Dress and care of the feet /

by John Lord Peck

It will be found true, we believe, that in persons of muscular temperament—the temperament that gives tall, spare, and angular forms—the curvature of the arch is greater than in those whose natural disposition of body is toward fleshiness. In the latter case, the muscles of the whole system being weaker, they allow the bones of the foot to separate more easily, and this, consequently, allows the flattening. In other words, we strongly suspect that in this temperament of the body the ligaments are not so dense, firm, and strong as they are in persons whose physical structure is more predominantly muscular. The ligaments which hold the bones together at the joints are not designed to stretch, under ordinary circumstances, but they do yield when sufficient force is exerted upon them, as in the case of sprains and dislocations, and it is reasonable to infer that they adapt themselves to the demand made upon them. The muscles grow longer and larger, as do also the bones, under circumstances that call for such growth or adaptations to conditions. So do all the organs and tissues of the body, in greater or less degree; and if the ligaments do not, they are a plain exception, which is not probable. This being so, a constant strain upon the ligaments of the foot’s arch, as in standing for several hours without rest, must cause them to stretch somewhat, allowing the bones to loosen and sink down, while the same severe strain, if continued for a yet longer period, would force them to grow into this lengthened condition, to meet the demand upon them, thus rendering the fault permanent. In persons of fleshy tendency, the natural softness and weakness of the muscles and ligaments allow them the more easily to give way to the pressure upon the arch. It is believed to be the fact that the deformity is more common among people of this type, and it will be well for those so constituted to guard against anything that tends to its development.

It is in persons of the opposite type—those who have firm, close, hard, and strong muscles, and no extra flesh—that the arch is found in its greatest perfection. There the strong muscles and ligaments bind the bones together with such firmness that the arch is enabled longer to resist the influences which tend to break it down. Yet the flat foot is very common, in spite of all nature’s efforts for prevention. The deformity, in greater or less degree, may be said to exist as the rule among adult persons, while the natural arch is the exception. Among some classes of people, flat-foot is almost wholly prevalent. Hard toil and degrading conditions not only debase the person morally and intellectually, but they affect the gait and carriage, and their influence may be seen to reach down to the very bottom of the foot.

It was this fault, possibly, which first suggested the practice of wearing heels, or, if it did not originate, at least continued it. Heels partially restore that elevation and airiness of the foot which is given by a natural arch, and which constitutes its grace and beauty. When rightly made, and worn as a choice of two evils, or as a partial remedy for an evil, they are not objectionable; but they can be only a partial corrective. They can never be substituted for a good arch; while, worn as they are and have been, they really become one of the causes of the deformity which in turn calls for their use. Another cause is thus explained in Prof. Meyer’s book:

“Flat-foot is occasioned by the loosening of the ligaments that knit the foot firmly together, and, by the consequent sinking of the arch, the inner aspect of the foot no longer presents the natural hollow in the sole. The causes of such loosening of the ligaments are numerous, but by far the most frequent, and one readily induced by the ordinary shoe, is weight improperly directed on the arch. If, for example, a shoe happens to be trodden on one side, and especially, as is most commonly the case, if it be so at the heel, then the heel has no support, except from the inner margin of the sole, which is thus worn away, and the heel-piece becomes oblique, or, in other words, lower at one side than the other. In walking and standing on such a heel-piece, the whole external margin of the foot is raised, and the inner, which naturally supports the arch, is so depressed as gradually to lose its convexity, and thus flat-foot is produced.”

The nature of the cause here spoken of seems to be like that of a sprain, to a slight degree, and may be an influential one, but we doubt that it is the most common cause of that loosening of the ligaments which allows the foot to break down. The most common and efficient of all the causes of this difficulty, it appears to us, is the short heel which has always been worn on boots and shoes, and is still, except where an innovation upon its shape has been made within a few years past. This, though not strictly a direct cause, like a strain from above, is the condition which most frequently admits and encourages the sinking of the arch.

That short heels most frequently admit of and encourage the sinking of the arch of the foot will be readily seen by an explanation. There are several bones which, together, form the forward part of the arch, while the back part consists of one larger bone, technically called the calcaneum, or os calcis, which makes up the principal part of the heel. Partly above this, and between it and the forward bones, is the one called the astragalus, which is the keystone, being located the highest of any, and the one upon which rest the bones of the leg; in size it is next to the calcaneum. An illustration will show the position.

Fig. 27.

The inner aspect of the foot, showing the arched construction of the whole foot—a, head of metatarsal bone of great toe,—b, calcaneum,—c, astragalus.

The forward part of the calcaneum, or heel-bone, at its lower surface, is somewhat higher than the back part, and has under it a thicker cushion of flesh. When the bare foot treads upon the surface, or when there is no heel upon the shoe-sole, this point—letter e in the diagram—is as well supported as any other, and, being so, enables all the other bones to keep their proper places, but when there is a heel on the sole of the shoe, it is not long enough—does not extend under far enough—to support this forward part of the heel-bone. The sole, forward of the heel, is not usually stiff enough to support it, and therefore it falls downward as much as the leather will give way; the heel-piece being often half an inch too short, and sometimes more than that. Then, if the sole is light, so as to give way easily, there is nothing to prevent this part of the bone from settling down to the extent of a quarter of an inch, or even more. While the back part is supported, the front is turning directly downward. This allows the astragalus and the whole arch to sink down to the same extent, and, in time, all parts of the foot will adapt themselves to their changed condition, and the flat shank become a permanent thing. If any person will examine a slipper worn with a heel, or a boot having an ordinary sole, it will be seen that just in front of the heel the sole is depressed, or bent downward, from one-eighth to three-eighths of an inch. This is almost invariable, except when a very long heel, or a stiff shank in the sole, preserves the natural position of the calcaneum or bone of which the heel is formed. The amount of this depression shows how much the arch has sunk, and how much higher it would be if properly supported. It indicates very plainly the occasion and origin of a large proportion of the flat and splay feet that may be so frequently observed.