“Natural gait is biomechanically impossible for any shoe-wearing person.” – Dr. William A. Rossi in a 1999 article in Podiatry Management
The following article is a guest post from Dr. Todd Thistle. Read the author's bio below.
What if you went to the gym and the weight lifting machines were electric and did all of the work for you? You would just sit down, hold on and the weight stack would move itself. Some of you may be thinking “Fantastic! I could eat a donut and workout at the same time!” If that’s you, you’re dismissed from this discussion and we’ll talk later. For the rest of us who enjoy using our man-muscles to move heavy things around, let’s huddle up. Here’s the core fact of this article – your shoes are making you weak and shoe manufacturers have you duped. Your shoes are the equivalent of the electric weight machines. They are doing the work that all of the muscles and ligaments in your feet should be doing. And, the more “features” you have on your shoes, the weaker your feet. Traction! Stability Control! Smooth ride! Shoes have become more “sport utility” and much less their simple, original purpose: to protect our feet from dangerous items on the ground (rusty nails, broken glass, angry vipers, etc.). Yet, shoe companies have you convinced that you need all of the accoutrement that their shoe offers. I don’t know how you feel but just like the food that I eat, I don’t want a long “ingredient” list for my shoes. I’d like the shoebox to say something like “Leather, Dirt.”
Here’s a headscratcher for the shoe manufacturers – in populations that live barefoot or in simple sandals, foot problems do not exist. In first world countries that have access to the latest and greatest shoe technology, foot problems are an epidemic. What say you, Nike?
How are the barefooters not tragically crippled by their lack of foam and arch support deficiency? Lemme ‘splain.
The typical shoe of a first world country has 4 major flaws that I have creatively dubbed “The Four Flaws”.
- Elevated Heel
- Tapered Toe Box
- Upturned Toe (Toe Spring)
- Arch Support / Rigid Sole
A heel does not have to be a stiletto for it to cause significant issues. Any shoe where the heel is higher than the toe…has a heel! Therefore, it will pitch you forward and your body must compensate. Yes, even your favorite sneakers. Take your sneakers and measure the height of the foam at the heel and then at the toe. Most sneakers have an elevation change between 8-13mm. Here is a great illustration, courtesy of Dr. William de Rossi’s article “Why Shoes Make Normal Gait Impossible” –
If you were to wear heels and not compensate, you’d fall flat on your face.
Here’s the takeaway: The single most common and significant negative impact that a heel has on your body is postural compensation. This is what happens every time you wear a shoe with a heel – remember, this applies to sneakers, men’s dress shoes, etc.
- Achilles tendon and calf muscles shorten and become chronically tight, increasing the risk for injury and knee pain
- Increased pressure on the balls of your feet, potentially creating hammer toes, bunions, neuromas and plantar fasciosis
- Excessive low back extension (hyperlordosis)
- Loss of normal hip and low back mobility, creating tightness, instability and increased chance for injury/pain
- Chest, shoulders and head get pushed forward of normal center of gravity, leading to tight shoulders/upper back and possible headaches and neck pain
Why did shoes originally have heels? Women’s shoes have heels to create height and shapelier legs. Men’s dress shoes have heels because we all used to be cowboys and needed them for stirrups and for when we’d jump off the horse and land on our heel – we needed more padding. I’m not joking. Giddyap, cowboy.
Tapered Toe Box
Do you know what should be the widest part of a healthy foot? The toes. What part of a typical shoe is the narrowest? The toe box. See the problem?
Baby toes are the cutest! And the widest part of their feet…
And then we do this to them…
Or even this…
And then you get this…The foot adapts to the shape of the shoe. Look up “Chinese foot binding” for extreme examples of this.
How do you know if your shoe has a toe box wide enough to accommodate your toes? Take The Sole Test. Take the sole out of the shoe, put it on the ground and stand on it, barefoot. If your toes are over the edge of the sole, you know that when your toes are actually in the shoe, they’re getting squeezed.
At this point in the conversation er, monologue, you may be asking two things – “Why do shoe companies disfigure our feet?” and “What’s the big deal with shoe companies disfiguring our feet?” If you’re not asking those questions, you must be a shoe company executive and I urge you, it’s not too late to change your ways!
First question – WHY are most shoes narrow in the toe box?
The answer is Fashion. Footshaped shoes just aren’t as attractive.
Second question – What’s the big deal about a narrow toe box?
Quick anatomy lesson, because I care about you (and your toes): Two primary functions of toes are balance and gripping.
Guess what your toes cannot do very well if they’re all squished on top of each other and shoved into a cramped little toe box? Both balance and gripping become compromised.
Your body relies on a wide, stable base for optimal biomechanical function. In other words, you wouldn’t put bicycle tires on a station wagon and that’s what you’re doing when your toes are not allowed to spread. Not that I’m calling you a station wagon…
With the toes being squished down to a narrow point, you lose surface area with which to push off every time you step and even when you’re just standing. This forces your body to compensate and shifts more stress to other parts of the feet as well as to the knees, hips and lower back. Any time there is compensation and asymmetry, risk of injury increases.
For athletes, especially at the elite level, a narrow toe box will prohibit ideal performance and the athlete will not reach their full athletic potential. Imagine if track athletes or soccer players wore shoes that allowed full, healthy toe splay – they would generate more power and speed and be less prone to injury.
Usain Bolt’s feet are pictured above…the bunions are probably courtesy of so many hours in restrictive track shoes. Imagine how fast he would be in proper shoes and no foot deformities!
Take one hand and press your thumb to your pinkie. Now, rest your 3 middle fingers on top of the thumb and pinkie. Try to grab something. Nearly impossible. Now, spread your fingers out and ahhhhh, that feels better and you can use your hand and fingers as they were designed!
The same concept applies to toes. Proper toe splay, or toe spacing, not only provides a solid base of support for your whole body but it also keeps proper foot bone (metatarsal) spacing and it keeps the foot and ankle muscles strong.
When toes are allowed to spread out, they will grip the ground (built-in traction control!), thereby firing the muscles of your foot and ankle, allowing for minimal compensation and stress on the adjacent joints – the knee and hip.
When you stand on the ground barefoot, do your toes touch the ground? I sure hope so. So, why are most shoes designed with an upturned toe (toe spring)? Toe spring can be defined as a design feature that “creates a subtle rocker effect that allows your foot to roll into the next step.” Have you ever had trouble rolling into your next step? Didn’t think so.
Here’s what I’m talking about:
See the upturned toe? It puts your toes in an unnatural position of extension.
Here is a great illustration of how the last two bones of the foot (metatarsals) are forced into extension (curved upward) in a shoe with toe spring.
This photo illustrates how to check your own shoes for toe spring. (Photo courtesy of pivotalmotionpodiatry.com.au)
Since most shoes have both an elevated heel AND toe spring, you get a shoe that is essentially “U” shaped – elevated at both ends. A healthy foot is shaped like a gentle arching bridge, sloping slightly downward at each end, with the 3 natural arches of the foot providing support. This dissonance between your foot’s ideal shape and the shape of a shoe will often give rise to problematic foot conditions/injuries, such as Plantar Fasciosis, Hammer Toes, Bunions and Morton’s Neuroma. Let’s explore the wonderful world of the Arch Support/Rigid Sole. Go get yourself another Hot Pocket and a glass of iced tea, this’ll be fun.
Arch Support / Rigid Sole
Arches of the foot, as defined by Wikipedia: The arches of the foot, formed by the tarsal and metatarsal bones, strengthened by ligaments and tendons, allow the foot to support the weight of the body in the erect posture with the least weight. They are categorized as longitudinal and transverse arches.
Even this illustration has bunions from a narrow toe box! Illustration courtesy of teachmeanatomy.info
So, reading the definition above and looking at the illustration, it should now be clear that we have THREE natural arches of the foot. Do we REALLY need a fourth arch, as provided in nearly every shoe worn in a developed country?
The shoes we buy have artificial arch supports in them because our natural arches have been weakened and made useless by the very shoes that have the artificial arch supports in them. And this is the point in the article where I go lie down on the couch and ask one of my sons to bring a warm washcloth and a large glass of Daddy’s special happy juice.
There was a study (see footnote 1) of 2,300 children with the conclusion of: “…shoe-wearing in early childhood is detrimental to the development of a normal longitudinal arch.” Children should be barefoot as much as possible and I will go further and say ADULTS should be barefoot as much as possible. Preferably, on a white sand beach with your own large glass of happy juice.
An arch support in a shoe is actually a brilliant design because it creates a need for itself. The artificial arch acts as a brace for the foot and the natural arches of the foot don’t have a need to work as hard, thereby weakening them. And, what do you need if you have weak arches?
An arch support! And so it goes, on and on and on…
You don’t want a rigid sole or a rigid soul. I can help you with the former. It’s this easy – your foot is flexible (or should be) and your shoe should be, also.
If your shoe does not allow your foot to bend, move and flex as it’s supposed to, you WILL be creating extra stress not just on your foot but in your knees, hips and low back. Your sense of balance and joint position will be diminished as well because the specialized nerve endings in your feet aren’t being stimulated properly when you walk.
Proprioception is an awareness of the position of one’s body and wearing clunky, stiff shoes takes that away. One segment of our population that I believe needs flexible shoes most of all are those 60+ years of age. And yet, these seem to be the folks most likely to NOT be barefoot and in clunky sneakers.
Test your shoes to see if you can bend them in half with minimal effort or, better yet, roll them into a ball.
Can your shoe do this?
Your shoes are making you soft and weak and likely creating issues elsewhere in your body.
Most people don’t need orthotics and certainly don’t need all of the accessories of a “sport utility shoe”. Just spend the time to build up the muscles of the foot, maybe get a functional movement evaluation from a specialist and be patient. It takes time to get healthy. Start by being barefoot as much as you can, practice standing on one foot and consider overhauling your shoe collection.
Dr. Todd Thistle, DC, CCSP