Foot binding

“ The feet are usually cold and sweat excessively. The gait is slouching, and there is a want of spring and elasticity. The lengthening of the foot results in the tendons, especially the flexors, being too short, hence hammer-like contraction of the toes may be brought about. The boots, after being worn, show a bulging of the instep towards the sole, greater wearing away of the sole along the medial border, and, when there is stiff great toe, an absence of the transverse crease on the dorsum opposite the balls of the toes. Footprints may be obtained by wetting the soles of the feet. ”

“ On the other hand, if the seating is insufficient, or the web of the shoe too wide, and too great a bearing thus given to the sole, then we get, first, an undue pressure upon the last-named portion of the foot a bruise, and, finally, lameness. The correct bearing should take in the whole of the wall and the whole of the white line, and should just impinge upon the sole. Above all, the heels of the shoe should be of full length, otherwise, if the shoe is worn just a little too long, its heels are carried under the sole of the foot, and by pressure there produce a corn. ”

“ The most common form by far is the inverted, usually denominated varus, in which the patient walks upon the outer ankle, the great toe being directed inwards and upwards. The muscles of the calf and the adductors of the foot are contracted, and hence there is not only elevation of the heel, but a peculiar inward twist of the foot, analogous to supination of the hand. This alteration occasions the most serious impediment to progression, and when it reaches its highest point imparts a most disagreeable aspect to the affected limb. ”

“ Raising the toe by means of a tip, a full shoe with thinned branches or a toe-calk, or paring away the quarters will tilt the os pedis backward, break the foot-axis backward in the pedal joint and to a less extent in the coronary joint, and increase the tension of the perforans tendon considerably and of the perforatus slightly. These tendons tightening behind the fetlock-joint force it forward, causing the long pastern to stand steeper, and taking some strain from the suspensory ligament. ”

“ 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. ”

“ Treatment.—In the case of weak or 'turned in' heels no suitable bearing is offered for the shoe in the posterior half of the foot. Any attempt to induce the heels to bear weight is immediately followed by their bending in. It follows from this that the best shoe to be used here is one in which the bearing is confined to the anterior half of the wall, the heels being relieved by being sufficiently pared. As might be expected, this bearing on the anterior half only of the foot is insufficient; pressure must be given the frog. ”

“ 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. ”

“ With the bar removed, the outward movements of the frog under pressure are naturally rendered of no account, and a proper and intermittent expansion of the wall denied it. The same evil follows, though to a less extent, excessive paring of the sole.
The shape of the bearing surface of the shoe is often to be blamed. Where this is concave—'seated'—and the 'seating' is carried back to the heels, it is easy to see that, when weight is on the foot, there is an ever-present tendency for the bearing edge of the wall to slide down towards the inner edge of the shoe. ”

“ When the eversion is more pronounced, the sole looks laterally and the tendons of the peronei stand out in relief. The anterior part of the foot is displaced laterally. Flat-foot is frequently associated with stiff great toe; the patient having lost the power of dorsiflexing the toe, the first phalanx and first metatarsal are in a straight line, instead of forming an angle open towards the dorsum.
The muscles of the leg are flabby and poorly developed. ”

“ The foot must be restored and held in its normal position and measures must be adopted to quiet local irritability or inflammation, and to strengthen the muscles. The best treatment does not consist in the permanent wearing of a flat-foot support; the support should be regarded in the same light as one uses a crutch in a fracture of the leg.
As a preliminary to all treatment, the use of proper shoes must be insisted upon. A shoe should be as wide in front, as the unshod foot, when bearing the weight of the body. ”

“ Even with a shoe of correct length, with a flat-bearing surface at the heels, and other conditions favourable to correct application, evil may still result from the shoe itself being made too narrow. As a result of this, the branch of each side is set too far under the foot, with consequent injury to the sole. This is, of course, sheer carelessness on the part of the smith. When practised, however, it is not easy of detection, as in all cases the foot is rasped down to cover what has been done. In other words, the foot is made to fit the shoe and not the shoe the foot. ”

“ In founder or chronic laminitis, where the sole of feet are dropped, caused by the displacement of the weight-bearing bones of the foot, fix the feet by lowering the quarters and heels so as to get as much frog pressure as is possible, without making the foot tender, and your foot is ready for the shoe. A shoe for a dropped sole foot must be a bar shoe, thick at the toe and thin at the heels, with a wide thin bar to receive the frog pressure. ”

“ Its joints are dragged open at every step, the tendons and ligaments give way, the arch collapses and the foot becomes quite flat. To treat flat-foot, get boots which fit well, and which are prevented from bending in the centre by being stiffened with a steel waist. ”

“ While choosing the shoe we must once more refer to the shape of our pattern shoe; the web is of equal thickness from toe to heel. A shoe, thinner at the heel than at the toe, by letting down the heel too low, is apt to produce sprain of the flexor tendon, and a shoe thicker at the heels than at the toe is fit only to elevate the frog, to the destruction of its function, and to its own certain disease, and also to press upon and to batter and to bruise that part of the foot which is soonest and most destructively injured. ”

“ Again, the tendons of the long flexor of the toes, and of the long flexor of the great toe, when they reach the sole of the foot, do not remain distinct from one another, as the flexors in the palm of the hand do, but they become united and commingled in a very curious manner—while their united tendons receive an accessory muscle connected with the heel-bone. ”

“ Then, since bending of the weakened arch causes discomfort, the feet have become turned outwards, by which the bending of the foot is reduced to a minimum; and as the left foot is the more flattened, so it is turned out more than the right. ”

“ The toe-piece is screwed into the toe of the shoe when the horse is about to be exercised, and forms a powerful point of leverage with which to stretch the contracted tendon, and the shoe, being thin at the heels, admits of this. The advantage of this form of toe-piece over the ordinary form of fixed toe-lever is that it can be removed when the horse is in the stable; while the curved point diminishes the danger of the horse hurting itself—a danger always present if it is on a hind-foot. (See also Treatment of Purulent Arthritis in Chapter XII.) ”

“ And yet that same cartilage, with the foot removed from the ground, is as pleasantly yielding to pressure of the thumb as the most exacting of us could wish for. In any case, then, where doubt exists, the foot should be lifted to the knee, and the cartilage carefully examined with the foot in that position. If, then, at any spot above the normal contour of the os pedis we meet with hardness or rigidity, we are to look upon that foot with suspicion. Nevertheless, providing our conscience is sufficiently elastic, the animal may be passed sound so far as the existence of a side-bone is concerned. ”

“ My dear child, these painful deformities are caused, as a rule, by ill-fitting shoes. A shoe too short for the foot or a very high heel will cause an ingrowing toe-nail, a source of endless trouble and suffering. Wear low heels, and have your shoes a little longer than your feet, and you will not be troubled by bunions, which are swellings of the joints. Change your stockings very often, and bathe the feet twice a day to prevent corns. A pretty foot is a foot in the right proportion to the rest of the figure. It is not always a small foot. ”

“ The ends must be far 311 enough apart to admit the width of the foot as far as the toes, and must be then drawn down to prevent the foot from pushing too far forward and striking against the toe-bar. The loop passing over the toes must be slack enough to allow free movement of the foot. When the strap suits the foot it is passed around the heel of the wearer and tied sufficiently tight to give ease and comfort. If too tight, the weight soon presses the tendon of the heel. ”

“ It varies from inability to flex the ankle beyond a right angle, to walking on the heads of the metatarsal bones. The astragalus is partially displaced forward and forms a prominence on the dorsum of the foot; the plantar fascia is shortened and callosities and bursae are formed under the heads of the metatarsal bones. Primarily, the obstacle to reduction is the tense Achilles tendon, and in advanced cases the shortened plantar fascia and posterior ligament of the ankle-joint constitute obstacles. ”

“ High and narrow heels give an insecure hold of the ground, and throw the weight, which ought to be distributed over the sole, forward on the front part of the base of the toes. This unnatural position, besides rendering the risk of sprained ankles much greater, stretches the fibrous bands which bind the various and complicated bones of the instep into a beautiful arch, strong yet springy. The tough fibres yield, the foot flattens, elasticity and grace of movement disappear to a large extent, and aching pains are complained of. ”

“ If flat foot exists, a support should be supplied for its aid in restoring the position of the great toe. In severe cases, nothing short of an operation is likely to be of value. A toe-post may be worn for a time in mild cases. ”

“ A few of the evils connected with the shoe may, however, be justly described as unavoidable. We must shoe; we cannot shoe and leave a normal foot!
A shoe excessively seated, especially from the last nail-hole backwards, may be regarded as dangerous. In this case, with every application of the body-weight, there is given to the foot a tendency to contract, especially at its lower margin. Result: undue pressure upon the tissues around and the production of corn. ”

“ Any mechanical displacement of one bone throws not only all bones out of harmonious working order but also disarranges their accompanying muscles and the nerves attached to them, resulting in inefficient action and in radiating pains. The fleshy parts of the foot are at the sole, ball, on the bottom of the heel and along the outer border and they play the part of protection where it is most needed. The bottom flesh forms pads in walking and supporting the body, insuring springiness and lessening the jar which is incidental to locomotion. ”

“ The great toe is usually twisted towards the median line, and the joint consequently has an ugly knotted appearance: all five toes are crushed together, and lose their natural shape, while the last, and often the last but one, is altogether distorted and deformed. Nor is the mischief confined to the toes: the whole foot, so seldom exposed to the open air, has a dry, lean, ill-nourished look. ”