Foot and Ankle
High Blood Pressure
On-the-Job Foot Health
Rear Foot Surgery
Seven Miles Overhead
When it comes to the feet,
unfortunately, the cabin of an airplane can be a uniquely unfriendly
Being a flight attendant
requires walking backwards at steep angles, up and down cramped aisles,
seven miles high, pushing and pulling 250-pound carts that are
unexpectedly shaken and jostled by turbulence without notice, and
getting tripped by passengers whose crossed legs and carry-on baggage
creeps into the aisle.
After work, it's walking
on what seems like miles of non-yielding concrete floors or airport
corridors, only to turn around and do it again the next day, and then
Foot problems are
sometimes painful enough to be debilitating, but more often hurt just
enough to be a chronic workplace nag - ignored at the start of a shift
and nearly unbearable by the end.
Several kinds of doctors
can treat foot problems. Podiatric physicians, with four years of
medical school as well as additional postdoctoral training, can make
independent diagnoses and judgments regarding treatment, prescribe
medications, and treat all foot and ankle problems medically and in some
Conservative treatment by
podiatrists can prevent, reverse, and often alleviate foot problems
before they become debilitating. Patients often feel better after a
Four Times Around the World
With 26 bones (the two feet
contain more than a quarter of all bones in the body), 33 joints, a
network of more than 100 tendons, muscles, and ligaments, and scores of
nerves and blood vessels, the human foot is a biological masterpiece.
The components of the
feet intricately work together all the time, sharing the tremendous
pressure of daily living. An average day of walking brings a force equal
to several hundred tons to bear on the feet. The average person walks
about 115,000 miles in a lifetime, or more than four times around the
complexity and daily stress make foot problems among the most common
health complaints. Studies show at least three-quarters of Americans
will experience foot problems of some degree of seriousness in their
lifetimes, but only a small percentage of them actually seek
professional treatment. Most suffer unnecessarily from foot pain.
This results from a
common misunderstanding that foot pain is normal. Foot pain is most
definitely not normal. Healthy feet are a key element in doing a job
well, especially for people like flight attendants, whose jobs require
them to constantly be on their feet.
Helping Feet Stay Healthy
ailments that can be effectively treated by podiatrists include:
Plantar fasciitis (heel pain).
This inflammation of the
the long band of connecting tissue running from the heel to the ball of
the foot, is a main cause of heel pain. Sometimes precipitated by faulty
biomechanics, or abnormalities in gait, heel pain can be treated with
orthoses which restore the foot's proper balance. Often caused by shoes
that cramp the feet in the arch area, especially women's pumps, the
condition is treatable medically through anti-inflammatory medication,
padding, and orthoses.
Heel spurs. Repeated strain on the
plantar fascia sometimes pulls away the band's attachment
to the heel bone. Bony tissue may build up, creating a heel spur. These
growths, identified through X-rays, are treated with anti-inflammatory
medication, padding, and orthoses. In severe cases, surgery may be
Metatarsalgia. A general term for
pain in the ball of the foot, metatarsalgia can be caused by many
problems, such as tight shoes, calluses, and high heels. Conservative
treatment can effectively alleviate the pain of metatarsalgia.
Bunions and hammertoes. Although
they tend to be hereditary, bunions and hammertoes are often aggravated
by ill-fitting footwear. Bunions are misaligned big toe joints, which
swell and become tender. Hammertoes result when the toes contract into a
Enlarged, benign growths
of nerves, most commonly between the third and fourth metatarsal bones,
result in pain, burning, or a tingling sensation in the foot. Orthotics,
cortisone injections, and oral medication are used to treat neuromas.
The Foot Specialist
Regular visits to a
podiatrist, the foot specialist, will help your feet stay healthy and
pain-free through prevention and early detection of problems. Systemic
diseases, such as diabetes (which often goes undiagnosed) and
circulatory problems, are frequently spotted first in the foot.
As part of an integrated
medical team, podiatrists can identify these pathologies, treat
manifestations in the foot, and refer patients to other specialists for
care in other areas of the body.
If your feet already
hurt, there are a variety of conservative treatment methods at a
podiatrist's disposal. Custom shoe inserts known as orthoses can solve
many painful problems by redistributing the bodyıs weight on the feet.
Inflamed muscles and joints frequently can be treated with oral or
injected anti-inflammatory medication. Casting, strapping, and padding
also help alleviate minor foot discomfort.
In the case of bone
malformation or other problems causing serious pain and difficulty
walking, a podiatrist may recommend surgical intervention.
Although footwear regulations
for flight attendants vary among carriers, some flight attendants now
have the opportunity to wear attractive shoes that are also comfortable
and promote good foot health while at work in flight. Women who are
required to wear heels in airports, or feel that they are, should get
out of them and into comfortable, supportive shoes as soon as possible.
As a rule of thumb, women
should never wear heels higher than one and one-half inches. Wider heels
offer more support than narrow ones. Podiatrists recommend a new breed
of "walking" pumps (also known as "comfort" or
"performance" pumps), designed to blend fashion considerations
and comfort during long work hours.
The best shoes for men
are good quality oxfords, ordinarily associated with wing-tip or cap
designs. For both sexes, podiatrists say, shoes constructed of materials
that "breathe," as well as support and cushion the feet, are
essential for flight attendants.
When shopping for shoes,
always have both of your feet measured while standing. Try on both
shoes, and walk around the store for a few minutes to get a good feel of
Be aware that one foot
frequently can be slightly larger than the other, and always buy for the
larger foot. Don't rely on the size of your last pair; shoes sizes
differ among manufacturers, and adult feet do get larger. Shop for shoes
late in the day, when feet naturally swell slightly. Finally, only buy
shoes that immediately feel "right." Don't rely on hopes that
a "break-in" period will make an uncomfortable shoe feel
better. That really doesn't happen.
Information You Can Use
The American Podiatric
Medical Association (APMA), which represents 75 percent of practicing
podiatric physicians (the major providers of foot care services in the
United States), is committed to helping flight crews enjoy long,
pain-free careers on their feet.
If you suffer from foot
problems and receive your health care in an HMO setting, ask your
primary care doctor to refer you to a podiatric physician, the most
thoroughly trained foot specialist. Your ability to perform well at
work, and your good health, may depend on it.