Prevention & Recovery

Why healthy feet are really important!

Photography by Jeff Coulson/TC Media Author: Canadian Living Credits: Photography by Jeff Coulson/TC Media

Prevention & Recovery

Why healthy feet are really important!

Flip-flops have been around since ancient Egypt, but that doesn't mean they're good for your feet. Still, it's hard to resist their elegant and simple design (especially when adorned with the Tory Burch logo). I'm a self-confessed flip-flop junkie and, because I work from home, you'll rarely see my feet in anything else from June to August. Since I spend a lot of time at a desk, my feet have been OK with that. But after I had my first baby and spent hours walking the city with a stroller, I found myself at the physiotherapist's office with pain on the top of my feet and a case of "flip-flopitis."
 
"Flip-flops [at a foot specialist's office] are akin to sugar at a dentist's office," says Jeffrey Cowen, a chiropodist in Toronto. "They're not OK – though they're better than bare feet." Their lack of support just about everywhere makes them your feet's worst nightmare when worn for more than just a casual walk.
 
I admit to wearing flip-flops too much, and I know I need to take better care of my feet. Twenty-five percent of the body's 212 bones are in the feet. If any of these bones – or the ligaments, tendons and muscles that surround them – become misaligned or stressed, the effects can be felt anywhere in the body. "It's common to experience hip pain and have no idea that it's because of what's going on in our feet," says Cowen. Because I turned 40 last year and decided that it's time to start taking care of myself, I figure there's no better place to start than my feet. There's a lot to know about keeping your feet in top shape, but the good news is, small changes can make a big difference – and you get to keep your high heels!
 
Get a foot assessment
Consider having your feet assessed. Book an appointment with a podiatrist or chiropodist to get a gait analysis (which involves a comprehensive assessment of the way you walk) to alert you to any problems. "The earlier you find a problem and treat it, the better," says Cowen. Medicine is becoming more proactive, so you may be able to ward off larger problems by using orthotics, arch supports or even a different type of socks. 

Baby shoes 
There are so many things to worry about in your baby's first year; luckily, footwear isn't one of them. Once your child starts to walk, however, his feet need shoes that have supportive, shock-absorbing soles and firm heel cups. "If you hold the heel, the rest of the foot often falls into alignment," says Adrienne Walker, a physiotherapist in Mississauga, Ont. Don't worry about arch support until age four or five, when your child's feet slim and develop arches and smaller muscles. 
 
Young feet can change by two to four sizes a year, so it can be tempting to buy shoes a little too big to allow for growth. But avoid buying them more than half a size too big, or else your child's feet won't be properly supported. Hand-me-down shoes aren't ideal either, because shoes tend to form to feet and lose support in the midsole.
 
Should your child visit a podiatrist?
If you're worried about the way your child walks, get a gait analysis done at age three or four. Many foot problems are hereditary, and finding them early makes them much easier to treat. If your child has any foot, leg or back pain, or trouble walking, he should see a podiatrist. Low muscle tone and hypermobility (joints that stretch farther than normal) can make walking a challenge, but a simple orthotic can make all the difference. 
 
Janice Brownlee,* a mom in Oakville, Ont., was troubled that her son Palmer wasn't walking by 18 months. She asked their doctor to run tests to rule out muscle disease. At 21 months, Palmer had his first visit to the physiotherapist, who suggested orthotics to correct laxity in the boy's knees and ankles. Within one week of wearing orthotics, Palmer was standing, and within three weeks, he was walking. "Orthotics have been life-changing for us," says Janice, who also suffers from hypermobility and has worn orthotics since age 25. "I probably could have saved myself a lot of pain by getting treated as a kid." 
 
A runner's foot
Foot problems among runners are extremely common but can usually be prevented by strengthening the shin area, stretching the calves and addressing pain as soon as it occurs. Every runner should get a gait analysis done to discover any potential problems and make sure they are running in the right shoes. Sports shoes have come a long way since the first sneakers were developed in 1873, but even with all the new technology, most people still don't have shoes that fit – and that's a serious issue. A study at Loyola University Medical Center in Illinois found that most injuries occur because of improper shoes, socks or training. Learn whether you're a supinator (your feet tend to roll out) who needs a cushioned shoe, a normal pronator (you have a slight inward roll that allows you to push off evenly from the front of your foot) who needs a shoe with moderate support or an overpronator (your feet have an excessive inward roll) who needs heavy support. 
 
Your running shoe shouldn't fit like a street shoe. If you run distances of 5K or more, your runners should be at least a half-size bigger to allow your foot to expand and move. Once you find running shoes that fit, you can use them for any activity that involves forward motion. "If you play squash or tennis, you need a court shoe, because there's a lot of lateral motion, but a running shoe covers most other activities," says John Stanton, founder of the Running Room. You should replace your runners every 500 to 800 kilometres.
 
Is barefoot running for you?
As the shoe industry strives to find the lightest training shoe possible, some runners are choosing to forgo footwear altogether. Stuart Wroden, an associate professor at Indiana University–Purdue University Indianapolis, says running barefoot changes your gait, reducing the force of impact. However, the heel cushions and arch supports of modern shoes have actually made our feet weaker, thus increasing our risk of injury when we run without shoes. Jeffrey Cowen, a chiropodist in Toronto, isn't a fan of barefoot running. "It only works if you have a perfect foot and leg structure," he says. "Plus, you might step on something and injure your foot." Although running sans shoes might be trendy, most experts say it's best to stick with proper footwear.
 
Top sports that cause sore, achy feet 
1. running
2. hiking
3. basketball
4. fitness walking
5. dancing
 
Tred wisely
For many women, pregnancy will be the first time they notice changes in their feet. A 2013 study in the American Journal of Physical Medicine & Rehabilitation found that increased weight on pregnant women's joints, combined with greater laxity due to hormones, can lead to permanent structural changes in their feet. Loss of arch height and increased foot length are two of those changes, and they are most pronounced during the first pregnancy, so it would be helpful to visit a podiatrist in your first trimester if you are having problems with your feet. "Orthotics will support your feet and can decrease changes," says Dr. Sheldon Nadal, a podiatrist in Toronto.
 
Everyone will experience some loss of bone density and protective fat padding with age, so there's not much you can do, aside from paying attention to any new pain and visiting a podiatrist every year or two. "Around age 30, the fat pads start to dissipate, and by age 60, about 50 percent will be gone," says Robert Thompson, executive director for the Institute for Preventive Foot Health. Wearing the right socks can help forestall the erosion of fat pads. "Cotton is the worst thing you can put on your feet, because it absorbs moisture well but doesn't know what to do with it, creating friction," says Thompson. Opt for acrylic-blend socks with defined toes and heels.
 
There are three problems that spell trouble for your feet at any age: arthritis, vascular conditions and diabetes. Arthritis can cause a host of issues, including bunions and stiffness, but physiotherapy may help. People with vascular disease need to pay special attention not to get a cut on their feet, as it may take a long time to heal or may not heal at all. Lastly, foot ailments for people with diabetes are a major concern. Of the 15 percent who develop foot ulcers, between 14 and 24 percent will have some sort of foot amputation. The biggest obstacle for people with diabetes is the loss of feeling in their feet, so they don't know if something is wrong. "It's a broken alarm system," says Dr. Timothy Kalla, a podiatrist in Vancouver. It's crucial that those who have diabetes be aware of this problem, have their footwear professionally fitted and try to see a foot professional every few months.
 
Wearing heels
Upper-class men had heels added to their footwear in the 1590s due to Persian fashion influences. Ironically, women's heels didn't really take off until 40 years later, when another fashion trend masculinized women's attire. It wasn't until the 18th century that heels started to be considered feminine, and women have been lusting after this (often painful) style ever since.
 
But you don't have to give up your high heels – provided they don't cause you too much pain. "When a woman wears uncomfortable heels and her feet hurt at the end of the day, that means there is inflammation," says Dr. David Agus, author of The End of Illness (Free Press, 2012). Inflammation is the root cause of many diseases; inflammation anywhere – even in your feet – is bad for your overall health. 
Wearing heels shortens the calf muscles and Achilles tendons, but doing simple stretches throughout the day can help alleviate the pain. Try stretching your calves, flexing your toes back and forth or trying to pick up a marble with your toes.
 
Comfortable shoes are important
Life isn't always fair. Like the miserable stepsisters learned in Cinderella, some women's feet are just better suited for glass heels. Women with thin feet, no family history of bunions and little flexibility fare better in heels. That doesn't mean you should shun heels if you have wide feet; just shop around a little more. Some brands are a better fit for certain foot shapes. Find one that works for you and stick with it. Shoe shapes tend to be relatively similar within particular brands.
 
"Invest in a few quality pairs of shoes rather than a lot of trendy ones," says Dr. Phil Vasyli, an Australian podiatrist and founder of Orthaheel. He recommends half-inch to one-inch heels to help reduce overpronation. And make sure your toes aren't being pinched into narrow or pointed-toe pumps. Vasyli also advises women to wear wedges instead of stilettos to provide greater stability while walking.   
And quality matters when it comes to comfort. Cheaper synthetic shoe materials don't form to feet or allow them to breathe. Even leather shoes lined with a cheap synthetic won't be as comfortable as 100 percent leather shoes.
 
Although you should be brand loyal, experts recommend buying shoes in a variety of styles and heel heights. Pressure points and the angle of your feet both change drastically with the height of your heels. Varying that height will prevent any one area of your feet from having too much pressure placed on it. In general, higher heels are worse for your feet because they increase pressure placed on the balls of your feet. "With a one-inch heel, 20 percent of the pressure is on the ball of the foot," says Dr. Jonas Eyford, a Toronto-based chiropractor. "That number can increase to 53 percent in a two-inch heel and 76 percent in a three-inch one." Once you get over three inches, things get much worse, so try to avoid super high heels unless it's a special evening (one that doesn't include all-night dancing). To increase the comfort of your favourite pumps, order custom orthotics made especially for heels. Slim-fit technology orthotics can fit into even strappy stilettos.
 
Summer shoes
Finding the perfect summer footwear is all about that balance between breathability, comfort, support and, of course, style. Ideally, sandals should offer heel support, straps over the toes and arches that form to your feet. "If there's a little cup in heel, the shoe will be so much more comfortable," says Vasyli. You also want shoes with soles that have complete contact with the bottoms of your feet. When trying on shoes, turn your feet sideways in front of the mirror so you can see your arches. Wedges are great because they ensure that your weight is evenly distributed over the bottoms of your feet, and these shoes tend to have a greater curvature under the arches. A lot of people worry about the safety of loose-fitting Crocs (especially for kids), but they're actually quite good shoes. They offer some heel support and curvature on the bottom. However, like adults, kids should steer clear of flip-flops.
 
Smelly feet
For some people, sweaty feet are more than just a mild annoyance. If you feel like you can't wear certain shoes, or you are afraid to go barefoot because of excess sweat, you likely have hyperhidrosis, or overactive sweat glands. There are over-the-counter liquid antiperspirants that can be applied at night to helreduce sweat, but most people need something a little stronger. The solution may be Botox. Twice-yearly Botox injections to the feet block the signal that causes sweating. Other than minor pain during injection 
and some bruising, there are no side-effects to this treatment. "Most people who have hyperhidrosis in their feet also have it in their hands," says Dr. Nowell Solish, a cosmetic dermatologist and assistant professor at the University of Toronto. "We usually try Botox in the hands first, as it sometimes will also positively affect the feet." 
 
*Name has been changed.   


This story was originally titled "Walk This Way" in the August 2013 issue.

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We have everything you need to know about healthy feet, including some ways you probably don't realize you're wrecking your feet and quick fixes for summer ready toes!
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Why healthy feet are really important!

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