Shoes are, surprisingly, more important than you may think. All forces from the ground go up through your foot to the ankle, then knee, hip, sacroiliac joint and eventually the lumbar spine (collectively known as the lower kinetic chain).

This means that an un-leveling of any of these structures can influence the other causing a domino effect. Most individuals are walking around on footwear that is inappropriate for their individual needs. This article is by no means a replacement for a trained eye in footwear and gait evaluation. If you are a current patient and are interested in having your shoes analyzed, please bring the pair to your next appointment and we will give our opinion of your current shoes.

The first and most important aspect of looking at a shoe is evaluating if the arch support is correct for your foot. The foot’s arch falls into the possibility of three classifications: supinated aka flat footed, where the foot puts pressure on the midline portion of the foot, normal, where the foot disperses forces properly through the arch of the foot and evenly between midline and the side of the foot, and supinated, where the foot has an excessively high arch while loading the side of the foot. Most individuals nowadays fall into the category of foot pronation. Why? Because our bodies are genetically designed to function as hunter gatherers. This means waking up when the sun comes up, going to sleep when the sun goes down, foraging for berries in the wilderness, and hunting food as our feet conform to soft dirt and grass. Do you know anyone who actually lives that way nowadays? For a quick moment, analyze what is below your feet. The likelihood is that it isn’t grass or dirt. It is probably concrete, tile, or carpet. AKA materials that cannot conform to the shape of the foot. As gravity weighs down on the foot over time, it’s likely is to collapse into the arch and create foot pronation. That is the reality we live in nowadays. In some occasions, foot pronation is so bad that orthotics are necessitated because the arch built into the shoe cannot create sufficient shock absorption for the foot.

A second major distinction in shoes has to do with the relative rigidity or flexibility of the foot in question. This concept is pretty simple. If you have a foot that is rigid, you want a relatively flexible shoe. Often if an area of the foot is excessively rigid, the foot may need to be adjusted to restore proper range of motion and motor control. If you have a flexible foot, you want a more rigid shoe for extra support. Two tests of the shoes can be done to test the flexibility of a shoe. Below you will see a flex test to assess the flexibility of the toe box which is responsible for the toe off part of gait. A flex test should never create excessive flexion, as seen below. Second is a torsional test of the shoe. This is designed to test the resistance of the shoe to turning corners or susceptibility to rolling your ankle. As you test different shoes, you will gain an appreciation for the relative flexibility and rigidity of different shoes.

Improper footwear, making its way up to the kinetic chain, can have devastating effects on not just the feet, but also the knees, hips, sacroiliac joints, and eventually the lumbar spine. This can result in conditions such as plantar fasciitis, Morton’s neuroma, knee instability, hip pinching, lower back pain, amongst a number of other secondary conditions. The feet are truly the base on which your entire body sits on. Would you want to buy a house with an unlevel or deteriorating foundation? May an unlevel foundation create other issues in the home such as difficulty closing doors, walls cracking, and creaking floorboards?

At Apex Chiropractic we value informing our patients and the public in strategies outside of our care that can assist in creating a full spectrum in supporting our treatment of structural spine issues. Shoes, undoubtedly play an important role in our focus of practice. Our initial examination always includes analysis of the feet and its interrelationship up the lower kinetic chain into the spine. This allows us to give proper complementary recommendations for our patients to create truly customized treatment plans, ensuring the best possible clinical result.

Additionally if you’re interested in learning more, feel free to contact us at our office located in Shelby Charter Township at 586-991-1505.