Shoe Wear Patterns: What They Mean, Why It Matters, & How To Fix It
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If you look under your shoes, do you notice how the tread is worn more in some places than others? Specific patterns of shoe wear correspond to how our body applies force, weight, and rotational movement. This reveals how we move, and uneven wear can indicate problematic movement dynamics.
The clues in your shoes
Common shoe wear patterns include:
- Diagonal wear on the outside of the heel: caused by foot angle, leg position, and instability, leading to joint stress.
- Rotational wear at specific points: due to internal or external rotation, often originating from the hip, pelvis, or torso.
- Wear above the big toe: caused by excessive toe lifting, often associated with a “lighter” or kicking leg.
Fixing movement issues to prevent wear involves correcting posture, improving balance, and adjusting how the legs land during walking/running.
Key fixes include:
- Aligning the center of gravity properly to prevent leg overcompensation.
- Ensuring feet land under the hips and not far in front.
- Stabilizing the torso to avoid unnecessary rotation.
- Engaging the glutes effectively to reduce hip flexor dominance and improve leg mechanics.
- Maintaining even weight distribution on both legs to prevent excessive lifting or twisting.
Posture and walking mechanics are vital to reducing uneven wear, but meaningful, lasting change takes time and focused effort, to build new habits.
For more on all this plus visual demonstrations, enjoy:
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Want to learn more?
You might also like to read:
Steps For Keeping Your Feet A Healthy Foundation
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Triple Life Threat – by Donald R. Lyman
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This book takes a similar approach to “How Not To Die” (which we featured previously), but focussed specifically on three things, per the title: chronic pulmonary obstructive disease (CPOD), diabetes (type 2), and Alzheimer’s disease.
Lyman strikes a great balance of being both information-dense and accessible; there’s a lot of reference material in here, and the reader is not assumed to have a lot of medical knowledge—but we’re not patronized either, and this is an informative manual, not a sensationalized scaremongering piece.
All in all… if you have known risk factors for one or more of three diseases this book covers, the information within could well be a lifesaver.
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How to Be Your Own Therapist – by Owen O’Kane
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Finding the right therapist can be hard. Sometimes, even just accessing a therapist, any therapist, can be hard, if circumstances are adverse. Sometimes we’d like therapy, but want to feel “better prepared for it” before we do.
Owen O’Kane, a highly qualified and well-respected psychotherapist, wants to put some tools in our hands. The premise of this book is that “in 10 minutes a day” one can give oneself an amount of therapy that will be beneficial.
Naturally, in 10 minutes a day, this isn’t going to be the kind of therapy that will work through major traumas, so what can it do?
Those 10 minutes are spread into three sessions:
- 4 minutes in the morning
- 3 minutes in the afternoon
- 3 minutes in the evening
The idea is:
- To do a quick mental health “check-in” before the day gets started, ascertain what one needs in that context, and make a simple plan to get/have it.
- To keep one’s mental health on track by taking a little pause to reassess and adjust if necessary
- To reflect on the day, amplify the positive, and let go of the negative to what extent is practical, in order to rest well ready for the next day
Where O’Kane excels is in explaining how to do those things in a way that is neither overly simplistic and wishy-washy, nor so arcane and convoluted as to create more work and render the day more difficult.
In short, this book is a great prelude to (or adjunct to) formal therapy, and for those for whom therapy isn’t accessible and/or desired, a great way to keep oneself on a mentally healthy track.
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Intuitive Eating – by Evelyn Tribole and Elyse Resch
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You may be given to wonder: if this is about intuitive eating, and an anti-diet approach, why a whole book?
There’s a clue in the other part of the title: “4th Edition”.
The reason there’s a 4th edition (and before it, a 3rd and 2nd edition) is because this book is very much full of science, and science begets more science, and the evidence just keeps on rolling in.
While neither author is a doctor, each has a sizeable portion of the alphabet after their name (more than a lot of doctors), and this is an incredibly well-evidenced book.
The basic premise from many studies is that restrictive dieting does not work well long-term for most people, and instead, better is to make use of our bodies’ own interoceptive feedback.
You see, intuitive eating is not “eat randomly”. We do not call a person “intuitive” because they speak or act randomly, do we? Same with diet.
Instead, the authors give us ten guiding principles (yes, still following the science) to allow us a consistent “finger on the pulse” of what our body has to say about what we have been eating, and what we should be eating.
Bottom line: if you want to be a lot more in tune with your body and thus better able to nourish it the way it needs, this book is literally on the syllabus for many nutritional science classes, and will stand you in very good stead!
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Try This At Home: ABI Test For Clogged Arteries
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Arterial plaque is a big deal, and statistically it’s more of a risk as we get older, often coming to a head around age 72 for women and 65 for men—these are the median ages at which people who are going to get heart attacks, get them. Or get it, because sometimes one is all it takes.
The Ankle-Brachial Index Test
Dr. Brewer recommends a home test for detecting arterial plaque called the Ankle-Brachial Index (ABI), which uses a blood pressure monitor. The test involves measuring blood pressure in both the arms and ankles, then calculating the ratio of these measurements:
- A healthy ABI score is between 1.0 and 1.4; anything outside this range may indicate arterial problems.
- Low ABI scores (below 0.8) suggest plaque is likely obstructing blood flow
- High ABI scores (above 1.4) may indicate artery hardening
Peripheral Artery Disease (PAD), associated with poor ABI results (be they high or low), can cause a whole lot of problems that are definitely better tackled sooner rather than later—remember that atherosclerosis is a self-worsening thing once it gets going, because narrower walls means it’s even easier for more stuff to get stuck in there (and thus, the new stuff that got stuck also becomes part of the walls, and the problem gets worse).
If you need a blood pressure monitor, by the way, here’s an example product on Amazon.
Do note also that yes, if you have plaque obstructing blood flow and hardened arteries, your scores may cancel out and give you a “healthy” score, despite your arteries being very much not healthy. For this reason, this test can be used to raise the alarm, but not to give the “all clear”.
For more on all of the above, plus a demonstration and more in-depth explanation of the test, enjoy:
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Antihistamines’ Generation Gap
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Are You Ready For Allergy Season?
For those of us in the Northern Hemisphere, fall will be upon us soon, and we have a few weeks to be ready for it. A common seasonal ailment is of course seasonal allergies—it’s not serious for most of us, but it can be very annoying, and can disrupt a lot of our normal activities.
Suddenly, a thing that notionally does us no real harm, is making driving dangerous, cooking take three times as long, sex laughable if not off-the-table (so to speak), and the lightest tasks exhausting.
So, what to do about it?
Antihistamines: first generation
Ye olde antihistamines such as diphenhydramine and chlorpheniramine are probably not what to do about it.
They are small molecules that cross the blood-brain barrier and affect histamine receptors in the central nervous system. This will generally get the job done, but there’s a fair bit of neurological friendly-fire going on, and while they will produce drowsiness, the sleep will usually be of poor quality. They also tax the liver rather.
If you are using them and not experiencing unwanted side effects, then don’t let us stop you, but do be aware of the risks.
See also: Long-term use of diphenhydramine ← this is the active ingredient in Benadryl in the US and Canada, but safety regulations in many other countries mean that Benadryl has different, safer active ingredients elsewhere.
Antihistamines: later generations
We’re going to aggregate 2nd gen, 3rd gen, and 4th gen antihistamines here, because otherwise we’ll be writing a history article and we don’t have room for that. But suffice it to say, later generations of antihistamines do not come with the same problems.
Instead of going in all-guns-blazing to the CNS like first-gens, they are more specific in their receptor-targetting, resulting in negligible collateral damage:
Special shout-out to cetirizine and loratadine, which are the drugs behind half the brand names you’ll see on pharmacy shelves around most of the world these days (including many in the US and Canada).
Note that these two are very often discussed in the same sentence, sit next to each other on the shelf, and often have identical price and near-identical packaging. Their effectiveness (usually: moderate) and side effects (usually: low) are similar and comparable, but they are genuinely different drugs that just happen to do more or less the same thing.
This is relevant because if one of them isn’t working for you (and/or is creating an unwanted side effect), you might want to try the other one.
Another honorable mention goes to fexofenadine, for which pretty much all the same as the above goes, though it gets talked about less (and when it does get mentioned, it’s usually by its most popular brand name, Allegra).
Finally, one that’s a little different and also deserving of a special mention is azelastine. It was recently (ish, 2021) moved from being prescription-only to being non-prescription (OTC), and it’s a nasal spray.
It can cause drowsiness, but it’s considered safe and effective for most people. Its main benefit is not really the difference in drug, so much as the difference in the route of administration (nasal rather than oral). Because the drug is in liquid spray form, it can be absorbed through the mucus lining of the nose and get straight to work on blocking the symptoms—in contrast, oral antihistamines usually have to go into your stomach and take their chances there (we say “usually”, because there are some sublingual antihistamines that dissolve under the tongue, but they are less common.)
Better than antihistamines?
Writer’s note: at this point, I was given to wonder: “wait, what was I squirting up my nose last time anyway?”—because, dear readers, at the time I got it I just bought one of every different drug on the shelf, desperate to find something that worked. What worked for me, like magic, when nothing else had, was beclometasone dipropionate, which a) smelled delightfully of flowers, which might just be the brand I got, b) needs replacing now because I got it in March 2023 and it expired July 2024, and c) is not an antihistamine at all.
But, that brings us to the final chapter for today: systemic corticosteroids
They’re not ok for everyone (check with your doctor if unsure), and definitely should not be taken if immunocompromised and/or currently suffering from an infection (including colds, flu, COVID, etc) unless your doctor tells you otherwise (and even then, honestly, double-check).
But! They can work like magic when other things don’t. Unlike antihistamines, which only block the symptoms, systemic corticosteroids tackle the underlying inflammation, which can stop the whole thing in its tracks.
Here’s how they measure up against antihistamines:
❝The results of this systematic review, together with data on safety and cost effectiveness, support the use of intranasal corticosteroids over oral antihistamines as first line treatment for allergic rhinitis.❞
~ Dr. Robert Puy et al.
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How To Avoid UTIs
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Psst… A Word To The Wise
Urinary Tract Infections (UTIs) can strike at any age, but they get a lot more common as we get older:
- About 10% of women over 65 have had one
- About 30% of women over 85 have had one
Source: Urinary tract infection in older adults
Note: those figures are almost certainly very underreported, so the real figures are doubtlessly higher. However, we print them here as they’re still indicative of a disproportionate increase in risk over time.
What about men?
Men do get UTIs too, but at a much lower rate. The difference in average urethra length means that women are typically 30x more likely to get a UTI.
However! If a man does get one, then assuming the average longer urethra, it will likely take much more treatment to fix:
Case study: 26-Year-Old Man With Recurrent Urinary Tract Infections
Risk factors you might want to know about
While you may not be able to do much about your age or the length of your urethra, there are some risk factors that can be more useful to know:
Catheterization
You might logically think that having a catheter would be the equivalent of having a really long urethra, thus keeping you safe, but unfortunately, the opposite is true:
Read more: Review of Catheter-Associated Urinary Tract Infections
Untreated menopause
Low estrogen levels can cause vaginal tissue to dry, making it easier for pathogens to grow.
For more information on menopausal HRT, see:
What You Should Have Been Told About Menopause Beforehand
Sexual activity
Most kinds of sexual activity carry a risk of bringing germs very close to the urethra. Without wishing to be too indelicate: anything that’s going there should be clean, so it’s a case for washing your hands/partner(s)/toys etc.
For the latter, beyond soap and water, you might also consider investing in a UV sanitizer box ← This example has a 9” capacity; if you shop around though, be sure to check the size is sufficient!
Kidney stones and other kidney diseases
Anything that impedes the flow of urine can raise the risk of a UTI.
See also: Keeping Your Kidneys Healthy (Especially After 60)
Diabetes
How much you can control this one will obviously depend on which type of diabetes you have, but diabetes of any type is an immunocompromizing condition. If you can, managing it as well as possible will help many aspects of your health, including this one.
More on that:
How To Prevent And Reverse Type 2 Diabetes
Note: In the case of Type 1 Diabetes, the above advice will (alas) not help you to prevent or reverse it. However, reducing/avoiding insulin resistance is even more important in cases of T1D (because if your exogenous insulin stops working, you die), so the advice is good all the same.
How do I know if I have a UTI?
Routine screening isn’t really a thing, since the symptoms are usually quite self-evident. If it hurts/burns when you pee, the most likely reason is a UTI.
Get it checked out; the test is a (non-invasive) urinalysis test. In other words, you’ll give a urine sample and they’ll test that.
Anything else I can do to avoid it?
Yes! We wrote previously about the benefits of cranberry supplementation, which was found even to rival antibiotics:
❝…recommend cranberry ingestion to decrease the incidence of urinary tract infections, particularly in individuals with recurrent urinary tract infections. This would also reduce the [need for] administration of antibiotics❞
Read more: Health Benefits Of Cranberries
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