ONE of the biggest myths about the feet is about the bunion. 'You can have surgery to shave it the bone off,' people say, as if a bunion is a growth. What they are in fact, is that they're an indication that your feet are in the process of getting deformed, notes Wong Yue Shuen, an orthopaedic surgeon who specialises in sports, foot and ankle, and knee surgery.

Bunions are one of the common problems of the feet that he sees, and like other foot issues, it's to do with the mechanics of how a foot works.

The bunion - which is the bony bump on the side of the big toe - is not a bone growth but rather a 'disjointed' joint; When the foot is out of alignment, and the big toe sticks out at an angle. In fact, very often it's an arch problem, rather than just to do with the big toe. 'Sometimes, the arch is too flexible, so when you step on the ground, the arch flattens and your foot turns inwards which causes toes to splay out,' explains Dr Wong.

When the arch is properly supported, then the foot is straight. 'When a person wears high heels, when 60 to 80 per cent of her weight is on the front of the foot, the toes are pressed in. The bunion is an indication that the big toe has shifted and is on its way to being a dislocated joint,' he points out.

The natural solution is not to wear high heels, but that, to a lady is tantamount to asking her to not leaving the house. 'Wear heels as little as you can,' replies Dr Wong when asked to what extent one should avoid heels. 'It's a case of the more you wear them, the more likely you're going to get bunions.' Shoes with points are another no-no, because they scrunch the toes together, again, causing misalignment. 'Once the deformity is there, it's difficult to correct,' Dr Wong points out.

Braces or splints don't really work, as the key is to correct the mechanical alignment which means some shifting of the bones - in surgery. 'In surgery, we'll put the bones back into a straight line, loosen some tight ligaments, tighten other loose ones,' Dr Wong describes. Post-surgery, one might have to avoid putting weight on the foot for three to six weeks.

Bunions can get so bad that one's toes are all curled up. High heels - the bane of fashionable women - can cause bunions, tight achilles heels and even ankle pain. Heels which are half to one-inch high are reasonable, advises Dr Wong, because shoes which are completely flat are uncomfortable when we are too used to wearing heels. Another common problem with feet is plantar fasciitis, often wrongly diagnosed as heel spurs, and experienced by athletes. 'The easy way to determine whether one has bone spurs or plantar fasciitis is whether one feels pain at the bottom of the heel at all times,' says Dr Wong.

Someone who feels pain at every step, all the time, might have bone spurs. But bone spurs are rare, even if half of us have a bony part at the bottom of the heel when x-rayed. 'If you look for it, you'll see some bone there, but that doesn't mean it's a bone spur,' he adds.

For those who feel pain when they first step onto the floor first thing in the morning, but the pain eases off after a while, that's a symptom of plantar fasciitis.

'A few stretches would do the trick,' he recommends. One is to push yourself against the wall, with one leg placed back and stretched straight; another exercise is to flex the foot on the kerb to stretch the heel; and if you're seated, put one foot over the knee, use one hand to flex the toes of that foot over, and massage the arch.

Getting a correct diagnosis of your foot problem is important, points out Dr Wong, who'll often study patients' posture and walking gait or look at their shoes to determine the problem, so that the right solution can be found. Often, shoes contribute to the problem. And not just high heels. Shoes or slippers which are very soft don't provide support - just like a soft mattress may feel good but not provide the support needed for a good night's sleep, a very soft cushiony shoe may contribute to poor posture, pain and even injuries.

He's also suspicious of the new style of football shoes that replace studs with 'blades', to give more traction.

'Sometimes they can give too much traction,' he says, citing a case when a patient snapped a bone in his foot. And then people don't wear the proper shoes for the sport they play, such as wearing running shoes to play badminton, which can give rise to a sprained ankle.

When it comes to the foot, it sure looks like wearing the right footwear can help eliminate a lot of problems from toe to heel.

To contact these doctors, please call Parkway Health's 24-hour helpline: 6735-5000 or e-mail [email protected]

This article was first published in The Business Times on Jan 31, 2009.