Feet hurt, lady? Blame your shoes

USA Today (Society for the Advancement of Education), March, 1994

A study by orthopedic surgeon Michael J. Coughlin of more than 2,100 foot surgeries performed over the last 15 years found that better than 80% of the patients were women and that the primary cause for their problems was tight shoes. Of those who had operations to relieve or correct a bunion or deformity of their big toe joint, 94% were female.

"The results of the study should educate consumers, shoe designers, manufacturers, and salespersons that shoes must be comfortable and fit well at the time of purchase. Shoes that are too tight alter the shape and joints of a normal foot.

During my 15-year practice, I have observed that many women unknowingly wear shoes that are two sizes too narrow, such as wearing an AAA instead of an A.

As people age, their bodies and feet usually change in shape and size. People should have their feet measured and change their shoe size, if necessary."

Coughlin, also points out that women place their rectangular-shaped feet into triangular-shaped high-fashion footwear that constricts the forefoot in the toebox. A high heel increases the downward pressure and exacerbates the problem. Over time, the forces can lead to deformity of the big toe and formation of a bunion. "Forefoot Problems can be modified or eliminated by the use of roomy footwear, as is witnessed by the low occurance rate in the male population."

TEACHING KIDS TO

BE "STREET SMART"

Detective Helen Shatinsky of the New York City Police Department's Crime Prevention Division offers these child safety guidelines for parents:

* Encourage your offspring to take a self-defense course or engage in sports. These activities help build self-esteem and give kids a more confident attitude.

* Know your child's friend. Get addresses and phone numbers.

* Tell youngsters to draw as much attention to themselves as possible if accosted by a stranger.

* Instruct children to avoid short-cuts. Walk the neighborhood with them and show them safe places to go - such as a trusted neighbor or reliable business.

* Make sure kids know how to use the phone and whom to call in case of an emergency.

* Teach youngsters that if someone demands money or belongings. to hand them over.

* Encourage kids to play in groups, not alone. Get together with other parents and develop some sort of neighborhood network where children can do things together.

* Tell your offspring to trust their instincts. If a situation or person makes them uncomfortable, they should get away.

HOW TO REDUCE

CHILDHOOD OBESITY

Obesity affects more than one in four children and adolescents nationality, a statistic that could be reduced with the help of improved family communication skills. "For too long, the assumption has been that overweight children have a problem with overeating or inactivity." notes Laurel Mellin, associate clinical professor of family and community medicine and pediatrics, University of California, San Francisco.

"The fact is, severe obesity in kids is almost always a symptom of a larger problem.... Family communication is a better predictor of the extend of obesity in children than either a poor diet or inactivity. This can manifest itself in several ways. The child is too enmeshed with a parent and indulged. The parent may not set sufficient limits on the child, resulting in [an unhealthy lifestyle]. Conversely. the child may be too distant from a parent, which can result in the vulnerable child not receiving the nurturing needed to thwart emotional overeating. Of course. generics, diet, exercise, and medical factors all can contribute, but, historically, child obesity treatments that focusd exclusively on these factors have failed.

Involving the parents in treatment should not be construed as blaming the parents for a child's obesity. "Often, only one child in a family is obese. That child may be particularly vulnerable to obesity because of genetics or temperament. The success of [childhood weight loss] programs demonstrates that there is an opportunity to build on the strength of the family unit as part of child obesity treatment."

For effective, long-term weight loss, a program must emphasize small, sustainable modifications in diet, exercise, and communication. Parents should be involved from the start, receiving instruction on how limits are met, as well as developing a healthier family lifestyle.