Foot and ankle problems in Thai Monks

Abstract

© 2015, Medical Association of Thailand. All rights reserved. Background: Foot and ankle problems in Thai monks have not been explored. This is an unshod population, and its members have a unique lifestyle living among others in our modern era. Beginning at their ordainment, they follow strict rules about barefoot walking, the amount of daily walking, and their sitting position, practices that theoretically can increase their risk of developing foot and ankle problems. Objective: To evaluate the prevalence of common foot and ankle problems in Thai monks. Material and Method: A cross-sectional survey was conducted in combination with foot and ankle examinations of monks living in northern Thailand. Foot morphology was examined using a Harris mat footprint. Results of the interviews and the foot and ankle examinations were evaluated. Results: Two hundred and nine monks from 28 temples were included in this study. Common foot and ankle problems found included callosity (70.8%), toe deformities (18.2%), plantar fasciitis (13.4%), metatarsalgia (3.8%), and numbness (2.9%). Callosity and toe deformities were associated with prolonged barefoot walking over extended periods since ordainment (p<0.05). The callosity was found on the forefoot (47.3%), lateral malleolus (40.7%), and heel (12%). Arch types were considered normal in 66.4% of cases, high in 21.6%, and low in 12%. No association was found between arch type and foot and ankle problems. Conclusion: Callosity and toe deformity were the most common foot and ankle problems found in Thai monks, especially those with prolonged period of barefoot walking and long-term duration of ordainment. The unique pattern of walking and sitting of Thai monks may have contributed to the development of those feet and ankle problems.