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Home/Large Joints and Extremities/88% of Women Wear Too Small Shoes, Fuels Surgery
Large Joints and Extremities

88% of Women Wear Too Small Shoes, Fuels Surgery

November 28, 2016 1 min read Premium comments

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88% of Women Wear Too Small Shoes, Fuels Surgery
Source: Wikimedia Commons and Ondřej Kocourek and Gabriel Urbánek
Secondary

Alexis E. Dixon, M.D., DISC Sports & Spine Center, Marina Del Rey California, defines herself as a woman who is both fashionable and an orthopedic surgeon specializing in foot and ankle injuries. However, she warns women that wearing and walking in fashionably designed shoes can be a risk to their health.

She refers to a study conducted by The American Orthopaedic Foot and Ankle Society (AOFAS), in which researchers examined the feet of 356 women. They found that 88% of the women were wearing shoes that were too small for their feet. Most of them had not had their feet re-measured in over a decade and more than 50% reported experiencing daily foot pain from their shoes.

Dixon points out that as people age, their feet grow wider and flatter, and the fat pad that sits under the bones in the ball of the foot begins to thin. She says that this diminishing protective cushion of fat can cause significant pain while walking, as the shock absorption from the fatty tissue is no longer there. Add to that the discomfort of wearing shoes that are too tight, and high heels that push the feet forward into a pointed shoe that bunches up the toes, and we have got a perfect recipe for bunions, hammertoes, corns, calluses, and a myriad other foot and ankle issues.

Dixon urges her patients to buy shoes later in the day when feet are larger, to buy shoes that are not tight or too small. “There is no such thing as breaking in a shoe. It either fits or it doesn’t” she says.

Dixon advises women to avoid narrow, pointed shoes that squeeze the toes and look for low-heeled (less than one inch in height), wide-toe box shoe styles. Judge the shoe by how it fits on the foot. Buyers should stand during the fitting process and check that there is adequate space (3/8″ to 1/2″) from the end of the longest toe to the end of the shoe.

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Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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