Trips, Slips & Falls – Occupational Hazards

Last week I was invited to the Headquarters of  ESKOM our Electricity Supply Commission, to talk about footwear selection and the effects of high heels, amongst other things!

From the outset it was clear that ESKOM is very concerned about safety – we were briefed on where and how to get out of the venue should there be a ‘problem’ –  before the talks began.

It seems that the greatest cause of occupational injuries at Eskom HQ is Slips, Trips & Falls, nothing to do with electricity at all! So they decided to do something about the problem by discussing it. There were two scientists from the National Institute for Occupational Health also presenting and they showed some of the scary activities that employees do in incorrect footwear. Like climbing ladders, wearing high heeled shoes on slippery floors, or wet floors.

Even with the current fashion for lower heeled shoes amongst women, there was a slipping incident at ESKOM recently.

Flooring was identified as a major cause of slips at work, but also there is the choice of inappropriate footwear as I pointed out previously. Amongst other causes are uneven floors, poor lighting.

Having  a spare pair of shoes at work is one solution, so that when you have to go to meetings or interact with clients you can put on your more fashionable ones.

However, perhaps the most basic concept is to be aware of your surroundings. For example, how many of us have fallen on our backsides at sometime in our lives, when at the poolside? In other words look where you are going!

Responsibility for foot health safety rests with employee and employer.

The Health & Safety legislation is designed to protect everybody. Including the forklift driver who says he must wear tekkies instead of safety shoes, because the safety shoes hurt. Fine, but remember that if you get hurt, there is no compensation.

However, I do blame employers who budget for only the cheapest safety footwear, when being distracted by uncomfortable footwear could lead to an accident at work. There is a real need to look to buy the best safety footwear the company can afford. It’s people’s health after all.

On the other hand, the beautiful corporate HQ with imported tiled floors, may actually be an accident waiting to happen.

Paying attention to where you are walking and what you are doing is another important measure in preventing slips, trips & falls. What do I mean? The dreaded cellphone! Walking & talking can be just as dangerous as driving and talking.

We had a good discussion about high heels!

On my way through the campus I noticed a beautiful young woman tip-toeing along past a wet floor [it was well-marked by the cleaning staff with warning boards] on what I guess were 7cm high heels. Her strides were very short and she wobbled along to keep from slipping on the tiled floor.

As I’ve pointed out before, a high heel shortens your stride and reduces your ability to walk normally. Add to this a shiny floor and there is an accident waiting to happen.

In the ESKOM HQ and many others I’m sure, the floors are spotlessly clean and shiny. Usually tiled and very smooth. This means that there is little grip between the sole of your shoe and the floor. An ideal situation for a slip, trip or fall. 

Foot Health and Safety at work is everyones business and responsiblity.

High Heels in the Spotlight Again

The visual delights of high heels were the subject of a post on this website on 24 March 2008 – go back and have a look. Recently however, the “high heels issue” was the subject of a motion at the UK Trades Union Congress (TUC), in September this year.

High heels

The Society of Chiropodists and Podiatrists (SCP) tabled a motion calling on employers who promote the wearing of high heels………..to examine the hazards involved. They suggested further that employers should not be able to insist on the wearing of high heels by female workers as part of a dress code.

It received massive media coverage, even pushing  Prime Minister Gordon Brown off the the early pages of some newspapers.

The dangers of long term (even short term) wearing of high heels are of back, hip and knee pains caused by the change in natural lower limb alignment. The forces placed on the metatarsals (balls of the feet) are estimated to increase sevenfold as the heel height increases. In addition there is an increased risk of  falling or tripping.

Needless to say there was intense debate of the issue. With one newspaper calling  it ‘raucous.”

If you compare your gait (way you walk)  barefoot or in low heeled shoes, with your gait in high heels, you can easily see that in heels your knees don’t extend, the heel can’t hit the ground first followed by the rest of the foot going over it – ‘heel over toe walking’ – so the muscles act differently and the joints get stressed. High heels shorten stride and cause a jarring to the joints.

There is evidence of the use of lower heels on airplanes, when female cabin crew use lower heels for their in-flight duties when they often spend long periods on their feet.

However, when we look back at the post of 24 March 2008, we get to see that high heels are all about image! The hunter and the hunted. The allure of a long leg attached to a 9cm stilleto heel and the associated ‘rock & roll’ of the hips, arms, shoulders and anything else, is why high heels are worn by women and men will watch whilst women endure!

So until your bunions get really painful, your feet look like the front of a bricklayers trowel, the varicose veins resemble a set of train tracks, your corns are hard and yellow and your joints ache all the time due to arthritis. Ladies strut your stuff and visit your podiatrist regularly.

On the other hand, according to the SCP, this is a serious health and safety issue  in the UK, with ‘two million days lost each year to ilness resulting from lower limb disorders.’

Ultimately, it comes down to the right to choose. Or should that be Jimmy Choo’s!

Can High Heels Heal?

‘Walking on sunshine.’ ‘Sexual heeling.’ ‘Toeing the line.’ All headlines for articles recently printed in the South African press taken from The Telegraph, The Sunday Times and The Times respectively, all from London. Toeing the line is all about the Chinese tradition of foot binding and I’ll pick up on that later this week.

The other articles are all about the benefits and effects of wearing high heels! Both suggest that wearing high heels is sexy and in ‘sexual heeling’ the research of a University of Verona urologist, Dr Maria Cerruto, is reported where she tackled “bizarre” theories about the effects of wearing high heeled shoes. The idea of sexual heeling refers to the Dr Cerruto’s assertion that pelvic floor activity is affected.

Traditionally we have blamed high heels for a variety of ailments, such as bunions, stress fractures, knee pain, lower back pain and increased risk of arthritis. South African research by Drs. Zipfel and Berger of The University of the Witwatersrand in Johannesburg showed scientific proof that wearing shoes had bad effects on the wearers when compared to unshod people. (I know this was on old bones but they have the proof). Dr. Cerruto’s evidence is due to be published in the journal European Urology. Since I am concerned with your foot health, I’ll leave that train of thought for you to follow.

However, in the article there is a comment from a UK fitness instructor who runs classes in London for women with high heels called Sweat and Stilletos. These sessions are designed to help women wear stilletos more comfortably. Whilst she agrees with the effects of muscle toning in the buttock region, she says that there must be compensation somewhere else and therefore her classes help with postural alignment.

Now as podiatrists we spend a lot of time dealing with and correcting the effects of postural malalignment. A personal trainer to some celebrities was quoted as saying that” the knees and metatarsals are put under strain, the hips are out of position. It can lead to long-term health risks.”

For me the evidence is there that the movement of the body’s centre of gravity forward causes increased loading and pressure. There is an increase in callus formation and the calf muscles shorten over time. This will lead to deformities of the toes. I agree however that exercises specifically to strengthen the intrinsic muscles of the foot will resist these deformations.

In “Walking on sunshine” they report on a New York sports therapist who holds classes for women to strengthen their foot muscles to cope with wearing high heels. Yamuna Zake also gives some good advice on foot care. She has been working with dancers for 25 years and those of you who struggled to get your (or your child’s) feet into the basic ballet positions without them falling flat will appreciate this. The essence of ballet is to be able to get your foot extended down from the ankle as far as possible and have almost 90 degrees of flexibility at the big toe joint.

So what’s the bottom line? Let me quote from the articles. ‘It’s a way to appeal to the male species. I have men who say heels have saved their marriage.’ Yamuna Zake says, ‘my husband is a freak about high heels. He thinks they’re very sexy.’ During my recent tutorials with Wits University medical students I was demonstrating the possible effect of rheumatoid arthritis on the way a person walks. I asked on of the girls to walk across the room in her high heels and then again barefoot to show the difference in patterns of healthy person. Guess what she said before walking barefoot? ‘Oh please I’ll walk like a boy!’

I wonder if walking in high heels will become an Olympic sport?

Read the articles:

Walking on sunshine. Melissa Whitworth. The Telegraph, London. In The Sunday Times (Johannesburg)Lifestyle section. [not sure when, towards the end of 2007].

Sexual heeling. Roger Dobson & Steven Swinford. The Sunday Times, London. In The Sunday Times (Johannesburg) Lifestyle. February 24 2008. Page 17.

Eschewing shoes may save your soles. Gill Gifford. The Star, Johannesburg. Friday October 26 2007.Page 6.