- Sep 05, 2018 -
It's hard to believe that there was once a time when humans simply walked around barefoot, no matter what the temperature or terrain was like. Nowadays, you'd struggle to make it down the local high street without passing several shoe stores, boasting a wealth of designer heels, on-trend trainers and seasonal specials.
Although your health might not be the first thing to spring to your mind as you peruse the Office sales, scroll endlessly through the latest ASOS collection or queue for hours to get your hands on a pair of Yeezys, the shoes we wear are actually central to our everyday health. Poorly designed shoes, or footwear that doesn't fit properly, can cause a number of short and long-term health problems that affect various parts of our bodies, so it's important to be clued up on what you're putting on your feet.
Michael Ratcliffe, Podiatrist at Carnation Footcare, says that the three main functions of shoes are to protect our feet, enable us to walk wherever we want and provide comfort when we are on our feet for long periods of time. He says:
"Correctly fitting footwear should have little or no negative impact on our health. Poorly chosen and incorrectly fitting footwear can impact negatively on our feet. Shoes with higher heels, poor grip and inappropriate or absent fastenings have been linked to impaired walking, balance and falls, while foot constriction within shoes can create parathaesia (pins and needles) or temporary numbness. If footwear is incorrect then short term problems can become long term ones with an unwillingness to pursue activities such as walking or even affect the ability to work in a chosen occupation with consequent mental, emotional and physical implications."
Ill-fitting shoes can cause damage to your feet almost immediately. Some of the more common conditions include:
Corns are a 'plug' of hard, dead skin that occur over a bony prominence, like a joint. They are often caused by prolonged pressure to the specific area – usually from poorly fitting footwear.
"It usually has a punctate, discrete shape and can be very painful when pressure is applied to the site. Corns can be hard or soft (and, where they exist between the toes, damp) and can contain blood vessels and/or nerve fibres. Long standing corns can be firmly attached to deeper soft tissues, which makes them hard to completely remove."
Shoes that are too loose can allow your foot to slide and rub, or designs that place excessive pressure on a certain area of the foot are the most likely contenders to cause corns.
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Nail and fungal problems are extremely common in the UK, with an estimated 16% of all Europeans thought to be suffering from some form of infection. Ingrown toenails, caused when the sides of the nail pierce the surrounding skin, are a particular nuisance and can be painful.
"Wearing shoes and socks that do not fit properly and are too tight places pressure to the sides of the toes and can push the skin into the nail plate. Additionally, cutting your toenails incorrectly (neither straight across nor in a gentle curve) and cutting down the sides of your nail can place your toe at risk of an ingrowing toenail."
Additionally, fungal toenail infections cannot only be unsightly – causing discolouration and brittleness of the nail – but they can also affect out self-esteem and (rarely) lead to further complications by which the infection is spread.
"Trauma, either a single episode or repeated minor episodes (caused by tight footwear), can lift the nail from the nail bed giving normal skin dwelling organisms a portal of entry into the nail bed and softer underside of the nail plate where they can thrive."
Avoiding wearing tight hosiery and footwear, which can damage the nail through repetitive trauma and create a moist environment in which the fungal spores can thrive, can help prevent fungal toenail infections.
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Athlete's foot is caused by a dermatophyte – a fungal species living on the skin. It causes intense itching, inflammation and flaking of the skin, and is simultaneously unsightly, uncomfortable and extremely contagious.
"This condition affects the damp and sweaty areas of the foot, particularly between the toes and the toe webbing spaces (especially in tight fitting shoes which bring the toes in close proximity to each other for the duration of wearing those shoes) and often under the inner arch of the foot."
This condition can be spreadable and caught while walking barefoot in an area where others are also foregoing footwear. Good foot hygiene and use of an antifungal cream will help – it is important to treat this condition before it spreads to the toenails.
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The wrong pair of shoes can cause permanent damage to your body further down the line, and resulting problems aren't just limited to your feet. Keep an eye out for:
Collapsed or 'fallen' arches (more commonly known as 'flat feet') is the term used to describe the instance when somebody's feet have low or no arches, and as a consequence press flat against the ground.
"This occurs when there is tightness in the Achilles tendon and the muscles at the back of the leg whilst walking. This can lead to strain in the ligaments that support the arch (the Spring Ligament), the Plantar Fascia and the tendon of the muscle (tibialis posterior), which also helps to support the arch. Prolonged strain to these soft tissue structures may result in damage and a lowering of the arches with consequent pain in the arch and heel area."
Wearing shoes that have no heel at all does not offer support to those people who have tight calf muscles and Achilles tendon.
There are number of potential problems that might arise from wearing improper footwear (especially heels) over a prolonged period of time, some of which target your back.
"Lumbar spinal muscle action can be exacerbated, leading to overuse with eventual stiffening and resulting in postural changes. Also, possible lumbar intervertebral disc compression (as a result of poor footwear) can lead to lower back pain."
Stick to low shoes where possible, and if you do wear high heels then make sure they are 'well made' and are not worn for too long.
Prolonged overloading as a result of shoes that don't provide adequate support can ultimately cause all sorts of joint problems such as arthritis and also knee pain – especially in the case of high heels.
"The knees are forced to bend more to substitute for the reduced shock absorbing at the feet when the heel hits the ground during walking. Also as a result the muscles in the front of the thigh have to work harder to allow you to get a good push off during walking."
Ill-fitting footwear can also lead to deformities such as bunions and bony lip development around the larger foot joints. It has also been recently suggested that breathing and vocal cord health can be affected by shoe choice, as Helen Sewell, a leading voice and communication coach, told a parliamentary committee that wearing heels all day could lead to faster, shallower breathing and damage the vocal cords.
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Taking preventative steps
The answer to avoiding such problems in both the short and long term is, thankfully, really simple. Just be mindful of the footwear you buy, and how often you wear a particular style. Some things you should be on the look out for when treating yourself to a new pair of shoes include:
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Ensure there is enough room in the front of your shoes (the 'toe box') to wiggle your toes freely. If the shoe is to tight here then you put yourself at risk of compression lesions and numbness.
Ideally your shoes should have a fastening of some sort, which allow you to adjust the fit of your shoe when necessary.
The shoes should have a slight heel gradient (around 20 – 40 mm high), be broad for stability and to offset any tightness that you may have in your Achilles tendon.
The upper part of the shoe should be made of natural materials for general flexibility, durability and comfort.
Cushioning inside the shoe is great for comfort and the reduction of the shock of impact when landing on your heel and pushing off from the balls of your feet whilst walking.
Choose shoes that are firm in the midsole (between the heel and the toe box) so that you can't twist them like a dishcloth.
It is also a good idea to consider changing into specialised shoes if you are going to be walking for a long period of time. For example, it has become quite popular for commuters traveling into the city centre to wear their trainers for the journey and then change into something more suitable once at the office.
"This is certainly a good idea in my opinion in situations where, at work, you must wear shoes that are not that appropriate to walk longer distances in, especially when commuting miles on a daily basis. However the 'commuter shoes' must fit correctly otherwise they then become as much a problem with potential short and long term implications for foot and general health. If higher heels have been worn for a longer period (years), then care should be taken before a switch to low heeled footwear."
Not only will you be looking after your feet better, but a change in footwear will also enable and encourage you to walk further and for longer periods of time, leading to lifestyle that is healthier in general.