Your feet more likely to suffer the heavier you are
By LEE BOWMAN
Scripps Howard News Service
February 25, 2005

WASHINGTON - A new survey confirms what most adults of a certain size have
long suspected - the more overweight you are, the more likely your feet and
ankles are to hurt.

There are many reasons for our feet to hurt, from bad shoes and injuries to
arthritis and diabetes. Almost everyone experiences some foot or ankle pain
at some point - other studies report lifetime prevalence of foot pain as
high as 80 percent.

The new online survey, presented before the annual meeting of the American
Academy of Orthopaedic Surgeons on Friday, was based on responses from
6,157 people, with an average age of 34.5 years.

The average body mass index - calculated by dividing metric weight by
height - was 27.9. People with BMI of 18.5 to 24.9 are considered normal,
25 to 29.9 classified as overweight and above 30 are classified as obese.

More than 40 percent of respondents to the survey, done through the Web
site of the American Orthopaedic Foot and Ankle Society, reported they had
experienced significant weight gain before the onset of their foot pain,
and higher BMI was also more common in people who had previously seen a
doctor about foot and ankle pain, or already had foot surgery.

"It is important for the public to know that obesity isn't just an
aesthetic issue, but a contributing cause of musculoskeletal health
problems, specifically with the feet and ankles," said Dr. Stuart Miller, a
surgeon at Union Memorial Hospital in Baltimore.

The average adult set of feet logs about 1,000 miles a year, according to
the society. Just walking puts up to 1-1/2 times your body weight on each
foot, Miller noted.

Being heavier increases foot pressure even when a person is just standing,
and the effects are exaggerated when a person is obese. Heavier individuals
tend to have an altered gait, with the rear of their feet landing outward,
and putting more pressure on the arch and the plantar ligament that
connects the heel and the ball of the foot.

As shock absorbers, the 26 bones and four main ligaments of the foot are
estimated to cushion up to 1 million pounds of pressure during one hour of
strenuous exercise.

"In general, people carry approximately four to six times their body weight
across the ankle joint when climbing stairs or walking steep inclines. This
is because the mechanics required to elevate your body create increased
force across the ankle joint," Miller explained.

They survey's findings also match earlier research on the effect of body
mass index and likelihood of knee injury.

The survey found some differences between the sexes in how they deal with
foot pain. Women were more likely to see a doctor for foot pain and to
change their shoes based on a physician's advice. Females were also more
likely to have had foot and ankle surgery than men.

Men more frequently cited a specific injury as the cause of their pain, and
were more likely to wear orthotic inserts in their shoes.

The surgeons recommend that people seek to avoid foot pain by:

- Exercising regularly to lower BMI and strengthen muscles, ligaments and
tendons in the feet and ankles;

- Stretch calf and other leg muscles daily, using techniques like a
runner's stretch, to reduce current and future foot pain;

- Wear shoes that are comfortable and fit properly, and place cushions in
shoes for additional comfort and support;

- See a physician sooner rather than later if you are experiencing
persistent foot and ankle problems.