Active Feet for Active Women

Women have more options in their lives now than ever before. Whether a lawyer, sales associate, executive, executive assistant, writer, doctor, or stay-at-home mom, the demands made on the daily lives of women can cause excessive demands and ultimate retribution to their feet. Healthy feet are important to keep you on the go!

Pumps, flip-flops, stilettos, and flats—women have almost as many options in shoe wear as they do professions. Great looking shoes have always been important to many women no matter what the daily demands of their feet are! Unfortunately, great looking shoes often lead to feet that are not so great looking, or not so great feeling.

Foot pain is not normal. A study conducted by the American Podiatric Medical Association (APMA) in 2004 found that 31 percent of those interviewed had foot or ankle problems within a year’s time. We all know that when your feet hurt, you hurt all over, but when we neglect listening to our body’s complaints, we allow small problems to progress into big problems. Hereditary foot deformities, workplace shoe restrictions, daily wear of hosiery, and busy lives all add up to the need for women to pay more attention to their foot care to avoid subjecting themselves to unnecessary foot problems.

High Heels: Use and Abuse

The wearing of high-heeled shoes is a prime example of how women demand more than their feet can really handle! Heels over two inches high change the way a woman normally walks, and heels over three inches put seven times the pressure on the ball of the foot! High heels may also contribute to knee and back problems, ankle sprains, shortened calf muscles, and an awkward, unnatural gait. In time, continual use of high heels may even make wearing flatter shoes impossible. Most women admit that high heels make their feet hurt, but they tolerate the pain in order to look taller, stylish, and more professional. Another APMA study found that 39 percent of women still wear high heels every day as a fashion statement. The good news is that the percentage is down from the 60 percent who wore heels daily in 1986. The same study found 42 percent saying that they would wear shoes that were uncomfortable, and 73 percent admitted to having a shoe-related problem.

Fashion today even has women wearing high heels with jeans. If you insist on wearing high heels, they are ways to reduce some of their abusive effects:

• Limit the time you wear heels above two inches in height.
• Alternate the height of heels in order to prevent the achilles tendon from tightening and shortening.
• Choose a wider, more stable heel.
• Never wear a heel that causes imbalance.
• Choose a shoe that allows ample room for the toes (wider toe box) and only wear pointed toes that narrow well past the ball of the foot.
• Shop for shoes at the end of the day to allow for normal daily swelling.
• Wear appropriate shoes for athletic activities.

Fortunately, women have other heel choices. There are comfortable and attractive walking pumps suitable for women at work and at social activities. The shoe manufacturers have introduced these comfort or performance pumps to offer a compromise of fashion and comfort. These shoes are often constructed as athletic shoes and have reinforced heels, a wider toe box , and more pliable soles. The APMA has awarded its Seal of Acceptance to several lines of walking shoes from various manufacturers.  Visit www.apma.org for a list of shoes holding the APMA Seal.

Flip Flops Can Be Even Worse!

Flip flops bring on their own set of problems, as do flats. Shoes that do not provide any arch support allow a foot to act as if it were barefoot. While this is recommended in children who are just learning to walk, adults need shoes with good support to assist their feet in carrying the body’s weight and force. It is common for women to have flat feet. Some have had flat feet all their lives, and others have developed the condition over the years. A flexible flat foot (one that has an arch when sitting, but diminishes when standing) can be worse than a foot that is flat with or without standing. Without support, the flat foot will likely develop bunions, hammertoes, and tendon inflammation. Many podiatrists feel that unrestricted flat footedness is the evil of all foot problems.

When shopping for any type of shoe, APMA recommends the "three-step test" be used. First, the shoe should bend where your foot bends naturally, at the ball of the foot. Second, the shoe should not twist from side to side. Finally, squeeze the back of the heel to ensure that it will firmly hold the heel. The "three-step test" can also be found at www.apma.org.

What about Stockings?

Women who always wear nylon pantyhose are also inviting foot problems. Nylon is occlusing—it doesn’t breathe—and the heat that it generates and traps causes excessive perspiration. A warm and damp area is an ideal place for the development of fungal infections, such as athlete’s foot and fungal nails. Nylon, which tends to be abrasive, is even more so when it’s damp; in a tight shoe that’s already irritating, nylon offers little protection against blisters. Support hose, because they are so much tighter, can be the worst culprits of all. Unfortunately, going without nylons can be equally damaging to the feet. Friction blisters, excessive pressure, and irritation can occur when the skin is directly against the shoe.

Inexpensive nylon pantyhose can also cause forefoot problems. The stretch of the material constricts normal expansion of the toes when walking. The cramping and pressure of the hose can contribute to ingrown nails and hammertoes. A better quality nylon will provide a better fit and lessen the chances for cramping. A stocking that fits properly is essential to the comfort and health of your toes, as much as it is to the comfort and health of your entire lower body!

Pregnancy and Feet

Pregnant women need to observe good foot health to prevent pain and discomfort. The increase in hormones that allow for a woman’s body to loosen in preparation for child birth also causes loosing of the support structure of the foot. Women should wear shoes with broad-based heels that provide arch and heel support and absorb shock as the additional body weight increases the demand for support. Proper sizing of shoes is very important both during and after pregnancy as the surge in hormones can cause a change in foot size, which may end up being permanent.

Women often experience more than ordinary swelling of their feet and ankles when pregnant, which can aggravate existing foot conditions and promote irritation and discomfort. While your ob-gyn may recommend compression stockings, Dr. Robinson prescribe custom orthotic devices that are often extremely helpful in eliminating these painful effects on the feet.

Foot Health and Aging

Older women often have more trouble with their feet than younger ones, especially if they have ignored their feet in the past. Age can also bring on new problems, such as the deterioration of the fat pads on the ball of the foot. Some of this pain can be alleviated by wearing properly fitted, well-constructed shoes that provide cushioning and have a soft, flexible sole. We provide custom shoes in our office as well as custom orthotic inserts. Low-heeled shoes provide greater stability, more protection for the feet, and greater comfort. Soles should be lightweight, flexible in the ball of the foot, and provide shock absorption. Older women with circulatory problems need to make sure that they wear appropriate hosiery to keep their feet warm.

My Aching Feet!

Whether the sources are congenital problems, improper treatment of the feet, high heels, improperly-fitted shoes, or a combination of causes, women are subject to may afflictions involving the feet..

Metatarsalgia: A general pain in the ball of the foot, often caused by wearing high heels. The condition may be caused by the degeneration of the fat pad, bursitis, tendonitis, or a stress fracture. Pain at the ball of the foot may also represent a rupture of the connective tissue padding under the ball of the foot. This rupture in younger women, as well as older women, can lead to a dislocation of the toe, what is called a "cross over" toe when the toe crosses over to the adjacent toe.

Bunions: A misaligned big toe joint that causes the great toe to move toward the second toe and presents a prominent bump at the base of the great toe. Bunions tend to have a hereditary component, but the tendency is often aggravated by shoes that are either too tight or narrow, or don’t allow for proper function of the foot. Women with flat feet are likely to develop bunions, which can also lead to painful arthritis.

Hammertoe: A condition in which the toe is bent or contracted in a claw-like position. The toe can be flexible or rigid, and the condition usually stems from muscle imbalance that is aggravated by ill-fitting shoes or hosiery that cramps the toes.

Neuromas: Enlarged benign tumors of the nerves between the toes. They are often associated with high heels or tight fitting shoes and can cause a variety of symptoms, ranging from sharp pain to tingling or numbness in the toes, to a sensation of walking on a lump.

Achilles tendonitis: Inflammation of the achilles tendon often occurs at the back of the heel where the calf muscle tendons attach to the heel bone. While this is found in men and women who have a congenital short achilles tendon, tendonitis is often found in women who wear high heels daily without allowing the tendon to relax. Achilles tendonitis is not only painful, but increases the chance for the formation of bone spurs and tearing of the achilles tendon.

Tendonitis within the arch: Flat feet can cause excessive use of the muscle of the arch, which can become inflamed, swollen, and painful. The lack of arch support in a shoe, excessive weight, and aging can all contribute to this debilitating condition. While this can become a chronic problem in older women, young women can suffer from this acutely.

Heel pain: Inflammation of the long band of connective tissue on the bottom of the foot is called plantar fasciitis, and is very common in both men and women. This condition may be exacerbated by a lack of proper arch and heel support either from inadequate shoe wear or going barefoot. All foot types may experience either plantar fasciitis or heel spurs, which often develop along with the inflammation.

"Pump Bump": An enlargement at the back of the heel bone is present on many people, and women who wear pumps often get pain from irritation and inflammation of the bone. Although any shoe may be a problem, the pump-style shoe is the most common style to irritate the bone in the precise area. The condition is also known as Hagland’s deformity.

These are just examples of the many types of foot problems that affect women on a daily basis. If you suffer from foot or ankle pain, it is important to make an appointment before a small problem becomes a much larger problem. Very often, it is much more difficult to treat a condition once it becomes chronic. Treatment options for foot problems may include rest, padding, shoe alterations, cortisone injections, immobilization, physical therapy, custom orthotic inserts, and surgery when all else fails. Contacting our office will be the best option for you when treating your foot and ankle problems.