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Put your foot in it with a shoe survey

October 1st, 2008

Dr Petra

Did you know that heel injuries cost ’29 million’ annually? Or that bunions cost millions? Or that high heels lead women to have trapped nerves, corns, bent toes, or the inability to walk properly?

Well, perhaps it’s no surprise that wearing high heels a lot might damage your feet, but do high heels truly lead to millions in healthcare costs per annum?

According to research out today – that’s got all the papers hopping with excitement (rather than sore feet) – our tootsies are definitely in trouble.

A breakdown of costs presented in media coverage suggests that bunion removal (which can cost around £4000 per operation) which adds up to 13.8 million a year. Toe straightening (at a cost of £1200 per op) results in an annual spend of £10.4 million. £3.3 million is spent on big toe joint replacement, £2 million on trapped nerves and £200,000 on ingrowing toenails.

Do these costs come from the NHS or private practice? It’s not made clear. How were these figures obtained? We don’t really know. Is this a problem? Yes, because often private cosmetic clinics encourage clients to see their toes (and other bits of them) as needing ‘fixing’ as a means of generating income. So it’s not clear from these figures exactly what they represent and whether they are surgical procedures carried out on people with severe toe and foot injuries, or whether they were carried out privately and may not have needed doing.

More confusingly the press coverage implies these figures came from a survey of 1000 women, which doesn’t quite make sense. The survey also found almost half of women in Liverpool and Manchester wore heels all week long – what the rest of the UK female population does wasn’t made so clear. And four in ten women have had a shoe-related accident – most commonly in the form of a twisted ankle.

An NHS consultant podiatrist who was the spokesperson for this research said “While we love our high heels, wearing them for prolonged periods is bad news for our health and wallets. We need to mix and match our choice of footwear to allow our bodies time to recover. Heaven forbid that we ban heels from our wardrobes but we want to balance out our heel wearing days, protect our bodies from future damage and avoid injuries. Bunions and corns can be incredibly painful, not to mention unsightly. Although operations to reverse them are available on the NHS, waiting lists can be long. By opting for private treatment, women can be painfree sooner and, more importantly, avoid long-term health problems.”

Why an NHS consultant is advocating private treatment (unless they also practice privately) isn’t explained. But for spokesperson you can read this as the-person-we-paid-to-endorse-this-research. Rather than someone who completed an independent study.

So who was this research completed by? Was it the NHS or a cosmetic surgery clinic? No. Was it a study published in a peer reviewed journal tackling podiatry or related issues? No.

The survey was run by footwear company MBT. MBT make trainers. They don’t make high heels. But presumably the company thought if they convince us that wearing heels are a health hazard then they could offer us a solution – their footwear. And having an NHS consultant as a spokesperson no doubt was a deliberate strategy to reinforce the idea that this is a genuine bad foot epidemic that needs to be tackled.

Ethically there are issues when practitioners and academics get involved in PR research. Sometimes being the spokesperson for a genuine good cause can be a worthwhile activity – particularly if you’re able to design and carry out the research yourself. However it may be somewhat less worthy (or ethical) to use your clinical status to support research that is creating a health crisis in order to promote a product.

I’m sure most podiatrists would suggest that wearing heels all the time is a problem, and that wearing correctly fitted flatter shoes is a good thing. But that doesn’t mean it’s okay to support a piece of research that’s specifically been created to sell a trainer.

At best it’s naive of the company to take this approach, at worst it’s very cynical. Either way it worked for MBT since this story has had lots of press coverage. Let’s hope a savvy woman who hears this story may understand that yes, high heels should be worn in moderation, but that the solution to the problem is not a shoe that costs from £70 to £200.

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