Monday, November 16, 2009

Platforms - Are They Better Than Heels??

I just answered a post on which asked this exact question. The answer is yes, and no.

Platform shoes do give you height without some of the problems of heels, but platform shoes have their own set of problems. The human foot is meant to go through a specific pattern of walking called the gait cycle. Shoes should allow normal gait unless there is a specific reason not to allow normal gait.

Normal gait includes the foot bending at the ball of the foot to allow propulsion of the body forward. The toes work in conjunction with the rest of the foot to stabilize while moving forward. Many people with arthritis find that normal propulsion is painful if their joints at the ball of the foot are arthritic. For these people, we recommend shoes that limit motion in that area.

Most of us do not have significant arthritis and have no reason to not allow that normal motion. Any shoe that does not bend at the ball of the foot does not allow normal motion. Most platform shoes fall into this category.

Platform shoes that are made of rigid materials stop the foot from its regular function and force the tendons and muscles to work abnormally. This can cause some muscles to be over used and others to be under used. Tendon pain, inflammation and irritation can occur if this is allowed for an extended length of time. If shoes worn on a regular basis cause the toes to grip the shoe excessively, hammertoes can even develop!

Listen to your feet. Foot pain is never normal and any shoes that cause pain or discomfort when wearing them or immediately afterwards should not be worn for any length of time.

Friday, November 13, 2009


I am always answering questions about shoes so I thought it was time that I began to write about shoes and how they can help or hurt your feet.

Lets start with everyone's favorite shoes - High Heels!!

High heels are simply not good for your feet! True, women with higher arches can wear them more comfortably and with more stability, but down the road they can cause problems at the ball of the feet. Torn ligaments, inflammation and stress fractures can occur from constant high heel use. Heels over three (3) inches put seven times the pressure on the ball of the foot and that pressure wears out the normal tissue. Many women as early as their late 20's start having problems at the ball of the feet.

I am realistic, however, and know women are going to continue wearing heels. So here is what you need to do:

1) Alternate your heel height daily, even if its from a 4" heel to a 3 1/2" heel. That will change the force on the bones daily.

2) When trying on shoes, get off the carpeted area. You want to see what type of padding the shoe itself gives - not the padding the carpet has!

3) Never wear a shoe that you feel unstable in. Many women sprain their ankles when they wear heels that are too high for them

4) Try to find a heel that is wide if you feel unstable.

5) Go for the kitten heels! Same look as heels but without the dangers

6) Height is an illusion! Stand tall, throw your shoulder back and go for the 1 1/2" heel instead of the 3" heel!

Next up - platform shoes!!

Friday, November 6, 2009

Subtle Injuries That Can Be Devastating

I had a patient on Monday that had the most severe arthritis that I have seen in a very long time. She told me that 18 years ago, she injured her foot in a step class and that the doctor at the time suspected a stress fracture but never found it on x-ray.

This woman had an injury to the middle of her foot that is very often missed by general doctors, emergency room doctors and even radiologists. It is a disruption of what is called the Lisfranc's Joint. It involves many joints across the middle of the foot and if it goes untreated when it first occurs can cause severe arthritis years later.

It is VERY important to see a podiatric physician anytime you have a foot injury or foot pain. Looking at this woman's current x-rays not only showed the arthritis but clearly indicated that this subtle injury had occurred. A podiatric physician would have been able to detect the problem at the time of injury. This woman is now left with severe pain, limited activities and a total change in life style.