Can You Wear the Shoes You Love?
Are high heels safe for people with diabetes?
You have diabetes. Does that mean you can't wear the shoes you love? You know – no high heels, no shoes with pointed toes, or no toes at all such as sandals and flip flops. And, does that mean you can't have a pedicure?
I had the opportunity to ask Bob Thompson, Certified Pedorthist and Executive Director for the Institute for Preventive Foot Health. I heard his lively presentation at the American Association of Diabetes Educators' annual meeting in Las Vegas this past August.
Read on to hear what he has to say about high heels:
Joy: You are a certified pedorthist. What is a pedorthist?
Bob: The textbook definition is one who designs, manufactures, fits and/or modifies shoes and foot orthoses to alleviate foot problems caused by disease, overuse or injury. But perhaps a more understandable everyday definition is this: I'm not permitted to diagnose, prescribe, perform surgery or give injections; but I serve as a consultant to orthopaedic surgeons and podiatrists and as a patient educator in my functional capacities as a biomechanical engineer, an appliance manufacturer, an artist, and a designer.
Joy: When a person has diabetes, and wears the types of shoes I mention above, what do you tell them? Changing someone's type of shoes, especially a woman's, is like asking someone to change their lifestyle.
Bob: I'm not so foolish as to think that anyone will change their lifestyle just because I ask them to. I do want people with diabetes to understand why each one of those types of shoes can adversely affect their well-being. Shoes that cause someone to put too much pressure on the balls of their feet; cause pressure on the medial and lateral sides of the feet; cause the toes to scrunch together; or maybe even overlap or push up against the tip of the shoes or fail to protect the feet by exposing them to injury if they are open-toed are all extremely dangerous footwear designs for anyone with diabetes. People with diabetes must be vigilant in the care of their feet…even if they think their feet are healthy. I can tell them of the thousands of diabetic feet I‘ve cared for, of the diabetic ulcers I've helped their doctors heal, and of the diabetic amputations we've worked diligently to avoid, but ultimately the person must come to their own decision to protect their feet.
Joy: Why are women with diabetes told not to wear high heels?
Bob: Whether someone has diabetes or not, no foot was made to stand on a 4- or 5-inch spike heel (stick) with disproportionate pressure being placed on the ball of the foot. Anatomically the foot was designed to bear the body's weight shared approximately 50% on the ball of the foot and 50% on the heel. Raising the heel of a shoe more than two inches begins to put too much pressure on the ball of the foot. And if the foot is neuropathic or insensate in the first place, nerve and circulatory vessels can be compromised, as well, leading to even greater problems.
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