After having lived in London for a few years, I noticed this everywhere too. I am no expert but I have a theory that it's a combination of: Genetics - you'll notice this when you watch people walk and have odd knee/ankle flex. Discipline - not learning how to walk properly. This sounds silly, but when you drag your feet and wear improper shoes injury is more likely. Healthcare - I have noticed that people are more likely to go to the doctor compared to the States