Shoes Causing Foot Deformities

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:
Foot Exercises

Foot Exercises

(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.

By Alice Holland, DPT.
Alice’s Google + page.

Ana Lucia Pinheiro
Ana Lucia Pinheiro
02:18 20 Oct 17
This place is amazing. I am so happy I found Stride Strong PT. Alice pays attention to all of the details, she watches every single move I make, my posture, and the way I move through every exercise. She is very knowledgeable, she was able to pin-point the problems in my back and she has a plan to help me become stronger where I need. The place is brand new, huge, and has nice exercise machines. I tried a few physical therapists in the area, and Alice is TOP, second to none, and I feel super lucky to have found her. Highly recommended!!
Prashant Gupta
Prashant Gupta
01:00 02 Oct 17
Dr. Alice at Stride Strong is one of the best PTs I have come across. Her attention to detail and assessment of the root cause of injury is very good. She is excellent in evaluating pain patterns and giving a training schedule for a rehab & injury prevention, she is extremely knowledgeable. I would strongly recommend Stride Strong to anyone looking for PT. It is easily the best PT clinics in Hillsboro area.
steven zollin
steven zollin
20:57 14 Sep 17
Highly recommend Stride Strong Physical Therapy , Alice showed me proper form to assist in recovery with my shoulder and is very knowledgeable.
Lindsay Nied
Lindsay Nied
23:33 18 Dec 17
I recently had a massage from Joel at the Hillsboro location. He was able to work on an ongoing issue I have been experiencing with my back after a sports injury, and I left feeling so much better. The whole facility looked incredible, and everyone I met was friendly and welcoming. I would highly recommend Stride Strong for massage and physical therapy.
JoAnn Hatch
JoAnn Hatch
08:20 08 Nov 17
Dr. Sydney is by far the absolute best physical therapist I've worked with ever! Her expertise in designing highly effective and efficient exercise plans is beyond compare. I feel so much better as my strength and function increases. She comes up with the most brilliant and fun ideas to motivate. To my delight she even offered to come to my home in Vancouver and work with me on my own equipment including a Stott Pilates Reformer. Talk about going above and beyond! Couldn't be more grateful I found her!!!
Clare Perry
Clare Perry
21:58 23 Oct 17
A full hour of a dedicated PT professional's time without aides or techs? That's just one of the things that sets this clinic apart from others. Competent, professional, and amiable, Dr. Alice Holland and her team are the best in the area. While I generally see them at the Cedar Mill Clinic on Cornell, situational constraints took me to their new Hillsboro clinic today near Intel Jones Farm. Beautifully furnished, spacious with easy parking and access. May you continue to grow and thrive, Stride Strong!
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