Neglecting foot pain can lead to long-term problems
Reported July 02, 2009
For more than 10 years, Marney Clark suffered excruciating foot pain caused by a bunion.
“Every step I took was painful,” she said. “I couldn’t wear any shoes…I actually wore Birkenstocks to a wedding.”
But since she had surgery this past April, she has been virtually pain free and is almost completely healed. Now, Clark said she has two things on her mind: the fact she should have had the surgery sooner and when she can go shoe shopping.
“I’m going to a huge shoe sale…I just want to wear pretty shoes again,” she said.
Dr. Hartley Miltchin, a Toronto podiatrist who has been practising for 27 years, said stories like Clark’s are common. He said the feet are the most ignored part of the body and most people think it’s pretty normal for them to hurt.
“We lead active lifestyles and wear crazy shoes so we sort of expect our feet to be painful. We never really think about maybe having them checked out,” he said.
Often times, people only begin to pay attention to their feet once pain has begun, and even then they ignore the pain as long as they can. Generally, Miltchin said if there is persistent pain for more than a week, people should see a podiatrist, however, most don’t.
“I see people in my practice who’ve had pain for a year, five years, 10 years, and the standard answer is ‘I thought it would go away,'” he said.
Like going to the dentist or eye doctor, foot care is also important for both children and adults. “People should be going to the podiatrist as well because adult foot problems begin in childhood,” said Miltchin.
Specializing in bunions and heel pain, Miltchin treats a myriad of foot problems, the most popular being bunions and plantar fasciitis, two conditions that are as debilitating as they are painful.
A common myth is bunions are hereditary, but it’s not the bunions you inherit, he said, it’s the foot type that’s prone to having a condition called overpronation. This is a hereditary foot imbalance affecting the way we walk and causing the rolling in of the feet towards the arch and big toe.
“It causes more weight and stress on the big toe joint and because of that the bone behind the big toe starts to drift outwards towards the arch and because it’s a joint, the big toe starts moving towards the smaller toes,” he said.
Many symptoms can manifest themselves from overpronation, including bunions, plantar fasciitis, shin splints and low back pain. This is why it’s important to have your feet diagnosed and properly treated.
Another myth is that years of wearing high heels cause bunions. Miltchin explains when wearing high heeled shoes, the higher you go on a heel, the more you overpronate, “So the shoe isn’t causing the bunion, it’s just aggravating it and making it happen sooner or more severely.”
Unfortunately, he said, fashion and vanity dictate the shoes we choose to wear, and most teens and young women have no idea the damage they are doing to their feet.
“High heel shoes, to be aesthetically pleasing, narrow at the top so you are bound to do damage,” he said. “If we think of our toes as five cars, we’re jamming them into three parking spaces.”
Flip-flops are also not recommended as they offer no support, nor are platforms, wedges or anything with a heel. We are meant to walk flat on the ground, he said, so putting your feet in any elevated shoe will cause an imbalance.
“When you’re feet are flat on the ground 50 per cent of the weight goes on your heel, 50 per cent goes on the ball of your foot,” he said. “If you increase that even as much as an inch, the body weight transfers, so we’re going to get 10 per cent on our body weight on our heel and 90 per cent on the ball of our foot…so there’s a whole chain reaction.”
Naturally, this means women have a lot more feet problems than men. While men and women have the same propensity to have feet problems, because of women’s shoes, Miltchin said the majority of his patients are women.
“What I do tell women, if you’re going to wear a heel, wear them occasionally. If you’re going to wear them day after day, there’s no question, there will be deterioration,” he said.
He also suggests buying a properly fitted shoe, the best being a walking or running shoe, that has both proper support and shock absorption.
Plantar fasciitis, a condition caused when the plantar fascae, a large band that runs from the heel bone to the toes on the bottom of our feet tears, is also caused by overpronation.
“When your foot overpronates and lengthens, this band can’t keep up, it can’t stretch like a muscle, tendon or ligament, so it ends up tugging by the heel bone and eventually people aggravate it,” he said.
Like bunions, he said plantar fasciitis is very painful and needs to be treated properly so it can heal.
Miltchin offers many minimally invasive procedures to alleviate a number of foot problems. They range from using a local freezing agent and small incisions for bunion treatment, to electromagnetic and laser therapies, but for preventative and after-treatment foot care, orthotics are also a great option.
Orthotics are shoe inserts made from a plaster cast of the foot that’s form fitted to the individual. While they are expensive, Miltchin said for the majority of people it means walking comfortably and pain free.
The number one treatment for plantar fasciitis is orthotics, as well, they are very useful in staving off the pain and slowing or stopping the progression of bunions if you start using them early on in their formation.
“That’s a good option rather than coming to me 20 years later when they’re limping because their bunions are so bad,” said. “At that point, we don’t have the orthotic option anymore just a surgical procedure.”
Orthotics are also crucial for foot health after you’ve had surgery. Antoniette Catenacci had the bunions on both her feet removed in 1994, and since then has enjoyed pain-free feet and can wear any shoe she wants.
“I love my feet. Now I wear shoes so I can actually show them off,” she said.
However, to remain pain free, she wears her orthotics and only wears her heels in moderation. Working in fashion, designing bridal and evening wear, she’s constantly on her feet, meeting with clients and going to glamorous fashion functions, so this can be challenging. However, it’s better than her bunions returning.
Miltchin said many people make the mistake of not using their orthotics after surgery because their feet feel so much better. But surgery, he said, fixes the symptoms, not overpronation, which caused the bunion, or plantar fasciitis, in the first place. If you don’t continue to use them you run the risk of your foot problems returning.
Source : Metroland Media Group Ltd.
