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Our Perception of Feet + Shoes

Updated: Dec 18, 2022

Lately I have been struggling to get through to patients on the importance of footwear and their effect on our entire body. Sometimes they've made the connection, understand it and display their knowledge back to me. However at any moment, because of the years that they have been misinformed, they can switch back quite easily and quite shockingly.

How can we reconnect that importance and how much clearer than an image can we be?

xray barefoot high heel
Credit: The Foot Collective. X-ray of barefoot vs foot inside high heel

I have been very careful in my personal life to not discuss footwear with others. It's a touchy subject, pffff that's understatement. I understand, as I have always been a shoe lover. My husband may have commented on my shoe buying "problem" once or twice. I've always had my own style that I would rather not have others comment on, so to that extent, I get it. And I am not here to change to anyone's style.

I am here to educate everyone on what hurts our feet and the misconceptions behind what we all know as traditional footwear. Let's review those features found in everyday shoes:

1. Narrow Toe Box: I don't care if it's a slip on, a men's shoe, a high heel, or a running sneaker. They all have tapered toe boxes, and I'm not talking about a wide width shoe either.

Altra Running shoe wide toe box vs narrow toe box
Credit: Altra Running. Xray image of same foot wearing Altra Shoe vs Traditional Shoe

2. Heel to Toe Drop: A lot of traditional shoes actually don't have a heel counter, take for instance the all loving Chuck Taylor. Zero heel drop, so that's a good thing. Anything greater than 3mm places excess stress on our metatarsal heads, it creates a "ramp" effect that we are standing on all day and actually changes the angle of our metatarsophalangeal joints. Beyond this, most obviously if our toes are downward and our heel is constantly above it, then our posterior muscles (aka calf muscles including our achilles tendon) will inevitably shorten. This is why the Doc then says, here wear this heal lift after your 17th achilles injury.

heel drop angle on foot effect on bone structure
Credit: The Universal Compendium. Early X-ray of foot inside shoe with notable heel to toe drop

3. Rigid Sole: A stiff sole or overly cushioned sole are basically the same thing when we're comparing it to being barefoot. We're loading our foot up with unnecessary garbage. So that wooden bottomed trendy non-movable shoe is just as bad as your super cushioned Nike.

flexible natural footwear vs birkenstock rigid footwear
Credit: Anyas Reviews. Demonstration of flexible vs rigid sole

Now that we've had our review, let's get back to the matter at hand. What does it take for people to accept this information? When will it just be accepted that changing your footwear can change SO many musculoskeletal problems that are rampant today? When will people be defiant enough to question their previous doctors that suggested: injections, orthotics, rigid/cushioned footwear, and the big one: surgical intervention?

For me all it took was a few weeks of wearing natural footwear to realize how uncomfortable I was in anything else. And I'm not talking about a high heel or a pointy ballet flat... I'm talking about Vans and a pair of Nike running shoes. I believe the difference between someone who immediately gets it and doesn't look back, and someone that will continue to abuse themselves, is the disconnect between their mind and their body. And boy have I seen a lot of that.

That may be my biggest struggle as a clinician—establishing an awareness between the patient and their own body and not treating it like it's a receptacle that can be replaced. Or worse, treating this receptacle with such disrespect that they blame it when it causes them pain. Shame on those individuals, is what I would like to say. Yet, I know it's more than that. It's our culture of reactive vs preventative healthcare. It's what we've sadly been taught, and it's our lack of understanding human anatomy. And as far as Western medicine is concerned it is also the lack of acknowledgement of mind, body, and spirit working together as one.

Okay, fine, so I worked out a little bit of this internal struggle by sharing these thoughts. But now what? How can I get you to appreciate your body more? How can I convince you that, YES, there are 5 minutes in your day to pay attention to whatever body part requires it. YES, there is time to move more frequently throughout the day. YES, part of your problem is your footwear and it will never change until you change and YES it will be a process. But what the HECK is the alternative that sounds better to you?

A. Quick. Fix.

Well guess what, they don't exist when it comes to poor lifestyle habits (and this includes footwear as I see I've digressed a bit). Think about it. This problem occurred from a lifetime of poor (insert problem here) footwear, movement patterns, abusing your body, postural habits, etc. How do you think your poor body can just bounce back and unlearn everything you taught it to do thus far?

It. Will. Take. Time.

Just accept it. Everything you did to your body, now needs to be undone. Whether it's sitting at a desk for years and shortening hip flexors and overloading your spine, or wearing traditional running shoes for miles and miles. Those bunions will not go away (pssst guess what, even with surgery) until you start wearing toe spacers, and wearing a sneaker that accommodates toe spacers. And every time you go back to wearing a narrow toe box and heel drop shoe, you've once again set yourself back. And every time your brain signals pain, it is your body talking to you, begging you, to make a change.

And keep remembering it, especially when you're tempted to buy a cute new pair of TERRIBLE SHOES.


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Or when you're a guy who is tempted to buy a pair of cool lookin TERRIBLE boots. Lol

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