November 15, 2024 2:02 am

Skipping shoes during the pandemic? That’s a problem, Yale doc says

With many people working from home for the past 21 months, padding around the house barefoot or with just socks or slippers, doctors are finding a problem related to the COVID-19 pandemic: Injured and unhealthy feet.

The problem has been exacerbated by people delaying health care in general, and thinking their feet don’t have a high priority.

But breaks in the skin, fallen arches and broken toes from stubbing them against the furniture can cause bigger problems if not cared for, according to Dr. Sean Peden, a Yale Medicine orthopedic surgeon based in Stamford, who specializes in foot and ankle conditions.

Collapsed arches have become more common, Peden said.

“This is one of the more complicated conditions I take care of. It’s often a condition that does end up requiring surgery,” he said.

A collapsed arch can happen from “a combination of weight gain during the pandemic, combined with more time in the house on their feet, not wearing good footwear,” Peden said. People will complain that “my arch is killing me. I’ve got all this swelling in my foot,” he said.

The condition requires “changing your footwear pretty much for life,” along with low-impact exercise and weight loss, Peden said.

Stiff, inflexible soles are the best, even in slippers.

At times, “surgery can be required to correct the arch and reestablish the tendons and ligaments that are damaged or weak,” he said. “The condition becomes more common as you get older.”

“I wouldn’t call it a crisis or anything like that,” he said. “People are just not coming to the doctor as quickly. The problem becomes more severe by the time they come into my office.”

Another painful condition is plantar fasciitis, which is inflammation of the thick band of tissue that connects the heel to the toes along the bottom of the foot.

It can be extremely painful and can occur when “doing a lot of high-impact exercise that’s tough on your foot and tough on your tendons,” Peden said.

Power-walking on pavement or aerobics classes that require a lot of jumping don’t help, either, he said. Spinning, swimming or “walking on better surfaces, on a track, for example, or a trail where there’s some give,” are better on the feet, Peden said.

“The biggest thing for me is people who have been off their feet for a while and want to get back to exercising,” Peden said. It’s important that “they choose the right footwear and take the time to have a trainer.” He said it’s best to try on shoes at a store and not to order over the internet, when you can’t try them on for a good fit.

And don’t believe those who say there’s one shoe that’s best for everyone, he said.

“A good shoe store is worth its weight in gold in avoiding my office,” Peden said.

Peden said he sees two main types of injuries during the winter: “People who come in who get injured fairly quickly because they’re not wearing the right footwear” or who fall off an exercise bike.

The other is those who overdo the exercise, “maybe using a slightly wrong technique,” and who end up with tendinitis or a stress fracture.

Peden also recommended keeping feet moisturized by soaking them, using lotion and wearing socks for an hour afterward. The foot has among the largest number of nerve endings in the body, he said, and pain is all the worse because we put “six times your body weight in force” onto our feet when we walk.

“Neglecting your feet and allowing the skin to become dry and cracked and callused … will magnify the pain from other conditions like plantar fasciitis or arthritis,” Peden said.

“When your foot is dysfunctioning, it’s very hard to adjust for that and it’s miserable,” he said.

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