2011 March | Total Care Podiatry

Are your shoes too old?

March 7, 2011
Black and white pic of a woman wearing red shoes.Fix or trash … wearing shoes past their prime can be a health hazard.

From the faithful running shoe to the whimsical sandal, from the sensible work loafer to the sexy stiletto, all shoes reach a point at which they have outlived their usefulness, and we must let them go.

Our time together may seem fleeting but we hang onto favorites past their prime at our peril.

“The shoe wears out in the area where we overload it, so the part where you need the most support isn’t there,” said Minneapolis podiatrist Paul Langer, clinical professor at the University of Minnesota. “A worn shoe can exaggerate the biomechanical faults you already have.”

Advertisement: Story continues below

A loss of support and cushioning can cause shin splints, Achilles tendinitis, knee pain and plantar fasciitis, a common form of heel pain. As a shoe’s sole and heel wear down unevenly, the likelihood of twisting an ankle increases. In severe cases, old shoes can cause stress fractures, Langer said.

Unfortunately, there’s no clear expiry date for a shoe, whose lifespan depends on the quality of construction, how well you take care of it and where and how often you wear it. But there are some guidelines for determining when it’s time for your shoes to pass on. The following guide to shoe death draws from the advice of Langer, author of Great Feet for Life: Footcare and Footwear for Healthy Ageing“; Karen Langone, president of the American Academy of Podiatric Sports Medicine; and cobbler Randy Lipson, owner of Cobblestone Shoe Repair in St Louis.

ATHLETIC SHOES

The cushioning on these wears down fastest because they suffer from fast starts, stops and changes in direction, plus more pressure than walking shoes, Langer said. When you run, the pressure you put on the shoe is two or three times your body weight. When you land from jumps in sports such as basketball or volleyball, the pressure is seven to eight times your body weight.

As a general rule, the life of a running shoe is 300 to 500 miles, Langer said, though it varies with your body weight, gait and surface on which you run. Following that rule, someone who runs six kilometers, four times a week should consider replacing shoes after about six months, while a more casual athlete could wait a year. Running shoes typically can’t be repaired.

One way to check if running shoes need to be replaced is to look at the midsole, which is the foam part of the shoe between the outer sole (the bottom of the shoe, where the treads are) and the upper (the top of the shoe, where the laces are). When it starts to wrinkle deeply, the shoe is losing its cushioning and getting worn out. The midsole warps with heat, sun exposure and moisture, so if you run somewhere damp, it breaks down faster.

CASUAL WORK OR WALKING SHOES

As a rule of thumb, Langone said, if you wear a pair of shoes to work three to four times a week, after a year or so they’ll either need fixing or trashing. You know it’s time to repair or replace when you have scuffed heels or flat spots on the outer sole, or when the back edge of the heel gets so worn that it’s angling sharply, Langone said. Another sign is when inside pieces of the shoe poke through, like a nails showing in the heel. One test is to set the shoes on a flat surface and look at them from behind, Langone said. If they tilt to the side, it’s time to fix or toss.

LEATHER DRESS SHOES

If you buy good quality shoes and take good care of them, re-soling and re-heeling when necessary, they could last five to 15 years, Lipson said. Whether repairing is worth the cost depends on how much you paid for the shoes in the first place, as high-quality leather resoling runs $35 to $45. If they’re inexpensive shoes, it’s probably smarter to just buy new ones. (The leather sole needs replacing if when you put your thumb in the center of the outer sole at the ball of the foot, the leather feels soft instead of firm.) A component to keep an eye on is the leather on the upper part of the shoe, which can get stiff if not regularly cleaned, polished and conditioned, Lipson said. Once it hardens, the leather can crack where the shoe bends, and there’s nothing you can do about that. In addition, these shoes can suffer damage to the toe box, the cardboard frame at the toe of the shoe, such as indentations from kicking or being stepped on. That’s too costly to fix, Lipson said, so it’s time to toss.

HIGH HEELS

Because the heels are narrower and the soles are usually thinner, high heels wear down faster than flatter shoes, Lipson said. The most wear happens near the toe on the bottom of the shoe, because that’s the area that bears the most weight. If the thickness of the sole has worn down by half, it’s time to resole or replace.

The heel also wears down quickly, so as soon as you start to see the nail poke through, get new heel lifts. High-quality heel lifts can last twice as long as the originals from the manufacturer, Lipson said.

SANDALS, THONGS

The upper part of a sandal bears a lot of stress to keep the foot in place, making for a shorter life than enclosed shoes, Langone said. Stretched or broken straps mean it’s time to replace or, if they’re very expensive shoes, repair.

The same heel and sole issues apply to sandals as other shoes. So if those thongs are starting to look like lopsided pancakes, time for a new pair.

Back to Top

Bunions can affect quality of life

 
 
 
Lahore News Desk
Monday, March 07, 2011
 
Bunions — deformities at the base of the big toe that can cause pain and disability — are common and can really slow a person down, a new study shows.

The study, which is published in Arthritis Care & Research, found that more than one in three older adults has at least one bunion, a hard bony bump that forms at the base of the big toe. Bunions are thought to have a hereditary component in that they tend to run in some families. It has also been suggested that wearing shoes with elevated heels and a narrow toe-box may contribute to bunion development.

Study participants with bunions were more likely to experience pain in other parts of their body, including the hip, knee, low back, and foot. And those with the most severely deformed big toes, a condition known as hallux valgus, also had the poorest scores on measures of life quality, like social and physical functioning.

“Our findings indicate that hallux valgus is a significant and disabling musculoskeletal condition that affects overall quality of life,” says Hylton Menz, an associate professor at La Trobe University in Melbourne, Australia, in a news release. “Interventions to correct or slow the progression of the deformity offer patients beneficial outcomes beyond merely localized pain relief.”

For the study, researchers in the U.K. surveyed more than 2,800 people ages 56 and over. Part of the survey included pictures of the left and right feet where the base of the big toe was progressively more deformed. Participants were asked to look at their own feet and pick the pictures that most closely resembled them. That helped researchers determine the severity of each person’s problem.

The study participants then were asked additional questions about their mental and physical health, pain intensity, concerns with personal appearance, and socioeconomic status and education level. The study found that bunions were about twice as common in women as in men, and that the likelihood of having a bunion increased with age. Overall, about 28% of people ages 50 to 59 reported having bunions, compared to nearly 56% of people over age 80.

As the severity of the deformity increased, so too, did the problems associated with it. Even after taking into account pain in other areas of the body, people with bunions still reported poorer mental and physical functioning than those without bunions. Previous studies have shown that bunions may affect gait, balance, and increase risk of falls in older people, but researchers speculate that along with these issues, people with severe bunions may report less satisfaction with their lives because they have trouble finding shoes they like to wear.

“There are all kinds of splints and padding that you can put between your toes and things like that to try to prevent the toe from drifting over,” says Andrew J. Elliott, MD, a foot and ankle orthopaedic surgeon at the Hospital for Special Surgery in New York City.

However, he notes that previous studies have shown that up to 90% of people who get bunions report a family history, which may mean that some feet are just more susceptible to them than others.

“If it’s going to drift over, it’s going to do that, and it’s mostly because of an imbalance in the muscles as well as maybe some laxity in some ligaments that allow the bones to sort of drift in the direction that they’re going to, which is where it is going to rub up against the shoe,” Elliott says.

He says patients should consider surgery if they’re in steady pain, or if they’ve noticed their bunion getting rapidly worse in the last year. As a bunion gets worse, it may also cause hammertoes or crossover toes, or pain in the ball of the foot, called metatarsalgia. “As the deformity gets bigger, it gets harder to get a good outcome with correction,” he says.

Back to Top
|