The shoe review: From high heels to low flats, local podiatrists analyze footwear

Tuesday, March 15, 2011

By Robyn Gautschy ~ Flourish

Women have been told that sometimes they have to suffer for fashion. That is certainly true when it comes to shoes.

Whether it's sky-high stilettos or the latest sandal trend, women's shoes are not often designed for function over fashion.

Local podiatrists give us the low-down on how our feet are affected by various styles of shoes.

Furry boots

How they affect your feet: "They're very comfortable and warm, but there's not much support in them," says Dr. Hugh Protzel, podiatrist at Foot and Ankle Centers of Southeast Missouri. Wearing these popular boots may lead to heel pain, foot aches and arch pain, especially if you have flat feet. "I wouldn't go for a long walk in them," says Protzel.

As for the furry lining, doctors don't see any relationship between the material and foot fungus.

"If someone already has a problem with excessive foot sweating, they could have a problem with foot fungus. But for the average person, there shouldn't be any kind of issue," says Dr. Robert Daugherty of Advance Foot & Ankle Center.

How to find a good pair: You may want to get a prescription insert for added support, says Protzel.

Flip flops

How they affect your feet: Flip flops are a good way to protect your feet when you're hanging out at the pool, says Protzel, but if you plan on going for any length of walk, they offer no support. "They don't allow for the proper gait cycle your foot should go thorough with each step," he adds. Protzel's flip flop-wearing patients have problems with heel pain and tendinitis.

How to find a good pair: Look for sturdier sandals. Protzel says Birkenstocks offer very good support.

Stilettos

How they affect your feet: "The visual, aesthetic things going on are nice, but functionally, they are potentially deforming," says Dr. Zenon Duda, podiatrist at Cape Foot Clinic. Stilettos alter the way the head and shoulders sit, increase the arch in the back, relax the calf muscles and cause the chest to protrude. As a result, you place excessive pressure on the balls of the feet, take unnaturally short steps, and struggle to maintain stability. With long-term wear, you're likely to see hammertoes, bunions, corns and red spots. Pointy-toed heels will eventually mold your feet into a triangular shape.

How to find a good pair: If you must wear stilettos, look for a pair made of soft leather and with not many stitches -- these will be more flexible and protective than heels made of man-made materials. Duda suggests wearing them in short bursts, with time in between for the feet to breathe and stretch.

Flats

How they affect your feet: "Most don't have any cushion or support, but then again, they don't cause any problems because they're nice and wide and are often made of soft leather," says Dr. James Main, podiatrist in Cape Girardeau. "Other than if you have a problem where you need cushion or additional support, these are probably not too bad. They're better than heels or pointy shoes." Daugherty thinks most women without foot problems can get by wearing flats, but he worries about the long-term effects. "If you wear them excessively over time, you might wind up with some problems. They have no support, especially for the arches, and people that stand a lot with their jobs will probably have some pain," he says.

How to find a good pair: Look for flats with enough room for an insert -- that way, you at least have some type of arch support, said Daugherty.

Wedges

How they affect your feet: "They're a good way to hurt your ankles," said Dr. James Main, podiatrist in Cape Girardeau. "Anytime you wear a heel, you shift your body weight forward to the front of the foot, and you're inherently unstable." Like heels, wedges place more weight on the front part of the foot, which can cause knee and lower back problems, says Main. Wedges usually have no support on the sides, making it easier to lose balance and topple over. "On a wedge, the weight is at least spread out over the heel," he concedes.

How to find a good pair: "A woman should go with the very lowest heel height that she can go with. The lower the better," says Main. Many wedges have a rubberized or corklike bottom, which Main believes may add more support than a hard material.

Platform heels

How they affect your feet: Platforms are better than stilettos, but still, "Any kind of shoe that puts abnormal stresses on the balls of foot can cause problems," said Daugherty. "Occasional wear is not a big deal, but this is definitely a shoe that I don't recommend."

How to find a good pair: A stable bottom should be the No. 1 concern, says Daugherty. Wood bottoms are probably more stable and will last longer.

Popular Flip-Flop Sandals Linked to Rising Youth Heel Pain Rate

Many of us wear flip-flop sandals throughout the year; however, their popularity among teens and young adults is responsible for a growing epidemic of heel pain in this population.

We’re seeing more heel pain than ever in patients 15 to 25 years old, a group that usually doesn’t have this problem. A major contributor is wearing flip-flop sandals with paper-thin soles everyday to school. Flip-flops have no arch support and can accentuate any abnormal biomechanics in foot motion, and this eventually brings pain and inflammation.

Wearing sandals with reasonably strong soles and arch support is recommended. Especially for girls and young women, thicker soled sandals with supportive arches might not be considered stylish, but if you want to wear sandals most of the time, you’ll avoid heel pain if you choose sturdier, perhaps less fashionable styles.
It is estimated that 15 percent of all adult foot complaints involve plantar fasciitis, the type of heel pain caused by chronic inflammation of the connective tissue extending from the heel bone to the toes. Tight calf muscles and wearing inappropriate footwear are common contributing factors.

The pain is most noticeable after getting out of bed in the morning, and it tends to decrease after a few minutes and returns during the day as time on the feet increases. Not all heel pain, however, is caused by plantar fasciitis. It also can occur from inflammation of the Achilles tendon, bursitis, arthritis, gout, stress fractures, or irritation of one or more of the nerves in the region. Therefore, diagnosis by a foot and ankle specialist to rule out other causes is advised.
Initial treatment options for heel pain caused by plantar fasciitis should include anti-inflammatory medications, padding and strapping of the foot and physical therapy. Patients also should stretch their calf muscles regularly, avoid wearing flat shoes and walking barefoot, use over-the-counter arch supports and heel cushions, and limit the frequency of extended physical activities.

Most patients with plantar fasciitis respond to non-surgical treatment within six weeks. However, surgery is sometimes necessary to relieve severe, persistent pain. To find out what is happening with your child feet don’t wait to see your foot specialist at Central Kansas Podiatry Associates today.