Foot and Ankle Problems in Thai Monks
Tanawat Vaseenon MD*, Thongaek Wattanarojanaporn MD*,
Piyapong Intharasompan MD*, Nipon Theeraamphon PhD**,***,****,
Sansanee Auephanviriyakul PhD***,****, Phinit Phisitkul MD*****
Affiliation :
* Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
** Department of Electrical Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai, Thailand
*** Department of Computer Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai, Thailand
**** Biomedical Engineering Center, Chiang Mai University, Chiang Mai, Thailand
***** Department of Orthopaedics and Rehabilitation, University of Iowa, IA, USA
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.
Keywords : Foot ankle, Monk, Prevalence, Problem, Unshod, Callosity
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