WEARING tight-fitting shoes or footwear without sufficient support may result in more than just minor discomfort. In the long run, foot problems that develop can range from corns and calluses to painful conditions called metatarsalgia or heel spurs.
Foot problems are commonly experienced but many people do not do something about them before they worsen.
Daniel Berkemeier, managing director of Schein Orthopaedics, said an estimated 80% to 90% of Malaysian adults suffer from some form of foot problem.
Daniel Berkemeier: ‘Most foot, knee and back problems are related to our feet.’ He is holding a shoe designed for diabetics.“Most foot, knee and back problems are related to our feet. Foot problems include serious conditions such as diabetic foot syndrome or rheumatism to those caused by ill-fitting footwear,” he said.
Schein specialises in custom-made orthopaedic shoes and in-soles for people with foot, knee and back problems.
The company recently brought in their master craftsman, Guido Fahrentrapp, an orthotist and prosthetist, to give advice and solutions to people with such problems. The German is an expert in designing and custom-making special footwear, in-soles and artificial legs. He will be in Malaysia through August.
Fahrentrapp, who has 27 years’ experience in this field, said wrong footwear is a common cause of foot problems.
“Many people wear shoes that are too tight or too small. Pointed shoes for women are also not advisable because they really hurt the feet as toes may cross over each other. In addition, the big toe and fifth toe may also develop bunions,” he said.
A bunion is a bony bump on the joint at the base of the big toe. This causes the big toe joint to be enlarged, leading to overlapping toes which puts pressure on the big toe joint. Pain in turn will be felt.
Bunions can also form on the joint of the little toe, known as a bunionette. The reasons bunions occur include heredity factors, abnormal walking patterns, arthritis and ill-fitting footwear.
Another common problem is calluses, caused by an accumulation of dead skin cells that harden over an area of the foot. This formation is part of the body’s natural defence mechanism against excessive pressure and friction. Calluses normally occur on the ball of the foot, the heel and the inside of the big toe.
Corn is also caused by accumulation of dead skin cells which can press on the nerves, causing pain. It is developed by wearing tight-fitting footwear or stockings, high heels and having deformed or oversized toes.
Special in-soles for people with foot, knee or back problems by Schein Orthopaedics.
Meanwhile, overpronation or flat foot, is a painful foot problem which occurs while walking. In this situation, the heel bone goes outward and the feet does not form a normal arch (or arch collapse).
This leads to extreme stress or inflammation on the plantar fascia, potentially leading to severe discomfort and other foot problems. (Plantar fascia is the tendon at the bottom of the foot that connects the heel bone to the toes.)
Flat foot condition can be genetic or due to the wrong footwear which does not provide proper arch support.
The heel bone is the largest bone in the foot and absorbs the most pressure and shock.
A heel spur, another painful foot problem, occurs when calcium deposits form as a result of the plantar fascia pulling away from the heel bone, causing a bony protrusion or heel spur to develop. Usually, heel spurs develop due to a high arch or flat foot condition.
“Spurs look like a hook which penetrate the fatty tissue and through the muscle. Having heel spurs is very painful, especially when one first stands up,” said Fahrentrapp.
Another common foot problem is metatarsalgia or spread foot, a painful condition in the metatarsal region of the foot, more commonly known as the ball of the foot. It is caused by improper and restrictive footwear, resulting in forefoot joints becoming painful or inflamed due to excessive pressure.
To prevent foot problems in children, Fahrentrapp advised parents to look out for signs of flat feet in their young children when they start walking.
Sandals designed to fit special in-soles.
“(When they are standing) check that their heels are straight (viewed from the back). If there is a flat foot condition, parents should support their arch with shoes that are high-arched and have cup heel in-soles.
“This helps the feet grow back to the normal position through walking because children’s foot cartilage is still soft,” he explained.
Children also frequently suffer from adducted foot condition where both the forefoot goes inwards towards each other.
“In this situation, special shoes with a very stable heel cup can correct the problem,” said Fahrentrapp.
People suffering from diabetics need to take extra care of their feet as the disease can destroy foot nerves and wounds take longer to heal.
“Special footwear can prevent ulceration in 80% of patients,” said Berkemeier, adding that the features of such footwear include a high toe box, a higher heel area and perforated, soft in-soles.
“The in-soles of these shoes are softer in the forefront but harder at the back. They have strong heel cups and outer soles to give foot better guidance as diabetics have less sensation on their feet,” he said.
Berkemeier does not recommend women wearing high heels for long periods of time.
“Heels more than 1.5 inches (4cm) are not encouraged. In normal walking, we do not put pressure on the three middle bones on our foot, only on the outer bones and the heel. With high heels, the normal arch of the fore foot is distorted,” he said.
Besides wearing sensible heels, the right shoe size is often something people get wrong. Berkemeier said the right shoes should have 1.3cm (half an inch) of space in front of the toes, not at the back of your heel as commonly thought.
“For sports shoes, you can take out the in-sole to check for this space. Children’s shoes must also be very flexible unless they have foot problems.
“For women, if you must wear pointed shoes, make sure all your toes have enough space to lie out straight in front and not cross over each other,” he said
