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Shoes, Sneakers and the Meaning of Life

Stability is the foundation of our existence - from the gravitational balance of the planets within the solar system - to the impact of our footsteps upon the Earth.  Furthermore, whether you're swinging a golf club or kicking a soccer ball, the ability to prevent unwanted motion is essential.  But let me digress

When we think about problems with our feet, we need to consider the environment in which they function.  Most importantly, this includes the thing that covers the foot all day long:  the shoe.  The shoe can be a force for creating stability or a source of our woes.  Unlike toddlers who need a shoe mostly for protection rather than balance, for adults the wrong shoe can set you up for an injury or exacerbate an already existing condition.

Let's say you've had Achilles tendon issues in the past.  The wrong shoe or sneaker may allow a little bit too much motion of your foot and ankle with each step. This loss of support can 'pre-fatigue' soft tissues such as the achilles tendon. The upshot is that, after a normal day's activity, if you go for a walk or run beyond the point at which the tendon can react to the additional stress, your Achilles tendinitis is back. 

So what is needed to prevent the excess motion and act as a control or guide for the foot?  For the majority of people, the proper shoe with sufficient support will do the trick. For others, prescription orthotics provide the answer. 

Now let’s review the 2 main qualities that we need to have in our shoes or sneakers that provide for proper support:

1.    The Heel Counter

The heel counter surrounds the heel on both sides.  If you squeeze it from the sides and there is no give, that's a solid heel counter.  If it compresses inward, then the shoe will not control the rear part of the foot.  This sets up the foot for excessive pronation. You may also consider the sponginess of the area under your heel.  If it's too soft, your heel will sink slightly with each step leading to too much movement.

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2.    The Bottom of the Shoe or Sneaker (the shank)

A rigid bottom is essential in a shoe or sneaker.  It is important that the rigid surface extends from the heel of the shoe to the ball of the foot.  It is at this point that the shoe needs to bend, at the level of the metatarso-phalangeal joints just behind the toes.  If you hold a shoe by the toes and the heel and bend it, it should not bend in the middle.  Flexibility at this area allows for excess motion of the foot. Additionally, if you hold a sneaker by the front and back and twist in opposite directions, it shouldn't twist like a corkscrew.]

Now let’s look at the 3 key ways to insure proper fit of your shoes or sneakers:

1.    Buy your shoes and sneakers late in the day.

Buy your shoes and sneakers after you have been on your feet for several hours.  I recommend that you purchase after 4 pm because that's when your feet may swell.  If you buy your shoes too early in the day they may be too tight later on.

2.    Buy your shoes wearing the same type of sock that you will normally wear

If you purchase a pair of shoes or sneakers with a thin sock they will not fit when you change to a thicker sock. This could lead to discomfort

3.   When fitting shoes or sneakers place your weight on your larger foot.

Yes, most people have one foot that's slightly larger). You should have a thumb's width, or about one inch, in front of your longest toe (for some people, the second toe is longer than the big toe).  This is because your foot shifts slightly forward with each step.  You don't want your toes jamming into the front of the shoe with each step. 

4.    Do not be ashamed to buy a full size larger if you need it.

Sometimes we need a larger size than we expected because some shoes are just cut smaller.  Your foot may have  gotten larger, which does happen with age.  You may not take the same size you did a couple years ago.  Don't get locked into thinking you'll always take the same size, either.  Companies don't size equally.  Even within the same company, similar sizes may fit differently.  That's the nature of manufacturing. 

5.    Do not fall for: "they'll break in", or "they'll stretch out". 

No, they won't.  The shoes must fit properly when you leave the store.  The wise thing is to wear them around the house for an evening (wearing them on carpet is even better).  This is so you can return them if they don't fit right.  

Follow these simple tips for proper support and fit and you too shall experience an increase in stability and balance.  As we know, stability and balance are keys to achieving a satisfying life. 

The Meaning of it All, or How Stable am I?  (This section is for biomechanics nerds, of whom I am one).  Please feel free to skip.

Whatever activity you do, stability provided by the foot and ankle is a must.  Whether you require accurate movement or are directing force toward a target you can't do it without stability. As the lower extremity functions as a closed chain, the loss of stability anywhere may affect the quality of movement elsewhere. (That's not to say that stability equals rigidity.  A small, controlled amount of motion is necessary.)  

Our strongest muscles are located near the center of the body: they include the glutes, abdominals, hamstrings, quadriceps and hip flexors.  They are prime mover muscles and their job is to generate power and move the pelvis. The pelvis transfers force to the legs, which then move the feet.  The feet (and hands) are where we usually interact with the environment. 

In contrast, the smaller muscles that connect the legs to the feet are weaker, but are capable of more precise and controlled movements.  Their job is to precisely channel forces to a target, usually the ground.  

Instability in the foot and ankle can result in the prime movers having to provide stability and balance, rather than generating the more powerful movements which is their proper function. Thus, whatever your activity, the generation of power is diminished.  In addition, because the joints of the foot and ankle are moving beyond their normal ranges of motion, the muscles controlling them may expend more energy.  This translates into fatigue. 

Lastly, the mechanical stress of movement should be divided between all of the joints of the lower extremities.  An unstable foot highly concentrates this stress, which increases the probability of joint pain, injury, etc.  

Or you just may find it difficult to appreciate the pleasures of a nice walk on a beautiful day.

Next I'll post my recommended local shoe and sneaker stores.

An excellent discussion on stability, flexibility and core strength can be found in "A Guide to Better Movement" by Todd Hargrove

Dr Jay Kerner