PREVIEW: Foot problems in Singaporean children

Environmental factors play a great role in health and wellbeing. Directly or indirectly, the sweet Singaporean life leads to different foot problems that Singaporean children encounter, when compared to that of a child growing up in the Western world.

Foot warts are infuriating for their appearance, persistence, and the pain they illicit. The nature of the Human Papilloma Virus (warts) is that they are contagious and contracted through skin contact.

As most Singaporeans have a “shoes off” policy in their homes, this makes it easy for the virus to spread. This virus also thrives in warm and moist environments. Here in Singapore, it’s wonderfully warm all year round which also means that swimming can be a frequent activity and public pool areas have wet, moist, germ-infested flooring.

The evolution of technology has contributed to a sedentary lifestyle. With lack of physical activity, not only will a child’s motor skills advance poorly, but his or her lower limb musculature development will be inhibited. Muscular imbalance of the lower extremities contribute to poor foot posture and arch collapse.

Conversely, insufficient training of the feet can contribute to shortening of muscles, as well as malalignment and tension in the entire body as a compensatory mechanism. We always encourage children to run, play, climb and jump!

There is a general consensus agreeing that shoes that are too small, are bad for your feet. Just as much, shoes that are too loose are equally detrimental. This is somewhat a common trend in Asian parents with the mind-set to allow their kids to grow into the shoes to save money. However, when a pair of shoes are too big, a lot of unnecessary movement is created within the shoe. The foot and ankle then loses support and stability. Also with poorly fitted footwear, clawing or gripping is inevitable and pressure distribution is disrupted.

Blue skies and hot days frequently equate to flip flops and sandals all day long. The people in Singapore are no strangers to a cupboard filled with flimsy footwear. Unfortunately, as convenient and fashionable as they are, flip flops offer no support, stability, cushioning or correction of the feet. Excessive movement and malalignment in the lower limb can cause pain and fatigue from the feet to the knees, hips and back.

Overuse of joints also increases one’s predisposition to arthritis. Singapore’s terrain is also not the most “feet-friendly” as they are often hard surfaces such as concrete, tarmac or marble.

Recent sports medicine research has suggested that minimalist running shoes may increase sports injuries for unprepared athletes, because the thin soft covering would “trick the body” into assuming that the feet are protected with shock absorption when in truth it wasn’t. The same principle applies to flimsy slippers and flip flops.

Asian Singaporeans typically have a lower arch index (having “flat feet”) when compared to Caucasians. We also have a higher proclivity to a hypermobile/flexible foot-type. This can be a problem as a collapsing arch puts a significant amount of strain on the tendons and ligaments of the foot; the muscles, tendons, ligaments that support the foot are overworked in trying to maintain one’s foot posture.

This puts a person in a higher risk of foot and ankle instability, muscular fatigue, and repetitive stress injuries. Typically, pain and fatigue are common symptoms. Foot deformities often develop over the long term if the initial symptoms are ignored.

Like well-guided saplings, preventative measures should be taken by parents to ensure that their children grow up tall and strong.