Step Right Up

Casual, COVID-era fashion took its toll on more than just our style. "Many people were dressing for comfort during the pandemic, effectively giving their poor feet a break from the negative impacts of high heels," says orthopedic surgeon Alexander Peterson, MD, a foot and ankle specialist with Keck Medicine of USC. "As soon as offices reopened and social functions kicked back up, the heels came out again, but for many people, so did the pain.

Pre-existing foot and ankle arthritis or deformities like bunions and hammertoes may have worsened in severity over the long lockdown. Podiatrist Bob Baravarian, DPM, director of the University Foot and Ankle Institute in Los Angeles, explains that staying home (and shoeless) left arches without support, the sole suspect in most post-pandemic foot problems: such as bunions and plantar fasciitis (pair along the bottom of the foot). "As the arch collapses, there's usually a widening of the foot and more stress on the big toe joint, which can result in a bunion," he says.

Whether the goal is to fit back into your dress shoes or walk without pain, Baravarian suggests rolling the sole of the foot on a frozen water bottle and stretching the calf muscles and Achilles tendons because tightness in those areas will put more stress on the arch of the foot. Wearing arch-supportive shoes, like Birkenstocks, at home is also essential, says Baravarian, who patented an arch-support sock called Archtek that mimics the arch taping that podiatrists do in office ($10 a pair, archteksocks.com). Baravarian and Peterson both caution against injecting dermal fillers like collagen or hyaluronic acid gel into the ball of the foot for extra cushion. "These are quick and convenient treatments, but the medical literature does not provide much evidence to support their use," Peterson says.

For painful bunions, Peterson suggests starting with nonsurgical care. Orthotics, toe spacers, anti-inflammatory medication, and larger-size shoes (or ones with a softer upper) are all options. If pain persists, surgical bunion correction realigns the bones to correct the deformity. "Traditional bunion surgery required large incisions on the top or side of the foot to gain access to the underlying bone," he says. "Newer, minimally invasive techniques obtain the same level of correction with only a few tiny incisions, generally less than a quarter inch in length. Patients generally report less swelling and less stiffness after surgery, when compared with traditional techniques."

According to Baravarian, a procedure called Lapiplasty, "which realigns the loose point and fuses the non-essential joint to correct the bunion in three dimensions, is the gold standard surgery for bunions." With Lapiplasty, patients can get back on their feet after two weeks, instead of the usual 3 to 16 weeks of downtime with traditional surgery. Because a longer, doctor-ordered lockdown is the last thing anyone wants right now.