We take them for granted and literally walk on them all day; our feet are a biological masterpiece and will walk you through life IF you take care of them. John Femino, MD, orthopaedic surgeon at University of Iowa Hospitals and Clinics, talks about the foot:
Medically speaking, how complex are our feet?
The human foot and ankle is very complex and comprised of 30 bones and has as many joints associated with those bones. In addition to that, these are all connected by multiple ligaments and their motions are controlled by 10 major muscles and tendons that come from the leg, in addition to several muscles that are contained within the foot itself.
All of these structures have to work together in exquisite synchrony in order to allow us to have the most basic functions of walking and standing, let alone athletic activity.
What foot medical problems are considered hereditary?
Many people consider certain foot deformities, such as flat feet, high arches, bunions, and other toe deformities to have a hereditary component or basis. The toe deformities in particular, however, can be affected by external factors, most commonly tight fitting shoes.
How much of foot problems come from a lifetime of abuse or neglect?
That is somewhat difficult to say with regard to problems such as flat feet, where some people suspect that obesity has a wear-and-tear effect on the structures that hold up the arch. But it is well accepted that tight shoes will cause the toes to become deformed, making bunions or hammer toes deformities that can become problematic for people over time.
Is there ever a time to just ignore foot pain?
Well, we all experience aches and pains all over the body, and I think that the common sense approach of trying to modify activities; and in the case of your feet, maybe changing shoes to see if that's affecting the pain, is a first step. Certainly any pain that persists for a number of weeks or months is something that one might consider seeing your primary care physician about as a first line of diagnosis.
How important is proper shoe fitting and alternating wearing several different pairs of shoes?
Certainly with running and a lot of the impact sports that people engage in, having proper shoes that allow for stability or cushioning, shock absorption, are very helpful. Trying to run in a very unsupportive shoe can lead to problems and pain in the foot.
How important it is to wear the right shoes for the right activity - running, cycling, or soccer for instance?
The general recommendations we talked about earlier, having the shoe fit properly so that the toes aren't scrunched up or the foot isn't properly supported being a problem, those still apply. But certainly, cycling shoes, for instance, are designed to enhance performance by having a rigid sole; soccer shoes are often designed to give a certain balance between flexibility and support. But ultimately, one has to pay attention to feet and make sure that pain is not being ignored, because that is the best indicator of a shoe problem.
How stressful is being overweight or obese on our feet?
Obesity is a huge problem nationwide and it affects so many areas of our health in general, but with regard to the feet, I see many patients who come in and even if they're not severely obese, they're still overweight by 20 or 30 pounds. What a lot of people do not realize is that for every pound of body weight, our foot and ankle joints and tendons see a multiplied affect because of the muscle forces that are required to hold us upright with standing and walking.
As an example, the ankle can see four times body weight with certain activities; the Achilles tendon, for instance, can see 10 times body weight with running. For that reason, even a modest amount of weight loss can in some cases lead to the pain in the foot or ankle going away.
Is walking barefooted hard on feet? Why?
That's an interesting question. Some people believe that walking barefoot, being more natural, if you will, allows for development of the small muscles within the foot and that actually provides for healthy activity for the feet. That is probably true when walking on soft surfaces like grass or perhaps sand. Although, in some cases, if you have an underlying problem in the feet, that can be difficult. Walking on hard surfaces is most likely to give people problems and that is certainly where having supportive and comfortable shoes is most important. I would like to point out that anyone with neuropathy or loss of sensation in their feet, which is common in diabetics, should never walk barefoot because of the risk of cutting or damaging the foot and potentially getting an infection. So we counsel all of our diabetic patients to avoid walking barefoot, even when they are in the house.
What is your best advice to keep our feet healthy throughout our lives?
I think to summarize what we've talked about, having comfortable fitting shoes that are appropriately supportive and keeping our body weight in a ideal range, if you will, or close to ideal body weight, are all important. In addition to that, regular exercise, especially low-impact aerobic exercise, is the best way to maintain good flexibility as well as strengthen the muscles to help support the joints and protect the tendons and ligaments. |
