Put Your best foot FORWARD
With the topic of this issue of A BETTER YOU being “Family Wellness,” this seems like the ideal time to discuss the “real” cause of most of the common foot problems I treat on a daily basis. These foot problems include bunions, tailors bunions (bunionettes), hammertoes, mallet toes, claw toes, displaced metatarsal bones, heel spurs and this list can even include ingrown and fungal toenails.
The “real” cause is not the wearing of high heeled shoes by women, the wearing of shoes that were too tight when you were younger or the shoes you borrowed from a family member or a friend. The “real” cause isn’t even those flip flops that people love and that most podiatrists detest. In fact, the “real” cause isn’t anything you really have control over unless you subscribe to Dr. Wayne Dyer’s theory that we actually choose our parents. Yes, the real cause of most common foot problems (not foot injuries, of course), is… heredity. Yes, if your parents or grandparents have/had bunions or hammertoes, or a myriad of other foot problems, you’re genetically predisposed to getting them.
Now, as this question often arises with patients in my office, I’d like to clarify the difference between the words “hereditary” and “congenital.” When a medical condition is congenital, it simply means that you were born with it. The term “hereditary” means that you have inherited it genetically via your parents.
It’s also important to understand that hereditary foot problems are acquired at the time of conception, but they may not manifest until much later in life. For example, I saw a patient in my office last week who was in her mid-50’s and who presented with very severe bunions on both of her feet. She explained that she had beautiful, straight feet well through her 40’s, but it seemed as though as soon as she hit 50, her feet began to deform. I asked her about her parents’ feet and she told me that her mother and her grandmother had “terrible” feet.” Then, I asked her if she had any brothers or sisters. She said that her older sister had just undergone bunion surgery where she lives on the west coast, but that her younger sister’s feet were just starting to form bunions. She said that both of her brothers had “beautiful feet.”
This is a common scenario. Why? Because the longer one lives, the more chance there is for hereditary foot problems to manifest. That explains why the oldest sister has the most severe bunions and why the youngest sister’s bunions are just starting. It’s also a common scenario because common foot problems like bunions are 3 to 4 times more common in women than they are in men, which explained why neither of her brothers seemed to have inherited this deformity.
Research has been underway for many years to determine if the wearing of custom orthotic devices in shoes to properly balance feet can slow down the progression of bunions and other foot problems. Whether this holds true depends on which podiatrist you ask. If you ask two podiatrists, you’re likely to get three opinions. As such, the jury is still out on the benefit of wearing custom orthoses strictly for the prevention of hereditary foot problems.