Our feet are remarkable structures, supporting our entire body weight and facilitating our movements throughout the day. Yet, they often bear the brunt of our busy lives, enduring prolonged periods of standing, walking, and sometimes inappropriate footwear choices. The importance of proper footwear cannot be overstated, as it plays a crucial role in maintaining the health of our feet and legs.
The human foot is a complex structure composed of 26 bones, 33 joints, and a network of muscles, tendons, and ligaments. It is designed to provide stability, support, and flexibility but as it is composed of many moving components, it is particularly susceptible to injury. Shoes have evolved from basic foot covers to protect from temperature extremes and rough terrain, to fashion items and in the last century or so, specific footwear for sports or athletic wear. The type and quality of footwear necessarily affects the quantity and direction of forces on the ankle and foot. Supportive footwear is protective, but providing too much or too little support and protection can lead to other issues which may become chronic and difficult to treat.
Common foot and ankle problems
Plantar Fasciitis -This painful condition involves inflammation of the plantar fascia, the tissue that connects the heel bone to the toes. Supportive shoes with cushioning and proper arch support combined with exercise and stretching can help alleviate symptoms.
Bunions – Ill-fitting shoes, especially those with narrow toe boxes, can contribute to the development of bunions. Shoes with a wider toe box can help relieve pressure on the big toe joint. Toe separators, used regularly, maintain the natural splay of the forefoot and avoid painful deformity. They work more effectively as a preventative measure.
Corns and Calluses – These hardened areas of skin often result from friction and pressure. Well-fitted shoes with padding and proper support can prevent these painful skin conditions.
Flat Feet – Shoes with arch support are essential for individuals with flat feet, as they help maintain proper foot alignment and reduce strain on the arch. The majority of children up to around 5 years of age have flat feet. This is part of normal development of their feet and over 95 percent of children grow out of their flat feet and develop a normal arch.
Achilles tendinitis – this is an overuse type of injury caused by inflammation and shortening of the Achilles tendon which lies behind the heel. It often occurs in runners or in people who suddenly increase the duration or intensity of their running or training .
Calcaneal spurs – this is a small bony growth at the bottom of the heel that is often caused by overuse, poor shock absorption in trainers or poorly fitting shoes.
Choosing the Right Shoes
Selecting the appropriate footwear is a fundamental step in promoting foot and leg health. Here are some key considerations when choosing shoes:
Proper Fit- Ill-fitting shoes can lead to a range of problems. Ensure that your shoes provide ample room for your toes, have proper arch support, and fit snugly without causing pressure points.
Take socks with you at your fitting and make sure you walk around for a while in the store so to have an initial feel of how the shoes feel. Find a retailer that is happy to exchange. It is only when we walk over uneven ground that we really know how good the shoes work for us.
Arch Support -The arches of the feet act as shock absorbers. Shoes with adequate arch support help distribute body weight evenly, reducing the risk of conditions like flat feet and plantar fasciitis.
It is not unusual for people to have slight differences in foot size. Footwear made to measure can be expensive, unless there are medical reasons for foot size to be different. In this case support from an NHS orthotist can help. Alternatively look for a shoe store that is understanding and would be happy to sell you a split pair.
Cushioning – Shoes with sufficient cushioning provide impact absorption, protecting the feet and joints from the stresses of walking and other activities. Specific orthotics can be prescribed to support the foot in the case of fasciitis or a calcaneal spur.
Breathability – Choose shoes made from breathable materials to prevent moisture buildup, reducing the risk of fungal infections and unpleasant odours.
Counter flexibility – when purchasing keep note of counter flexibility. If you can push the counter down towards the sole, then that shoe is not going to give you enough stability at the ankle. Too firm a counter may be uncomfortable. Counters without internal padding may cause blisters.
Physiotherapy plays a crucial role in addressing foot and leg problems associated with improper footwear choices. When coupled with the right shoes, physiotherapy can enhance the effectiveness of treatment, promote recovery, and prevent the recurrence of issues.
Diagnosis and Assessment
Physiotherapists are trained to assess musculoskeletal conditions, including those affecting the feet and legs. They can identify the specific biomechanical issues related to gait, posture, and foot structure that may be contributing to problems. It is important to give specific advice to people with poor circulation or neurological damage, such as diabetics, as they will require footwear that is well padded to avoid risk of skin breakdown and tissue loss.
Through a comprehensive evaluation, a physiotherapist can determine the impact of improper footwear on a patient’s condition and develop a tailored treatment plan.
Physiotherapists often conduct gait analysis to assess how an individual walks or runs. This analysis helps identify abnormalities or irregularities in the biomechanics of the lower limbs.
By understanding the gait pattern, physiotherapists can recommend appropriate footwear that supports the natural movement of the foot and corrects any gait abnormalities.
However, it is important to remember that walking barefoot is important because it helps retain good proprioception, which is important in helping us know where our body in space. Feeling the ground under our feet is important in having good reactions to maintain balance. Spending all our time on our feet in shoes does affect the sensory input occurring through the soles of the feet.
In cases where individuals have specific foot issues or imbalances, physiotherapists may recommend custom orthotic insoles. These are personalised shoe inserts designed to provide additional support, cushioning, and stability based on an individual’s unique foot structure.
Custom orthotics, when combined with properly fitting shoes, can address biomechanical abnormalities, redistribute pressure, and alleviate symptoms of various foot conditions. Physiotherapists can assist with the prescription and moulding of custom orthotics to fit. In some instances where the issues are complex, referral to an orthotist may be helpful.
Strengthening and Stretching Exercises
Physiotherapy often includes exercises to strengthen the muscles of the feet and legs. Strengthening exercises can improve stability and support the arches of the feet.
Stretching exercises may be prescribed to address tight muscles and improve flexibility, reducing the risk of conditions such as plantar fasciitis.
Physiotherapists employ various techniques for pain management, including manual therapy, ultrasound, and electrical stimulation. These interventions can help alleviate pain and inflammation associated with foot and leg problems.
By addressing pain, physiotherapy enables individuals to engage more comfortably in rehabilitation exercises and activities recommended for their specific condition.
Investing in the right footwear is a small yet impactful step toward ensuring the health and well-being of our feet and legs. Whether for work, exercise, or casual wear, choosing shoes that provide proper support, cushioning, and a comfortable fit can go a long way in preventing and alleviating various foot and leg problems. Our physiotherapists at the Home Physio Group can provide valuable education on proper footwear selection and maintenance. They can guide individuals on choosing shoes that offer adequate support, cushioning, and stability for their specific needs.
For more information please contact us on 0330 335 1016 or alternatively please fill out our contact sheet and we will get back to you.