The pandemic has been hard on our feet

In March 2020, Krista Fahs started working from home. As she approached her desk, the 53-year-old saleswoman at a computer distributor dropped her usual sneakers. She found herself doing laundry, playing with her cat and even visiting the neighbors without wearing shoes. “I was barefoot all the time“, she said.

A few months after working from home, she began to feel a pang of ache in the heel, but disregarded it until last month, when the pain became too intense to ignore. Even lying in bed, the throbbing wouldn’t stop. “’This is ridiculous,’” she remembered thinking, “I didn’t even know how I was going to sleep.”

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A foot massage with a frozen water bottle helps to minimize pain and inflammation.
A foot massage with a frozen water bottle helps to minimize pain and inflammation. Photograph: AMANDA JASNOWSKI PASCUAL

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the beginning of pandemic coincided with a sharp decline in foot trauma, said Dr. Robert K. Lee, chief of foot and ankle podiatry surgery at UCLA Santa Monica Medical Center, but his office quickly filled with patients like Fahs who complained of foot pain. “I thought, ‘Oh, so this is the effect of the pandemic on feet across the country,’” he said.

There is no hard data on the increase in foot pain, but Dr. James Christina, executive director of the American Podiatric Medical Association, said this has been a clear trend for many of its 12,000 members.

Members like Dr. Rock Positano, co-director of the Non-surgical Foot and Ankle Service at the Hospital for Special Surgery in New York, saw foot pain increase so much—20% to 30%—that he called the phenomenon “pandemic foot”.

Now that spring has arrived, the demands regarding Covid-19 are lighter and people are eager to get their pre-pandemic bodies and hobbies back, everyone is taking to the streets, said Dr. James Hanna, chiropodist and president of the New York State Podiatric Medical Association. Many are aggravating existing foot injuries or creating new ones.

“People thought they could just pick up where they left off or try something they hadn’t tried in a few years,” he said, “but their feet aren’t ready for what their bodies want to do.”

By instituting a few simple measures, Hanna reassures owners of sore feet that this pain can be alleviated and avoided.

Overuse injuries

Some of the most common foot ailments occur simply because they were under greater strain during the pandemic. Perhaps you chose to walk long distances instead of using public transport or going barefoot at home. “People don’t realize how much mileage they do walking and standing in their homes,” Positano said.

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

THE metatarsalgia is another overuse injury, also caused by inflammation, but in the joints of the toes, which causes pain in the supporting part of the front of the feet.

For those who started ambitious running routines soon after the pandemic, Achilles tendonitis has been a common diagnosis. The tendon connects the calf muscle to the heel bone, and with a sudden increase in use, it can become irritated and swell.

These injuries can affect more than the health of your feet. If left untreated, they can “go up in jail” and cause knee, hip and back pain. “People think they’re falling apart, but they’re not,” Positano said. “They are using their feet too much.”

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

Meanwhile, Dr. Judith F. Baumhauer, an orthopedic surgeon at the University of Rochester Medical Center, has been removing more bunions, which are bony bumps at the base of the big toe. Without supportive shoes, the foot can open up—actually widen—and the anatomical structures can change. Among other problems, this can make bunions worse.

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

Baumhauer said pandemic weight gain could also be to blame for increased foot discomfort. She explained that even a few extra pounds have an impact. “It’s literally just physical,” she said, explaining that the foot takes on four times the strength of our body weight when walking. Losing or gaining 2 kg would be an “8 kg change in the ankle and foot”, she said.

A lot and very fast

Jacqueline M. Dylla, an associate professor of clinical physical therapy at the University of Southern California, said one of the biggest triggers is people doing too much too fast. Many of us have suffered atrophy and loss of bone density from inactivity without realizing it, making it difficult to stabilize on uneven surfaces. “Smaller injuries are causing more catastrophic problems,” she said. “I have patients who look like they’ve been in a car accident,” she added, “but only sprained their ankle while walking.”

Even young children, after a year or two of taking virtual classes, are having trouble playing sports. “You have a kid sitting at home every day for a year going straight to cross-country,” Parthasarathy said.

Chiropodists say that one solution to foot pain can be quite simple: wear shoes with good support. That means a semi-rigid sole, roomy toe cap and a small heel lift. Get the proper fit at a shoe store, and if you don’t want street shoes in your house, buy a pair specifically for indoor use. If you’re wearing older shoes, make sure the soles aren’t too worn, as they may have degraded too much to provide substantial support. Insoles can also be used for additional arch support.

Dylla said it’s also essential to prepare our bodies for renewed activity by strengthening them first. This means exercising your feet by moving your toes and stretching. “There’s a chew to prepare the stomach,” Dylla said, “the foot needs to be prepared too.”

Hanna said the best advice might be to start slowly. “If you’re going to start walking, practice a moderate pace for short distances,” he said. “If you tolerate it well, try a faster pace for longer distances.”

If you are experiencing any persistent foot pain, make an appointment with a chiropodist. There are many simple ways doctors can relieve pain and prevent chronic problems from developing. If you are uncomfortable, “seek care,” Baumhauer said, “because there are a lot of tricks up your sleeve.” / TRANSLATION LÍVIA BUELONI GONÇALVES

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About Abhishek Pratap

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