Women's Feet
Women need to pay 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
Podiatrists generally find high heels to be
biomechanically and orthopedically unsound. There are medical, postural,
and safety faults of such heels.
We 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 follow the fashion trend. In a Gallup Poll, 37% of
the women surveyed said they continue to wear high heels, even though they are uncomfortable.
Toward Greater Comfort
There are ways to relieve some of the abusive effects of wearing
high heels; women 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 a good idea
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 and compromise their foot health. The key is
wearing the right shoe for the right activity -- and that means varying
heel height.
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 American
Podiatric Medical Association's Seal of Acceptance.
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.
Hosiery
Women who always wear nylon hosiery 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 fungal infections such as athlete's foot to grow. (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.) 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 even worse.
Inexpensive nylon 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.
Pregnancy
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 "breakdown."
The expectant
mother often experiences swelling of her feet and ankles which can
aggravate existing 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, one
should see a podiatric physician.
Women Over 65
As we age, the fat pads on the bottom of the feet tend to
deteriorate. Some foot problems can be alleviated by wearing properly
fitted, well-constructed shoes -- shoes which provide cushioning and
have a soft, flexible upper that will conform to the shape of your feet.
Leather shoes which "breathe" and will reduce the possibility of skin
irritation are also important. 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, there is a special need to keep their feet
warm in cold weather, to prevent frostbite or chilblains.
Self treatment is generally not advisable. Over-the-counter preparations contain acids or chemicals
that destroy skin cells, and it takes an expert to destroy abnormal skin cells (warts) without also
destroying surrounding healthy tissue. Self treatment with such medications especially should be
avoided by people with diabetes and those with cardiovascular or circulatory disorders. Never use
them in the presence of an active infection.
Foot Problems
Whether the sources are congenital problems, high heels, poorly fitting shoes, or other
maltreatment, women are subject to a number of foot problems (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 Tendinitis.
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 sometimes surgery.
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.