Go to any shoe store and you will see hundreds upon hundreds of designs and purported “functions”. Some claim to help you lose weight, some purport to support your feet, some add extra springs and rubber technology to the sole to cushion your stride. Obviously, there is no one size fits all, and some shoes work well with certain dysfunctions and others are just blatant “snake oil” for shoes that cause a number of foot injuries.
Though I can’t fully stand by or endorse a brand or type of shoe, I can outline how some design features of shoes – if worn day in and day out, could cause foot deformities, deconditioning of the muscles of the feet, and pain/dysfunction.
(* Note how I emphasized “day in and day out”. Certain occasions in our lives call for dress shoes and high heels – job interviews and weddings for instance – but wearing a certain type of shoe all the time could cause harm. Read on.)
Shoe features that can deform the feet:
1) High heels
It is not surprising that this type of shoe is the #1 offender for foot dysfunctions. It places extraordinary pressure on the balls of the feet, and with narrow toe box designs (such as pointy-toed shoes) can scrunch and malalign the bones of the foot, causing bunions and pain in the long-term. Factoid: a 2.5 inch heel can increase forefoot load by 75%!
2) Toe Spring
This describes the very tip of the shoe where the angle of the sole changes from flat to upwardly curved. This feature pulls the toes upward, purportedly “increasing toe spring”. The dangers of this is that it stretches foot nerves, malaligns fat pads in the ball of your foot, and eventually (with prolonged wear) causes chronically tight toe extensor tendons.
3) Narrow tapering toe box
This is common with dress shoes (for men and women) and athletic shoes. The toe box tapers in toward midline and is an evolutionary design to make feet look more appealing and “skinnier”. The effect of wearing tapered shoes, is that bones are chronically scrunched and bunions, hammertoes, and plantar fascia pain can develop.
4) Rigid soles
Though most think that rigid soles offer support, wearing rigid soles is actually much like putting your foot into a paddle. Feet are much like hands – they flex, extend, wrap around objects, with each digit pushing against surfaces. Placing feet in rigid soles all day long is like placing boards under them all day. Eventually, over a long period of time, the foot will lose its ability to wrap around uneven surfaces, it will lose strength and fine motor function. It can also start to lose its flexibility in its joints. This is largely what has happened to every human who lives in the developed world.
So are you saying that it is best to go barefoot all the time?
Going barefoot is very difficult – almost impossible – in the developed world. Asphalt and concrete is too rough on uncallused feet; our cultural habits do not support it; and most of us have far unconditioned feet from decades of shod wearing that tolerating continuous barefoot walking all day would cause pain and damage. Additionally, some patients may have such serious foot dysfunctions and surgeries that going barefoot would detrimental to their health.
Instead, we support a moderated return to foot health and prevention of foot dysfunctions from ill-fitting shoes:
1) Dare to go barefoot, at least for a few hours of the day. Alternate from different types of footwear.
2) When buying shoes, remove the liner inside and place your standing foot on top. If you toes spread farther than the boundaries of the liner, you are in an ill-fitting shoe. You should limit your time spent in them.
3) Give yourself some foot TLC:
(best done in the evening after being in dress shoes for work, for 10-15 minutes)
a) Stretch your toes outward by splaying them. See Diagram A.
b) Stretch your toe backward by curling them under, placing mild pressure against the ground at the top of your foot. See Diagram B.
c) Place a tennis ball under your foot and roll it around the soles of your feet to stretch and spread the bones. Use mild pressure but keeping the rolling slow and steady for optimum stretch. See Diagram C.
d) Practice scrunching and flexing your toes. Scrunch a towel, or the carpet. This helps exercise the foot instrinsics that are play a big role in balance. See Diagram D.
e) Rub, massage, gently twist and spread the bones of the foot with your hand. This should not illicit pain, but a stretching feeling.
** DISCLAIMER** If you cannot perform the above exercises with adequate range of motion, or if the exercises cause pain, consult with a physical therapist before continuing.
What about barefoot running?
Barefoot running, or minimalist footwear running, can be dangerous for the novice with deconditioned feet. There is a specific exercise progression involving dynamic doming of the foot to condition one’s feet for barefoot running, and must be considered a long-term (i.e. several months) strategy. Consult with a Stride Strong Physical Therapist before initiating.
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