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Orthopedics and Health

Shoe size, discomfort

North american chinese foot torture

By Dr. W. Gifford Jones

June 9, 1991

I often look at women's feet during an annual examination. Why? Because I am bemused by the great discrepancy between the size of their feet and the width of their shoes. And I wonder how women keep smiling when their toes are squeezed into such narrow pointed shoes? Now a report from California confirms that women's shoes are the modern version of the ancient Chinese custom of foot binding. As a result shapely legs often end in deplorable feet. And it's time that women tell shoe manufacturers they're not going to take it any longer.

Dr. Carol Frey, Chief of Foot and Ankle Surgery at the University of Southern California, recently told doctors attending the American Foot and Ankle Society meeting in Anaheim, California, that everything physicians suspected about women's shoes is true.

Dr. Frey studied 356 women from 20 to 60 years of age in Los Angeles, New York and Atlanta. None of these women had a history of arthritis, diabetes or injury to the feet. There were shocking findings.

The study showed that almost 90 per cent of women wear shoes at least a size and a half too small. The result is obvious. 75 per cent suffered from bunions, hammer toes and pain.

Dr. Frey commented, " We know that through socialization, women get used to a certain discomfort level in shoes. But until now no hard data confirmed this fact. So we designed this study to evaluate trends in women's shoes and the effect on pain and deformity".

Researchers examined the patient's occupation, foot size, shoe preference, comfort and size. All participants were asked to bring along the fashion shoe they wore most frequently.

Participants were shocked by one particular aspect of the study. Orthopedic surgeons first did a tracing of the feet in the standing position without shoes. Then they traced the outline of the fashion shoe. Women couldn't believe what they saw. Those admitting to foot pain found that their shoes were too small by 1.2 centimeters (one-half an inch). The majority of women wearing a B width needed a C or D. High-heeled shoes were not the only culprits. Most flat shoes were also much too narrow in the toe box.

Are males exempt from this idiocy? Not so. The study showed shoe length was not as critical a problem as the width. But still many longer shoes have such a narrow pointed toe box that toes are pressed together like sardines. High-heeled Texas cowboy boots with pointed toes and the slim Gucci loafers present the same problem for male toes.

So how do women get a shoe that doesn't cripple their feet? Dr. Frey pointed out that shoes should never be bought early in the day. Waiting until late afternoon means the feet are larger.

Never let a salesperson convince you that shoes will stretch. That's nonsense. It's your toes that give. Moreover, as a shoe gets older, the leather shrinks.

Make sure the heel grips the foot snugly so it's not necessary for the toes to clutch to hold on. And make certain that the end of the longest toe is one finger's width away from the end of the toe box.

Don't wear high heels for more than two to three hours a day. Buy fewer shoes and pay for better fitting ones. If all else fails Dr. Frey recommends unisex-style shoes. Even try the men's department for boots, a rather drastic remedy!

Don't forget that, as we age, the feet get larger. This is due to increased weight, slackening of the tendons and general wear and tear. Dr. Frey reports that 95 per cent of the women's feet had grown larger since they were 20 years of age. But most had not had their feet measured for five to ten years. And 66 per cent showed one foot larger than the other.

Remember, what's true for Newton's apple is equally valid for the feet. Isaac Newton concluded that when you drop an apple gravity pulls it to the ground. This immutable law makes it impossible to stop gravity from pulling feet into the cramped, encased area of high-heeled shoes. Apples get bruised when they hit the ground. Feet get bunions.

Dr. Frey pleaded with doctors to look at their patients' feet during routine physical examinations to detect abnormalities, and advise correct shoes. But, alas she adds, that most doctors are not even aware of what a normal foot looks like!

I've often heard males remark, "Wow, look at those legs!" It's fortunate the conversation ends there. The romance would be gone if they could also see the feet. I'm equally sure that high-heeled shoes with cramped toe-boxes, like having babies, would end tomorrow if males had to endure the pain.


W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com

My book, �90 + How I Got There� can be obtained by sending $19.95 to:

Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1

Pre-2008 articles by Gifford Jones
Canada Free Press, CFP Editor Judi McLeod