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Why Women Have More Foot, Knee, Hip, & Back Pain (and what you can do about it)

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Hello EmpowHER Readers! Thank you for inviting me to write about our remarkable feet, and how they affect our entire body.

Pain and problems in the female foot are common—four times greater than for men. One study found that eighty-two percent of U.S. women report having foot pain, seventy-two percent have a foot deformity, and of all foot surgeries in the U.S., women undergo ninety percent of them.

Incredibly, it isn't just the woman's foot that leads in pain and problems. Females suffer with more ankle, leg, knee, hip, back, and neck problems. Clearly, when it comes to pain, this is one place women have too much equality!

Don't despair! You can do simple things to prevent and alleviate pain now. Before I get to that, I want to explain why women are more prone than men to experience muscle-skeletal pain and ailments.

It All Starts With the Feet

Feet are your foundation—whether you are man, woman or child. Strong, well-functioning feet and ankles are essential for support and balance. Working in unison with the body, your feet rapidly adapt to maintain balance over a variety of surface, whether you are running, walking, jogging, carrying a backpack, baby, purse, or all three, or even recovering from a sudden stumble. Feet do it all.

Having incredibly dynamic feet is great until something with them goes wrong. The smallest imbalance in your feet shows up as larger problems up above—in your knees, hips, back, and/or neck. Thus, a misaligned foot leads to a misaligned hip and/or back and/or neck.

Our body depends on agonist-antagonist muscles pulling against each other around our dozens of joints, and any joint imbalance will cause weakness of the muscles on one side of the joint and tension and strain of the muscles on the other side. The result is pain.

Further, these muscle-skeletal misalignments are more likely to occur due to the unique shape of the woman's "normal" foot.

How is Woman's Foot Unique?

Compared with males, the female’s foot is generally shorter, narrower, and the length of instep is not as long.

Add a Comment4 Comments

Hi Kristen -

Thanks for your detailed comment. You are right, shoes are a BIG factor and do contribute in a big way to foot problems for women (and men), however, science proves the woman's foot is unique (and different) from the male. Briefly, the bones of the female foot are unique from the male foot, and further, these differences contribute to women developing foot problems. For instance, the contour of the end of the metatarsal bone that forms part of the big toe joint, increases the likelihood women will form a bunion. And at the ankle the main bone of the leg, the tibia, is narrower in women and its outer shell (or cortex) is thinner (both these factors contribute to ankle fractures).

Beyond shape, the joints of the foot differ in the female. There are 33 joints in the foot. A joint is a fluid-filled capsule that connects two bones and allows movement. Within the joint, cartilage (the shiny white gristle that you see on the ends of chicken bones) covers the edges of the bones that are touching each other. The joints of the female foot have less fluid, less surface and the cartilage is thinner. As a result, the joints are more likely to breakdown and become arthritic.

Ligaments—strong, thin bands of tissue—hold joints together. In women, ligaments are more lax or looser than in men. A looser ligament creates a weaker joint, which in turn, contributes to women experiencing more ankle sprains, dislocations of the foot bones, and misalignment problems, such as bunions, flat feet and crooked toes.

These looser ligaments are due to the hormones’ estrogen and progesterone. The levels of these hormones fluctuate with the woman’s menstrual cycle. Some scientists believe that during ovulation (day 10-14) when the amount of estrogen in the body is the highest, the woman is most at risk for a ligament injury.

This is a little bit of the science that proves male and females have different feet. This doesn't mean that the female foot is worse than the male; just different. Again, thanks for your comment.

March 24, 2010 - 4:39pm
EmpowHER Guest

To me, it sounds like in all your descriptions of how a woman's foot is different from a man's, you're basically saying a woman's foot is smaller than a man's, which makes sense since women are generally smaller and shorter then men. And as for the flat footed thing, what evidence do you have to back that up? I know that I have high arches, as well as most of the women in my extended family. Is there really that much of a difference in how our feet are formed? Or could it be that women have so much more trouble with their feet and related areas because of the shoes they generally wear? Men don't usually wear high heels every day to the office. It's an issue with how society expects women to dress, not with how women are formed physically. This may sound a bit accusatory/argumentative for an article that isn't obviously attacking women, but I believe in speaking out when something sounds derogatory towards women, even when it's something like this. Reproductive rights are being stripped from women in the US (there are all kinds of accounts online of women who are pregnant and are court ordered to have a c-section against their will, a direct result of women being viewed as inherently weak and sickly/basically incapable of making their own decisions). This prevalent opinion among medical professionals that view women's bodies as being weak, incapable and prone to illness needs to change or we'll never be treated as fully equal citizens. Just do a search on 'court ordered c-section' if you don't believe me about women's rights being in danger. Also, when a women goes in for birth control pills, she's almost always required by her physician to have a pelvic and breast exam. These are two exams screening for cancer. They have no bearing on whether or not the doctor prescribes the pills, but most doctors will flat out refuse to prescribe these pills without performing these exams. This medical attitude towards women is a sneaky phenomenon that is happening all over the US and that women are generally not aware of until they become an outright victim. If you're looking for more proof, try googling 'birth rape' as well. Anyways, yes, I think going barefoot is a good practice and it was actually when I was googling info on minimalist foot wear that I found this article. I just don't like the beginning of the article that blames all of the problem women have with their feet on how their feet are physically formed. I have no doubt women suffer more then men when it comes to feet issues, but again, I ask you to take a look at the difference in shoes that women and men generally wear, instead of putting all the blame on how women's feet are physically formed. If there was something inherently wrong with how a woman's foot is physically formed, would walking barefoot really fix it?

March 17, 2010 - 7:54pm

Thanks, Pat! If you have a specific foot-related interest, please let me know!

January 27, 2010 - 8:12pm
HERWriter Guide

Welcome Dr. Nirenberg! I enjoy your articles, and appreciate your commitment to female foot health. You're a great addition to our site, and I'm looking forward to your contributions.
Take care, Pat

January 27, 2010 - 5:37pm
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.


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