Studies have found a strong link between foot problems and disability; if you’ve ever had a sore foot, you know why.
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Are your feet killing you? Or are they keeping you alive? You use your feet with every step, and healthy feet are essential for walking, running, stepping and most other activities that keep you active and alive.
Studies have found a strong link between foot problems and disability, and if you’ve ever had a sore foot, you know why. You get off your feet with every opportunity; you don’t get the exercise you need, and your feet still hurt every time you get out of the chair.
Women at any age are four times more likely than men to suffer foot problems, and women undergo about 90 percent of corrective surgical procedures on the foot. Bunions, stress fractures, hammertoes, plantar fasciitis–all are common complaints, and nearly all can be traced at least in part to women’s shoe styles and the tendency of some women to wear shoes that are one or two sizes too small. High heels are a major culprit, putting increased stress on the forefoot.
Bunions: It’s one of the ironies of life that the shoes that make your feet most attractive are also likely to lead to unsightly–not to mention painful–bunions.
A bunion is an enlargement of the big toe joint, creating a bony bump and causing the toe to turn inward. In the early stages, the most noticeable feature may be the enlarged joint which makes crowded toes even more cramped. Constant rubbing irritates the bursa (the fluid-filled sac that surrounds and protects the joint), leading to redness and swelling. At this stage, it’s more crucial than ever to wear shoes with a large, roomy toe box and to avoid the added stress of high heels.
The inward turning of the toe can range from a few degrees to an extreme deformity that makes walking difficult. At this point, surgery may be required. Hammertoes: Usually occurring on the second toe, a hammertoe is bent up slightly and curled under like a claw. The condition is also associated with poorly fitting shoes, particularly in women who have overly tight tendons that don’t allow the toe to flatten properly.
With early detection, a foot doctor can prescribe exercises, stretches, splints and orthotics to help return the toe to a more natural position. Once the toe becomes stiff, however, the only solution is surgery.
Fractures: A forefoot fracture can occur stepping off a curb, treading on a stone or from the repeated stress of pushing off with the toes while walking or running.
A fracture causes pain that becomes gradually more noticeable and doesn’t respond to self treatment measures such as rest, ice, antiinflammatory medications and a change of shoes. Eventually, it causes some degree of pain most of the time, and it must be treated by a doctor.
Depending on the nature of the fracture and the location, treatment usually includes full or partial immobilization for four to six weeks.
Plantar fasciitis: A pain in the heel, particularly one that is worse in the morning just after you get out of bed, is most likely plantar fasciitis. Most vulnerable are runners and persons who are overweight or spend a lot of time on their feet.
The plantar fascia is a strong, elastic band of tissue that helps form the arch and absorbs shock as the foot hits the ground. Treatment requires patience but the condition usually resolves, sometimes after a period of as long as 12 to 18 months. Activity should be decreased for six weeks combined with exercises to stretch the plantar fascia four to five times daily. A doctor may also advise use of a heel pad to cushion the heel and antiinflammatory medications.
To protect your feet and prevent problems, it’s important to take note of the shoes you wear. Buy shoes that are roomy and feel comfortable when you try them on in the store. Don’t expect to “break them in” or get used to the feel. Remember that feet tend to get both wider and longer with age.
Regular physical activity is bound to put stress on your feet, but you can make sensible decisions to wear the right shoes for the activity, reduce the impact and to build up mileage gradually.
When you do get hobbled by a foot problem, don’t rush back into activity or cheat on the prescribed treatment. There are other forms of exercise–swimming, biking, rowing–to keep you healthy until your feet stop killing you.
Don’t Cramp Your Toes!
Researchers in one study found that 88 percent of women frequently wore shoes that were at least one-half inch too tight. Of the 356 otherwise healthy subjects, four of five complained of foot pain or deformity.
Most women have feet measuring three and one-quarter to four inches wide; yet many fashion shoes come in widths no greater than three inches.
High heels can increase the pressure on a woman’s already cramped forefoot by 75 percent or more, eventually leading to chronic pain, bunions, hammertoes and pinched nerves.
[SOURCE: Michael J. Coughlin, “Women’s Shoe Wear and Foot Disorders,” The Western Journal of Medicine, December, 1995]
Foot Pain Common
During Pregnancy
Pregnant women frequently suffer bouts of foot pain lasting two weeks or longer. One study found that pain was more common during the later stages of pregnancy and most likely caused by the weight gain and biomechanical changes associated with the pregnancy rather than hormonal changes.
Women who exercised during pregnancy were at no greater–or lesser–risk of foot and leg pain.
[SOURCE: Valerie J. Vullo, James K. Richardson and Edward A. Hurvitz, “Hip, Knee, and Foot Pain During Pregnancy and the Postpartum Period,” Journal of Family Practice, July, 1996]
Women Vulnerable
To Morton’s Neuroma
Numbness, burning, cramping in the forefoot or the feeling of walking on a wrinkled stocking–these are the symptoms of Morton’s neuroma, a common foot problem that affects women more frequently than men.
Usually occurring between the second and third or third and fourth toes, Morton’s neuroma is caused by pinching, entrapment or degeneration of a nerve that passes through the forefoot.
Treatment usually consists of rest, switching to shoes with a roomier toe box and flatter heel and, sometimes, injections of corticosteroids. Surgery is reserved for difficult cases since it results in permanent loss of sensation in that part of the foot.
[SOURCE: Iliya Beylin, Ira M. Fox, Vijay J. Rajput, “Effective Approaches to Chronic Foot Pain,” Patient Care, January 15, 2002; Todd M. Van Wyngarden, “Common Forefoot Deformities,” American Family Physician, April, 1997]
Cool Your Heels
Plantar fasciitis can make you feel like you’re stepping on thumb tacks every morning for months on end. With patience, however, and self treatment the condition will eventually get better.
Plantar fasciitis typically plagues both active young adults and overweight middle aged individuals, particularly those who tend to over pronate, or turn their feet inward when walking or running.
Even though the pain can continue for 12 to 18 months, one study found that 89 percent of patients improved without surgery. The most important part of treatment involves stretching the feet and lower legs four to five times a day along with intermittent use of nonsteroidal antiinflammatory medications (NSAIDs) and use of an insert to cushion the heel.
[SOURCE: Marty Munson, “Heel Thyself: Find Foot Relief without Surgery,” Prevention, June, 1995; Iliya Beylin, Ira M. Fox and Vijay J. Rajput, “Effective Approaches to Chronic Foot Pain,” Patient Care, January 15, 2002]
Ridding Yourself of
Unsightly Fungal Nails
Starting as a discoloration of the nail, a fungal infection of a toenail eventually creates a thick, flaky, unsightly nail that is difficult to trim.
Once it has invaded the nail bed, a fungal infection is almost impossible to treat with over-the-counter remedies for athlete’s foot. Two oral prescription medications, both introduced in 1996, have been found effective in eradicating the infection in about half of patients although they are expensive and require several months of treatment. Also approved by the Food and Drug Administration is a prescription antifungal nail polish that must be applied once a day for up to a year.
[SOURCE: “Taking Steps Toward Good Health,” Harvard Women’s Health Watch, March, 2000]
When Pumps Cause Bumps
Doctors often refer to it as Haglund’s deformity, but pump bump is a more descriptive term for the painful ridge that develops at the back of the heel, usually from wearing high heel pumps. As the stiff shoe counter rubs against the heel, it irritates the protective bursa, causing redness and swelling.
The remedy is to reduce the pressure on the back of the heel by switching to sandals or shoes with a soft heel counter. Other helpful measures include use of a rubber heel cup, ice massage and nonsteroidal antiinflammatory medications.
[SOURCE: Todd M. Van Wyngarden, “Common Rearfoot Deformities,” American Family Physician, May 1, 1997; Eron G. Manusov, Wade A. Lillegard, Robert F. Raspa and Ted D. Epperly, “The Hindfoot and the Ankle,” American Family Physician, September 1, 1996]
REFERENCES:
Iliya Beylin, Ira M. Fox and Vijay J. Rajput, “Effective Approaches to Chronic Foot Pain,” Patient Care, January 15, 2002.
Michael J. Coughlin, “Women’s Shoe Wear and Foot Disorders,” The Western Journal of Medicine, December, 1995.
Stephen J. Dale, Daniel J. David and Ted F. Sykes, “Effective Approaches to Common Foot Complaints,” Patient Care, March 15, 1997.
Chike N. Okechukwu and Henry Schneiderman, “What’s Your Diagnosis?” Consultant, May, 1999.
Maggie Spilner, “Better Cures for Big Toe Woes: Stop Foot Pain Before It Stops You,” Prevention, October, 1996.
“Taking Steps Toward Good Health,” Harvard Women’s Health Watch, March, 2000.
Valerie J. Vullo, James K. Richardson and Edward A. Hurvitz, “Hip Knee and Foot Pain during Pregnancy and the Postpartum Period,” Journal of Family Practice, July, 1996.
Todd M. Van Wyngarden, “Common Rearfoot Deformities,” American Family Physician, May 1, 1997.
S.G. West and J. Woodburn, “Pain in the Foot,” British Medical Journal, April 1, 1995.
Todd M. Van Wyngarden, “Common Forefoot Deformities,” American Family Physician, April, 1997.
