What to wear?
Importance of good footwear for your health.
Good footwear not only provides you with stability and comfort but largely influences the alignment of your ankles, knees, hips and the spine. Good alignment of these joints insures good function and prevents problems and pain.
Feet normal anatomy
Just as I explained in the article related to flat or “pronated” feet, your feet are built for natural surfaces like sand and grass stones and pebbles. Soft natural surfaces suppose to make your foot “grab” and mould into them and more rough surfaces would stimulate and massage your feet. This natural combination of two different environments are there to keep our feet strong. This strength is provided by a number of muscles and ligaments keeping the multiple joints of your feet aligned and flexible.
Modern living binds us to flat walking surfaces where foot doesn't have to grip and never stimulated appropriately. This slowly weakens the muscles of the foot, over stretches the ligaments and our feet start to “over-pronate” this is when the alignment of the foot and the ankle changes, flattening and changing the angle of the foot arches (see picture below).
Depending on the individual, foot arches may become over or under-pronated, however the over-pronated arches normally much more common and cause more widespread problems. Also we found that over-pronated or flat feet generally is a slow developing problem, when under-pronated or high arch feet is often in-born problem causing problems mostly local to your feet and ankles.
What can be done to preserve a healthy alignment?
Chiropractic approach to health is based on restoring natural alignment and flexibility of the joints of the spine, and of course as a holistic natural medicine, chiropractors look at the alignment of all parts of the body from foot to neck. All joints of the body have certain anatomy and shape designed for perfect fit and good function. If foundation of this chain of joints changes (your foot changes it's shape), joints above will have to move and behave differently. When joints don't move according to their shape and form, they start to “wear and tear” much faster or as medical doctors call it – they degenerate. Of course that will bring inflammation and pain in all joins involved.
This is why pronated or flat feet may cause ankle pain, knee pain, low back pain, neck pain and slouching posture.
We often see, that over-pronated or flat feet may cause knee, hip and back problems, not mentioning slouching posture. We also witnessed, that improving the alignment of your feet may bring patients faster recovery from knee and back pain and certainly improves their posture, therefore we recommend to wear healthy footwear daily.
Healthy shoes rules
Lets talk about footwear. Choices of appropriate footwear must be based on restoring and maintaining the properties of natural foot arch or/and compensating for lack of soft and “bouncy” surfaces to walk on. This is very effective approach, because it helps to restore natural balance in the chain of movement from foot through knees and hips into your back and neck.
Most of modern shoes have flat insoles and hard soles, which contributes to flat feet. This is very unfortunate, but fashion designers do not seem to care much about your health.
Some of the brands are more comfortable and soft but designed mostly for older ladies and gentlemen and although these shoes are more comfortable and pleasure to walk in, they have no where near enough support for your arch.
More trendy and fashionable shoes, unfortunately often have very thin soles. This not only contributes to flat foot but maximises impact on your joints while you walk, providing no amortisation (bounciness) and making every step a direct hard blow to your cartilage and bone in your knees, hips and spine.
Bunions, hill spores and plantar fasciatis
And by the way, if there is no arch support, your weight is distributed between two points of the foot - the toe and the hill, that causes the development of bunions and hill spores and also through over stretching the ligaments at the base of your foot it may give you the plantar fasciatis – an inflammation of the ligaments at the sole of your foot which makes walking painful.
Prevention and correction
There are number of things you can do to prevent all these problems. If you want to improve your current shoes, all you need to do is wear arch supporting insoles, which will keep your arch supported and distribute your weight across most of the foot, taking pressure off the toe and hill, preventing all above mentioned problems.
When buying shoes please try to get a pair with arch support built in (difficult to find...) or with the soft sole to mould to your sole when you put pressure on it like Crocs or similar. Or if you own a pair of arch supporting insoles, make sure they fit into your new shoes, when you buy a new pair.
You can also get shoes which make your foot “work out”, keeping ligaments and muscles of the foot strong. Generally these shoes will also work for your ankles, knees and hips but less for the arch of your foot especially if it is already “pronating”. They are also very famous to strengthen your low back and buttocks and this is why women like them so much. Im talking here about the MBT, Sketchers Shape-Ups, some Reebok trainers and Fit Flops
Crocs for pronated feet and other foot problems.
Crocs are absolutely brilliant in compensating the impact of daily standing and walking. The Crocs are very light, actually much lighter than you think. And main properties of these shoes are based around a thick inner sole made from CrocliteR material, which is a spongy rubber, hard enough to support your weight and soft enough to make you feel like you are walking on soft carpet.
Although Crocs have only minimal arch support built in, you are creating an arch support when walking or standing, because your foot moulds into the inner sole, distributing your weight evenly and making the muscles and ligaments work according to their design.
Crocs don't do trendy office shoes or high heels, but have couple of new black working shoes and snickers, which may suit you for that that matter. For ladies, they do shoes which are good enough to be worn in the office and some of my patients swear by it. The high hill platform version is very pretty.
By the way, they do a lot of other “normal” shoe designs now, so you don't have to buy pink slippers with holes. Crocs range now includes even working shoes, so you will be surprised. JUST REMEMBER TO ORDER A SIZE BIGGER (e.g. if your size is 37-38 order 38-39 in Crocs sizes that would be W8 instead of W7).
Fit flops have slightly harder and higher sole compared to Crocs and are called Fit Flops because they exercise your feet, knees and ankles making you "more fit". If you like wearing flip-flops, then the Fit-flops are for you. The main function of this marvellous shoes if to minimise the impact of walking and standing and just as I mentioned earlier to compensate for the luck of natural walking surfaces. FitFlop footwear features patent-pending, muscle-loading Microwobbleboard™ technology to increase the time that your muscles are engaged every single time you take a step. However, if your feet are pronated or flat, it will not support the arch.
MBTs, Sketchers Shape-ups
These are the ones for your “training on the go” just as I recommended in my article “The Cure” when I recommended incorporating exercises into your daily routines. The aim of this shoe is to make your foot "less stable". All muscles in you foot, knees, hips and in your back are arranged in pairs and are constantly working in synchrony to keep every joint aligned and balanced, just as I mentioned in my article “Mechanical Balance”. Of course, when the “foundation” (your foot) becomes unstable all these muscles have to work harder to ensure the alignment stays right. This is why this shoes make the muscles of your legs stronger all the way from the ankles to the spine.
The MBT shoes introduced this principle first, producing the MBT Anti-Shoe and later Sketchers made their version. Both are very effective and it is hard to tell which is better. MBTs are much more expensive, but claim that they have more research and more science behind the construction and design of their shoe. Sketchers don't claim anything, and their models are very successful and are very comfortable.
Designers at MBT say:
- Experience movement through instability MBTs' patented Masai Sensor and Balancing Area induce instability that your body instinctively attempts to correct. This corrective action can help add more movement into everyday life and can also lead to increased muscle activation and can help improve posture and balance.
- Get the most out of your MBTs To optimize the use of MBTs, we have created a series of specially designed exercises to help optimize MBTs' potential to increase muscle activation.
- The implementation of instability training means that MBTs can be used not only for everyday activities but also as a training device.
- Find the right MBTs for you There are MBT styles to suit every occasion and need, so you’ll always be able to do more for your body while standing and walking – wherever you are.
- Our Instability Index simplifies the process of finding the right level of instability for your needs. It ranks MBTs into one of four categories, starting at Activate, our least unstable level, and progressing through Dynamic and Performance, and ending with our most extreme level, Ultimate".
Wearing these shoes is very beneficial for back pain sufferers as it trains deep spinal muscles along with legs and ankles.
If you have very flat feet, but still want to use MBTs, you would have to wear arch supporting insoles at the same time.
Reebok Moving Air Technology
Reebok has now a whole range of trainers for running, walking and training - all with toning technology built in: "Moving Air Technology is based on built-in balance pods, featuring Moving Air Technology, transfer air in response to your stride and create micro-instability with every step. Out of all shoes on this page the Reeboks are the most classical trainers with toning capabilities built in".
Reeboks motto is "Having Fun Staying in Shape"
"Having Fun Staying in Shape comes to life through a fun, bold, provocative manner expressed through fresh, eye catching imagery signed off with a unique 'Reeword.' The tone and manner allows the consumer to look at sport and lifestyle through our lens of 'Ree.'"
This footwear is well known brand of "natural footwear" famous by their slippers with two main advantages - the arch support and the cork material. This shoes are good for a moderate intensity arch support and good comfort.
One of the latest designs has higher arch support and it is called Birkenstocks High Arch, unfortunately I couldn't find them in UK shops or UK online shops. Normally UK catches up soon with new things, so give it a year or two or buy it from USA or mainland Europe.
According to Birkenstock website there are further advantages as follows:
"High quality materials and unique construction give durable comfort and long lasting good looks. The concept of Birkenstock is easily understood when one considers the design of our feet and the mechanics of walking.
Each contour in a Birkenstock footbed is precisely placed to stretch, flex and move naturally. Your feet benefit from free movement, constant exercise and improved circulation, resulting in long lasting comfort and better health.
1. Footbed Edge
Deliberately elevated to protect the toes.
2. Toe Bar
Guides the toes, promoting the natural rolling movement of the foot.
3. Cross arch support
Helps shift pressure from the middle to the front of the foot.
4. Suede leather lining
Creates a healthy foot climate around the foot.
5. Inner and outer longitudinal arch supports
Gives the foot support and provides stability for the heel.
6. Deep heel cup
Gives the foot a firm hold and maintains the heel profile.
7. Cork Latex Footbed
Extremely flexible, providing a uniquely high level of wearing comfort."
Birkenstocks currently have all sorts of designs for beach, sports and even office, so go and browse their collection (Amazon).
The arch supporting insoles
Now, the most important bit: choosing the arch supporting insoles. If you noticed, I say "insoles", not just “arch supports”? Your foot is much more complicated than an isolated arch support may provide for.
Your foot has three arches and using an arch support which may slide back and forth inside your shoe will not solve the problem. The insole has to have a hill part which “cups” the hill of your foot to align it. The arch supporting part of the insole will do the main job, but without correct hill alignment it won't be as effective, so your insole has to have a hill cup.
Insoles normally come in full length or 3/4 length. 3/4 length insoles are easier to fit into different shoes and they leave more space inside the shoe, so that may be more comfortable. There a false opinion exists, that 3/4 insoles may slip deep into the shoe and that full length is preferable, it may be true for some insoles, however the ICB design has a hill cup which fixes insole in the right place cupping your hill. We only use full length insoles in cases where some special attachments are to be used to support metatarsal arch or for additional wedges mounted to the side of the insole.
The design of the arch supporting insole is the same for both the full length and the 3/4 length version. On the picture below you can see all the curves and angles of a good arch support that is what a good insole should look like (Full length ICB dual density sport insoles). The 3/4 insoles will look like the one on the picture in the head of this article (ICB hard density 3/4)
The hardness of insole is very important, if the insole is too flat and soft it wouldn't do anything and I would say the harder it is the better. If you weigh over 80 kg you need hard insoles, below 60 you will do with medium and if you have sensitive or painful feet (e.g. diabetic), you will have to wear soft insoles. This is different for different makes of insoles, of course. Harder insoles will do better job, just take longer get to get used to. Anyway they will be very unlikely too hard for you, because they all made out of soft rubber this days.
Below is the list of properties of the ICB insoles we offer in our clinic, these properties are desireable in any insoles if you are looking for good results. These are professional grade product and has to be fitted appropriately. We are based in East London at Chimes Chiropractic.
100% EVAEVA has a long 'construction memory' and can be moulded and adjusted to the patients' feet or cast, simply by applying heat. The Taibrelle covers resist bacteria, and are easily cleaned in warm water.
CLOSED CELL CONSTRUCTIONNo air bubbles - so ICB Orthotics will resist compression and distortion.
TRIANGULAR SHAFTIs a mid foot stabiliser which runs longitudinally from the mid foot through to the forefoot and splays out in a triangular shape. The Triangular Shaft allows weight to be dispersed evenly across the bones of the foot through its unique Weight Distribution System (WDS).
5˚ INTRINSIC REARFOOT VARUS ANGLEThis is the ideal angle (due to patients having an average 4°- 6° tibial varum) for optimum performance as recommended by industry standards.
42˚ SAGITTAL INCLINATORThis gives biomechanical control of the subtalar joint during stance and gait, allowing balance, control and coordination.
DUAL DENSITYFirmer density EVA gives support to the longitudinal arch and rear foot, aiding in mid tarsal joint support, the medium density EVA provides the patient with forefoot comfort during the gait cycle.
You will be needing a softer insoles for running and other sports and harder ones for daily standing and walking. The softer ones will fit better into your trainers or other sport shoes and the harder ones will suit more for the office shoes or working boots.
When you get a new pair of arch supporting insoles, start to wear them gradually increasing the time day by day. General recommendation is to wear them for no more than an hour of standing and walking on your first day and then increasing day by day until you are comfortable to wear them all day.
The summary of Healthy Footware - Natural Chiropractic Approach!
As you see from above, there is a good selection of shoes to suit your healthy needs. I personally wouldn't wear anything which doesn't feel comfortable and doesn't support my foot arch. We went to a city break to Paris and walked for 9-10 miles a day for 5 days. My Crocs Santa Cruz (below) absolutely saved my life. They weigh absolutely nothing and have super comfortable sole inside which is bouncy and with additional arch support.
At work I have to wear office shoes, so I use ICB orthotics hard density. When I walk home I wear ordinary walking trainers with medium density ICB insoles. In a gym I wear Nike Air Running trainers with very comfortable and soft inner sole and high arch support which is built in.
And you know what? I never get tired, although I spend most of the time of the day standing and walking!
Images courtesy of www.advancedhealth.ca, MBT, Crocs, Reebok, Grays Anatomy, Birkenstocks, ICB
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