Podiatry

Avoid the shoe blues this summer

When summer arrives, the whole pace of life changes — even what we wear. As sweaters and leggings give way to T-shirts and Capri’s, footwear also makes that welcome seasonal switch. No more Uggs: It’s sandal time.

But for some of us, that means a different kind of “ugh.”

Face it: Sandals bare everything from this squished little piggy to those dry heel pads crying for pumice stones. Even worse, there may be corns, calluses, hammertoes, bunions and unsightly sores brought on by two or three seasons hiding in ill-fitting, closed-toe shoes.

Yet Dr. Joseph Carbone, a podiatrist with Rochester Foot Care, says shoes alone aren’t to blame for the condition our feet are in.

“Most musculoskeletal problems of the foot are genetic or inherited and cause an imbalance in the foot,” he said. The wrong shoes just exacerbate the problem.

“You could say that a large percentage of people have a foot deformity, but not a lot are symptomatic,” he said. “A lot of men, for instance, have bunions but never seek treatment. They just wear wider shoes to accommodate the bunion.”

Not so for many women, since “fashionable footwear” for women rarely includes the word “wide.”

That’s what Brighton mom Jennifer Cintron discovered after living for nine years in Fort Lauderdale, Florida, where she wore flip-flops every day. When she left the Sunshine State in her mid-20s and donned fancy heels for jobs back up north, she discovered that her standard-width shoes no longer fit. Her feet had widened because of the lack of support from her flip-flops, she said. Now she’s stuck with D- and sometimes E-width shoes, which aren’t always available — or attractive.

Vexing as she finds that, Cintron is thankful to have avoided the foot pain that many women suffer. But some of those women willingly endure the pain — much to the chagrin of podiatrists.

That a 2014 survey of 1,000 women published in Today’s Podiatry showed that 49 percent of women wore high heels; of those, 71 percent had foot pain. With high heels, the higher the heel, the more pressure is placed on the ball of the foot.

“Many patients, even knowing that shoes will cause pain, will not change the shoes they buy,” he said. “So I try to minimize the damage. Regarding high heels, I encourage women to look for a lower heel (under two inches) and a wider toe box to lessen the pressure on the foot. Some women can tolerate buying a shoe a half-size larger, which gives them more room in the toe box.

“Sometimes having a metatarsal pad added to the shoe for cushioning helps. I also encourage women to limit the amount of time they spend in very high heels — if they are going out for an evening and want to wear a dressy shoe for a few hours, fine. But don’t try to make it all day in a very high-heeled shoe.”

Gruttadauria said women might develop pinched nerves in the ball of the foot because of the increased arch height, especially in a shoe with a narrow, pointy toe box.

“Using heels chronically can cause long-term problems, too, especially shortening of the Achilles tendon,” he said.

The other end of the spectrum, no heels, can cause problems, too (as Cintron learned). You should limit the time you wear flip-flops, Gruttadauria said. And he advises patients to look for ones with a molded foot pad, which offers a little more support.

“If you’re on vacation in the summer, don’t try to go on touring hikes or walk the boardwalk in them all day,” he said.

Besides high-heels and flip-flops, what shoe styles invite trouble?

  • Pointy-toe shoes that squeeze toes into too small a space, twisting, bending and curling them in ways nature never intended.
  • Platform shoes that have a rigid foot bed, preventing the foot from bending the way it needs to.
  • Plastic jelly shoes that don’t let the foot breathe, increasing the chance of fungal infections.
  • Any shoe that’s too tight.
  • Size matters

By some estimates, 90 percent of women wear shoes that are too small — some because they can’t stand the thought or look of wider, longer feet, and others because their shoes fit when they bought them, but suddenly don’t at another time. That problem, Carbone said, can be avoided by trying on shoes in the afternoon when feet are a bit swollen. Feet are at their smallest in the morning, which means shoes bought then will be tight by mid-afternoon.

Whether it’s vanity or an error, the impact of tight shoes can’t be overstated, given the painful bone and nerve damage they can cause.

Carbone’s go-to advice for foot pain is to wear shoes that fit right.

“If someone comes in with a terribly crooked second toe, corns, ulcerations, I’ll tell them to wear shoes with bigger toes boxes. Unfortunately, some patients won’t go for that,” he said.

“If someone won’t alter their physical activity or their shoes, their foot pain won’t get better.”

One of the more common painful foot maladies is plantar fasciitis, an inflammation of the thick band of connective tissue that stretches from the heel to the ball of the foot. Wearing shoes that support the arch area limits the pressure on the heel, preventing the painful inflammation.

Treatment ranges from icing, stretching and anti-inflammatory medication to surgery to lengthen the fascia, Carbone said.

No pain, no surgery

Unless you’ve done it yourself, you might be surprised to hear that podiatrists see numerous patients asking for foot surgery.

“We’ll have women who literally want to have surgery to fit into a certain shoe that’s how far some women will go to wear a shoe they love,” Gruttadauria said.

Carbone said surgery is an option if pain doesn’t respond to conservative treatment.

“But, if you’ve got a crooked toe, you shouldn’t have it broken to straighten it just to make it look better,” he said. “It might end up hurting after surgery if you do that.”

The good news …

Another summertime favorite is going barefoot, and Carbone said that, in moderation, walking in the sand without shoes has its benefits: It works the muscles and helps rub off the hard skin on the bottom of feet.

There is a “but,” however …

“The introduction of foreign objects is the biggest risk, especially for people with diabetes and peripheral neuropathy, because they can step on something without feeling it,” he said. “That’s how people end up with terrible conditions.”

Go-to shoe advice

Overall, there are things you can do to protect your feet from shoe-inflicted damage.

  • Make sure new shoes bend at the toe box but aren’t too flexible.
  • Don’t assume that an expensive shoe is the right shoe for you.
  • Consult a doctor about foot pain, “especially if it doesn’t resolve quickly with a change in shoe or a change in activity,” said Dr. Gruttadauria of UR Medicine.
  • Get your foot measured periodically to be sure you’re getting the right size shoe (shoe size can change over the years).
  • Don’t try removing thick calluses on your own. “One of the biggest things we see is people going to the store and buying callus or corn removers and inadvertently burning a wound on their foot,” Gruttadauria said.
  • Consult a podiatrist before buying an orthotic to be sure that you’re getting the right one for your specific condition.
  • Pedicure primer

Summer is pedicure season, too, so Dr. Michael Gruttadauria said there are a few things to keep in mind:

  • Nails can pick up the pigmentation of polish and any chemicals that are in the polish, which will make them more prone to flaking. So, let your nails remain unpolished for a while between pedicures to reduce the risk of fungus.

  • Don’t make a pedicure a one-stop foot-care visit. Letting a pedicurist remove corns and calluses and address ingrown toenails can cause bigger problems. “I worry about infections,” Gruttadauria said. He advises women to leave those treatments to a medical professional.

 

 

 

 

 

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s