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April 20, 2022

What is 'pandemic foot'—and how can you treat it?

Daily Briefing

    Writing for the New York Times, Mara Altman explains the condition that podiatrists are calling "pandemic foot," and offers several ways to treat it.

    'Pandemic foot'

    After a brief lull in foot trauma at the start of the pandemic, Robert Lee, chief of podiatric foot and ankle surgery at UCLA Santa Monica Medical Center, quickly experienced a surge in patients complaining about foot pain. "I was like, 'Aha, so this is the effect of the pandemic on feet across the country,'" Lee said.

    While there is no hard data on the recent increase in foot pain, James Christina, executive director of the American Podiatric Medical Association, said many of his 12,000 members have seen a clear correlation between the two.

    For instance, Rock Positano, co-director of the Non-surgical Foot and Ankle Service at the Hospital for Special Surgery, has seen a 20% to 30% increase in what he calls "pandemic foot."

    As Covid-19 mandates relax, many are eager to get their pre-pandemic bodies and hobbies back, according to James Hanna, a podiatrist and president of the New York State Podiatric Medical Association. As a result, many have aggravated existing injuries or sustained new ones.

    "People thought they could just return to where they left off or try something they hadn't tried in a couple years," Hanna said, "but their feet aren't prepared for what their bodies want to do."

    What is driving the increase in 'pandemic foot?'

    Overuse

    One of the most common foot ailments happens simply because of the increased strain placed on the foot. "Perhaps you opted to walk long distances instead of use public transportation or went barefoot at home," Altman writes.

    "People don't realize how much mileage they put on walking and standing in their houses," Positano said.

    Overuse injuries like plantar fasciitis can potentially impact more than foot health. Ultimately, if they are not addressed, they can "go up the chain," and cause knee, hip, and back pain. "People think they are falling apart, but they are not," Positano said. "They are overusing their feet."

    Household accidents

    According to Priya Parthasarathy, a Maryland-based podiatric surgeon, there has also been an increase in toe and foot fractures since the start of the pandemic—some of which are caused by household accidents like kicking furniture and tripping over pets.

    "You see one, then you see two, then three and then four," of these pet-related fractures "and you're like, 'Wait, there's definitely a connection here,'" Parthasarathy said.

    Toe spreading

    In addition, Judith Baumhauer, an orthopedic surgeon at University of Rochester Medical Center, has been removing more bunions—bony protrusions at the base of the big toe—since the start of the pandemic. "Without supportive shoes, the foot can splay — actually widen — and the anatomical structures can change. Among other issues, this can aggravate bunions," Altman writes.

    "They let their feet do whatever they wanted," Baumhauer added, "and now that they have to go back to work, their feet are rebelling."

    Increased weight on the foot

    According to Baumhauer, pandemic-related weight gain could also contribute to the increase in foot discomfort—even a few extra pounds can have an impact. "It's literally just physics," she said.

    When we walk, our foot takes on four times the force of our body weight. As a result, losing or gaining five pounds would result in a change of "20 pounds to their ankle and foot," Baumhauer added.

    Too much too soon

    According to Jacquelyn Dylla, an associate professor of clinical physical therapy at the University of Southern California, one of the biggest triggers is people engaging in too much activity too soon.

    "Many of us have undergone atrophy and bone density loss from inactivity without noticing it, making it harder to stabilize ourselves on uneven surfaces," Altman writes.

    As a result, even small injuries can cause "more catastrophic problems," Dylla noted. "I have patients who look like they were in a car accident," she added, "but they just rolled their ankle during a hike."

    How to prevent and ease 'pandemic foot' pain

    Wear supportive footwear

    One of the simplest ways to fix foot pain is to wear supportive footwear. In particular, experts recommend shoes that have a semirigid sole, a spacious toe box, and a small heel lift.

    "Get properly fitted at a shoe store and, if you don't want street shoes in your home, get a pair specifically for use indoors," Altman writes. "If using older shoes, be sure that the tread is not too worn, as those may have degraded too much to offer substantial support. Insoles can also be added for additional arch support."

    Strengthen your body

    According to Dylla, an essential part of resuming activity is strengthening the feet with toe curls and foot doming. "There's a crunch for the stomach," Dylla said, "doming is the crunch for the foot."

    Start slow

    According to Hanna, his best advice is to start slow. "If you're going to start walking, do moderate pace at short distance," he said. "If you tolerate that well, maybe go at a faster pace for longer distance."

    In addition, podiatrists encourage stretching to prevent and treat foot problems. "A proper warmup," Hanna said, "I cannot emphasize this enough." (Altman, New York Times, 4/19)

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