Many times we hear of people falling and fracturing their hip, what would you think if I said in a lot of instances the hip breaks first and then you fall? Interesting maybe but could this be prevented? With the research I did with my thesis and what I have seen and heard since, I feel yes it could well be prevented.

Lets go back to when we evolved, we would all be running around on grass and soft terrain which would act as a shock absorber to the joints of the knees and hips. I wonder if lower joint problems would have been as prevalent then as now?

We now spend most of our life walking on hard surfaces and on average walk the equivalent of 6 times around the world. Without the soft terrain or grass there is immense pressure from our weight needing to be cushioned from this relentless concrete. In a word its like driving a car with shock absorbers or without. A car last a lot longer with them as would your hips and knees given half the chance.

Many people wear hard soled shoes, woman’s shoes are often the worse as high heeled shoes hardly ever have a thick sole, city gent shoes also lack much shock absorption, in fact any shoes with a thin sole will send vibrations up the legs. If we filmed someone in shorts walking on grass or concrete we would see the difference on the knees if it was replayed in slow motion.

A survey was done many years ago over a 10 year period comparing people wearing hard soled shoes and others in thicker bouncy soled shoes and there was a marked increase in hip and knee replacements with the thinner soled group. I remember an Orthopaedic surgeon giving us a lecture at university, he said we wouldn’t remember much of what he would say but would always remember how he was dressed. He stood on the desk for 10 minutes not saying a word wearing a black suit, black tie, black shirt and a large white pair of trainers. He said after that if thicker soled shoes were worn orthopaedic joint surgery would be at a minimum.

At university there was a tutor Mr Hawes who I always respected with his down to earth views on Podiatry. He had his own busy private practice in Brighton and worked at the University 2 days a week when we were treating patients. He always had a different approach to other lecturers with his long service in Podiatry. He often taught things which were never in a book.

I always remember him saying “Any pain in the foot then fill in the hollows”. What he meant by this was to fill in the arch maybe to give more support to the foot, or under the toes etc. Most people don’t realise that the human foot in its form should be running around on grass or soft terrain. Debris gets caught under the arch when in bare feet giving more surface area to take the load. I am sure that people feel much more study on their pegs when walking with bare feet on the grass as you are gripping the earth more and holding onto it as monkeys do.

Our bodies haven’t evolved to accommodate a hard surface below. Many foot problems such as metatarsal, heel pain and bunions could be caused by pressure from this surface, there is no give in concrete and we walk on it all the time. I feel that our feet are so small compared too the rest of our body that it is quite amazing that we can walk at all. It is interesting that life size robots can not be made to the same measurements to us, where they have a problem is in the feet, they are just too small. Any robot made has to have very large feet to accommodate the height its no wonder that older people are prone to falling.

When walking most of our weight (which can amount to over a ton a mile) is on the heel, some on the lateral border and then onto the ball of the foot, these are the areas that have pressure and maybe pain. I often use a felt pad with elastic to “fill in the hollows” which takes away pressure from the heel and metatarsal area.

It is like having a Lintel put in; the weight is then redistributed from the heel to the arch area and onto the ball of the foot. This allows more ground contact surface area. If patients are happy very thin orthotics can be made in the clinicwhich are heat moulded to the foot in a few minutes which has reduced the cost dramatically and has a life-time guarantee. These are prescription made which is much better than bought arch supports as each arch is different from foot to foot let alone patient to patient.

So many people ask us what is the difference between a Chiropodist and Podiatrist and we answer that nowadays there is no difference. Our society; the Society of Chiropodists and Podiatrists introduced the term Podiatrist in 1993 as it’s the internationally recognised name for a foot specialist and also to help distinguish State Registered Chiropodists  (those that had undertaken a 3 year training course) from Chiropodists that had done a home study course.

Nowadays both titles are protected and anyone calling themselves either title have to be registered and regulated by the Health Profession Council (HPC) Health Professions Council

Podiatry is a branch of medicine devoted to the study, diagnosis, and treatment of disorders of the foot, ankle and lower leg and these days in the UK training consists of a Bachelor of Science degree undertaken for 3 or 4 years full time at University.