Thursday, January 26, 2012

High Heel Habituals, Flip Floppers, and Comfy Clogs!

So I always hear a lot of questions about what kind of shoes people should be wearing or if they should be using a specific shoe brand or succumbing to the latest shoe trends. So let's talk about how different shoes effect your posture, spine, and some other foot related conditions. I'll cover a bit about heels, flip flops, and even clogs!

So let me first address some posture (you should know by now this is my favorite topic to come back to!) When we stand with our feet flat on the ground our body weight is directed straight into the ground with our weight just in front of our heel. When we wear heels or wedges our body is directed forward with our weight shifting to the front of our feet. When this happens our body has to adapt our posture, otherwise we would fall over. See the picture below for a good visual.

A This shows good posture with flat or no heels and gravity being directed straight downward.
B This shows how heels effect the distribution of gravity and that you'd fall over if your body didn't adapt!
C This is how our bodies adapt! Notice the increased curvatures to the spine, the forward tilt of the pelvis, and the knee bend.

The increased curvature of the spine is decreasing spinal bone density due to less axial loading being directed through the spine and increasing degeneration in your spine (especially in the lumbar spine since the weight isn't being distributed through the bones properly). This can cause or contribute to neck and back pain as well as disc herniations and compression fractures of the spine and joints.

The forward tilt of the pelvis causes increased demands on the supportive muscles of the lumbar spine while using less and less of the abdominal muscles. This can contribute to tight and spasms in the muscles of the lumbar spine, weak abdominal and core muscles, and also diminish the bodies coordination between the abdominal and spinal muscles that provide a natural girdle of support to our body. Weakness in the core muscles can cause an increased risk for umbilical and inguinal herniations and make us more prone to lumbar injuries. In addition, the hammock-like muscles in your pelvis that aren't being used fully will weaken and can possibly lead to pelvic conditions just as urinary incontinence, uterine prolapse, etc. The forward tilt of the pelvis also leads to torsion and rotational forces on the hips and knees and lead to osteoarthritis later on.

The chronic knee bend causes the muscles of the legs (especially the hamstrings and calf) to stay contracted which can lead to muscle shortening. For those of you ladies who've worn heels all the time and now which to "quit" heels all together, this shortening of your calf muscles can put you as risk for achilles tendon rupture. (If you've worn heels for years, it's better to gradually decrease the height of your heels over a few months time while incorporating a stretching program to rehabilitate the muscles. Shoot me an email or give me a call at my office (309) 689-6200 if you'd like to know more about this.)

Now that's just the things you can see from the simple picture above, but what about the things you can't see like the bones of your foot?
When we walk, the weight of our body is supposed to be directed through our heel first and then distributed to the rest of our foot as flattens from the "heel strike" of our gait. However, when we wear high heels the weight is distributed through the plantar fascia on the bottom of the foot (commonly related to plantar fasciitis and foot cramping),to the ball of our foot (the bones of the common bunion), and through our toes (which are now jammed in the front of the shoe). This leads to chronic tightening and shortening of the plantar fascia leading to plantar fasciitis,  increased incidence of degeneration and deformation of the joints such as bunions, corns, and unsightly calluses, and lastly hammer toes from the shortening of the intrinsic muscles of the toes while they are crammed in the front of our shoe.

Now don't get me wrong, I love shoes and think that they are cute and can greatly add to any outfit! I'll confess to you that I have plenty of heels in my closet and my husband can attest to this addiction, however I wear them for short periods at a time (think less than 4 hours) and do a stretching program after I wear them to assure that the muscles return to their normal length and so does my posture.

So what about flat shoes that can contribute to foot problems? Flips flops and clogs can cause wearers to grip their toes into the foot to keep them on while walking, shorter strides with less force being directed through the heel, and an abnormal gait pattern that doesn't stress heel strike to toe off. This can lead to many of the problems mentioned above such as plantar fasciitis in addition to new problems such as decreased range of motion in the hip, knee, and ankle joints and even shin splints.

Flip flops don't become a problem when worn for short periods of time like quick errands to the store or a trip to the beach, but tend to cause more effects after lengthy time periods or athletic activities such as playing frisbee or volleyball. Clogs that are unsupportive (such as slip on sweater shoes or the fuzzy lined ones) can pose this same risk if the heel lifts out of the shoe while walking.

No what about walking barefoot you ask? Guess what I ENCOURAGE it daily!! (However, I don't condone walking barefoot over nails, in public restrooms, or through freshly fertilized soil) Walking barefoot (or with many of the new bare foot movement style shoes such as vibrams and adidas' new line) helps to encourage movement throughout the foot and loads each of the joints especially if you're walking on uneven surfaces such as grass or sand. This helps to develop your body's proprioceptive sense which helps your brain recognize where your foot is located in space and in relation to your environment and can help your foot to protect itself if you were about to twist or roll your ankle. Walking barefoot also helps to stretch out the intrinsic muscles of your foot and can help get your feet healthy again. I encourage, no I CHALLENGE you to walk barefoot at least two hours every day! When you get home from work or errands every day take your shoes and socks off and get moving for a great new healthy habit!

For those of you looking for great "all day on your feet" shoes for work that look presentable in a business setting, I personally recommend Kalso's Earth shoes. They are a little on the pricey side (around $80-130) but they come in leather and many different style and color options. I have three pair in varying colors and also a pair of winter boots that are very comfortable and are holding up very well. The reason I like these shoes for business is because they have a slightly negative heel and plenty of room for my toes. The negative heel means that there is a slight heel/wedge near your toes that forces your weight back towards your hel to prevent plantar fasciitis and the large shoe box provides plenty of room so your toes don't jam in the front of your shoe.