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Saturday, February 26, 2005

AAOS, AOFAS release foot survey results

At some point in life, everyone experiences foot pain. Whether it is a temporary or persistent problem, pain in the ankle, heel, arch or toes can limit physical activity, causing a great deal of stress on a person's life. According to survey results released by the American Orthopaedic Foot and Ankle Society (AOFAS), foot and ankle problems can be linked to an individual's weight and body mass index (BMI).

The survey results were presented by orthopaedic surgeons Stuart D. Miller, MD, of Baltimore; Sharon M. Dreeben, MD, chairman of AOFAS' Public Education Committee; and Glenn B. Pfeffer, MD, immediate past president of AOFAS. The online survey was answered by 6,157 respondents, with a mean age of 34.5 years and average body mass index (BMI) of 27.9 kg/m2. People with a BMI between 18.5 kg/m2 and 24.9 kg/m2 are classified as normal; those with a BMI of 25.0 kg/m2 to 29.9 kg/m2 are considered overweight, and individuals with a BMI above 30.0 kg/m2 are classified as obese.

The results shoed a correlation between overweight participants-as measured by BMI-and foot problems. Statistical analysis found an increased BMI for those with current foot and ankle pain. Patients who had prior foot surgery or who had previously seen a physician about foot and ankle pain seemed to have a higher BMI. Also, 40.8 percent of the respondents reported weight gain prior to the onset of pain.

While problems vary from patient to patient, foot and ankle pain often occur in weight-bearing areas, as well as in the tendons and ligaments. Common foot problems include posterior tibial tendonitis, plantar fasciitis and hindfoot arthritis.

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

The survey also uncovered some differences between the sexes. Among respondents, women were more likely to see a physician for foot pain and more likely to change their shoes based on physician's advice. Similarly, more women underwent foot and ankle surgery than men. Men, however, more often claimed a specific injury as the cause of pain and were more likely to wear orthotic inserts in their shoes.

These findings linking overweight individuals to orthopaedic foot and ankle problems echo similar knee-related investigations previously conducted. Increased BMI has also been found to increase foot pressures with standing and walking, and is no doubt a precursor to foot and ankle pain.

To avoid future pain and problems with your feet and ankles, the panel recommended that people:

  • Wear shoes that are comfortable and fit your feet properly.
  • Place cushions in your shoes for additional comfort and support.
  • Exercise regularly to lower your BMI and strengthen the muscles, ligaments and tendons in your feet and ankles.
  • Stretch your leg and calf muscles daily, using techniques like the runner's stretch, to eliminate current and potential foot pain.
  • See a physician sooner rather than later, if you are experiencing persistent foot and ankle problems.

"An uncomfortable shoe can lead to more serious foot problems," said Dr. Miller. "It is important to wear proper shoes, because in the long run, fashion is not worth the price of pain."

The data was analyzed and study formalized in the Department of Orthopaedic Surgery at Union Memorial Hospital in Baltimore, Maryland.

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