Friday, December 21, 2012

Monday, December 17, 2012

Foot Pain & High Heels Q&A:

Do a lot of people come in with foot pain as a result of wearing heels?

High heels are a western society icon for dressing well and making a fashion statement for today’s women. Wearing high heels can come with a cost beyond the price tag. Foot pain from wearing heels can occur in virtually any part of the foot. Because the heel is elevated, body weight is taken off 
the heel and driven through the mid-foot into the forefoot. Most of today’s fashions typically have a tightly constrained forefoot leading to compression of the forefoot and toes. This position can lead to forefoot mechanical deformity and pain (bunion, hammertoe, bunionette deformities), pressure pain (corns and calluses), and nerve pain (neuritis and Morton’s neuromas). It can also lead to mid-foot pain (tendonitis, joint) and heel pain (plantar fasciitis, Achilles tendonitis, pump bump). All of these issues are commonly seen in our office. Many can be treated with conservative care and some require surgical intervention.

What are some general tips you’d give to women to prevent pain from the heels they wear?

Unfortunately, the higher the heel, the higher the abnormal load that is placed on the foot and also the ankle. Logically, the narrower the base of the heel the more unstable it will be. As a result, this will increase the risk of rolling and spraining your ankle. A lower heel with a wider base will be safer. If this is not in your fashion future or can’t be found in your closet, avoiding walking on uneven surfaces especially if you have had a drink or two will help avoid injury.

Make sure you wear high heels that fit well. Buying a cheaper shoe or one that is too small or large can feel good at the store but may cause pain after walking in them for a while. After you buy them, wear them at home for a while before taking them out on the town or to work. This can prevent being trapped for a day with a painful pair of shoes and an ongoing painful problem in the foot or ankle.
If you wear high heels regularly, don’t wear the same pairs routinely. Mix up heel heights, forefoot widths and try to use flats as much as you can when you don’t need to wear heels. Stretching the calf muscle on a step can also help prevent calf muscle, Achilles tendon, and plantar fascia issues.

Are there heels that don’t cause much damage?

A lower wider heel in a shoe with softer form fitting leather and wider forefoot is going to be your best option if you are dressing in heels.

What are some tips that you would give for preventing leg pains, varicose veins, etc?

Leg and ankle pains can come from wearing high heels. Commonly, these pains can come from inflammation of the muscles or tendons from overuse or altered use because of the alignment and tension on the muscles, tendons and ligaments. Limiting use or altering shoes along with calf stretching, strengthening and massage can help prevent these pains.
Sometimes pain can come from varicose veins. Blood enters the legs through arteries and exits through veins. The veins bring blood back to the heart against gravity and there are valves in the deep veins that allow this to happen. If the valves leak, the segmental feeding veins start to dilate causing varicose veins. These are difficult to prevent. Genetics, pregnancies, weight and prolonged times on your feet can promote varicose veins. Maintaining good muscle tone and strength, along with occasional leg elevation and sometimes vascular compression hose can all help guard against this problem.