Tuesday, 6 August 2013

Your shoe an indicator of arthritis

The way your shoe wears out could signal muscle and bone conditions, including the early onset of arthritis

Standing in long queues, crossing the entire length of a railway platform, and chasing a cab during rush hour — the average Mumbaikar takes between 8,000-10,000 walking steps (about 6-7.5 kms) every day while commuting.

No wonder that your brand new office shoes are likely to wear out in less than couple of years. Practising podiatrist and mobility consultant Chaitanya Shah says wearing of the shoe is normal in Mumbai. However, if the signs of wear and tear are more defined in specific areas than others, it could be an indicator of problems with your feet, knees, hips and back.

TOI gets experts to analyse patterns of weathering in footwear, and what each says about your health.

1. Outer heel worn out
The natural biomechanics of a foot landing start with a heel strike, followed by the mid-foot strike and flattening of the arch to absorb the landing impact, and finally the forefoot strike which pushes you off the ground and leads to the next stride. Normal shoe wear is seen at the centre of the heel with an exception of four degree on the outside. If the wear is seen beyond four degrees on the outside, the person is said to be supinating. "This happens with people who have a high arch that doesn't flatten with mid-foot landing. Therefore, their body weight is likely to fall on the outer edge of the heel and the foot. The feet lose shock absorption ability while landing and are not stable on rough surfaces," says Shah.

Health indicator: Such people are prone to frequent ankle sprain and injuries. Weight imbalance on the knees can lead to erosion of the knee cartilage on the outside and bring on early arthritis. This style of walking also puts a lot of pressure on the hip bone and can lead persistent pain of the bone while sitting or standing. Tip: Consult a podiatrist or orthopaedic expert who can guide you on gait training or the correct style of walking. Correcting your gait can remodel your bone structure.

2. Inside of heel
You are a pronator if the inner edges of your shoe heel wear out more than the rest of the sole. Pronation is a common problem with people with knocking knees and flat feet. Your arch flattens with the mid-foot strike and causes your foot to roll in under your body weight.

Health indicator: The spring action which leads to foot-lift off is gone with pronation. This leads to tightening of the calf muscles which become overused with the missing spring action. Cramps are frequent and swelling may be seen on the inside of the ankle joint. "This pattern of walking will also lead to an anterior pelvic tilt — when the front of the pelvis drops and the back of the pelvis rises — causing lower back aches. Such people often complain of getting tired very easily while walking," says Shah. Tip: Go for gait training. You may also need in-soles in your shoes to correct your walk.

3. Ball of big toe
If your shoe has become worn out at the ball of the big toe, you may be suffering from equinus deformity. Dr Sachin Bhonsle, orthopaedic surgeon at Fortis Hospital says, "The equinus deformity causes limited movement of the ankle due to a tight Achilles tendon. While walking, such people compensate by picking up the heel early during foot-landing and placing increased pressure on the ball of the foot."

Health indicator: In some patients, this tightness is congenital, while in others it is acquired by keeping the foot pointing downward for extended periods, such as, while sitting in a chair, or frequently wearing high-heeled shoes. It can lead to corns and calluses — hard dead yellowish skin — at the bottom of your feet. Tip: You will need soft cushioning or custom gel in-soles under the ball of your foot. Perform light stretches of the calf muscle and upward foot flexors to relax your Achilles tendon.

4. Big or little toe
When the shoe surface starts tearing on either sides of the big or the little toe, it indicates that you have a wide foot and have been wearing shoes that are too tight for you. Wearing high heels with a narrow toe also causes a similar pattern of wearing.

Health indicator: When your body weight falls unevenly on your forefeet, the pressure causes the joints to become unstable and protrude beyond the shape of your foot, causing bunions. It can lead to ingrown toe nails or hammer toes that form a claw shape. Tip: You need to wear wide boxtoes shoes in which you can wriggle your toes easily.

5. Mouth of shoe inside: You are wearing shoes that are bigger than your foot size. While walking, your feet are trying to adjust to the oversized shoe and therefore keep slipping out of the mouth. Friction causes the heel to rub against the rear causing the wear. As the heel is not stable, there is too much friction on the forefoot. If you put your hand inside the shoe, you will notice that the insole at the forefoot has entirely collapsed.

Health indicator: Friction can cause blisters on the heels or plantar fasciitis — inflammation of the thick tissue on the bottom of the foot. Because of the constant pressure on your forefoot, you may suffer from shin splints — acute pain in the shin and lower leg. Tip: Always measure your foot size before buying a new pair. Make sure they are snug fitting.
http://articles.timesofindia.indiatimes.com/2013-08-02/health/39026050_1_heel-shoe-indicator

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