Feet are the foundation of our entire body, setting the stage for proper support, balance and posture. If our feet are out of alignment, then the rest of the body, including our hips, knees and backs, are likely out of alignment as well. That is why wearing proper footwear often holds the key to reducing, or even preventing, joint and back pain.
The shoes you wear dramatically affect the impact your knees and hips take with every step. Shoes with proper support help keep knees in alignment; arch support helps prevent feet from rotating inward; and cushioning reduces the impact from the body’s weight with each step. All of this helps to reduce pressure on our joints and back.
In my practice, I have long cautioned women to avoid frequent or prolonged use of high heels. For professional or fashion reasons, this can be challenging to accept. However, understanding why high heels are bad for the body’s mechanics might convince you.
High heels place the foot in an unnatural position. As the shoes lift the heel off the ground, they tip the body forward, causing the quadriceps to work harder to keep the knee straight, which causes knee pain, and contributing to poor posture, which leads to back pain. Over time, this takes a toll, with research indicating premature aging of knee joints that can ultimately lead to osteoarthritis.
On the flip side, flats are often not ideal either as they tend to lack proper arch support, important to absorbing shock and stabilizing the body. So, what should you look for? Here are a few guidelines to help when shopping for shoes that feel good on your feet and relieve unnecessary pressure on the knees, hips and back:
• Proper cushioning and support
• Flexible soles, enabling natural bend at the toes to maintain stride.
• Athletic shoes are often a safe choice. You don’t need to purchase the most expensive, just ones that are comfortable, provide support and cushioning to maintain full range of motion.
• “Rocker shoes” with a thicker sole and rounded heal help propel you through your gait, distributing weight more evenly.
• Sandals with straps on the back and closed-back shoes help to keep the foot in place, providing stability. Strapless sandals or open-back shoes or clogs cause toes to grip to stay on.
• Ensure proper fit. Shoes too small can cause feet to roll inward or outward, creating stress on the rest of the body. Shop for shoes later in the day as feet tend to swell as the day goes on.
• Rotate at least three pairs of shoes each week to prevent overuse syndrome.
• Replace shoes when the tread pattern is worn or there is more wear on one side, causing the foot to roll inward or outward.
The good news is shoe manufacturers have come a long way in designing styles both fashionable and safe for our back and joints. Making a few changes can have a dramatic effect on the way you feel.
Dr. Matthew Levy writes about orthopedics for the Cleveland Jewish News. He is an orthopedic surgeon at St. Vincent Charity Medical Center and practices in Solon, Independence and downtown Cleveland.