Help: For Your feet
Shoe-spiracy!
How to know if your shoes are causing your low back pain
Every time a new patient comes into my office complaining of low back pain, one of the very first things I’ll assess is the function of their feet and what kind of shoes they love to wear. The reason being is that footwear is much more than an indication of one’s social status, hobbies, or occupation. It serves as a guide to one’s quality of life and I believe that if I can get my patients to make choices on footwear that support healthy feet, then I can get them on a path to eliminate lower back pain for good.
Both feet have a combined 52 bones, 60 joints, and more than 200 muscles, tendons, and ligaments all working together. Moreover, the feet are some of the most neurologically rich sources of proprioception in the entire body, meaning they allow us to communicate and interact with our environment to a significant level.
How to know if you’re standing correctly
We should be able to stand with our feet straight ahead and hip-width distance apart (i.e, the 3rd toe pointed forward)
When standing, we should feel the contact of every toe on the ground with equal pressure in the balls of the feet and the center of the heel in contact with the ground
While walking, the heel strikes softly as we move through the entire foot, and uses the toes to propel us forward.
My Footwear Conspiracy
This, in my opinion, is where the footwear industry falls short. I’m not here to bash on high heels and flip-flops, because plenty of people have done that already. Rather, where the boobytrap lies are that instead of developing shoes with functional feet in mind, dozens of footwear companies are developing shoes to support dysfunctional feet and marketing them as “good-for-you” footwear. Unable to propel with your toes? How about a toe and heel lift? Dropped arches or bunions? Arch support inserts ought to do it. Do your feet hurt? Let’s add 3 inches of foam. With all these iterations and combinations, it is as if are trying to not feel or use our feet at all.
What Shoes Are Best?
Simply stated, nothing is going to promote healthy posture and gait more than walking around barefoot, and we should purchase shoes that help promote this. Enter the somewhat recent advent of “minimalist shoes,” and fortunately plenty of newer companies have been designing minimalist shoes that also won’t hurt your footwear fashion street creds, such as Xero Shoes and Vivobarefoot.
Functional shoes are designed to improve your foot’s health and functionality.
Dysfunctional shoes are considered to be a category of shoes that have no positive health effects on your feet, like commercial shoes, sandals, and high heels.
How do I find functional shoes?
Zero drops, meaning there are no toe or heel lifts
A thin, flexible sole to allow proper proprioception when standing and walking
A wide toe box to allow free movement and function of the toes
And specifically for sandals, heel support via a strap or otherwise is a must.
Working towards a “Barefoot Lifestyle”
Keeping in mind that I am a physician and that I ought to encourage and support my patients to the best of my abilities, the other more political (and boring) answer to “What shoes should I wear?” is that, it depends. Simply stated, structure equals function. When we put the body in a more structurally sound position, then there will be better function and decreased pain.
So when I start working with someone for back pain relief or regaining the health of their feet, I may have them continue to wear orthotics or other structural “crutches” for the time being. Because chances are if they go straight to barefoot/minimalist shoes, things may fall apart and they will not be happy with me. However, with time and consistency, we can implement things such as plantar fasciitis stretches, reduce the need for bunion surgery, add toe correctors, and actually get patients back to using their feet the way they were intended! And clinically, that is a huge success. Improve the health of your feet, wear shoes that support a healthy gait and posture, and your low back will thank you.
Schedule an appointment with our clinic team to check on your foot health.