Science

Fashion for pointy shoes unleashed a plague of BUNIONS in Medieval Britain, study finds 

Winklepickers have been a staple for British rock ‘n’ roll fans since the 1950s.

But a new study has found that a similar fashion for pointy shoes actually unleashed a plague of bunions in Medieval Britain. 

Cambridge researchers believe a change in shoe style during the 14th century, from a rounded toe to a lengthy, pointed tip, drove the rise in foot deformities. 

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They studied almost 200 skeletons at the city's cemeteries (pictured) dating from the 11th to 15th century

Bunions: Cambridge researchers believe a change in shoe style during the 14th century, from a rounded toe to a lengthy, pointed tip, drove a rise in hallux valgus (pictured left). They studied almost 200 skeletons at the city’s cemeteries (right) dating from the 11th to 15th century

The skeletons (including the one pictured) came from four burial sites around Cambridge

The skeletons (including the one pictured) came from four burial sites around Cambridge

WHAT WERE POULAINE SHOES?

Poulaines were a style of shoes with extremely long toes that were very popular in the 14th and 15th century.

The arrival of this fashion in England is traditionally associated with the marriage of Richard II and Anne of Bohemia in 1382.

Poulaine-toed shoes in 14th century London were mainly found in men’s sizes, but 15th century art shows them being worn by both men and women, with the toes of men’s shoes being the most extravagantly long.

Across late medieval society the pointiness of shoes became so extreme that in 1463 King Edward IV passed a law limiting toe-point length to less than two inches in London.

Archaeologists analysed almost 200 skeletons from the city’s cemeteries and found that 27 per cent of those dating from the 14th and 15th centuries had been hobbled by longstanding hallux valgus – often called bunions. 

This compared to 6 per cent of those buried between the 11th and 13th centuries. 

Hallux valgus is a minor deformity in which the largest toe becomes angled outward and a bony protrusion forms at its base, on the inside of the foot.

While various factors can bunions, from genetics to muscle imbalance, by far the most common contemporary cause is constrictive boots and shoes. 

The University of Cambridge study claims that the change in shoe style in the 14th century, to a type known as ‘poulaines’, was to blame for the outbreak of bunions.   

‘The 14th century brought an abundance of new styles of dress and footwear in a wide range of fabrics and colours. Among these fashion trends were pointed long-toed shoes called poulaines,’ said study co-author Dr Piers Mitchell from Cambridge’s Department of Archaeology.

‘The remains of shoes excavated in places like London and Cambridge suggest that by the late 14th century almost every type of shoe was at least slightly pointed – a style common among both adults and children alike.’  

The sole of an adult's shoe from late 14th century Cambridge, showing the winklepicker-like pointed shape

The sole of an adult’s shoe from late 14th century Cambridge, showing the winklepicker-like pointed shape

Poulaine-toed shoes in 14th century London were mainly found in men's sizes, but 15th century art shows them being worn by both men and women, with the toes of men's shoes being the most extravagantly long

Poulaine-toed shoes in 14th century London were mainly found in men’s sizes, but 15th century art shows them being worn by both men and women, with the toes of men’s shoes being the most extravagantly long

He added: ‘We investigated the changes that occurred between the high and late medieval periods, and realised that the increase in hallux valgus over time must have been due to the introduction of these new footwear styles.’

Fellow author Dr Jenna Dittmar said: ‘We think of bunions as being a modern problem but this work shows it was actually one of the more common conditions to have affected medieval adults.’

Researchers found that the burial plots for wealthier citizens and the clergy were much more likely to have skeletons with bunions.

The skeletons came from four sites around Cambridge: a charitable hospital (now part of St John’s College); the grounds of a former Augustinian friary, where clergy and wealthy benefactors were buried; a local parish graveyard on what was the edge of town; and a rural burial site by a village almost four miles south of Cambridge.

Across late medieval society the pointiness of shoes became so extreme that in 1463 King Edward IV passed a law limiting toe-point length to less than two inches in London

Across late medieval society the pointiness of shoes became so extreme that in 1463 King Edward IV passed a law limiting toe-point length to less than two inches in London

Researchers found that the burial plots for wealthier citizens and the clergy were much more likely to have skeletons with bunions

Researchers found that the burial plots for wealthier citizens and the clergy were much more likely to have skeletons with bunions

‘Paleopathological assessments’ were carried out including inspecting foot bones for the bump by the big toe that is the hallmark of hallux valgus. 

Only 3 per cent of the rural cemetery showed signs of bunions, 10 per cent of the parish graveyard (which mainly held the working poor), and 23 per cent of those on the hospital site.

However, some 43 per cent of those buried in the friary – including five of the eleven skeletons identified as clergy by their belt buckles – had evidence of bunions. 

‘Rules for the attire of Augustinian friars included footwear that was “black and fastened by a thong at the ankle'”, commensurate with a lifestyle of worship and poverty,’ said Mitchell.

‘However, in the 13th and 14th centuries it was increasingly common for those in clerical orders in Britain to wear stylish clothes – a cause for concern among high-ranking church officials.’

In 1215, the church forbade clergy from wearing pointed-toed shoes. However, this may have done little to curb the trend, as numerous further decrees on clerical dress had to be passed, most notably in 1281 and 1342. 

Across late medieval society the pointiness of shoes became so extreme that in 1463 King Edward IV passed a law limiting toe-point length to less than two inches in London.

The majority of remains with signs of hallux valgus across all sites and eras within the study were men (20 of the 31 total bunion sufferers).

The study is published in the International Journal of Paleopathology.

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