Shoes and Our Feet

A while ago I wrote a post about our Feet and Chiropractic Care and today I would like to expand on that a bit. Today we are going to be looking at footwear and their impact on our feet. There are many different types of shoes out there but we will be looking at a few of the more common ones that people wear on a regular basis. For a reminder of proper foot biomechanics take a look back at the original post on feet

The biggest criminal in the shoe world is the high heel. I touched on this briefly last time but let’s go into more detail now. High heeled shoes take the foot, which is designed to spread the weight of the body evenly between the forefoot (toes and arch) and the hindfoot (heel and ankle), and angles it so that all that weight is now on the balls of your feet. The higher the heel, the greater the amount of weight bearing down on this one area. This puts a lot of pressure on the tissues between the bones of your toes. Add to this the restrictive nature of high heeled shoes (trying to maintain some stability) and you have a bad mixture which can lead to a condition called “Morton’s Neuroma”. Morton’s Neuroma is the build-up of scar tissue around the nerves that run between the bones of our forefoot and into our toes. This scar tissue takes up more space than we have available and so squeezes the soft tissues of the nerve and can cause significant amount of pain. The most commonly suggested solution to this problem is surgery where they cut the nerve to kill it and we lose all feeling to that part of the foot and toes. Not the most desirable of situations. Chiropractic and Acupuncture treatments can have a good effect on this condition but are much more effective if caught early.

At the other end of the foot we have the ankle being held in a toe-pointed (Dorsiflexion) position which is not good for it. The pressure that runs down the bones of our shin (Tibia and Fibula) should be transferred through the middle of the ankle joint but instead if pushing down on the back side of the bones. This puts pressure into the closest joints can causes tension in the ankle and hindfoot joints which can cause pain and discomfort. As well, this maintained dorsiflexion put the Garstrocnemius in a shortened position when, as I’ve talked about before, muscles like to reset their default length to the one they spend the most time in. That means that prolonged use of high heels will make it more difficult to bring the ankle through its natural full range of motion and thus make it hard to perform proper biomechanics of walking when not in high heels. Regular stretching and Chiropractic care can help clear up these tension and tight muscle problems.

Flip flop sandals are the next big culprit. They are on almost everyone’s feet during the summer but they are not very good for us. The problem is that we have to work to keep them on while moving around. This means that we grip them with our toes so that they don’t go flying off or twist under our feet. In doing this we eliminate a key part of the gait cycle (the pattern of our walking stride) called “Toeing Off” when we are pushing off with our back foot and our toes are relaxed and extended. This applies to both thong and Berkinstock style sandals. Sandals that strap to our feet around the ankle and will stay on without us actively keeping them there are fine. The gripping action of our toes causes tension along the bottom of the foot and can lead to discomfort and foot problems down the road. Massage, Acupuncture, Physiotherapy, and Chiropractic are all great choices in dealing with this kind of tension.

The next type of shoe I would like to discuss is ballet slippers. These little flimsy slip-on shoes are an interesting conundrum. The provide no support what-so-ever, which is not a bad thing for our feet but the majority of people do not have the muscle strength and endurance to support a barefoot because of the way we have treated our feet in the past. On the other hand we need to challenge our feet to support themselves but in this case the necessity of the shoe trumps our foot’s need. In order to stay on the slipper needs to be snug on the foot from toes to heel, which does not allow for full range of motion of the toes as they splay out and extend back as we are toeing off. So in the end I would say these shoes are not great but are definitely better then high heels by a wide margin.

Men’s dress shoes are much like women’s high heels in their rigidity compared to other shoes out there. They are stiff and do not provide much ability to accommodate the movement of the arch and toes during our gait cycle. A well worn in pair will be more flexible but to get to this point we have to put up with a lot of discomfort and dysfunction in our feet.

At the other end of the spectrum we have athletic shoes. These puppies are designed to be perfect for the foot. They cushion the foot but also allow it to move when it needs to. The only problem with these types of shoes is that they are only designed for one activity. So when doing anything else they are not necessarily what we need. Depending on the sport they can be too restrictive in the ankle or hold the forefoot too tight for everyday life. The only exception that I would say if good for most things is a real running shoe. They are designed for our gait in a wide variety of speeds.

So is all footwear bad? Can we every find something that won’t hurt us? Well, of course we can. The ideal shoe is one that is relatively flat so that the ankle is aligned and weight is spread even throughout to foot. It needs to provide some support as our feet are not used to working by themselves but not too much so that our feet will have to work a little and we can keep them strong. This shoe should also allow for full ankle range of motion and have a flexible enough sole to allow for our toes to extend during toeing off. Make sure to really explore all the aspects of a pair of shoes when buying them so that you don’t regret it later. Of course we can’t limit ourselves completely in our lives. If you have a pair of shoe that you absolutely love you can still wear them but I highly suggest only doing so sparingly. Also, no matter what shoes you wear, we should all spend a portion of the day barefoot so that our feet can move the way they were designed to. Make sure your feet and healthy and happy and the difference in your life will be amazing.

Next week we will take a look at some exercises for the feet which will help to keep us strong and mobile.

Thanks for reading.
Dr. Ben

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