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Why should people wear shoes in the house?

Why should people wear indoor shoes in the house?

 

Walking barefoot on hard surfaces for an extended amount of time is bad for your feet because it allows our foot to collapse which can lead to a tremendous amount of stress not only to the foot but to the rest of the body. Our feet naturally pronate during the gait cycle, however when we walk barefoot we pronate for a longer period of time which then alters the biomechanics and distribution of pressure and weight across the foot. This imbalance may increase the progression of underlying foot deformities such as bunions and hammertoes and lead to painful conditions associated with excessive pronation such as arch/ heel pain, shin splints/ posterior tibial tendonitis, and Achilles tendonitis. This imbalance can then translate upward affecting other parts of the body such as our knees and back. 

I strongly advise against wearing outdoor shoes indoors to avoid the unnecessary and non hygienic transfer of soil, bacteria, viruses, and pollen from the environment into our homes.  A study by Charles Gerba, a microbiologist and professor at the University of Arizona, and The Rockport Company found large numbers of bacteria both on the bottom and inside of shoes. Although some scientists suggest this concern is overblown, some of the bacteria found on the shoes such as E. Coli can cause intestinal and urinary tract infections, meningitis and diarrhea while other bacteria such as Klebsiella Pneumonia, can cause pneumonia as well as wound and bloodstream infections. A convenient new shoe that recently entered the market are Muvez shoes.  Muvez shoes are indoor slippers with a detachable outdoor sneaker sole.   These shoes would be a nice compromise for those that do not currently remove their outdoor shoes when at home. The outdoor sneaker sole easily comes off when you arrive at home turning into an indoor slipper and then quickly attaches when you leave to become an appropriate outdoor shoe.

Plantar Warts are easy to contract.  A wart is a thickened and elevated small growth of skin that develops when the skin becomes infected by the human papillomavirus (HPV). Warts can develop anywhere on the foot, but typically occur in areas of direct pressure under the foot, such as the ball and the heel. Hard and thick callus can grow over the wart lesions as they grow inward and make them more painful. Clotted blood vessels or as they are commonly called “wart seeds” present as black dots at the base of the lesions. I know what you’re thinking – I can catch this at home? Absolutely! If you’re wearing outdoor shoes inside, you can bring a number of bacterial and fungal infections to yourself. You can catch the virus from a spouse or roommate if they have plantar warts. That’s why I suggest having an indoor shoe specifically inside. Do not walk barefoot inside and do not wear outside shoes in doors.

Athlete’s Foot/Fungal Nails: Athlete’s Foot is a fungal infection of the foot that develops commonly on the soles of the feet and in between the toes. It usually produces itchy, dry, scaling skin. In more severe cases, inflammation, cracks, and blisters may form. If left untreated, it can infect the nails leading to discolored and brittle fungal nails. Like plantar warts, this can be contagious and brought into your home by outdoor shoes.

Last but not least, I highly recommend not wearing outdoor shoes particularly if you have young children crawling on floors or have allergies, because pollen can be transferred to floors, especially to carpets.

However, I do recommend wearing indoor shoe gear in the house as it protects our feet from a number of ailments, including:

Plantar fasciitis (Heel/ Arch Pain): The plantar fascia is a shock-absorbing bowstring like thick ligament that connects your heel to toes. When you stand your arch collapses causing this bowstring to stretch out leading to the formation of micro tears in the ligament that can result in weakness, swelling, and irritation of the plantar fascia. The main issue with walking barefoot at all is that you put a tremendous amount of stress on the foot allowing it to collapse which could lead to foot pain.

Bunions and Hammertoes: Our feet naturally pronate during the gait cycle means that the arches of our feet naturally collapse.  However, prolonged pronation which occurs more so when walking barefoot on hard surfaces can exacerbate faulty biomechanics of the foot which can lead to the formation and progression of foot deformities such as bunions and hammertoes.

Posterior Tibial Tendonitis (also known as Shin Splints): is also common when walking on hard surfaces. The posterior tibial tendon provides support to the arch of the foot and gives stability when walking.  When the arch collapses for prolonged periods of time, the Posterior Tibial Tendon stretches excessively, which can lead to micro tears of the tendon which can lead to swelling, pain, and instability of the tendon.

What type of support is important in a shoe at home? Is an actual shoe necessary, since it's usually less steps than our usual routines?

I typically encourage people to look for the following support:

Shank Rigidity: In order to tell if the shoe is rigid enough, you want to take the shoe and bend it in half. The ability to bend the shoe or not should depend on your foot type.

Wide forefoot: Most of the problems that occur with our feet - particular for women - are because our shoes don't have a wide enough forefoot. Bunions, hammer toes, neuromas, ingrown toenails, etc. are all caused if you don’t have the wide forefoot.  In order to determine whether the forefront is wide enough, I suggest that you trace your foot onto a piece of paper at the end of the day when your feet are most swollen. Then place the shoe over the tracing of the foot. If the tracing of the foot is external to the periphery of the shoe then you know that your shoes are too narrow.

Supportive and durable: It is important to pick a shoe that offers as much durability and protection as possible without sacrificing comfort or flexibility.  Look for a shoe designed with smooth, solid leather uppers that are not only highly durable but also flexible and comfortable.

Author
Dr. Miguel Cunha Dr. Miguel Cunha, founder of Gotham Footcare and a leading podiatrist in Manhattan, is a highly trained and skilled foot and ankle surgeon with experience treating a wide array of foot and ankle conditions from minor problems to complex reconstructive foot and ankle surgery. Dr. Cunha takes pride in having a genuine interest in each and every one of his patients while providing them the utmost compassion and exceptional care.

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