Tuesday June 23 2015
If you are going to be active, comfortable clothes are the way to go
The UK media have had a field day with the suggestion that "Skinny Jeans Could Be Bad for Health".
They have taken the opportunity to indulge in some shameless clickbaiting by showing photos of various skinny-jean-wearing celebs such as Russell Brand, Kate Moss, Harry Styles and the Duchess of Cambridge.
By the tone of the reporting you could assume that hordes of hipsters are having skinny-jean-related health problems. In fact the furore has been sparked by just a single case report.
A woman in Australia who, after squatting for a long time while wearing skinny jeans, had severe ankle weakness. She fell over and could not get back up by herself, and ended up having her jeans cut off and staying in hospital for four days until she recovered.
It is thought that she developed a condition called compartment syndrome, where pressure in an enclosed bundle of muscles can adversely affect muscle and nerve function. This can sometimes occur, for example, as a result of a crush injury, or in people who are wearing a plastic cast, which constricts swelling tissue.
Given the fact that many people wear skinny jeans and this is the first report of this kind of severe problem, it is likely to be a rare occurrence. If you know you’re going to be squatting for long periods, even if it’s just for your comfort and the safety of your jeans, commonsense dictates that it’s probably better to wear looser trousers. Also make sure you take regular breaks to stretch your legs.
Where did the story come from?
The case study was written up by researchers at the Royal Adelaide Hospital in Australia. No specific funding was reported for the study and the researchers reported no conflicts of interest.
The case was published in the peer-reviewed Journal of Neurology, Neurosurgery and Psychiatry.
Many news sources covered this story. We suspect that this was because it gave them an excuse to carry photos of skinny-jean-wearing celebrities such as the Duchess of Cambridge. Call us cynical, but we doubt a case report involving anoraks or thermal underwear would generate the same level of coverage.
BBC News and The Guardian make it clear that the squatting was a major factor, and the jeans made the effect worse. The Daily Mail focuses on the jeans, suggesting that they "drastically reduced the blood supply to her leg muscles, causing swelling of the muscles and compression of the adjacent nerves". This is not quite true, as the blood supply to her feet was normal and doctors believed it was the prolonged squatting that started the problem, and her jeans made it worse. The Mail does not mention the squatting until later in the article.
What kind of research was this?
This was a case report describing a woman who presented with severe weakness in her ankles, what the doctors found and how she recovered.
Doctors will often publish reports of unusual cases they have seen, or phenomena that have not yet been described in medical literature. These reports can be useful for describing unusual conditions, or rare side effects of treatments or combinations of circumstances that have never been seen before. As they describe only one person, it can be difficult to be absolutely certain of what causes these events, and also to know how frequently they occur.
What did the research involve?
The researchers describe the woman’s symptoms and the results of their investigations.
What were the basic results?
The 35-year-old woman came to hospital after experiencing severe ankle weakness, which led to her falling over and not being able to get up by herself.
The doctors found out that the day before she had been helping a relative move house, and had been squatting for many hours cleaning cupboards. She was wearing skinny jeans while doing this, and felt that they were becoming tighter during the day. When she was walking home she realised her feet were feeling numb and she was not able to pick them up off the floor properly. This resulted in her tripping and falling. She then spent several hours on the floor until she was found.
When the doctors examined her, her lower legs were swollen and her jeans had to be cut off. Her ankles showed weakness and she had poor toe movement, she also had reduced feeling in her feet and the sides of her lower legs. Her hips and knees showed normal muscle strength.
One of the nerves travelling down her legs was found to not be transmitting electrical signals to her feet properly. Testing also showed that there had been some muscle damage, a part of something called "compartment syndrome", which occurs when too much pressure builds up in the muscle. There were also problems with the nerves lower down in her leg.
The woman was given intravenous fluids and her legs gradually improved. After four days she was discharged from hospital and could walk unaided.
How did the researchers interpret the results?
The researchers say that the sort of nerve problem the woman had has been known to be caused by the nerve being squashed at around the knee, for example through prolonged squatting. They suggest that the woman’s squatting probably started the problem off, and caused her calves to start to swell. This swelling caused problems with other nerves in the calf, and the skinny jeans were "likely" to have made this worse by causing even more pressure as her legs swelled. They say that while there have been reports of compression of nerves in the thigh with skinny jeans, this case of nerve problems in the lower leg is a "new neurological complication of wearing tight jeans".
This study describes a case where the combination of squatting for a prolonged period while wearing skinny jeans seems to have led to severe ankle weakness.
With this kind of one-off event, it is difficult to be absolutely certain what causes it, but doctors look at the circumstances around the event and see what might explain it. They concluded that it was the extensive squatting that probably started the problem off, but once the woman's legs started to swell the jeans probably made it worse.
Given the fact that many people wear skinny jeans and this is the first report of this kind of severe problem, it is likely to be a rare occurrence. If you know you’re going to be squatting for long periods it is important to take breaks and stretch your legs, and even if it’s just for comfort and the safety of your jeans, it’s probably better to wear looser trousers. You don’t want to end up as a "fashion victim".