Wednesday, September 28, 2011

Shoes, Injury, Misinformation, and a Soap Box

Time to get a little preachy.

On Tuesday mornings I go to a business networking meeting before I go to my office.  I've been a part of that group for a few years now.  The other day I was wearing my Trail Gloves to work for a change of pace.  I've been preaching foot strengthening and barefooting for a few months now, and a few people have actually been genuinely interested.  Not necessarily about running barefoot, but at least in strengthening their feet up to help with things like plantar fasciitis and the like.

Before the meeting a few of us were talking and someone asked, "how long until we hear that those are bad for your feet?"  They had seen brands like Earth Shoes come and go (and incidentally come back again after a hiatus of 20 years).  Another example is the current mess rocker shoe by Sketchers and a few others.  Those rocker soles came out in the 1990's from a company called MBT (Masai Barefoot Technology).  Sketchers say they will supposedly tone your flabby butt so it looks a little more like a Victoria's Secret model all without you having to do anything but hoof it to the kitchen for another bag of Cheetos.  Probably not happening.  MBT says that their shoes mimic the natural motion of walking over soft uneven ground, based on their observations of the Maasai people in Africa.  They supposedly cause better posture and function.  MBT says on their website, "When the body is unstable, the body is stronger".  That is nonsense.  Ask a person with a torn, unstable rotator cuff how strong their shoulder is.  Strangely enough a University of Wisconsin study even found no significant difference in muscle activity when comparing the "toning" shoes vs. a regular athletic shoe.

So how long until minimalist shoes are bad for you?  Depends on who you ask!  Some physicians, podiatrists, etc. are already screaming dire warnings about taking the $400 arch supports out of your motion control shoes.  They are quite sure your feet will literally fall into pieces and you will have to balance on the bloody stumps that used to be your ankles.  That position is interesting because you won't find a medical doctor, chiropractor, podiatrist, or shaman that will recommend putting your toddler in a hard-soled supportive shoe.  Why?  Because it interferes with normal foot development and function.  The question is, at what point do our feet become so frail that we need to constantly encase them in a shoe that prevents movement?

I like to take a different route with my patients.  I give them strengthening and self-massage activities to do at home to strengthen the muscles in their feet and promote good circulation and a self-supporting arch.  I do those same things at home.  I firmly believe that strengthening the foot to support itself is a better way to go.  Orthotics aren't bad, and shoes aren't bad.  They are tools, but we have started to look at them as armor for our frail feet, and our feet have become frail because of it.  At this point I must admit I used to promote orthotics and supportive shoes to everyone.  Why did I do this?  It is what you are taught in school.  You don't question your instructors.  You nod, smile, and move on to the next topic.  Critical thinking is removed.  Barefoot should be a no-brainer for chiropractors.  We constantly promote natural healing and movement.  How can we in good conscience then say that your feet need constant outside support for the rest of your life?  There are instances where orthotics are appropriate, but they should be used as a temporary device while the foot is remodeled and strengthened to function naturally. 

To ensure full disclosure, there are some people who shouldn't be walking around barefoot.  If a diabetic (or anyone) no longer has sensation in their feet, barefoot probably isn't appropriate.  If you can't feel damage happening, you need some protection.  That's common sense.  I don't think that rules out some barefoot activity in a safe environment, or minimalist shoes for periods of time either.  That answer must come on a case by case basis.

My answer to the question of how long until a minimalist shoe is bad for you is simple.  Never!  They are a tool and should be used appropriately by someone who is instructed in their use and will use them appropriately.  In a perfect world, that could be nearly anyone!  Who does the instruction?  Well, you can find someone who is using them already and get a little instruction from them.  If your shoe salesman can't answer your questions, find a different shoe salesman!  In reality, the best teacher is your own feet.  If it hurts, you are doing it wrong.  Start slowly and build up activity as you are able!

Run on, runners!


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