Foot and Ankle
High Blood Pressure
On-the-Job Foot Health
Rear Foot Surgery
Active Women's Feet
As women move into the US
work force in greater numbers, a lot of them are finding that their
professional and white-collar employment brings job satisfaction, but
that it's tempered by other realities. One is that the new
responsibilities probably haven't replaced those of the woman's
once-traditional role as homemaker and mother.
Those roles remain, and
many women find themselves not only holding down a full-time salaried
position, but still doing the marketing, the child-rearing, the laundry.
Women probably were on their feet a lot more than men before work
outside the home beckoned, and their new situations certainly haven't
alleviated that. Their feet are taking even more punishment, and the
footwear that some feel obliged to wear in the work place may be playing
All this adds up to a
need for women to pay more attention to foot care, to avoid subjecting
themselves to unnecessary foot problems, particularly those that might
be caused by improper footwear and hosiery.
High Heels: Use and Abuse
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.
They know, for example,
that 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.
Toward Greater Comfort
If women persist in wearing
high heels, there are ways to relieve some of the abusive effects; they
can limit the time they wear them, for example, alternating with
good-quality oxford-type shoes or flats for part of the day. High heels
that are too tight compound the abuse; it's good advice to buy shoes in
the afternoon, since feet tend to increase in size later in the day.
Women have other
heel-size choices, fortunately. They don't have to endure pain at the
expense of their foot health. The key is wearing the right shoe for the
right activity -- and that means varying heel height, determining what
heel is most suitable.
For example, there are
comfortable and attractive "walking" pumps (also called
"comfort" or "performance" pumps) for women for work
and social activities. The shoe manufacturers who have introduced them
seek a marriage of fashion considerations and comfort, offering
fashionable pumps with athletic shoe-derived construction, with
reinforced heels and wider toe room. They are using space-age materials,
like long-lasting memory cushioning that acts as a shock absorber. And
the soles are more pliable. At least three lines of walking pumps have
the use of the American Podiatric Medical Association's Seal of
Several companies have
also designed footwear for certain athletic activities, including
aerobics, specifically for women.
Perhaps the best shoe for
women, from an orthopedic point of view, is a walking shoe with ties
(not a slip-on), a Vibram type composition sole, and a relatively wider
heel, no more than a half or three-quarters of an inch in height -- even
though such a shoe may not be widely acceptable in the work place.
What About Stockings?
Women who always wear nylon
pantyhose are also inviting foot problems. Nylon is occlusive -- it
doesn't breathe -- and the heat that it generates and traps causes
excessive perspiration. A warm, damp area is an ideal place for the
encouragement of fungal infections such as athlete's foot. (Pantyhose
aren't the only apparel that cause excessive perspiration; the dress
boots and shoe boots many women don in cold weather shouldn't be worn
all day in an office.) Nylon, which tends to be abrasive, is even more
so when it's damp; in a tight shoe that's already irritating, it offers
little protection against blisters. Support hose, because they're so
much tighter, can be the worst culprits of all.
pantyhose can also cause forefoot problems, because the stretch
mechanism constricts normal expansion of the foot when walking, and may
pull the toes backward when the pantyhose ride up. The cramping and
pressure of the hose can contribute to ingrown toenails and hammertoes.
A better quality nylon will provide a better fit, and the better the
fit, the less likely it is that cramping will occur. Women's feet have
grown larger because of improved health care and nutrition. The
one-size-fits-all stocking no longer is the universal answer, if it ever
was. Attention to proper fit is essential.
Pregnant women need to
observe good foot health to prevent pain and discomfort. Since the body
undergoes changes and acquires a new weight-bearing stance, women should
wear shoes with broad-based heels that provide support and absorb shock.
Additional body weight also calls for more support, to prevent foot
The expectant mother
often experiences more than ordinary swelling of her feet and ankles,
which can aggravate existing foot conditions and promote inflammation or
irritation. Pregnancy also triggers the release of hormones which
enhance laxity in ligaments, which can contribute to foot strain. If
problems develop, she should see a podiatric physician.
Women Over 65
Older women have more trouble
with their feet than younger ones, for the simple reason that fat pads
on the bottom of the feet tend to deteriorate in the aging process. They
can alleviate some foot problems by wearing properly fitted,
well-constructed shoes -- shoes which provide cushioning and have a
soft, flexible upper that will conform to the shape of their feet. They
also need leather shoes which "breathe" and can reduce the
possibility of skin irritation. Soles should be lightweight, with enough
flexibility and shock-absorbing quality to provide solid footing and not
be slippery. Low-heeled shoes provide greater stability, more protection
for the feet, and greater comfort. Because older women often have
circulatory problems, they have a special need to keep their feet warm
in cold weather, to prevent frostbite or chilblains.
Women's Foot Afflictions
Whether the sources are
congenital problems, foot abuse, high heels, poorly fitting shoes, or
other maltreatment of the feet, women are subject to a number of
afflictions involving the feet (most of which can also occur to men):
Achilles tendinitis: inflammation of the
Achilles tendon, the link between the calf muscle and heel bone. Those
who wear high heels regularly can expect to acquire shortened tendons;
switching to low heels for strenuous physical activity without
appropriate warm-up exercises creates an ideal scenario for Achilles
Bunions: misaligned big toe joints
which become swollen and tender. Bunions tend to be familial, 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 contracted in a claw-like position. Although the condition
usually stems from muscle imbalance, it is often aggravated by
ill-fitting shoes, socks, or hosiery that cramp the toes.
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.
Treatment includes orthotic devices and/or steroid injections, and
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. This condition is sometimes
caused by shoes that cramp the feet, especially in the arch area.
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 shoe counter.