Working on your Feet
Who Could Be Affected?
European studies report that between 1/3 – 1/2 of all workers spend more than 4 hours a day on their feet, standing and/or walking. The largest proportion of these workers work in the manufacturing and service industries, which include:
- Retail Salespeople
- Industrial Workers (e.g. Machine Operators, Assembly-Line Workers, Quality Control Inspectors)
- Supermarket Workers, especially Checkout Personnel
- Food Services Staff
Of course, many other kinds of workers also spend a large percentage of time on their feet, such as:
- Casino Dealers
- Mail Carriers
- Workers in Large-Scale Laundering Facilities
- Health Care Workers
How Are Feet Affected?
The foot has dozens of bones, joints, muscles, nerves, blood vessels, tendons, and layers of fascia (connective tissue). When the body tissues are sufficiently stressed, they become swollen and/or inflamed. Chronic inflammation may create scar tissue and changes to bony structures. The “it is” behind the words such as “Achilles tendonitis” means “inflammation of the Achilles tendon”.
The bones of the foot form arches that are supported by ligaments and muscles. These arches contribute to the strength, stability, mobility, and resilience of the foot. During standing, walking, running or jumping, the arches serve as shock absorbers, spreading energy before it is transferred higher up the leg.
If the arches are lost (for example through conditions of flat foot, overpronation, or simple overuse), the shock-absorbing quality of the arches disappears. This affects the feet, knees, hips and spine. Losing the arch in your feet also changes the position of the knee and hip, which makes them more vulnerable to injury from working on your feet.
Besides the stress of prolonged standing and walking on the foot, the architecture of the foot can also increase the symptoms from pre-existing conditions:
- Plantar fasciitis refers to the inflammation of the fascia under the heel. Flat or tilted feet (from heel pronation) and bony spurs in the base of the ankle may make the condition worse.
- Achilles tendonitis results from overstretching of the Achilles tendon.
- Bunions at the side of the big toe may arise because of heel pronation and may be aggravated by narrow shoe boxes (the area in front of the shoe) and prolonged standing/walking.
- Corns on top of the toes may be aggravated by scraping against the inside of your shoe.
What Are Possible Health Symptoms From Working On Your Feet?
The most common symptom from working on your feet, and usually the first to occur, is discomfort and fatigue in the legs.
The closer the body part is to the ground, the more likely it will be affected by prolonged standing (i.e. the feet are most often affected, followed by the shins and calves, followed by the knees, thighs, hips and low back). However, symptoms from working on your feet may reach to the top of your body. In some studies, neck symptoms have been related to prolonged standing work!
Beyond simple fatigue and discomfort, more serious health effects can result from working on your feet. Some of these are:
- Low Back Pain (Drewczynski, Hansen, et al., Redfern & Chaffin)
- Painful feet and other foot problems (Drewczynski, Hansen, et al., Redfern & Chaffin)
- Plantar Fasciitis and Heel Spurs (Cailliet)
- Orthopedic changes in the feet (e.g. flat feet) (Redfern & Chaffin)
- Restricted blood flow (from standing only) (Hansen, et al.)
- Swelling in the feet and legs (Drewczynski, Hansen, et al.)
- Varicose veins (Drewczynski)
- Increased chance of arthritis in the knees and hips (Croft, et al.)
Initial symptoms can start within minutes into a standing task. Health effects have been shown to accumulate within days (no studies have assessed longer time periods).
What Causes These Problems?
Gravity squeezes your joints under the weight of your body. Each body part is compressed by all of the sections of the body above it. (For example, your hips are compressed by your head, arms and torso, but your feet are compressed by the weight of your whole body!)
Compressing a joint is like squeezing a sponge – body fluids are squeezed out of the space in the joint. Without body fluids and circulation, your joints become malnourished, and cannot continue to support the weight of your body. Wear and tear of body parts occurs.
Postural muscle fatigue
Postural muscles keep your body from falling over while you are standing or walking. Standing or walking for a long time forces these muscles to work without a rest. Without rest, these muscles become exhausted, resulting in pain. These effects are like working without lunch. Joints and muscles get their “lunch” from circulation, and need rest breaks to recoup from bouts of work. Think how you would feel without lunch!
Insufficient venous blood return in the legs
Gravity pulls blood down into your feet. One way that blood is pushed back up to your heart is through cyclic muscle contractions, often called a “muscle pump”. If the muscles are engaged in one long contraction to keep you standing, they cannot produce a “muscle pump” effect. Continuous muscle contractions also hinder circulation of body fluids.
Additional Causes Specific to Walking
Shock transmission from heel impact on the floor with regular walking, your heel lands on the floor with a force of 11/2-2 times your body weight. Such impacts can cause microscopic damage. Without enough rest (i.e. sitting or lying down), these microscopic traumas can build up into an injury.
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