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Secret Shoe-Buying Guide


For women, it’s an uncomfortable mystery: How can a flat shoe cause so much foot pain? Most likely, the sole is too flexible, says Johns Hopkins podiatrist Alex Kor. When buying footwear, the most important feature to look for, he says, is a rigid shank, the supportive part of the shoe extending from the arch to the base of the heel.

Kor suggests using this simple test: Turn the shoe upside down. Place one hand on the heel and one hand on the ball of the shoe. If you can bend the heel toward the toe, “it’s not a great, supportive shoe,” he says. This means that ballet-style flats are probably out, but a modest heel could still work. “Most dress shoes don’t bend in that shank area,” Kor says. “The problem is that as soon as women get out of the high-heeled shoe, they put on a flat shoe that bends.” Still, even a stiff-shanked heel shouldn’t be more than 2 inches tall, he says: “The higher the heel, the more unstable the rear foot and the higher your risk for an ankle sprain,

women trying on shoes
Edwina White

Vaccinate This!


Human papillomavirus, or HPV, is the most common sexually transmitted disease in the United States, affecting more than 20 million people. While the virus infects the anus and genitals, it can also live in the oropharynx (the tonsils and back of the throat), where it causes the highest number of cases of oropharynx cancers in the U.S.

Many people will likely be exposed to oral HPV in their lifetime— around 10 percent of men and 3.6 percent of women have HPV in their mouths from oral sex. Infections generally clear up on their own, but a few persist to become cancerous. To help reduce the risk, Johns Hopkins otolaryngologist Carole Fakhry recommends that boys and girls receive the HPV vaccine before sexual debut. “Most head and neck cancers that are HPV-related are due to one type: HPV 16,” she says. “HPV 16 is included in the vaccine, so we think it will reduce the cases of HPV-related cancers in the future, provided that there’s good compliance with the vaccine.”

Tooth Delay


Bleeding or swollen gums? Painful or shifting teeth? If you have symptoms like these, don’t wait to book a dental visit. “If you think there is a problem, more often than not, there is,” says Leah Leinbach, a general dentist in the Johns Hopkins Department of Otolaryngology. Plus, she adds, oral discomfort can be a sign of a serious ailment beyond the mouth. “What is happening in the oral cavity can in some cases reveal an issue elsewhere in the body, providing an opportunity for earlier and more comprehensive treatment,” Leinbach says.

Some conditions to look for include pain and/or numbness with sudden onset and rapid progression, nonhealing lesions or ulcerations, or a change in texture or color of the gums. In most cases, these complaints are benign. But in others, they indicate a malignant or pre-malignant tumor, suppression of the immune system (HIV-related or otherwise), diabetes, or vitamin deficiency. In addition to brushing and flossing, Leinbach prescribes a diet low in sugary and acidic drinks, which can lead to dental disease, and high in fresh foods, which naturally debride the oral cavity while providing nutrients for maintaining soft tissue health.

Tang Yau Hoong

Vitamin D and ED

men's health

Vitamin D deficiency has been linked to serious illnesses ranging from dementia and schizophrenia to heart disease and prostate cancer. Now, a study by Johns Hopkins researchers suggests that low levels of the “sunshine vitamin” may contribute to erectile dysfunction. The findings are based on the records of more than 3,400 men participating in a National Health and Nutrition Examination Survey. Men deficient in vitamin D were 32 percent more likely to have ED than men with adequate vitamin D levels, even after investigators accounted for other factors commonly known to lead to impotence, including certain medications, alcohol use, smoking, diabetes, inflammation, and high blood pressure. If subsequent studies affirm the results, “checking vitamin D levels may turn out to be a useful tool to gauge ED risk,” says lead researcher and Johns Hopkins cardiologist Erin Michos. “The most relevant clinical question then becomes whether correcting the deficiency could reduce risk and help restore erectile function.”

Break-Proof Your Bones


For each birthday after 40, your risk for osteoporosis and bone fractures grows. The good news: You can reduce your chance of fractures by as much as 65 percent through proper nutrition, exercise, and, when appropriate, medication. In the process, avoid being misled by prevailing myths surrounding skeletal health. For starters, don’t assume you can get a complete dose of vitamin D— essential for strong, dense bones—from sun exposure alone. Supplements are a safer bet—take 600 IU (International Units) daily up to age 50 and 800 IU over age 50. Nor are vitamin D and calcium the only nutrients your bones require. For example, potassium (found in beans, squash, and tomatoes) counteracts the acid levels in the body that eat away at bone. And don’t forget weight-bearing exercises. Simply walking for 30 minutes a day helps boost bone density.

Women, Protect Your ACLs


You’ve hit your athletic stride, when your knee gives way with a sudden pop. You’ve torn the anterior cruciate ligament—a noncontact injury that’s four to 10 times more common in young women than young men.

Miho Tanaka, an orthopedic surgeon and director of the Women’s Sports Medicine Program at Johns Hopkins, says she’s on a mission to educate young female athletes of their increased risk and what they might do to lower it. Although there isn’t yet enough research to recommend a specific set of exercises, Tanaka says that a daily warm-up composed of strengthening, stretching, plyometrics (jump training), postural control (balance), and agility training could improve women’s neuromuscular control and cut their rate of injury by up to 90 percent. Strengthening and stretching exercises should focus on correcting asymmetry, which is more prevalent among women. “If one side is stronger or more flexible than the other, you’re going to be favoring it,” Tanaka says. “That slight variance can force you to put more load onto one knee and put you at risk.”

woman stretching
Andrew Lyons

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