Something's afoot — Ill-fitting shoes, obesity contribute to problems with your feet

Add foot problems to the list of ills, such as certain types of cancer and some cases of high blood pressure or heart disease, that are greatly influenced by both heredity and personal choice.

Many of the most common, painful foot problems are inherited. It's not so much a particular gene that's at fault but rather the inherited shape and biomechanics of the foot.

As for choice, there are different views. Some podiatrists say the shoes you wear play a big role in foot problems, although not all agree. They reach consensus, though, on the importance of wearing the right shoe, especially when you have foot problems.

And excess weight is indisputably hard on feet. Often, simply shedding pounds resolves foot problems, says Dr. William Martin, a Logan podiatrist. "Weight is a huge issue. I try to work with the patient on that in a gentle way. The bigger you are, the more problems you are going to have. It puts more pressure on joints, whether the hips, knees, ankles or joints of the feet.

Overweight patients will probably develop arthritis. All that pressure is going to go somewhere. Just losing weight can fix some problems. Heel pain and arch pain can absolutely go away."

Heavy people are more prone to twisting their ankles and suffering arch collapse, Martin says.

"The No. 1 complaint I see is heel pain, plantar fasciitis, and it's related to faulty foot gear," says podiatrist Dr. Ryan Anderson, of Advanced Foot and Ankle in Bountiful. "Most of the patients I see are female, and it's related to their shoes."

Plantar fasciitis is heel pain caused by inflammation from the ligament that holds up the arch.

When podiatrist Dr. Steven Royall of Mountain View Foot Clinic in Salt Lake City talks about foot care, he talks footwear. "Shoes are crucial," he says. "There's such a variety, especially for women. Stiletto heels are job security for me." Shoes need to fit well, and "the stiffer the better" so the shoe does the work, not the foot. The toe box must not pinch or let the foot slide around.

Footwear is not where anyone should skimp, Anderson says. "You don't have to spend a lot to get the right shoes. People spend a lot on other types of apparel, but shoes are the most important thing you wear."

Martin says footwear doesn't cause most of the problems he sees. He divides common problems into four groups: Skin problems include ingrown toenails, athlete's foot, fungal nails and warts. Tendon problems attack the arch, heel and ankles. The third group is nerve related, including neuromas, which are inflamed nerves between the metatarsal heads. And finally, he sees bone deformities such as bunions or hammertoes.