I have bad knees. Do I really have to wear sneakers all the time?
I've had a torn meniscus in my right knee for eight years. My knee was OK for 47 years, and then I went on the easiest hike in recorded history and stepped up on a not-very-high ledge. That was it.
It's not ideal. I can walk, but I can't run or sit cross legged. But whenever I'm about to bite the bullet on surgery, it seems like the wrong time to be sitting around for six weeks or longer. Or someone says: 'That surgery didn't work for me.'
The time I got closest, I suddenly needed shoulder surgery, which seemed more pressing because reaching over your head is kind of important in day-to-day life. In middle age, it's hard to know which physical problem to deal with first.
In the meantime, I'm having a massive style crisis about what shoes to wear. I've never been a serious heels person, but I do like wedges and I really love boots – especially the Frye harness boots I've had for 15 years. But every time I've asked a health professional which shoes are least hard on the knees, they say sneakers. I absolutely hate the way sneakers look on me. I feel instantly un-hot the moment I even look at a pair.
There were more than 700,000 knee replacements last year in the US, at least the same number of meniscus repairs and about 400,000 ACL repairs. So I can only imagine others are struggling with the knowledge that they need sensible footwear.
I texted my friend Lauren Sherman, a fashion journalist at Puck. Was there a shoe that was comfortable but not hideous?
I whispered to myself, Please don't say sneakers.
'I assume just sneakers?' she responded. God, millennials really love sneakers. It's a sickness!
What if I didn't want to wear sneakers everywhere? They look so bad with jeans (on me). And with dresses and skirts – sob. I would rather just not go anywhere ever again.
The professionals were no help. 'You should aim for well-fitted, comfortable shoes so as to not affect your gait, how you walk, stand, move,' says Dr Cassandra Lee, professor of orthopaedic surgery at UC Davis School of Medicine. She cited a Stanford study where women wore a flat athletic shoe, a low heel and a higher heel. Guess which was the worst for your knees and which was the best?
'As much as we like the look of heels, there is a lot of evidence they do not love us back,' Lee said. The higher the heel, the more weight is pitched forward, the more your gait is changed, and your knee affected.
She did not say 'sneakers'. But Theresa Marko, founder and owner of Marko Physical Therapy in Manhattan, did: 'I recommend a supportive sneaker, such as a running sneaker. These provide cushion and arch support, which help support the knee in a neutral alignment. They also help soften the forces that the foot transmits when it strikes the ground, which travel up towards the knee.'
She added that every body is unique – if someone is experiencing pain, they should see a physical therapist to address their issues, develop a personalized treatment program and review what footwear might work best.
I did not think running shoes worked best for me. They made me feel weird and wobbly. To my surprise, Marko acknowledged that running shoes can feel unstable. This is because of something called the heel drop, or how much lower the toes are than the heels in a given pair of shoes. I was glad to know this, even if the heel drop situation didn't seem to be my Waterloo.
The reason I hate running shoes is they make me feel like I'm walking on stilts, or on stage. When my foot is separated from the earth by a thick piece of rubber and molded plastic, I feel like I'm perched above the earth, floating in the ether. Then my gait is off because I feel unmoored, and an off-gait is precisely what you're not supposed to have.
'The wrong shoes and [their effect on gait] can cause a slight torque in the knee, which could cause rubbing on the cartilage or improper tracking,' said Carrie Collins, founder of Stretch Chi, a stretching and movement studio in Chicago. This resonated with me! My boots felt comfortable, but they were definitely not snug around my foot like a sneaker or another less rigid shoe would be.
I could not ignore that all the experts were suggesting sneakers. Well, fine. But if I had to wear sneakers, they could not have laces. Otherwise, I'd be too lazy to put them on.
Sign up to Well Actually
Practical advice, expert insights and answers to your questions about how to live a good life
after newsletter promotion
After Googling 'most supportive slip-on shoes for women', I settled on a gray sneaker by a brand called Ryka. They are not sexy or cool at all, but there is something subtle and under-the-radar about them. The shape is also slightly aerodynamic, space-agey – at least they have some personality. I don't love them, but I don't hate them. I will admit that they are nice and snug around the top of my foot, and the entire bottom of my foot is supported. Yesterday, I had to walk thirty blocks and I wore them with a sundress and no one died.
I have to say that wearing sneakers, despite being sad, is just the right thing to do. But what about when I absolutely cannot bring myself to wear them? Like a job interview or dinner anywhere other than Chipotle?
'If someone must wear a heeled shoe, I advise rubber bottoms and a very low heel – one to two inches,' said Marko. A round toe is better than a pointed one (more room in the shoe for your foot) and a block heel is better than, say, a stiletto, because there's more surface area to support your weight and distribute it more evenly over the bed of the shoe.
She mentioned some brands. Unfortunately, I would not be caught dead in any of them.
I called up Brandon Holley, who was my boss a long time ago when she was the editor of Lucky magazine, and I had two amazing, working knees. Holley, a consultant to fashion brands, had an ACL and meniscus repair in college, and sent over a few suggestions. One was a sneaker – LOL – and one was a loafer. Loafers are 'in' right now, but sadly, I look ridiculous in them.
But two options stood out. One was a lace-up suede flat with a rubber bottom and a very low heel, the sort of thing you could wear to weddings, summer parties or a bar. It came in a pretty color, and had ties encircling the ankle, or, as Holley said, 'wrap-around sexiness'. The other was a slip-on sandal with a two-inch block heel.
If I could wear sneakers 80% of the time, and an acceptable alternative 20% of the time, would that work? Like those people who eat mostly spinach, boneless chicken and blueberries, then have the occasional piece of chocolate, enormous sandwich or martini.
Nope. If my meniscus tear is actively hurting me, I should not be wearing heels 'for any amount of time,' said Marko. If I had an old meniscus tear that had healed, maybe. But 'it really depends on the individual and their needs'.
Sounds like it's sneakers for me. And maybe the next place I should wear them is an orthopedist's office.
Sarah Miller writes for many publications, including NewYorker.com, ParisReview.com, Dirt and n+1. Her Substack is the Real Sarah Miller. She lives in Nevada City, California
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Telegraph
44 minutes ago
- Telegraph
NHS boss claims Nigerian mother got the ‘black service'
An NHS boss has claimed his Nigerian mother received the 'black service, not an NHS service' after dying from suspected lung cancer. Lord Victor Adebowale, chairman of the NHS Confederation, which represents all health organisations, said the death of his 92-year-old mother was 'undignified'. His mother Grace, who worked as an NHS nurse for 45 years, died in January, possibly from lung cancer, but it was not detected until after she died. Lord Victor said there were 'too many situations where people that look like me and shades of me don't get the service'. 'It was not the dignified death that we would have wanted for her. It wasn't the death she deserved,' he told the NHS ConfedExpo conference in Manchester. 'So it makes me clear about the need to address the inequity. I think she got a black service, not an NHS service.' Mrs Adebowale emigrated from Nigeria to Scotland in the 1950s and worked as a nurse across mental health, maternity and acute care, during her career. Lord Victor, who grew up in Wakefield, said that he did not want to blame anyone for her death as the details were not yet clear, but he said that he wanted to highlight a 'systematic problem'. 'She lived to the age of 92 and you may think, 'well, she had a good old innings', but for a lot of those years she was in some discomfort, and it looks like she died from cancer,' he said. 'It's still the case that if you look like me, you're more likely to discover that you've got cancer in A&E, and that for me is an example of two different services.' 'Black people have worse outcomes' He added: 'I used the phrase 'black service'... you only have to look at the stats – across all the major disease categories that we talk about, black people have a worse experience and worse outcomes – we've known that for years, I'm not saying anything new.' He said his mother was an example of a wider issue and he was 'sick of it not changing like everyone else, and I'm close enough to it to know that it happens'. He said there was nothing in his mother's medical records to suggest she had cancer, and that she had gone to A&E in 'poor condition' at a hospital that 'was really struggling when she went in'. Lord Victor said his sister had to argue for their mother to be given a room but that they had not found the reason for her death yet. 'We haven't got to the bottom of it, and that's why I'm not blaming anybody, and I don't want to, but I can talk about my experience and my observation of what happened to my mum,' he said. 'How does that happen? I know it does happen. People have chronic diseases and people don't know and they die of them – I know it's more likely to happen if you're black, it's also more likely to happen if you're poor.' Of his mother, whose full name was Grace Amoke Owuren Adebowale, and who worked in various nursing sectors including mental health, acute care and maternity, he said: 'If you are a nurse, it is what you are, it's what you're born to do.' He went on: 'It is not acceptable that someone who looks like me, on average waits 20 minutes longer in A&E than white patients.' Kate Seymour, head of external affairs at Macmillan Cancer Support, said the story highlighted 'the heartbreaking reality for some when it comes to accessing cancer care in this country'. 'It is categorically unacceptable that some people with cancer are having worse experiences simply because of who they are or where they live. The Government in England has a unique opportunity in its upcoming cancer plan to revolutionise cancer care,' she said. An NHS spokesperson said: 'Everyone – no matter their background – should receive the best NHS care possible. 'That's why we are working across the NHS to ensure that happens – from improving access to cancer diagnosis and treatment, to expanding health checks for Black and Asian communities and increasing uptake of blood pressure and cholesterol medication in under-served groups. 'But we know there is much more to do, and tackling health inequalities will form an important part of the upcoming 10 Year Health Plan.'
Medical News Today
an hour ago
- Medical News Today
Celiac disease: Is an easier way to diagnose it on the horizon?
Could a blood test diagnose celiac disease without the need to trigger symptoms? Image credit: Alvaro Lavin/Stocksy. Celiac disease has to do with an abnormal immune response of the body to gluten. Experts are interested in the best ways to test for celiac disease. A recent study discovered that a blood test called WBAIL-2 could aid in diagnosing celiac disease and even contribute to biopsy-free diagnosis. Celiac disease occurs when someone's immune system responds abnormally to gluten. Efforts to improve celiac disease diagnosis are ongoing. A study recently published in Gastroenterology evaluated the effectiveness of using a blood test that measures the cytokine interleukin-2 to diagnose celiac disease. The study's results indicated that the test to be highly effective for celiac disease diagnosis, even for people following a gluten-free diet. The test could offer another option to help with celiac disease diagnosis — importantly, one that would not require triggering symptoms to confirm the disease. The authors of the current study note that there is often a delay or lack of diagnosis when it comes to celiac disease. Diagnosis usually involves people having to eat gluten and get biopsies of the small intestine. Celiac disease also has to do with the response of a group of immune cells, CD4+ gluten-specific T-cells. For this study, researchers wanted to determine if the use of a blood test that measures interleukin-2 — a protein produced by some T-cells — release could help to accurately diagnose celiac disease. This research involved a total of 181 adult participants between 18 and 75 years old. Of these participants, 88 had celiac disease, and others were controls. Among controls, 32 participants had a non-celiac gluten sensitivity and were on a gluten-free diet. The rest were healthy controls who did not have gluten sensitivity. All participants provided blood samples, and researchers collected data on medications and medical history. A subset of participants, including healthy controls, participants with non-celiac gluten sensitivity, and treated celiac disease, went on a gluten-free diet for four weeks or more and then consumed gluten for 'a single-dose open-label gluten challenge.' Some participants with treated celiac disease also did an oral gluten challenge that lasted 3 days. If participants underwent the oral gluten challenge, they used diaries to keep track of their symptoms. Researchers utilized a blood test called a WBAIL-2 assay, which measures the release of interleukin-2 in vitro after adding gluten peptides. In general, the test was able to effectively confirm celiac disease, with higher concentrations and fold change of interleukin-2 in participants who had celiac disease. However, the results were less sensitive for participants with a certain, less common genotype. Analysis results also found that the WBAIL-2 assay correlated with age and the number of years participants had been following a gluten-free diet. Next, researchers tested participants' serum levels of interleukin-2 after they did an oral gluten challenge. The levels of interleukin-2 were higher for participants with celiac disease following the oral gluten challenge. Researchers also found these levels 'positively correlated with the WBAIL-2 results.' So, if the levels of interleukin-2 were elevated on one test, they were also elevated on the other. They also tested how the WBAIL-2 results related to the presence of gluten-specific T cells, which were higher among participants with celiac disease. They did find that the presence of these cells, as well as activated versions of these cells, correlated with the WBAIL-2 test. The researchers further found that gluten-specific T cells, activated versions of these cells, and WBAIL-2 increased after participants underwent a gluten challenge. However, one participant had lower gluten-specific CD4+ T cells and a lower WBAIL-2 test on day six. Researchers also looked at treated celiac disease participants and how the tests related to their symptoms after gluten exposure. When it came to gluten-specific T-cells, their frequency was higher in participants who experienced vomiting. The measurement of serum interleukin-2 following the gluten tolerance test was also elevated, as was the WBAIL-2 level. The WBAIL-2 level was also increased greatly for one participant who did not experience vomiting but did report severe tiredness. Further analysis also suggested that activated gluten-specific CD4+ T cells are the cells that lead to gluten-induced production of interleukin-2. The results suggest that the WBAIL-2 assay can help with celiac disease diagnosis, even when people are already following a gluten-free diet. There are some limitations to this study. For one thing, it was performed out of one area, most participants were female, and there were strict inclusion criteria, so it has a limited generalizability. It also had small sample sizes for some subgroups, which means more research may be particularly necessary in these subgroups. Since researchers did not test children or people taking immunosuppressants, more research is needed to see how well this testing method would work in these populations. Researchers also acknowledge an untested 'reproducibility across laboratories.' More research is thus needed before the WBAIL-2 assay can really be used in the clinical setting. Further, the authors did not examine the cost-effectiveness of the WBAIL-2 test and how well this would stack up against current ways of diagnosing celiac disease. Then, the test was not as accurate for some participants with a specific genotype, which means it might not work for everyone. However, the number of participants with this genotype was very small in this study, and it is possible that the level of interleukin-2 response of some participants with this genotype was just not able to be detected by the test. Overall, more research is required regarding this subtype of individuals and the use of this test. Ian Storch, DO, an osteopathic physician specializing in gastroenterology and internal medicine, and an American Osteopathic Association member, who was not involved in this study, spoke to Medical News Today about its findings. 'One limitation of this study is the poor performance in the DQ8 genetic arm, which makes up 10% of celiac patients. This will decrease the sensitivity and specificity for the control group or require HLA typing before the assay is run.' Researchers acknowledge that the serum analysis of interleukin-2 following a gluten challenge does not always line up with the results of the WBAIL-2 assay, which could have to do with the assays' differences. Shilpa Mehra Dang, MD, double board-certified in gastroenterology and internal medicine with Medical Offices of Manhattan and contributor to LabFinder, who was similarly not involved in this research, noted that 'we need to look at bigger samples to really see its clinical usefulness.' In addition to larger studies, research can also focus on more details regarding gluten-specific T cells. Celiac disease is a challenging condition to manage, and accurate diagnosis is important. Researchers suggest that examining WBAIL-2 and serum interleukin-2 after gluten consumption could allow people with celiac disease to not have to get biopsies done to confirm celiac diagnosis. The authors of this study also suggest that the WBAIL-2 assay could also become a first test among people following a gluten-free diet and help with symptom severity prediction. Storch said: 'I do not think that based on the data presented, removal of histology to confirm the diagnosis can be suggested.' Jeffrey D. Davis, DO, CMD, an osteopathic physician specializing in Family Medicine and Preventive Health and an American Osteopathic Association board member, who was not involved in the study, noted the following to MNT : 'I see potential for a commercially available rapid, simple, cost-effective laboratory test for physicians to use to assist in the accurate diagnosis of celiac disease. This study shows that especially in adults already on a gluten-free diet using this lab test versus currently available tests would improve our diagnostic capabilities for Celiac Disease. However, it would most likely be just another tool in our tool box to aid in the diagnosis along with other current diagnostic methods.'
Daily Mail
an hour ago
- Daily Mail
Surprising ingredient in dessert favorites that raises your risk of a heart attack
Cardiologists are warning of an often overlooked ingredient in desserts that can lead to high blood pressure if consumed in excess. Typically a garnish on cookies, bread and butter, soft pretzels, and caramel treats, coarse sea salt contains more sodium than its less expensive grocery store alternative. People enjoy the added crunch and marriage of savory and sweet in desserts, but people are inadvertently eating too much salt. Because coarse salt has larger crystals, it may feel less salty per bite, leading some people to use more than they would with fine salt. Excessive sodium intake is linked to high blood pressure, heart disease, stroke, and kidney problems. The body only needs a small amount of sodium to function properly. Sodium is an essential electrolyte that plays several critical roles in the body, including maintaining fluid balance and blood pressure, supporting nerve function, and enabling muscle contractions. Most Americans consume too much sodium, though – 3,300 mg per day on average, or about 40 percent more than the recommended 2,300mg limit. People tend to believe that coarse sea salt contains less sodium than standard fine salt, yet both contain about 40 percent sodium. Salt lurks everywhere in the Western diet, not just in processed meats, snack foods, but in unsuspecting foods, including breads, canned soups, frozen meals, cheese, sauces, and marinades. An estimated 89 percent of adults and around 94 percent of children consume too much sodium, according to the CDC. Eating too much salt is a major setup for high blood pressure. The World Health Organization also estimates that 1.9 million deaths globally each year can be attributed to eating too much salt. As sodium causes the body to retain fluids, blood volume and pressure on artery walls increase. High blood pressure is a significant risk factor for heart disease, stroke, kidney disease, and other serious health issues. Dr Brent Egan, an internist and vice president of cardiovascular health at the American Medical Association, said: 'It would take us about a little over 1,000 milligrams a day to get from where we are to where the recommendation would be for the upper limit.' 'And if we did that, we'd probably see a significant reduction in blood pressure, heart attack and stroke.' Roughly 116 million Americans have high blood pressure. Approximately 805,000 heart attacks occur each year, as well as 795,000 strokes. 'If someone has high blood pressure, heart disease, that type of thing, 1,500 milligrams is probably a better target, but for the general population that's really interested in limiting the burden of chronic disease, 2,300 milligrams is generally what is recommended,' Dr Egan said. Too much sodium also causes bloating – the uncomfortable feeling that the stomach is swollen and tight. Body parts like hands, feet, and ankles are likely to swell. And feelings of thirst take over due to dehydration. Too much salt before bed can also cause restless sleep. Studies suggest high-salt diets may alter cortisol (stress hormone) levels, which regulate sleep-wake cycles. A recent study by researchers at Vanderbilt University found that reducing daily salt intake by just one teaspoon is as effective as blood pressure medication. They tested high and low-salt diets on hundreds of patients, some of whom had high blood pressure, and found that cutting out a can of Heinz soup each day lowered people's blood pressure by six percent within a week. This reduction was comparable to that of thiazide diuretic hydrochlorothiazide, a popular blood pressure medication. 'Obviously we need some sodium—it's essential for life,' Dr Egan said. But 'here we are with an average intake of 3,400 milligrams. 'Now the body has to make a lot of adjustments, but we can get by with very little sodium,' he said, noting 'there's very little danger in this country that most people won't get enough sodium, even if they're eating those fresh foods and not processed foods. 'They'll still—for the most part—get more than sufficient sodium that the body needs,' said Dr. Egan. 'We live in a state of pretty much constant excess.'
