The Essential Guide to Stop Foot Pain in Women
By Dr. Rion Berg
July 30, 2019
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When a new patient comes to my office, it's more likely to be a woman than a man. While it's true that women are more likely to see a doctor for a health issue sooner than a man, women are also at greater risk for many common foot problems. In this guide I'll be discussing the 1) types of foot problems women are likely to encounter, 2) the role of foot type and shoes in developing foot problems, 3) the role of exercise in women's foot and ankle problems, and 4) how to prevent and treat foot and ankle problems in women.

The Role of Foot Type in Women's Foot Problems
All of us have a particular foot type: either a flat arch, normal arch, or high arch. If you have a normal arch, you're fortunate. Although people with normal arches can still develop foot problems they are far fewer than those who have a flat arch or high arch.

It's important to know what kind of foot type you have so you can prevent some of the foot conditions that plague women. Your foot type is inherited, so if your parents had a specific foot type you're more likely to have it as well.

To determine your foot type, wet the sole of your foot. Step onto a blank piece of paper or a shopping bag. Step off the paper or shopping bag to examine the shape of your footprint and compare it to the photo to the right.

If you have flat feet you'll tend to role your feet inward or pronate. Pronation can increase your risk for many painful foot problems such as plantar fasciitis, bunions, neuroma, and hammertoes. High arches can put you more at risk for ball of foot pain.

Painful Foot Conditions More Common to Women
You might wonder why women are more likely to have painful foot conditions than men. While flat feet contribute to foot problems in both men and women, women get them more often for three reasons:
1) a greater amount of weight gain throughout life, 2) rapid weight gain during pregnancy, and
3) improper shoe choices.

Weight Gain Can Cause Foot Problems
Weight gain places more pressure on the feet causing the arch to flatten out. For women who already have a flat arch, weight gain can make them flatter. Women who gain weight are more likely to develop plantar fasciitis, bunions, and posterior tibial tendon dysfunction. Shoe size also increases with extra weight due to the flattening of the arch. It's important for women who have gained weight to get their feet measured when buying new shoes to avoid foot pain caused by wearing a shoe that's too small.

Pregnancy and Foot Problems
Weight gain
Rapid weight gain during pregnancy can bring on plantar fasciitis and Achilles tendonitis. Wearing a supportive shoe during this time is imperative.

Swelling
Another common foot and ankle issue in pregnancy is swelling. In addition to retaining extra fluid, weight from the growing uterus compresses lower extremity veins, impeding their function of returning blood to the heart.  While this usually goes away when baby arrives, it can be incredibly uncomfortable.  Elevating the feet and wearing compression stockings help to control edema. Physical activity, including walking, reduces swelling by activating the leg muscles, which act as pumps on the deep veins. It's important to avoid tight shoes and instead wear shoes with a wide toe box to help prevent other foot problems during that time.

Loss of balance
Weight gain and changes in body shape shifts a women's center of gravity forward. Hormonal changes cause loosening of the foot ligaments. This combination can throw off a women's balance. For that reason women should never wear high heels when pregnant since this type of shoe is already less stable then a lower heeled option. Wearing more stable, low-heeled shoes are essential to prevent falls.

Shoe Choices That Can Cause Foot Problems
Women often make shoe choices that can cause painful foot problems.

Frequent high heel wear can increase your risk for ball of foot pain including bunions, neuromas, and hammertoes. When wearing high heels your weight is placed primarily on the ball of the foot which places a lot of stress on the metatarsals, the toes, and the nerves.

Tight shoes or shoes that are too short can increase your risk for ingrown toenails and fungal toenails. When the toenail is pushed against the front of the shoe, hiking boot, or ski boot an ingrown toenail can result. Shoes that are too tight or too short can cause damage to the nail plate, making it easier for fungus to set up shop.

Flat shoes can increase your risk for plantar fasciitis and Achilles tendonitis. Flat shoes with no arch support can be problematic for anyone but particularly women who have flat feet. When walking or engaging in other activities such as dancing or running the arch will flatten out causing the plantar fascia to stretch beyond its limits. This can result in pain and inflammation in the heel and at the Achilles tendon.

Shoes with no support can also cause foot pain. Women who have had problems with their feet in the past or have flat feet or high arches should not wear these types of shoes.

Pumps can be problematic for women who develop a bony enlargement called Haglund's deformity or so called "pump bump", due the location of the deformity and the rigidness of pumps. Any shoe with a rigid back can cause problems for anyone with this type of foot problem.

Flat flip flops with no arch support can lead to a myriad of foot problems for women. Flip flops were only created to be worn at the beach, swimming pool, gym locker rooms, and shower rooms. Unfortunately flip flops have become extremely popular and women wear them for long walks and for other activities that require a much more supportive shoe. The constant gripping at the toes to keep the shoe on, the flatness and lack of support, and absence of protection make flip flops problematic for women to wear off the beach. They can cause blisters, hammertoes, Achilles tendonitis, neuromas, heel pain, and worsen bunions. Their dearth of support can also lead to sprained ankles. A better choice is a Vionic sandal which is a flip flop with great support. Even better is a water sandal that has foot support and straps.

Preventing and Treating Women's Foot Conditions
Prevention
Many women's painful foot problems can be prevented or reduced by wearing proper shoes. It's important to select shoes that work well for your foot type, the kind of athletic activity you prefer, while avoiding heels higher than one inch and shoes that are too tight. Shoes also need to provide proper support. To test any shoe before you buy it, watch this video.

Treatment
While treatments vary widely by foot problem, some treatments can help resolve several types of painful foot issues. That's because several foot problems have a similar cause.

Flat feet and pronation
Earlier we talked about how foot type can play a role in women's foot problems. Flat feet and lower arched feet tend to pronate. Together these factors can cause a variety of foot problems such as plantar fasciitis, Achilles tendonitis, ball of foot pain, bunions, hammertoes, and neuromas.

Orthotics can correct the faulty biomechanics of a flatter foot providing relief from heel pain and Achilles tendonitis and preventing bunions and hammertoes from worsening. Initially I suggest patients with mild foot pain start with an over-the-counter insert such as Powerstep. If pain continues then a prescriptive custom orthotic will be required to control the abnormal foot motion.

Tight calf muscles
Heel pain, plantar fasciitis, and Achilles tendonitis will also require adequate stretching of the calf muscle since a tight calf muscle also plays a big role in development of these conditions. Learn more about how to reduce tight calf muscles by reviewing this information and these videos.

Inflammation
Inflammation plays a big role in many chronic foot problems including plantar fasciitis and Achilles tendonitis. Visit our website to learn how to reduce inflammation for these foot problems.

For acute injuries to the foot or ankle such as stubbing your toe or spraining your ankle, it's important to take immediate action to reduce the pain and swelling. The most effective treatment is a protocol called “RICE”. RICE is an acronym for rest, ice, compression, and elevation. 

  • Rest – Stop all activity. Keep weight bearing to a minimum, making sure ankle strength and stability have returned before attempting physical activities.

  • Ice - Apply an ice pack or a package of frozen peas to the affected area (use a layer of cloth between your skin and the ice) 20 mins on and 20 min off for up to 48 hours after the injury.

  • Compression - Hold it in place with an elastic bandage to provide compression.

  • Elevate - the ankle slightly higher than the heart to keep down swelling.

High arches

High arches come with their own set of foot problems. High arched feet primarily contact the ground in the heel and the ball of the foot. Pain can develop in three regions of the foot due to this foot structure.

Ball of Foot
Metatarsalgia or ball of the foot pain can occur with prolonged standing or exercise. Hammertoes can also form as a result of extra weight on that part of the foot.

Heel of the Foot
Pressure on the heel of the foot can lead to plantar fasciitis and Achilles tendonitis.

Middle of the Foot
Because most shoes don't support the middle of the foot, high arches can result in pronounced midfoot pain.

Supportive shoes with good arches are essential for preventing problems in the high arched foot.

Ball of foot pain
Many different conditions cause ball of foot pain including neuromas, metatarsalgia, hallux rigidus, sesamoiditis, and capsulitis. For a complete review of the causes, symptoms, and treatment for these conditions, visit our website.

Nail and Skin Problems

Nail and skin problems of the feet are most often caused by tight and poor fitting shoes, and physical activity, and diabetes.

Ingrown toenails result from shoes that are too tight and by cutting the toenails on an angle instead of straight across.

Toenail fungus is more common in women who wear tight shoes, participate in sports such as running, go barefoot in pool showers and gym locker rooms, or are exposed at nail salons. Sometimes trauma to the nail can look like toenail fungus. It's best to see a podiatrist who can test the nails to be sure it is fungus. Treatment methods include topicals, oral medications, laser therapy, and methods to keep nail fungus low. To avoid toenail fungus it's important to follow these recommendations. If you already think you have fungal toenails, visit our Seattle Fungal Toenail Center to learn more about how it's treated.

Diabetes is hereditary and also more common among women who are overweight, don't exercise, and have a diet high in fats and sugars. People with diabetes are at greater risk for developing wounds or ulcers of the feet which can be very dangerous. Dry skin on the feet is very common in people with diabetes and is treated with special moisturizers. An annual visit to the podiatrist to get a Comprehensive Diabetic Foot Exam is essential to prevent ulcers from forming.

Foot and Ankle Problems in Women Who Are Physically Active

Women who are physically active are more prone to foot and ankle problems due to the repetitive movements, high impact, constricting or unsupportive footwear, or increased risk of trauma due to the nature of the sport. It's important to understand the particular risks of a sport to help prevent pain and injury.

Women runners are at greater risk for plantar fasciitis, Achilles tendonitis, neuromas, and stress fractures. Purchasing supportive running shoes at a store that specializes in running, switching out the shoe insert for a better insert such as Powerstep, avoiding high heels, and doing dynamic warm-ups will help prevent many foot problems in women runners. Here's a more complete description of foot problems in women runners.

Women hikers need to assess the type of hiking they'll be doing before purchasing boots. The right socks are also extremely important in preventing blisters. Check out my "Definitive Guide to Prevent and Treat Heel Pain in Hikers".

Learn how to prevent foot and ankle injuries in other sports such as Zumba, martial arts, soccer, and tennis.

If you're experiencing foot or ankle pain, call us today at 206-368-7000 for an appointment. We'll often appoint you the same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

You can also download the following book for runners.

"The Complete Guide to Stopping Heel Pain in Runners".

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

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