Prevention - Between Attacks: Shoes (Part 1) |
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Patients always complain about their feet, their ankles or even their backs, when the cause is clearly their shoes.
Once the cause is clear the treatment is simple --- properly fitting shoes.
Ask 'Do your shoes fit?'. A simple check is to put your bare foot alongside the shoe and see whether the size and shape of the shoe could possibly allow room for your foot.
No one would go to a tailor who made suits in which the parts cut to the chest or bust measurements were inches too high or too low but many people will accept all manner of ill-fitting shoes.
A shoes that fits grips behind the base of the big toe: the test for this is to cut the shoe through the line of the big toe joint; if the shoe then falls off it cannot fit well. This has actually been done by shoe manufacturers, who have plenty of shoes to play about with but in practice one has to do it mentally. It does not matter whether the part of the shoe beyond the toes if square, whether it is pointed or whether, as in the Middle Ages, it has bells on it. What does matter is that the shoe shall grip behind the big toe and leave the toes room to spread.
This brings some of us into conflict with fashion. Fashion at the moment is best suited to a foot that is more like an ape's than a man's. The makers know this: they have made shoes to fit a truly human foot: they have lost money on them because they were not fashionable. The result is that the reputable makers have a steady output of shoes that are a compromise, that are comfortable enough for 99 per cent of wearers but which are fashionable enough to sell fast enough to keep the maker in business. These shoes do not necessarily have flat heels: most men and still more woman are more comfortable with a heel. They are not necessarily drab, though they cannot be in color that is only going to be fashionable for one season; they are practical shoes for everyday use. Wear what you like for parties, but through the day wear a shoe that will not distort your foot and lead to muscular rheumatism and osteo-arthritis, or make rheumatoid arthritis or gout worse.
This business of shoes is particularly important in children and in those who already have rheumatism. it is important because ill-fitting shoes can deform the toes as they grow, so that the joints have to work at an angel that nature never intended and wear unevenly and painfully as a result. If the big toe is deflected more than 10o by the age of 15 the battle is lost: the pull of the tendons and the pressure of shoes will push the big toe farther and farther over until the result is a bunion at the base of it -- the knobbly foot only too often seen an old woman and one of the most tragic, because avoidable, causes of people having to spend years stuck in their houses when their feet have become too painful for them to do more than hobble. The moral of all this is that children's feet, just as much as their eyes and teeth, deserve the best attention they can get; incidentally, even though it does take more time, it costs no more than poor attention. |
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