Many of the estimated 70 million obese Americans are trapped in a life-threatening vicious cycle: Obesity aggravates foot problems, like heel pain and flat feet; sore feet make it hard to exercise and lose weight; and without exercise, obesity worsens and exacerbates progression of diabetes, heart disease, and other serious health threats. Today we urge obese adults to seek immediate treatment for chronic, activity-limiting foot and ankle problems to foster compliance with physician-directed exercise programs.
“It’s unfortunate obese adults get caught up in the vicious cycle of avoiding physical activity due to foot or ankle pain, thereby permitting cardiovascular disease and other life-threatening conditions to worsen as a result,” says Julaine Miller, DPM, a member of the American College of Foot and Ankle Surgeons (ACFAS). “For example, in many cases, chronic heel pain occurs from carrying too much weight. Left untreated, it becomes an impediment to physical activity and meaningful weight loss.”
Dr. Miller says there’s no reason foot or ankle pain should stop obese patients from exercising. The first step toward breaking that vicious cycle is an evaluation by a foot and ankle surgeon.
According to the ACFAS consumer Web site, FootHealthFacts.org, many causes of foot pain can be relieved without surgery through stretching exercises, orthotics, and athletic shoes with good shock absorption and support. If a bunion, heel pain or other condition requires surgery, patients can participate during their recovery in non-weight-bearing activities, such as riding a stationary bike, swimming or weight training.
For those moderately to severely overweight, Dr. Miller says a thorough physical examination is mandatory before beginning an exercise program.
“Once cleared by your physician to begin exercising, don’t try to do too much too soon. Follow a gradual routine until your body adjusts to the stress of regular physical activity,” she says. “For example, I counsel overweight patients to avoid working out on treadmills or elliptical machines to minimize pounding and stress on their joints.”
Shedding excess pounds helps diabetic patients control their disease, but Dr. Miller notes many who experience foot ulcerations and vascular problems caused by diabetes might think they shouldn’t exercise.
“Every diabetes patient needs regular foot exams to check for possible sore spots and assess nerve sensation,” says Dr. Miller. “And with proper diabetic foot care and the right footwear, most patients can follow an exercise regimen that is safe and appropriate for them.”