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Foot problems? Here’s the rub: it’s not what you step out in but how you step out that matters

When I was a little girl I wore black lace-up shoes. I called them my ‘built-ups’ because they had an inner sole designed to create an arch where nature had omitted to give me one. Pretty shoes were not for me: I had to wear those horrid built-ups every day, with play clothes or party dresses. I even wore them (teamed with a frilly swimming cozzie) to the beach.

I was told to walk on tip toe and on the outsides of my feet, and to practise picking up objects with my toes. Then I was enrolled in a ballet class in the hope that all that turn-out would counteract my tendency to turn in. Pink satin slippers! Oh, rapture! By the age of ten I was en pointe, dreaming of Covent Garden as I wobbled at the barre in the school hall. Sadly, the only turn-out of my brief romance with ballet was that I destroyed the cartilage in the joints of both big toes. Ever since, I’ve been restricted to low-heeled tugboat shoes that are broad enough to accommodate the arthritic knobs that emerged as a result of all that pounding.

My footwear may be boring, but I’m thankful that I haven’t had to go Under the Knife, like my friend Vera, who developed a hammer toe – a condition in which one toe bends and lifts as its neighbour tries to tuck underneath it. ‘I have more respect for my feet now’, she says. ‘Before, they were minions who had to be grateful to be in my shoes. Now I’ve invested in shoes that suit them.’

‘We see 100 women to one man with bunions, claw toes and other forefoot problems,’ says orthopaedic surgeon Craig Hastings. ‘As soon as heels go over two or three centimetres, there’s increased pressure on the front of the foot. It’s really not possible to fit into some of the fashion shoes on the market.’
But we shouldn’t put all the blame on shoes, says Cape Town podiatrist Carlo Longano. ‘Yes, wearing high heels every day can lead to trouble, but 90% of foot problems can be attributed to issues of balance and body mechanics.’

It’s like your car, he explains. If the wheels aren’t aligned, it doesn’t drive well. If your skeletal structure is out of whack, you will walk badly and your feet will suffer the consequences. ‘Let’s have a look at yours,’ he says. Nervously, I unlace my flat suede trainers and reveal my winter-pale, flatter-than-flat feet. Even though my shoes are comfortable, the knobs at the base of my big toes look rubbed and red.

‘You have a lower back problem’, he says.
‘No, I don’t. My back has never troubled me.’
‘Well, you pronate [the fancy word for inward-rolling feet] and that could be caused by slight scoliosis or one leg being longer than the other …’

Ah-ha. I’ve always wondered where my son’s skeletal misalignment came from, and now I know. The fact that I’m not aware of mine is apparently due to my weekly yoga class. All those strengthening and stretching postures have done my spine the world of good. ‘Never give it up,’ he advises. In his opinion, everyone should have a six-weekly tune-up with a chiropractor to correct balance and posture. That, combined with podiatry and regular stretching and toning exercise, should keep you light on your feet.

Now I understand why I needed those built-ups, and why I damaged my toes at ballet: I have a design flaw that runs unseen, like the Worcester fault, through generations of my family. I confess to having done ballet, but he’s not a bit disapproving: this podiatrist is also a fifth generation shoemaker who tested his own range of ballet shoes on dancers of the Bolshoi Ballet. ‘Ballet is great!’ he enthuses. ‘But you need a teacher who understands body mechanics. Your toes should not be doing the work.’

He inspects my curled-in chipolatas and says, in a kindly tone, ‘the shape of the toes is the luck of the draw. But there are hairs on these feet, and that’s a good sign.’
Hairs! Oh, horrors! I snip them off with my nail scissors in summer, but the winter crop is there, sprouting on the bridge of my Hobbit-like foot.
‘You must have some hair,’ Longano explains. Your feet are furthest from your heart and have the poorest circulation. Hair indicates a good blood supply.’

I remember, as a teenager, rubbing the bloodless, numb-cold patches that developed on my soles after hardly moving from a school desk all day.
‘That’s called Raynaud’s Phenomenon,’ I’m told. ‘You see it a lot in old smokers.’ I’m slightly cheered by the discovery that my circulation is better now than it was at 15, and that, no matter what else might lie ahead, being a non-smoker has at least spared me a life with Raynaud.

The foot bone’s connected to the knee bone …
When you look at them objectively, feet are funny things, and we bipeds have a strange, disconnected way of dealing with them. We abuse them and neglect them, and even though they are so delicate and complex in their construction we always treat them as if they were second-class and, well, pedestrian. We even use that word to describe something dull and plodding. Poor feet; they just aren’t glamorous, which is why Vera, who is terribly glamorous, asked me not to use her real name. ‘Please understand,’ she said, swirling the ice in her G & T, ‘I can’t be doing with feet right now.’

Vera has settled for feet that function, but there are some women who want more than that. The abomination of foot binding might have gone out of fashion, but cosmetic surgery on feet has apparently become big business in the US, where some doctors are willing to re-shape healthy feet so that they can fit into the shoe style of the moment. ‘They filet the baby toe,’ Longano tells me, which instantly makes mine curl even more, ‘and sculpt the foot to fit the desired shoe. If the fashion changes, so do the feet. I’ve seen some foot jobs that would make you cry.

‘I believe that a woman should be a woman. If you want to wear designer heels for three or four hours to a formal function, go ahead. But for general wear, the shoe must work with the foot, and be supportive and comfortable. It’s the fit that matters, not the price.’ The bottom line is that you’ve got to be sensible, and carving up your feet for vanity’s sake is not sensible.

You should even think twice about having legitimate surgery, says Longano, as years down the line you may develop other problems if your mechanics are still out of kilter. ‘Surgery is not holistic; it treats the symptom of a problem. So try everything else first: different shoes, foot exercises, acupuncture and reflexology. Get three opinions and only have surgery if two out of three recommend it. And for six months before the operation, have physiotherapy and podiatry to correct your balance. You’ll have less trouble later.’

Diabetics, people with cardiovascular and circulatory problems, and those whose gait changes because of motor-neuron diseases such as Parkinson’s or Multiple Sclerosis must take extra care with their feet, as they are more prone to infections and complications. Whatever your complaint, a podiatrist is a good first port of call. There is such variety in feet, and any number of reasons why you might develop calluses, corns and bunions. It’s wise to check out your ailments before wasting money on potions that make grandiose claims but have little effect.

Longano’s recipe for the best foot bath is to put two potato-sized beach stones into a basin of water, add the juice of a lemon, two tablespoons of salt and a couple of drops of lavender, peppermint or geranium essential oil. As you rub your feet over the stones, you get a rejuvenating soak and an exfoliating massage at the same time. For the rest, all you need for daily foot care is a pot of good old petroleum jelly with vitamin E, a small glass cold drink bottle, which works as a roller, and a few minutes a day to appreciate the feet that have carried you so far.

I’m pathetically pleased when he says that, externally, my feet are fine. It’s taken half a century to release that little girl from her clumpy built-ups, but it’s done. I will paint my toenails and when I go shopping for shoes and they bring me tugboats, I will wave them away. ‘Please understand,’ I will say. ‘I can no longer be doing with them. Bring me something I can dance in.’

Originally published in Femina Magazine, 2008

Categories: Featured, Health

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