. In a Gallup Poll, 37 percent of the women surveyed said they would continue to wear high heels, even though they did not think them comfortable.

Avoid a flip-flop fiasco
Balmy temperatures in San Antonio make flip-flops our favorite footwear nearly year-round. Unfortunately, we often slip into these casual icons without considering the safety and health of our feet. You can avoid painful foot ailments, including cuts, abrasions, tendonitis, broken toes and painful sprains, by following these simple do’s and don’ts:


Shop for a flip-flop made of high-quality, soft leather to prevent blisters.
Look for flip-flops that have some arch support.
Bend the flip-flop gently from end to end, ensuring it bends at the ball of the foot. Shoes of any kind should never fold in half.
Wear a sturdy pair of flip-flops when walking around a public pool, at the beach, in hotel rooms and in locker room areas — think plantar warts and athlete’s foot.
Ensure that your foot doesn’t hang off the edge of the flip-flop.

Re-wear flip-flops year after year. Throw them out if they show signs of wear.
Ignore irritation between toes, where the toe thong fits. This can lead to blisters and possible infections.
Wear flip-flops while walking long distances — they don’t provide enough shock absorption and arch support.
Do yard work while wearing flip-flops — especially when weed-eating or mowing the lawn.
Play sports in flip-flops—thinks sprains and breaks.
Getting to the point
High heels aren’t the only fashionable footwear we can blame our plantar fasciitis, bunions and hammertoes on — there are those wickedly narrow pointed- toe shoes. Case in point, local resident Peggy Pace, whose podiatric woes were recently profiled in the Express-News by Jessica Belasco:
“Pace wore high heels to work every day for years without a problem. But when she started squeezing her feet into pointed-toes shoes, the trouble began. Eventually, she needed bunion surgery on both feet. Her orthopedic surgeon, Dr. Marvin Brown with the San Antonio Orthopaedic Group, blamed her stylish shoes.
‘He told me if I kept wearing them, I’d be back,’ says Pace, 56. “I still do wear pointed-toe shoes. The good news is, rounded-toe shoes are coming back in style.’
“The shoe manufactures make shoes that women find visually attractive but that don’t fit their feet,’ Brown explains. “Most people I see in my office only need to change their shoes to stop the pain they’re seeing me about.'”
Give ill-fitting shoes the boot
Like wearing sunscreen everyday or a helmet while cycling, vowing to wear only comfortable, practical shoes may seem like a dorky public health campaign. (Of course, now we all wear sunscreen everyday — at least on our faces! — and wouldn’t think of allowing our children to ride a bike without a helmet.) Sure, the occasional blister offering to the fashion goddesses is going to happen, but perhaps it’s time to withdraw our commitment to a lifetime of foot neglect and abuse in favor of kinder, gentler footwear?
Now excuse me while I do a Google search for orthopedic stilettos.
10 Tips for Healthy Feet
The general public and even many physicians are unaware of the important relationship between foot health and overall health and well-being. Diseases, disorders and disabilities of the foot or ankle affect the quality of life and mobility of millions of Americans. Follow these recommendations to keep your feet healthy:
1. Don’t ignore foot pain—it’s not normal. If the pain persists, see a physician.
2. Inspect your feet regularly. Pay attention to changes in color and temperature of your feet. Look for thick or discolored nails (a sign of developing fungus), and check for cracks or cuts in the skin. Peeling or scaling on the soles of feet could indicate athlete’s foot. Any growth on the foot is not considered normal.
3. Wash your feet regularly, especially between the toes. Dry them completely.
4. Trim toenails straight across, but not too short. Be careful not to cut nails in corners or on the sides; it can lead to ingrown toenails.
5. Make sure that your shoes fit properly. Purchase new shoes later in the day when feet tend to be at their largest, and replace worn-out shoes as soon as possible.
6. Select and wear the right shoe for the activity that you are engaged in (i.e., running shoes for running).
7. Alternate shoes—don’t wear the same pair/type of shoes every day.
8. Avoid walking barefooted—your feet will be more prone to injury and infection.
9. Be cautious when using home remedies for foot ailments; self-treatment can often turn a minor problem into a major one.
10. Diabetics need annual checkups. See a podiatric physician at least once a year.
Source: American Podiatric Medical Association

Author: Kelly A. Goff

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