I just spent three days looking for comfortable shoes. I have large, wide feet and it has always been a struggle, but now with arthritis in my knee and big toe, it is extra hard to find low/no heel shoes to fit my feet. I got to spend an inordinate amount of time sitting around in shoe stores and department store shoe sections. I noticed how women’s shoes are narrow, pointy at the toes and often with ridiculous heels. I watched one middle-aged lady after another hobble around trying on these pointy high heeled shoes. I had to wonder: what is this doing to their feet?
It didn’t take long to find out, once I got back home and logged in to the research library. Wearing of these shoes does ridiculous damage to women’s feet. It makes me think of the Chinese, who used bind girls’ feet to bend the toes under and make the feet look tiny. The girls couldn’t walk, but the men thought it was sexy. American women seem to struggle along with the same idea: that female feet are supposed to be small, though obviously not to that extreme..
The results of this pedal abuse are: knee and hip arthritis due to the unusual torque forces caused by high heels on the knee (Kerrigan et al., 2005), bunionettes, hammer toe, hallux valgus, neuromas and ankle fractures (Thompson & Coughlin, 1994). The prevalence of these conditions is much higher in women than in men, whose shoes are made to actually follow the shape of their feet. The damage can be directly correlated to the fashion shoes. Women’s shoes are designed to be narrower than their feet (Thompson & Coughlin, 1994) and so with a narrow shoe squishing your feet, and the high force of the weight pushing the toes down into the pointy toes by the torque from the high heels, well you get the picture:
- Bunionette: http://www.footdoc.ca/www.FootDoc.ca/Website%20Bunionette.htm
- Hammer toes: http://orthoinfo.aaos.org/topic.cfm?topic=a00160
- Hallux Valgus: http://footandankle.mdmercy.com/conditions/bigtoe/hallux_valgus.html
- Neuroma: http://www.podiatrynetwork.com/r_neuroma.cfm
As you see in these sites, none of these conditions are a piece of cake They cause pain deformity and often the need for surgery, all in the name of fashion. It is estimated that it costs Medicare $1.5 billion for the surgeries to correct these problems for cases caused by fashion shoes, in ONE year (1991) (Thompson & Coughlin, 1994).
Bottom line: let’s see if we can educate our patients regarding these conditions, and maybe moderate their shoe selections in order to help prevent these needless painful conditions:
Kerrigan, D. C., Johansson, J. L., Bryant, M. G., Boxer, J. A., Della Croce, U., & Riley, P. O. (Arch Phys Med Rehabil. 2005 May;86(5):871-5.
Thompson, F. M., & Coughlin, M. J. (1994). High price of high-fashion footwear. Journal of Bone and Joint Surgery, 76:1586-1593