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Are Your Shoes Setting You Up For Injury?

"Oh, my aching feet! I don't think I can walk one step farther!"
Sound familiar?

Chiropractors, like Dr. Christiana, often hear complaints about foot-related injuries. That's why Dr. Christiana teaches patients how faulty footwear affects joints throughout the body - and how to choose shoes that promote optimal posture. The Spine/Shoe Connection Foot disorders triggered by inferior footwear include Achilles tendonitis, plantar fascitis, bunions, Morton's neuroma, black toe, calluses and blisters. Foot problems aren't the only adverse effects of shoddy shoes, however. They may also wreak havoc on your spine. Shoes that don't provide adequate support can throw your entire skeleton out of alignment. When the foot is held in an improper position, excessive force is placed on the knee joint during standing, walking or running. Quite often, one knee receives a disproportionate amount of force compared with the other, setting it up for injury. Misalignments in the knee joints trigger a shift in the placement of the pelvis, the base of the spine. The spine itself is affected next. Specifically, a condition known as vertebral subluxation ensues. Vertebral subluxations are regions in the spine where motion is restricted or bones (vertebrae) are out of alignment. Scientific studies link vertebral subluxations with a plethora of health disorders, such as headache, back pain, carpal tunnel syndrome and ear infection. Could substandard shoes be taking a toll on your joints? Ask Dr. Christiana for a demonstration of how shoes affect posture, h.Qw to examine your shoes for signs of postural discrepancies and how to keep tabs on your spinal health by performing simple "posture checks." A chiropractic checkup also includes an examination of your spine for vertebral subluxations. If subluxations are detected, Dr. Christiana will restore motion and alignment with specialized maneuvers called chiropractic adjustments. Heels Today, Pain Tomorrow High heels top the list of features to avoid when shopping for shoes. Study after study confirms that towering heels upset the body's natural posture, spawning a vast array of ailments from blisters to back pain. In a barefoot vs. high-heel comparison, one study showed that wearing high heels, "caused [low back] flattening, a backward tilting pelvis, a reduction of the distance of the knee and ankle from the line of gravity and a posterior displacement of the head and [mid-back] spine." (Spine 1988;13:542-7.) Research also shows that high heels up the risk of osteoarthritis of the knee, hip and spine (Annals of Internal Medicine" 4000; 133:726). Despite the hazards of heels, some women staunchly refuse to dump their pumps. If you're one of these slaves to fashion, at least limit the number of hours per month you don high heels and opt for "comfort" or "performance" pumps with extra cushioning. Wear heels only on days when you won't be walking a great deal - and pack a pair of sneakers for lunchtime promenades and jaunts to and from the office, subway station or your home. Men, Misconceptions and Malarkey Women aren't the only ones who need to be concerned with high heels. The half- to three-quarterinch platforms on many male dress shoes predispose men to heel-related injuries as well. That's not the only misconception about high heels that should be tossed back into the closet: "Chunky" styles are no less perilous than stilettos. One recent report revealed that broad-based heels cause a more dramatic shift in posture than do their narrow cousins, resulting in a heightened risk of knee and hip arthritis (The fancet 2001;357:1097-8) Arch Issues Foot problems occur when arches are too high or too low. Fortunately, specific footwear modifications combat the conditions associated with abnormal arches. For example, individuals with high arches benefit from extra cushioning while their low-arched peers require stiffer shoes that -limit motion, preventing feet from rolling inward. Arch type should also be considered when examining the form of the shoe, called a last. "Patients who have low arches do best in a shoe that has a straight shape and a broad last; those who have high arches require a shoe with a curved shape and slip-lasted construction; and those who have a medium arch benefit from one that has a semicurved shape with a combination last." (Physician and Sports Medicine 1997;25.) Once Upon A ... Ouch! Women are nine times more likely than men to develop foot problems from improper shoes. This is primarily due to high heels and trying to cram size nine feet into size six shoes. It didn't work for Cinderella's step-sisters and it won't work for you either! So, when it comes to shoe size, put vanity aside. Choose the size you actually are not what you wish you could be. When shopping, ask to try on the size you usually wear plus a half-size and full-size larger and smaller. Try on the various shoes, without peeking at the label, and then choose the pair that fits best - regardless of the size. Inserts & Orthotics In some cases, simply choosing quality footwear isn't enough. Certain foot types and postural imbalances require custom-molded or pre-manufactured inserts called orthotics. If you think you may benefit from orthotics, ask the doctor to order a pair for you (following an examination) or refer you to an orthotics specialist in the community. Sneaker Savvy: What to took for When Shopping for Athletic shoes If you workout several days a week, purchase new athletic snoes every three to six months. Or, if you have logged more than 500 miles on your shoes, it's time to invest in a new pair. You may need to shop for shoes more often if you have a postural imbalance. Have BOTH feet measured (while you are standing, not sitting) each time you purchase new shoes. If your feet are different sizes, always buy for the larger foot. Shop for shoes immediately following a workout or in the evening when feet are swollen. Wear the s same type of socks you wear while exercising. Try on BOTH shoes in a pair for at least 20 minutes before purchasing them. Walk, run and jump around the store to simulate the activity required by your sport. Consider arch height, cushioning, support, "breathability of.material and flexibility of the shoe. Ensure that there is at least one thumb's width of space from your longest the to the end of the shoe. Have a salesperson check this measurement for you. If you bend over to check it yourself your foot's position will shift. Choose an athletic shoe made specifically for your sport. Shop at athletic-shoe specialty stores that offer free consultations with an injury-prevention specialist. If you suffer from "weak" ankles, look for sneakers with built-in "neoprene sleeves," which work like ace-bandages to prevent ankles from wobbling. Consider "laceroni" shoelaces (those odd looking round laces used in hiking boots), which prevent pressure points by evenly distributing stress. According to a review article by D.R. Martin in the journal Physician and Sports Medicine, "Though the new laces untie more readily during use (without double-knotting or lace locks), when used with the new loop or web eyelets, they slide more easily through a shoe's loops and distribute the pressure across the top of the foot mgre evenly than/flat laces." (Pbysician and ports Medicine 1997;25;) If your sport requires cleats, look for the shorter, plastic variety. Longer spikes may cement your foot into the soil, causing excessive twisting at the knee anct related injuries. Forget the frills, Don't be.swayed by extravagant packaging or advertising campaigns. Instead, choose shoes from companies that pour money into research and development, not splashy marketing. If your sport requires heavyeguipment - such as.football gear or hiking packs - make sure to try on shoes while wearmg the equipment.

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