The pandemic has been hard on our feet


In March 2020, Krista Fahs started working from home. As she sneaked to her office, the 53-year-old computer distributor saleswoman put aside her usual sneakers. She found herself doing laundry, playing with her cat, and even visiting neighbors without putting on shoes. “I was barefoot the whole time,” she said.

A few months after working from home, she started feeling pain in her heel, but she ignored it until last month when it got too bad to ignore. Even when she was lying in bed, the beatings wouldn’t stop. “‘This is ridiculous,'” she recalled thinking, “I didn’t even know how I was going to fall asleep.”

The onset of the pandemic coincided with a sharp decline in foot trauma, said Dr. Robert K. Lee, chief of podiatric foot and ankle surgery at UCLA Santa Monica Medical Center, but his practice quickly declined. repopulated with patients like Ms Fahs who complained of foot pain. “I was like, ‘Aha, so this is the effect of the pandemic on feet across the country,'” he said.

There’s no hard data on increased foot pain, but Dr. James Christina, executive director of the American Podiatric Medical Association, said it’s a clear trend for good number of its 12,000 members.

Members like Dr. Rock Positano, co-director of the non-surgical foot and ankle service at New York’s Hospital for Special Surgery, who saw foot pain increase so much – 20-30% – that he called the phenomenon “pandemic foot.

Now that spring has arrived, warrants are easing and people are eager to get back to their pre-pandemic bodies and hobbies, they’re hitting the pavement, said Dr. James Hanna, podiatrist and president of the New York State Podiatric Medical Association. . Many aggravate existing foot injuries or create new ones.

“People thought they could just go back to where they left off or try something they hadn’t tried in a few years,” he said, “but their feet aren’t prepared for it. what their body wants to do.”

By instituting a few simple measures, Dr. Hanna assures owners of sore feet everywhere that foot pain can be relieved and prevented.

Some of the most common foot conditions arise simply because the foot is under increased pressure during the pandemic. Maybe you chose to walk long distances instead of using public transport or went barefoot at home. “People don’t realize how many miles it takes to walk and stand in their homes,” Dr. Positano said.

Ms Fahs was diagnosed with one such overuse injury, plantar fasciitis, where the ligament under the foot that supports the arch of the foot becomes inflamed, often felt as heel pain. “I knew what it was because my brother, my sister and one of my best friends all had it recently too,” she said.

Metatarsalgia is another overuse injury, also caused by inflammation, but in the toe joints, which causes pain in the sole of the foot.

For those starting ambitious running routines right out of the pandemic, Achilles tendonitis is a common diagnosis. The tendon connects the calf muscle to the heel bone and with sudden increase in use it can become irritated and swell.

These injuries can affect more than the health of the feet. If left untreated, they can “climb up the chain” and cause pain in the knees, hips and back. “People think they’re collapsing, but they’re not,” Dr. Positano said. “They abuse their feet.”

Overuse injuries aren’t the only reasons people are experiencing foot pain lately. Dr. Priya Parthasarathy, a podiatric surgeon from Maryland, has also seen an increase in toe and foot fractures. Some are caused, she said, by accidentally kicking furniture — the result of being home and barefoot more often — and tripping and clumsily falling on pets. “You see one, then you see two, then three, then four,” she said of such pet-related fractures, “and you’re like, ‘Wait, there’s definitely a link here.”

Meanwhile, Dr. Judith F. Baumhauer, an orthopedic surgeon at the University of Rochester Medical Center, removed more bunions, which are bony protrusions at the base of the big toe. Without supportive shoes, the foot can flare – in fact, widen – and the anatomical structures can change. Among other problems, it can make bunions worse.

“They let their feet do whatever they wanted,” Dr. Baumhauer said, “and now that they have to go back to work, their feet are rebelling.”

Dr Baumhauer said pandemic weight gain could also be to blame for increased foot discomfort. She explained that even a few extra pounds had an impact. “It’s literally just physics,” she said, explaining that the foot takes on four times the force of our body weight when walking. Losing or gaining five pounds would represent a change of “20 pounds in the ankle and foot,” she said.

Jacqueline M. Dylla, associate professor of clinical physical therapy at the University of Southern California, said one of the main triggers is people doing too much too soon. Many of us have experienced atrophy and loss of bone density from inactivity without realizing it, making it harder to stabilize on uneven surfaces. “Small injuries cause more catastrophic problems,” she said. “I have patients who look like they were in a car accident,” she added, “but they just rolled their ankle on a hike.”

Even young children, after a year or two in virtual school, encounter problems when they throw themselves headlong into sports. “You have a kid sitting at home every day for a year who jumps straight into cross-country practice,” Dr. Parthasarathy said.

Podiatrists say one of the remedies for foot pain can be quite simple: wear supportive shoes. This means a semi-rigid sole, roomy toe box and a little heel lift. Get a proper fit at a shoe store, and if you don’t want dress shoes in your home, get a pair specifically designed for indoor use. If you’re using older shoes, make sure the tread isn’t too worn, as these may have degraded too much to provide substantial support. Insoles can also be added for additional arch support.

Ms Dylla said it is also essential to prepare our bodies for renewed activity by strengthening them first. This means exercising the feet with toe loops and domed feet. “There’s a stomach crunch,” Ms. Dylla said, “the doming is the foot crunch.”

Dr. Hanna said the best advice might be to start slow. “If you’re going to start walking, do a moderate pace for a short distance,” he said. “If you tolerate that well, maybe go at a faster pace for a longer distance.”

Podiatrists also say stretching is key to preventing and treating unhappy feet. “A good warm-up,” Dr. Hanna said, “I can’t stress that enough.”

In the morning, even before going to the bathroom, Dr. Hanna recommends flexing the feet by pulling the toes towards the body. Then pretend your toes are a pencil and write the alphabet. “If you do that,” he said, “you’ll activate all the joints and be much less likely to injure yourself.”

Even if the calf seems far from the sole of the foot, stretching it plays a vital role in pain-free walking. “When your calf and Achilles tendon are tight,” Dr. Lee said, it “creates a lot more stress on all the joints in your feet.”

He suggests getting into a lunge position with one foot in front of the other, hands against a wall, and feet flat on the floor. You should feel the stretch in the calf of the back leg. He suggests doing it several times a day.

Massaging the arch area can also prevent injury by keeping the bottoms of our feet supple. Dr. Lee advises grabbing a tennis ball or golf ball while sitting at a desk or watching TV. “Roll your foot over the ball and massage that area to loosen those fibers,” he said.

However, if you have heel pain, have your foot checked by a doctor before stretching. In some cases, Dr. Positano said, there may be undiagnosed tears in the plantar fascia that stretching can make worse.

If you experience persistent foot pain, make an appointment with a podiatrist. There are many easy ways for doctors to relieve pain and prevent chronic problems from developing. If you’re uncomfortable, “seek care,” Dr. Baumhauer said, “because there’s a lot of tricks up our sleeves.”

Mara Altman is a journalist and author of “Gross Anatomy: Dispatches From the Front (and Back)”


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