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Department of Orthopaedic Surgery
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Items filtered by date: December 2014 - Foot Associates of NY
Monday, 22 December 2014 23:10

Effect of High-Heels on the Feet

For hundreds of years, women have been wearing various kinds of high-heels for mostly aesthetic reasons. Women who wear high-heels appear to be taller and to have longer and thinner legs, and the wearer’s gait and posture changes. Though high-heels have had an association with femininity and have kept them popular over the years, there are definite health problems caused by wearing them too frequently.

The motion of the ankle joints is limited when heels are worn. The ankle joint is very important to the body when it comes to walking. Because of their location, these joints have a great deal of weight put on them. Thus, it is very important to keep them as healthy as possible. The Achilles tendon is the main tendon in the ankle. Wearing high-heels too often, studies have shown, can cause the calf muscle and Achilles tendon to shorten and stiffen, which can cause problems when shoes without heels are worn.

By putting a great deal of pressure on the ball of the foot, by forcing the toes into a small toe box, high-heels can cause or may worsen many foot problems, such as corns, hammertoe, bunions, Morton’s neuroma and plantar fasciitis.

Not only does wearing very high-heels regularly have negative effects on the feet, the rest of the body can suffer as well. The knees, one of the most important joints in the entire body, can be affected by wearing high-heels.  High-heels causes the knees to stay bent all the time. Also, it can cause them to bend slightly inward as well. Doctors believe that women can suffer from osteoarthritis later in life because of constantly walking like this. By limiting the natural motion of the foot during walking, high-heels also cause an increased in stress on the knees.

Similarly, the back may also be affected by high-heels because it causes the back to go out of alignment. If high-heels are worn constantly, the spine’s ability to absorb shock can cause continued back pain. They can compress the vertebrae of the lower back, and can overuse the back muscles.

However, this is not to say that high-heels can never be worn. If worn occasionally, they will not cause serious problems. They should not be worn every day in order to avoid the long-term physical health problems of the feet, knees, ankles, and back like mentioned above.

Are your shoes the right size? Many people are walking around with ill-fitting shoes. Picking the right shoe size is not rocket science, but there are a few things to remember when selecting your next pair.

Most shoe stores and department stores have rulers for measuring your feet, and these can give you an exact size. Be sure to measure with your shoe on. Measuring your foot will give you a different size than your shoe. If you do measure your foot size, you will need to add 1-2 inches to get the proper sizing.

Wiggle room is the most important factor when selecting shoes. Make sure that your toes are not cramped and that you can wiggle them. A rule of thumb is that there should be one inch between your toes and the tip of your shoe. If your shoes are not properly sized, you can experience foot pain, knee pain, blisters and swelling.

Don’t assume that you will always wear the same size in a shoe. Often manufacturers size shoes differently. The size you wear with one company may not be the same as the size you wear with another. Make sure that the company you buy from has a return policy. No one needs a closet full of shoes which they cannot wear.

It is advisable not to buy your shoes in the morning, but rather late in the day. Your feet actually swell as the day goes on and you need plenty of room to walk comfortably. Buying shoes in the morning that are snug is sure to cause problems once the day is done. Also, make sure that you are buying the right sizes for both feet. It is not uncommon for one foot to be larger than the other, and some people have to buy two separate sizes to accommodate different sized feet.

The biggest concern in buying shoes is comfort. Oftentimes people will buy shoes that are not the most comfortable in the store. People think that the shoes simply need to be “broken in”. If a shoe does not fit in the store, it will not fit at home either. Comfort should be the ultimate goal when purchasing a pair of shoes; your feet will thank you.

Let’s face it; we all walk a lot, some of us more than others. Selecting the best shoes for your particular lifestyle is essential. By properly sizing your shoes and buying the proper comfort level, your feet will be dancing all day long.

Thursday, 04 December 2014 15:51

What Are Ankle/Foot Orthotics?

Orthotics is a medical field concerned with the design, manufacture and use of aids used to support weak limbs or direct the proper function of limbs, in this case the foot and ankle. Ankle-foot orthotics, or AFOs, are braces worn at the ankle that encompass some or all of the foot. Diseases that affect the musculature or weaken the affected area require AFOs to strengthen the muscles or train in the proper direction. Tight muscles that need to be lengthened and loosened also benefit from AFOs.

When we think of diseases that affect the musculature we think of the big boys: muscular dystrophy, cerebral palsy, polio and multiple sclerosis. We rarely think that arthritis and stroke can affect the musculature or that there are some who "toe in". But whatever trauma affects that musculature, there is a way to correct it. The orthosis helps to control range of motion, provide support by stabilizing walk, correct deformities and manage pain load. A podiatrist would be consulted for those who "toe in", for instance, or an arthritis sufferer whose ankles suffer through walking on the job or perhaps a victim of stroke whose musculature is wasting away and requires strength.

Before the advent of modern orthotic devices, it wasn’t uncommon to see polio victims wearing metal braces from mid thigh to the bottom of the foot, or children who "toed in" wearing metal braces around their ankle and foot. However, both designs and materials have improved dramatically, allowing for new levels of comfort, functionality, and appearance. Many orthotics are now made from plastics in the shape of an L and designed to fit inside a corrective shoe. These can be rigid, buckling at the calf and extending the length of the foot to support the ankle. This same design except with a hinged ankle provides support while walking by normalizing the gait. In the past boots lined with leather and fiberboard provided the rigidity needed for correction and support. Now corrective shoes are available with built up soles to correct the gait or manage pain by sharing it with another area when the foot spreads during walking.

The podiatrist would prescribe this orthosis in the rigid L shape because the foot moves on a hinge. If the hinge isn't functioning as intended due to an injury or malformation, the muscles tighten up, thus making it difficult to flex the foot. When we walk, the foot flexes and muscles stretch. This brace or AFO would support the ankle and musculature during flexion of the foot, in much the same way a knee brace works. Corrective shoes are for people whose feet hit the ground backward, causing tight muscles and arch problems. Wedges and rocker bars on the heels correct the step to heel first and rock onto the ball of the foot, resulting in relaxed musculature and strengthened ankles.

Appearance also counts when we consider a particular support device, especially if the item is intended for regular, daily wear. The L shaped orthotic is contoured to the calf and flesh-colored, fitting into a sneaker or dress shoe. As present, corrective shoes are more attractive than past models, enabling patients wear such devices with greater comfort and confidence.

Midtown Manhattan
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New York, NY 10022
(212) 355-4229

NYP-Columbia Hospital
161 Fort Washington Avenue
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New York, NY 10032
(212) 355-4229

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3616 Henry Hudson Parkway
Riverdale, NY 10463
(718) 548-5757

Foot Associates of New York


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an affiliate of:
Department of Orthopaedic Surgery
Columbia University Medical Center