On Your Feet
Most problems with the feet are caused by heredity and environment ˇ corns, calluses, bunions, and heel spurs. Corns (usually between toes) and calluses (usually on the bottom of the foot) are very common problems ˇ caused primarily by irritation (friction or pressure) of bony prominences. The irritation is due to external factors, like a job or your shoes. Faith Shapiro, doctor of Podiatric Medicine, had a patient who developed problems because of her job. "A woman who climbs poles in her work has a bony prominence irritated by the placement of her foot in the stirrup that bears her weight on the pole.
"Bunions are an extremely common problem. The bony and soft tissue prominences near the head of the first metatarsal, and can form even without irritation. They are often due to bio-mechanics [the dynamics of human motion] and extreme pronation [the tendency to roll the feet toward each other when standing]. Bunions are most common in women, due to an inherited type of foot but primarily because of shoes."
Heel spurs are another common problem. The arch drops down and pulls on the plantar fascia (the fibrous tissue fanning from the heel to the toes], causing pain.
Bob Wilson, a medical doctor specializing in sports medicine and the non-surgical treatment of injuries, says that "the most common problems are related to flat-footedness ˇ a dropping arch (hyper pronation) where the instep of the foot drops down when walking," There are other common problems, too: crowding toes; Metatarsalgia (pain in the front of the metatarsal bones); and hammer toes (toes that lift and curl so that weight cannot be put along the flat of the toes, causing pain).
For years, women have damaged their feet by wearing fashionable but not smart shoes. And while spike heels are no longer politically correct, high heels are still part of the dress code and some women have been unwilling to make choices that are better for their feet. Most of us, however, are making much better shoe choices.
"Women are much smarter about their feet now," Shapiro says. "There have been good changes in women's shoes. Now there is a lot of choice. Toe boxes are deeper (higher) and wider. Heels are lower. There are new materials which act like shock absorbers and take into account the pounding. We're starting to see widths like A, B, C, and extra wide. ... And these big heavy shoes, like combat boots, have lots of room, and good support. ... Cowboy boots are okay ˇ they have a little heel, a stiff shank, and if the toe box is big enough, they can help heel and arch pain. And socially acceptable today is for women to 'commute' in athletic shoes. Now fashionable shoes that look good also feel good."
Wilson agrees. "Women's shoes have a more healthy variety now. The running shoe is well constructed ˇ a lot of science and money has been spent on its design. It stabilizes the foot, cushioning it and supporting the arch is one of the best things we can do to help prevent problems. And the running shoe is acceptable with suits. Doc Martins (combat boots) are good ˇ there's lots of room in the toe box; it's not confining. And they're flat. ... Birkenstocks, Earth shoes, and Bamas support the foot in mid foot, and they have metatarsal bars that the toes grab. It's exercise like our ancestors."
But, they aren't for everybody. "I never liked Earth shoes," Shapiro said. "They drop the heel and put excess pressure on the Achilles tendon."
Shapiro laments "Women's shoes have caused so many problems over the years." And they still can. High heels are back in fashion and if we're not careful, we could damage our feet again. Our feet are not constructed to take our weight in the front. And when we war heels, the pressure goes right to the ball of the foot.
Wilson agrees. He does not like high heels. "Cowboy boots and high heel shoes jam the foot into the toe box, sliding down hill." And if we don't take care of our feet, we could end up having surgery, as Karin Boyle has just had. "I lived with foot pain for years. Didn't know it was called bunions. I just thought I had painful feet."
She received a gift coupon for a podiatric consultation. "I'm a student at T-VI and am going into nursing. I'll be spending a lot of time on my feet." She went to the consultation and was so reassured by the podiatrist, she had the surgery the very next week ˇ on both feet. "I'll wear orthotics [devices used to support or supplement weakened joints or limbs] for the rest of my life to protect the areas of prominence. I'll buy good shoes. And never again wear shoes that are too tight."
Remember, exercising our feet will make them stronger. Wilson says "Our shoes protect our feet but prevent us from using all the muscles. Muscle weakness allows deformities to progress. Muscle strength will help prevent the progression of deformities."
So, go ahead. Wear your heels, but not all the time. Wear your running shoes and your clogs, walk barefoot, let your feet breath. Exercise your arch.If you take care of your feet, chances are they will support you easily for the rest of your life.
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