Does the Shoe Fit?

Never underestimate the importance of proper footwear. Often times we believe that we shape our shoes to fit us -- we “break in” our shoes, wearing out the sole, making holes in the toe. True, in the clinic we often examine the wear and tear of a patient’s footwear to give us an idea of how the patient plants their foot and distributes their weight. However, as much as we shape our shoes, our shoes also shape us. Like any relationship in life, there is a duality between shoe and foot whose effect extends beyond the contact between sole and sole. The question is whether this relationship is a beneficial one. An old Chinese medicine proverb translates to something like, “if the feet are happy, the body and mind will follow”. So we should ask, does the shoe fit?

Recently a patient came to see me for an ankle sprain sustained during a basketball game. Upon examining  the feet, I could see the ankle joints were unstable on both sides, the soles of the feet were flat (a.k.a. “flat feet”) and the toenails were too long. The patient had sustained innumerable ankle sprains over a lifetime of playing sports. Although the patient typically wore sneakers while playing basketball, the patient came to the clinic wearing a pair of flat, very worn out canvas shoes. These were the patient’s everyday shoes worn to both work and fun. “How long has it been since you wore a sneaker outside of sports?” I asked. The reply was “a very long time”.

In this case I diagnosed that  the impact of flat shoes over time affected the ligaments of the foot and ankle, which had already sustained repeated trauma. Without support, the arches collapsed or got more flat over time, and consequently the shock meant to be absorbed by the arches was absorbed by the joints. Meanwhile the patient’s long toenails were affecting how the patient stepped while running and sprinting during basketball, making the patient susceptible to rolling and injuring the ankles.

The improper shoe can damage the foot in many ways. We see many foot related issues at the HeCares clinic. Bunions, plantar fasciitis, achilles tendonitis, morton's neuroma, flat feet, ankle sprains and strains, knee, and even hip issues are all caused or worsened by improper footwear.

Most of us do not hesitate to invest in a quality car, because we need reliable transportation, and a comfortable bed because that is where we spend a quarter to a third of our  lives. However, we easily spend half of our life or more in our shoes! Whatever the occasion, whether work or play, the shoe must fit!

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