THE HEART OF THE MATTER
a special program of the National Emergency Medicine Association (NEMA) 

Week: 524.2 Guest: Carol Frey, M.D., Assoc. Prof. Orthopedic Surgery Topic: Foot Problems Associated with Shoes- One Part Host: Steve Girard Producer: Ed Graham

NEMA: This program should be titled: When the shoe doesn't fit. We're talking with Dr. Carol Frey, an associate professor of orthopedic surgery and Director of the Foot and Ankle Center at the University of Southern California. Bunions, hammertoes, calluses, pinched nerves...you know...90% of people who have these problems are...women. Why, Doctor?

FREY: "It's because those problems that you mentioned, most of them are the result of , and are caused by ill-fitting shoewear. And women have, through the ages, been much more a victim of ill fitting shoewear than men ever have been, and the main culprit is the high heeled shoe, with a very narrow, pointed toe area, that just squeezes and compresses the foot, so that the foot begins to take on the shape of the shoe, and the results are very deformed feet.... men don't wear shoes like that!"

NEMA: I've always thought high heeled shoes must be torture...with the foot really being jammed downward into the front of a pointy shoe.....

FREY: "We refer to that as the modern form of Chinese foot binding...it used to take about three years to bind the female foot in China and obtain the desired result, which was referred to as the "lily foot', the very small, petite feminine foot. Nowadays, we feel it takes ten years of using a high heeled shoe, with a very narrow, pointed toe area to get the results, which in this case are not so beautiful, not so feminine.

NEMA: Dr. Frey...you've told me 90% of foot problem sufferers are women...you did a study at USC of 400 women with some results that are surprising...but at the same time, common sense....

FREY: "What we found was that 88% of these women in our study, who were normal women, they were wearing shoes that were too small for their feet, and what I'm talking about is at least a width size, and more commonly two width sizes too small for their feet. 80% of the women in this study say that they had foot pain related to shoewear, and over 70% of the women in this study had bunions, hammertoes, pinched nerves, corns, calluses....and remember these were normal women. And a lot of them thought that those foot deformities were also normal.....they're not!"

NEMA: Okay, we seem to know why...now how can women...some men too...go about preventing these problems when they go out to buy shoes.....

FREY: "Simply the worst advice you can get is someone who tells you, "Oh, those shoes will stretch". The shoes only stretch because they don't fit! If they'd fit well, they wouldn't have to stretch. So, therefore, we suggest that you shop at the end of the day, when your feet are at their largest, make sure you're standing when you're fitting your shoes, always remember that the majority of people have one foot that's larger than the other - so fit the largest foot! While you're standing, you should be able to extend all of your toes, and even wiggle them, and most importantly, those shoes should be comfortable the moment you put them on....there is no break-in period for shoes. Shoes should be comfortable and fit well the moment you put them on. If you have to break in your shoes, what will happen is that the feet will start to give sooner than the shoes will start to give...and the results will be all those painful, ugly deformities that we've already mentioned."

NEMA: Dr. Frey emphasizes women don't have to shop at a men's store to get shoes that fit...and recommends heels no higher that 2 and a quarter inches...rounded toed shoes, soft leather or woven fabric. And, she adds....go barefoot whenever you can, it's the best thing for your feet. I'm Steve Girard.