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The Role of Shoes in Treatment and Prevention of Foot, Ankle and Leg Problems

The Role of Shoes in Treatment and Prevention of Foot, Ankle and Leg Problems

The heel counter of the shoe should be firm and not flexible when squeezed side to side

Our feet interact with the rest of our body by providing the foundation for alignment of the rest of our lower extremity. The foot and ankle provides structural support from 28 bones, movement from 33 joints and power and movement from 28 muscles and their tendons. Sensation, position sense and muscle function are provided from hundreds of nerves.

When we walk, foot strike occurs 30-50 times per minute or 3000 steps per hour. Forces of 2-4 times body weight are developed during each step. Walking surface affects forces transmitted through the foot and leg. Shoe gear influences foot and leg motion and forces and subsequent ankle and foot position influence the position of the knee, hip and back.

Foot type affects many factors in activity. A pronated foot or flexible flat foot is inefficient and requires more muscle activity. A high arched or supinated foot is less flexible and provides less shock absorption sometimes leading to functional issues or pain. As the foot moves past its normal position the muscles of the leg must work harder to control the foot, leg alignment is lost, more energy is needed to walk the same distance, joints can begin to degenerate from too much stress, Overuse syndrome can occur leading to pain.

How do we treat foot strain and abnormal position? Proper shoes are one of the best ways to give your feet the best environment for good function. Shoes are generally divided into stability and cushioning types. Eight of ten people benefit from increased shoe support. Many features and gimmicks are marketed but these rarely are necessary or beneficial. Shoes can give support to weak arches to reduce ligament, joint and muscle stress. Proper shoes can help counteract mechanical defects in our feet. Shoes can also serve to cushion pressure points and proper shoes can help with overall leg alignment.

The best shoe is almost always a sturdy shoe or what we call a stability shoe. These shoes have a solid outer sole, solid mid sole (no bend in arch), and a solid heel counter (no flex in the back of the heel). It is usually best to avoid air pockets, springs and other gimmicks. But what if shoes are not enough to treat a particular foot problem? Shoes can be professionally modified to perform better by adding “Arch supports” or orthotics. These devices fit easily in most shoes and can have a significant effect on support. Custom fit orthotics or “arch supports” can help the foot function better by improving foot biomechanics, reducing overuse injuries by balancing foot pressure, realigning the leg, and reducing muscle strain. Orthotics can even improve performance by decreasing muscle overuse.

Shoe Fit is another factor that is important to understand. When choosing a shoe it is helpful to know your foot type, fit later in the day, and don’t stick with a particular size or width (different brands and styles can vary in size). High cost does not necessarily give you a better shoe. Shoes should fit comfortably in the store, don’t expect to “break shoes in”.

How Long Will Shoes Last? Shoe life depends on the materials in the shoe, the construction of the shoe, level of activity and your weight. Most shoes last between 300 and 400 miles or about 6 months if you use them all day, every day.

Bottom Line= Shoes assist foot function. The wrong shoe can result in overuse injuries. The right shoe helps to resist injury. Style selection is very important for each activity. Price does not necessarily make the shoe and careful fitting and appropriate replacement is very important. If shoes do not help the problem it is definitely time to see one of the experts at Foot and Ankle Center of Iowa to see if there are other options such as orthotics to help.

You can schedule your consultation by calling us at (515) 639-3775, or schedule online here:

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