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Gerrard Farrell
06-24-2018, 06:18 AM
During gait we have two windlass phases ,the initial windlass phase and the second windlass phase . Generally speaking , shoes are designed not to interfere with the second windlass phase but I believe that most do interfere with the " initial windlass phase of gait " . This interference may lead to a number of pathologies including shin splints and plantar fasciitis and ,in my opinion , these conditions may well persist for as long as the footwear is used .

Recap on initial windlass phase of gait - ( for fuller explanation of " initial windlass phase of gait " see link 1 )

The initial windlass phase of gait (IWPG) occurs during the swing phase of gait and during weight acceptance . The mechanism involves the dorsiflexion of the toes before foot strike , which winds the plantar fascia around the MTFJ s and then passive plantar fexion of the toes ,against the eccentrically contracting toe dorsiflexors during weight acceptance ,and the progressive " paying out" of the wound plantar fascia , rather like line being pulled off a fishing reel against the drag . This mechanism allows the forces generated during weight acceptance to be spread over a significantly longer time period than would otherwise be the case ,thus protecting the plantar tissues of the foot from damaging levels of peak force .


Shin splints -

Shoes which inhibit the dorsiflexion of the toes by the toe extensors , during the swing phase of gait , can cause these muscles to have to work harder than would otherwise be the case leading to overuse and shin splints .



Plantar fasciitis - ( from posts of mine in Pod arena )

My understanding is that clogs are a common choice of footwear amongst nurses . I believe that shoes which require that the toes be pressed down against the sole of the shoe to hold the heel in place during the swing phase of gait , may habituate suppression of the initial windlass phase of gait ,causing unnecessary stresses on the plantar foot structures during gait , leading perhaps to plantar fasciitis .


Consider a nurse , male or female , getting home from a hard day around the hospital , performed wearing a clog type shoe with no heel restraint . The nurse's feet and legs are sore and they are glad to get in and put on their slippers ........which have no heel restraint!

. The feet are again obliged to planter flex the toes during the swing phase of gait to keep the slippers on , which in my opinion should not be encouraged as it suppresses the initial windlass phase of gait .

Ok , its a day off and our nurse goes for a run . No initial windlass phase , strain on the plantar fascia giving plantar pain , and 40 years of struggle begin .
And over all those years , in the corner of the room , sit the clogs , the backless slippers , and the restrictive running shoes .


Link 1

Windlass mechanisms - plural - and diabetes - Biomch-L (https://biomch-l.isbweb.org/threads/31054-Windlass-mechanisms-plural-and-diabetes)

https://biomch-l.isbweb.org/threads/31054-Windlass-mechanisms-plural-and-diabetes


2 Mar 2018 - 8 posts - ‎1 author
Post 1 So during the gait cycle the windlass mechanism is engaged and reversed twice . Going from heel strike to heel strike we have windlass




Gerrard Farrell

Glasgow

Gerrard Farrell
07-07-2018, 04:37 AM
This from a Phd thesis (LF Reed 2007) which looked into foot problems in a population of nurses in Australia .


"Foot and ankle problems were the most common MSDs experienced by nurses in the preceding seven days (42.7% of nurses). They were the second most common MSDs to cause disability in the last 12 months (17.4% of nurses), and the third most common MSDs experienced by nurses in the last 12 months (54% of nurses). Substantial foot discomfort (Visual Analogue Scale (VAS) score of 50mm or more) was experienced by 48.5% of nurses at sometime in the last 12 months."

LINK

An investigation of foot and ankle problems experienced by nurses ... (https://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=14&cad=rja&uact=8&ved=0ahUKEwi74MT8yIzcAhUMa1AKHQ_-DTg4ChAWCFMwAw&url=https%3A%2F%2Feprints.qut.edu.au%2F35779%2F&usg=AOvVaw2egyNKAzTpdEQSFpUBYL0C)https://eprints.qut.edu.au/35779/







by LF Reed - ‎2007 - ‎Cited by 3 (https://scholar.google.co.uk/scholar?espv=2&biw=1034&bih=751&um=1&ie=UTF-8&lr&cites=2366459363285235537) - ‎Related articles (https://scholar.google.co.uk/scholar?espv=2&biw=1034&bih=751&um=1&ie=UTF-8&lr&q=related:UXcDvEBa1yDEsM:scholar.google.com/)
22 Jun 2017 - Relatively little information has been reported about foot and ankle problemsexperienced by nurses, despite anecdotal evidence which ...

Gerrard Farrell
07-08-2018, 06:50 AM
Many occupations involve standing in one place over a long period of time . For example assembly line workers , theater nurses, surgeons and the like .

However , standing still is actually a lot more dynamic than many might imagine with constant weight shifting occurring between the feet over time . This causes constant fluctuations in the stresses to which the plantar fascia is subjected which over time may lead to pathological changes . A properly functioning "initial windlass mechanism phase " will likely reduce the rate of loading of the plantar tissues and therefore the cumulative stresses to which the plantar fascia is subjected , thus reducing the risk of plantar fasciitis .

In my opinion the " initail windlass phase " will function best in shoes with the following design features .

1. A sole which allows the feet to remain flat when at rest .

2 A toe box which allows the toes to dorsilfex freely ( Anecdotally , I have noticed that when standing in queues , the toes of people wearing open toed sandals often dorsilfex and plantar plantarflex quite noticeably during weight shifting )

Gerrard Farrell
07-11-2018, 02:04 PM
A little reading on the subject of workers who stand all day showed that this can lead to serious musculoskeletal problems as well as other complications such as a "doubling the risk of heart disease "(see link to article below ) .

What really struck me however , was the fact that just standing ,or moving around minimally , on hard concrete surfaces leads to a higher risk of plantar fasciitis than if the underfoot conditions are more forgiving ie rubber matting .

It seems to me then , that methods of loading the plantar fascia less rapidly during weight shifting and thus reducing strain in the fascia would be of benefit to workers who stand all day even if they do not actually take many recognized steps .

So back to that ideal shoe and one more feature .In my opinion a spring type sole might be of benefit .

We now have ( from above )

1. A sole which allows the feet to remain flat when at rest .

2 A toe box which allows the toes to dorsilfex freely ( Anecdotally , I have noticed that when standing in queues , the toes of people wearing open toed sandals often dorsilfex and plantar plantarflex quite noticeably during weight shifting )

and now
3. a springy sole .

I recently came across a shoe which might meet the bill made by a company called OESH .

It would be very interesting to see how this type of shoe performed against the industry standards although I realise that all the relevant health and safety standards ,were applicable , would have to be met first .

link

Standing for a long time doubles heart disease risk: study (https://www.today.com/health/standing-long-time-doubles-heart-disease-risk-study-t116840)https://www.today.com/.../standing-long-time-doubles-heart-disease-risk-study-t11684...






29 Sep 2017 - Over time, that can increase your risk of heart disease. ... to force certain occupations to stand for long periods of time,” Smith told TODAY

LauCamiSotelo
07-11-2018, 03:15 PM
[QUOTE=Laura Sotelo] High-heeled shoes have been suggested as a main explanation for the female dominance in foot pain and deformities. Aim of study was to test this hypothesis scientifically. The investigations were weight bearing radiographs of foot and ankle of 95 women using high-heeled shoes at their work since 5 years, and 105 women who had never worn them at thei work. Radiographs showed no statistically significant differences between the two groups concerning deformities or joint disease. For women aged 4066 years wearing of high-heeled shoes had not caused foot deformation, but more foot pain and callosities.
As an analysis of this study it can be observed that in the work of these women it is not necessary to spend a lot of time in the place, for this reason no plantar deformations are generated. On the other hand, because they also have to walk to get to work, we present the tiredness, pains and appearance of calluses on their feet; A possible solution to this problem is to observe where in the pie is the greatest number of pressures, by means of the templates of analysis of the march, and thus generate a more appropriate footwear to reduce these pains and / or callosities.