What’s New in Foot & Ankle Science?

It’s 3:28 a.m. and I am standing at my computer station stretching the top of my foot (will post this exercise soon) and browsing abstracts from the Journal of the Podiatric Medical Association. Yup. That’s what I do on a Friday night. Technically, it’s Saturday morning because I have been to bed, but was rooted out by my dog, Jolie, who makes the occasional appearance in FootLove Yoga videos and pics.

I thought it might be interesting to share with you some peer-reviewed research conclusions from the main trade group of podiatrists (foot docs) in the US. Bear in mind, that you are receiving my cherry-picked extractions from abstracts that can only be understood and evaluated in the context of their full articles and require knowledge of how to evaluate research methods. That is the buyer beware. My intention is only to bring your attention to what is being studied and learned. [In brackets you’ll find my snarky 2 cents].

Bits from the Journal of the Podiatric Medical Association 2013 & 2014

Podiatric Medical Abnormalities in a Random Population Sample 40 Years or Older in Spain
There was a high prevalence of podiatric medical abnormalities, which increased with age and female sex. The most common diseases were claw toes (69.7%), hallux valgus [bunions] (38%), and hallux extensus [big toe permanently lifted up] (15.8%), which increased with age and female sex. [Each of these are likely load-induced conditions; and all are impacted by shoe choice]

Forefoot Midsole Stiffness Affects Forefoot and Rearfoot Kinematics During the Stance Phase of Gait
This study looked at the difference between shoes with stiff arches and those less stiff arches and how they affected gait kinematics (how you walk). They concluded that a less rigid mid-sole was associated with greater range of motion and foot stability. [Another argument for wearing thin & flexible soled shoes]

Effects of High-Heeled Shoes and Asymmetrical Load Carrying on Lower-Extremity Kinematics During Walking in Young Women This study demonstrated that when high-heeled shoe wearing and asymmetrical load carrying are combined, changes at the ankle, knee, and hip joints are much greater than with high-heeled shoe wearing or load carrying alone. [Your purse, making your positive heeled shoes even more harmful]

Recognizing the Prevalence of Changing Adult Foot Size
Ill-fitting shoes may precipitate up to half of all diabetes-related amputations and are often cited as a leading cause of diabetic foot ulcers (DFU), with those patients being 5 to 10 times more likely to present wearing improperly fitting shoes. The current study, performed in a male veteran population, is the first such effort to examine the prevalence and extent of change in foot length affecting individuals following skeletal maturity. Nearly half of all participants in our study experienced a ≥1 shoe size change in foot length during adulthood. We suggest that these often unrecognized changes may explain the broad use of improperly sized shoe wear, and its associated sequelae such as DFU and amputation. [Your feet are getting bigger, so should your shoes].

“Good for Older Ladies, Not Me” How Elderly Women Choose Their Shoes
The main themes identified about footwear selection were aesthetics and comfort. Aesthetics was by far the main factor influencing footwear choice. Wearing safe footwear was not identified as a consideration when purchasing footwear. [Golden Darwin Awards]

Effects of Nonslip Socks on the Gait Patterns of Older People When Walking on a Slippery Surface
Participants walked more slowly and took shorter steps when wearing standard socks. Participants rated nonslip socks to feel less slippery than barefoot and standard socks. Compared with wearing standard socks, wearing nonslip socks improves gait performance and may be beneficial in reducing the risk of slipping in older people.

Effectiveness of Foot and Ankle Exercise Programs on Reducing the Risk of Falling in Older Adults
Evidence suggests that FA exercise can improve certain fall risk–related motor outcomes and reduce falls. [Check out my foot exercises in the category…”Foot Exercises” on this blog]

Effect of Shoe Flexibility on Plantar Loading in Children Learning to Walk
When evaluating early walkers during gait, peak pressure was significantly different across shoe conditions for all of the masked regions. The stiffest shoe had the lowest peak pressures and the most flexible shoe had the highest.It is likely that increased shoe flexibility promoted greater plantar loading. Plantar pressures while wearing the most flexible shoe are similar to those while barefoot. This mechanical feedback may enhance proprioception, which is a desirable attribute for children learning to walk. [Get your toddlers out of shoes people!!]

Alterations in the Plantar Pressure Patterns of Overweight and Obese Schoolchildren Due to Backpack Carriage
Among other adverse consequences, childhood obesity is known to influence foot structure and functionality.Overweight and obese children generally had larger contact areas and higher peak plantar pressures compared with their normal-weight peers. In overweight and normal-weight participants, the backpack induced a similar generalized increase in contact area and pressures. However, the largest changes were observed in the forefoot, suggesting that load action tends to modify the physiologic pressure patterns. Backpack carriage raises the already elevated peak plantar pressures in overweight children during upright stance and modifies the physiologic pressure patterns. [Lose the weight. Lose the backpack. Humans were genetically adapted (evolved to) carry things with our hands and arms. Feelings of tightness and lack of range of motion in your shoulders & upper back is directly a result of no longer using your upper body by carrying things (or climbing, hanging by your arms, digging, throwing spears, erecting shelters, i digress). Wearing a backpack causes alignment issues that can lead to shearing of your vertebral discs and mal-aligned shoulders. How about putting your kid’s books and things into cloth bags with handles (you could even use $2 reusable grocery bags) and let them carry their stuff. Busy hands and arms are well behaved bodies and brains??]

Anthropometric Foot Changes During Pregnancy
The foot of the pregnant woman tends to flatten during gestational weeks 12 to 34, taking a more pronated posture, and the anthropometric changes in late pregnancy result in increases in foot length and forefoot width, changes that seem to be moderate. [Bigger feet require bigger shoes. Shoes that are too small lead to load-induced injuries and conditions of the feet]

Foot Overuse Diseases in Rock Climbing
Overuse foot diseases related to rock climbing are particularly frequent and debilitating. Eighty-six percent of the climbers were affected by a pathologic condition. Nail disease was found in 65.3% of patients, followed by recurrent ankle sprains (27.8%), retrocalcaneal bursitis (19.4%), Achilles tendinitis (12.5%), metatarsalgia [pain and inflammation in the long bones of the forefoot] (12.5%), and plantar fasciitis (5.6%). Male sex, the use of high-type shoes, the high degree of climbing difficulty, and the competitive level were often related to the onset of foot diseases. Climbing shoes are usually smaller than common footwear. This “shoe-size reduction” averaged 2.3 sizes, forcing the foot into a supinated [rolling to the outer edge] and cavus [high arched] posture that favors lateral instability. The posterior edge of the shoe aperture produces increased pressure on the heel, with retrocalcaneal bursitis. [ why don’t you just climb barefoot? asks the former climber who crammed her puddins into shoes 2 sizes too small for 15 years]

The Occurrence of Ipsilateral or Contralateral Foot Disorders and Hand Dominance
Left-handed people were less likely to have foot pain or any foot disorders ipsilateral [same side of the body] but were more likely to have hallux valgus [bunions] on the left foot. Among right-handed people, the following statistically significant increased odds of having an ipsilateral [same side] versus contralateral [opposite side] foot disorder were seen: 30% for Morton’s neuroma, 18% for hammer toes, 21% for lesser toe deformity, and a twofold increased odds of any foot disorder [If you are right-handed, and most of us are, you are more likey to have these conditions on your right foot]; there was a 17% decreased odds for Tailor’s bunion and an 11% decreased odds for pes cavus. [This begs the question of foot disorders in ambidextrous people]

I hope you enjoyed this literature review!

Namaste, Michele





One response to “What’s New in Foot & Ankle Science?

  1. Pingback: Dear Friend, you are ruining your feet, and your health, to be fit – an open letter | FootLove Yoga

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