Mar. 02, 2001- When it comes to their feet, women can be their own worst enemies. Studies show that females are much more likely to suffer certain foot disorders - including toenail problems, corns, callouses, bunions, arthritis of the toes and joint deformities - than males. They are also much more likely to undergo surgery to repair foot problems.
Older women are especially vulnerable to foot pain - partly because fat pads on the bottom of the feet deteriorate with age. In one 1998 U.S. study, 14 percent of more than 1,000 older women surveyed reported chronic and severe foot pain in the previous year. The research also found a link between severe, chronic foot pain and disability.
Why are women's feet such a problem?
While genetics and hormones certainly play a role, a major source of poor foot health has been women's traditional choice of shoes, says Lynn Carter, an occupational therapist and director of the Foot Care Centre at Sunnybrook and Women's College Health Sciences Centre in Toronto.
Besides contributing to sore, unhealthy feet, poorly fitting or improper shoes can affect how you walk and stand, which in turn can lead to a variety of health problems, including lower back, hip and knee pain, she says.
But growing numbers of women have started making better footwear choices, Carter adds. "Fortunately, the style of dress at work has become more casual in recent years. This has allowed more women, especially younger women, to opt for comfort over fashion." What kind of shoe should you choose?
Look for a shoe with a toe box (the front of the shoe) that's wide enough and deep enough to accommodate all your toes comfortably. There should be at least three-eighths of an inch of space between your longest toe and the tip of the shoe. Also look for sturdy arch supports, and a fairly thick sole to absorb shock when you walk on hard, flat surfaces. The upper part of the shoe should be made of breathable materials like leather. As for heel height, the ideal is about three-quarters of an inch, says Carter.
Always shop for shoes later in the day - to accommodate for normal swelling of feet and ankles - and have your feet measured every time. New shoes should fit comfortably before you buy them: snug but not too tight.
Are high heels are completely out of the question?
For many years, high heels - usually defined as pumps with heels two inches or higher - have been considered the height of female fashion. While proponents claim high heels lend women an air of sexuality, confidence, and femininity, health experts say they are deforming and unnatural.
Many studies have implicated high heels in causing or at least aggravating foot problems, By elevating the heel and pointing the foot unnaturally downward, they weaken the foot's natural arch, cause wear-and-tear on the ball of the foot and the toes, create unnatural pressure on skin, and dramatically change the dynamics of how women walk and move. Research has linked wearing high heels to an increased incidence of sprained ankles, lower back pain, and shortened Achilles tendons (in the lower calf, above the heel).
A recent U.S. study of 20 healthy women wearing high heels found that, when they walked, the torque (rotational force) on the inside of their knees was 23 percent greater than when they walked the same distance barefoot. Such twisting can damage cartilage over time and cause arthritis of the knee - a painful and disabling condition that is two times more common in women as men.
If you can't bear to throw away your high-heeled shoes, boots or sandals, you can minimize the damage they cause, says Carter. Wear them on special occasions only, and limit the amount of time they are worn - that means wearing them during the party, but walking to and from the event wearing flats. If you feel compelled to wear higher heels at your workplace, leave them under your desk: wear running shoes or flats to and from your job. Finally, to reduce wear-and-tear on your toes, make sure you buy high-heeled shoes that aren't too tight-fitting - a square or round toe-box is better for your feet than one that's pointed or narrow.
What about stockings?
Regular wear of nylon pantyhose can also invite foot problems. Because nylon doesn't allow the feet to "breathe," there may be excessive perspiration around the feet, which encourages fungal infections such as athlete's foot. When worn with tight shoes, tight-fitting nylons offer little protection against blisters. Tight hose can also constrict normal expansion of the foot when you walk, contributing to ingrown toenails and hammer toes.
When should you consider orthotics?
Many women who suffer from foot problems eventually explore the option of orthotics - custom-made, corrective devices designed to go inside shoes. When properly fitted and worn, orthotics can re-distribute the weight on your feet, deflect pressure, and help feet function more efficiently and normally.
"However, orthotics don't cure foot problems," Carter explains. "They are corrective devices like glasses or contact lenses." The custom-made inserts - which cost from a few hundred dollars up to $800 per pair - aren't for everyone. "The motivation for getting orthotics should be some kind of foot dysfunction or pain - for example, localized pain in the heel or ball of the foot, joint pain in the foot, ankle, knee or hip," Carter says. "Simply having flat feet isn't a reason for orthotics, since many people with such feet never develop any symptoms." While many shoe stores advertise that they test and measure customers for orthotics, she recommends consulting a foot specialist such as a pedorthist who is trained to analyze step and gait and who is expert in fabricating orthotics.
