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Don't Fail Me Now

Just put one foot in front of the other. Keep your feet on the ground. Take it one step at a time. Don’t drag your feet. 

Feet. Two of the hardest-working parts of our body, but do we give them any attention? Not really, unless and until we have to. We walk, we run, we hike, we jump, we dance. We subject those poor feet to ski boots, high heels and flip flops. We assume our feet will take us wherever we want to go, with nary a complaint. Each foot, with its 19 muscles, 26 bones, 33 joints, 107 ligaments and 8,000 nerves, just keeps on keepin’ on. Until it doesn’t. 

The day comes when our feet revolt. Enough, already, scream those bruised metatarsals. Or angry joints. Or stressed ligaments. Now what do we do?

William Montross, Doctor of Podiatric Medicine (DPM) with the UCHealth system, and Director of the new Lower Extremity Salvage Center, says one of the most common foot issues people experience—especially men—is plantar fasciitis. Plantar fasciitis is an inflammation of the plantar fascia, a band of tissue that stretches from the heel to the middle foot bones, supporting the arch and serving as a shock absorber. “This usually presents as pain the morning after rest,” says Dr. Montross, “or pain upon standing after a long rest such as watching TV or after a meal. Often it involves tightness of the leg muscles.”

Or, we might experience bunions, a painful swelling of the first joint of the big toe. Though there is often a family history involved, he says, “I find that shoes—dress shoes/heels—by themselves do result in bunion formation. If someone is developing a bunion, bad shoes can make the bunion develop faster.” 

According to Foot.com, wearing a 2½-inch high heel can increase the load on the forefoot by 75%. Though surgery is sometimes called for, says Dr. Montross, “There are instances where I suggest holding off on surgery until it becomes a bigger problem.” Many times bunions are not painful or are not slowing the patient down, says the doctor, but they can eventually cause deformity that can affect lifestyle.

The long list of potential foot ailments includes foot sprains or breaks, arthritis, atrophy of the foot pad, diabetes-related neuropathy and circulation issues and foot strain caused by overweight. And of course, we know that some of these issues require far more than a few weeks of rest and pain management.

We bi-peds will walk, over the course of a lifetime, more than 100,000 miles. Twenty-five percent of us in the U.S. have flat feet, and 20 percent of us have high arches. Studies suggest that nine out of ten women wear shoes that are too small. Seventy-five percent of us will experience some type of foot problem in our lifetime. More than two million of us seek treatment for plantar fasciitis every year. 

“Mechanically,” says Dr. Montross, “I see that women are more prone to instability of the big toe joint, which can cause a bunion formation. Men, on the other hand, seem to injure feet more often and drop things on their feet more often. This causes more arthritis issues.” Working on hard and uneven surfaces, says Montross, can be an issue in developing plantar fasciitis. And a bad gait can cause pain in the ankle, knee, hip and back. “Conversely,” he says, “having hip or knee problems can put extra stress on the feet.”

So, what can we do to make sure we, well, put our best foot forward? 

Shoes! Wearing the right shoes, says Dr. Montross can make all the difference.

“If a job requires a man or woman to wear fashionable shoes,” says Dr. Montross, “this can lead to our tissues, particularly our fat pad, to wear out faster. Fashionable shoes typically have less cushion and tend to fit our feet tighter. Having shoes that fit tighter does not let our feet adapt well, and causes our toes and other bony prominences to rub. This rubbing can cause calluses and blisters. 

“Many athletes get good shoes but neglect to change them out. The athlete needs to discuss this with a reputable athletic-shoe department to see when the shoes need to be replaced. On average, running shoes can last 500 miles.”

To keep our hard-working feet in good shape, says Dr. Montross, we should stay active within our abilities and use proper shoes for the activity – hiking shoes for hiking, walking shoes for walking…. And it’s important to change the liner in our shoes, he says. “Shoe liners wear out faster than shoes, and the padding is very beneficial.” 


Exciting treatment options either on the horizon or currently available for foot issues include:

• Biological substitutes to replace cartilage and restore or improve function

•Diabetes-related treatments, including limb salvage, i.e. implementing treatments early in foot and leg issues that can save limbs and vastly improve circulation. Not delaying care is critical.

• Improved ways to move and grow bone

• The ability to change the shape of the foot with surgery

Source: Dr. Montross