Too tight, too high: shoe fashion can make you sick

Frequently wearing shoes that are too tight means that more than 80 percent of women over 45 years of age in Austria suffer from misalignments of the forefoot such as hallux valgus, hammertoes and splay feet. This is what experts are drawing attention to when discussing the advantages and disadvantages of new surgical techniques at the foot congress in Vienna.

Hallux valgus is the most common deformity of the forefoot. “In 40 percent of all women over 45, the disease is so advanced that surgery is required,” says Hans-Jörg Trnka, one of the two congress presidents, a specialist in orthopedics and orthopedic surgery and co-founder of the Vienna Foot Center. The main reason for this clinical picture is “Western shoe fashion with shoes that are too tight”, and only six to ten percent of the cases of the disease are genetically determined. “Therefore, 90 percent of all hallux valgus patients are women.”

Healthy sneaker trend

The problem, also known as “overleg”, “bunion”, “frostbite” or “crooked toe”, is a degenerative, civilization-related disease. “It is hoped that the current trend towards sneaker shoes will have a positive effect on the frequency of the disease. However, we will only see that in 20 years,” says the foot specialist.

“The foot has an extremely complex structure with 26 bones, over 33 joints, more than 100 ligaments and around 20 muscles,” so there are numerous surgical techniques that require specialist knowledge and experience, says Trnka. “There are over 300 different surgical techniques for the operation of hallux valgus alone, with around five techniques being used internationally.” Good follow-up care is at least as important as a precise operation: patients who received physiotherapy after the operation showed a healthy gait again just eight weeks after the procedure. However, without subsequent physiotherapy, those affected “often cannot walk well even after a year”.

The most common misalignments

Hallux valgus is a deformity in which the big toe moves out of line because the base joint of the big toe tilts outwards. This causes the foot to become wider; if left untreated, the big toe will slide under or over the little toes. This leads to further foot deformities and painful inflammation.

Hammer toe and claw toe: They are caused by an imbalance in the small muscles in the forefoot. Because the toe bends too much, it can cause pain, inflammation, open skin, and infection.