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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. The average woman wears a size 8.5 (her foot is approximately twenty-four centimeters or 9.5 inches in length, about an inch shorter than the foot of the average male). The woman’s heel is narrower when compared to the ball of foot, which is wider and has a larger girth relative to the rest of the foot.
Overall, the woman's foot is flatter than the male foot. This lower (or more pronated) foot is the root cause of the many of the body's structural problems.
When feet flatten more than necessary (or over-pronate), the legs compensate by rotating excessively inward. This increased internal rotation creates abnormal stress on the knees causing them to become painful and deteriorate (osteoarthritis). With the knees now strained and out of alignment, a "ripple effect" can occur, causing imbalances, pain and arthritis in the hips, back and neck Since a woman's foot is already on the flat-side, she is more predisposed to this painful cascade of events. (For those people whose feet are high arched (or supinated), a similar cascade of joint misalignment occurs leading to pain, imbalance and osteoarthritis.)
To make this chain-of-events even worse, a foot—male or female—that is on the flat side (excessively pronated) is more prone to become even weaker through a vicious downward foot-flattening cycle. Ultimately, this progressive flattening of the foot results in even more foot problems and more muscle-skeletal problems throughout the body.
What You Can Do About Foot, Knee, Hip, Back and Neck Pain
To restore normal alignment to your body, you need to restore balance. The best way to do this is by strengthening agonist and antagonist muscles around your major joints with the goal of improving posture.
This sounds complicated, but there is a very simple way to start: walk barefoot. Shoes act as braces for your feet, altering the alignment of your body and negating the need for many muscles to work at all. Walking barefoot or in minimalist footwear (very flexible shoes such Terra Plana's Vivo Barefoot), allows your body to "feel" the ground. Do as much walking barefoot as safely possible.
Barefoot activity allows your body's muscles to develop and remarkably, an innate biofeedback system kicks in that tells your body how to make subtle, unconscious adjustments in the way you walk (your gait). To walk correctly takes a lot of work and study, and is beyond this article, but barefoot walking is a great way to start.
When you must wear shoes, less is more. As mentioned, wear minimalist shoes or very flexible, thin shoes that provide basic protection but still let your feet sense the ground beneath them.
Final Thoughts on Muscle-Skeletal Pain
Now, you can begin to understand the effect of foot misalignment and other joint imbalances on your body. The simplest way to start to strengthen your muscles and rebalance your body is through your feet, and how by losing your shoes, you will be on your way to losing the pain.
For more information on feet, foot problems, barefoot activity and other foot and walking issues, visit my blog, http://www.americaspodiatrist.com. If you have any questions or foot, ankle or walking-related topics you would like to learn about, please let me know.
References:
Bingefors K, Isacson D. Epidemiology, co-morbidity, and impact on health-related quality of life of self-reported headache and musculoskeletal pain--a gender perspective. Eur J Pain. 2004 Oct;8(5):435-50.
Stubbs D, Krebs E, Bair M, Damush T, Wu J, Sutherland J, Kroenke K.Sex Differences in Pain and Pain-Related Disability among Primary Care Patients with Chronic Musculoskeletal Pain.
Pain Med. [Epub ahead of print]
Khang YH, Kim HR. Gender differences in self-rated health and mortality association: role of pain-inducing musculoskeletal disorders. J Womens Health (Larchmt). 2010 Jan;19(1):109-16.
Terrier P, Dériaz O, Meichtry A, Luthi F. Prescription footwear for severe injuries of foot and ankle: effect on regularity and symmetry of the gait assessed by trunk accelerometry. Gait Posture. 2009 Nov;30(4):492-6. Epub 2009 Aug 25.
About Dr. Nirenberg:
Dr. Nirenberg is podiatric physician dedicated to alleviating pain through foot and walking-related activity, modifications and treatments. He has been featured on Fox News and the History Channel. To learn more about foot problems and alleviating muscle-skeletal pain, visit his blog, http://www.AmericasPodiatrist.com
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 - 4:39pmThis Comment
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~Kristen
This Comment
Thanks, Pat! If you have a specific foot-related interest, please let me know!
January 27, 2010 - 8:12pmThis Comment
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.
January 27, 2010 - 5:37pmTake care, Pat
This Comment