A woman from CBS News “the early show” recently interviewed me about women’s footwear. The segment is about a brand of shoes known as Worishofer. Apparently, a new trend is developing and The NY Daily News recently had a piece titled “Worishofer granny sandal shoes are comforting Hollywood stars like Maggie Gyllenhaal”. In the segment, I speak about the differences between these shoes and high-heels (I mentioned a bit about flip-flops as well).
Now that I have a bit more time, I’d like to expand on the topic. First, I’ll talk about the drawbacks of high-heels. Essentially, high-heels are a biomechanical and neurological nightmare. Humans were designed to walk in a manner where the heel strikes first and then the toes “push-off”. Obviously, with high-heels the heel-strike phase of gait never occurs. As a result, all of the body weight lands on the balls of the feet. This is a problem because that area the foot is not designed to bear all the weight with each step. The possible detrimental results include (but are certainly not limited to): low-back muscle strain, knee strain and degeneration (potentially leading to osteoarthritis), tight calf muscles (potentially leading to achilles tendonitis), muscle cramps in the foot and calf, bunions, metatarsalgia (pain at the metatarsalphalangeal joint(s) – the “toe joints”, usu. the ball of the foot), Morton’s neuroma, and hammer toes. Foot dysfunction can then in turn result in hip problems, including hip joint degeneration); mid-back pain; neck pain; and even jaw or TMJ pain and dysfunction. Again, the major problem is that all of the body weight is forced onto the front of the foot with each step, and opposed to first landing on the heel. Additionally, many high-heels often lack proper shock absorption, because the soles are extremely thin. There’s a few more issues, keep reading.
The Worishofer fortunately helps with a few of these issues. The sole is nicely cushioned to provide with good shock absorption. And even though there is still a bit of a heel, not all of the weight is transferred directly to the front of the foot the way it is in a typical high-heeled shoe. Another great feature of this shoe is that it has a built-in metatarsal lift. This is essentially a raised cushion in the front of the shoe, just before the toes. This helps to support the transverse metatarsal arch (there are really three arches in the foot: the medial/inside longitudinal arch, the lateral/outside longitudinal arch, and the transverse metatarsal arch). I’ve only ever seen these “lifts” built into orthotic shoe inserts. Also, women tell me that it’s still possible for them to “push-off” with their toes which is extremely important for not only foot function, but entire body biomechanics and neurological function. In toeing-off (along with proper heel-strike), you are able to use the full range of motion in the ankle and foot which helps to keep those joints functioning well and prevent breakdown and degeneration.
“Use it or lose it” applies to joints (and their cartilage) as much as it does to maintaining muscle mass. Not using your toes (as in “pushing-off” or going through the “toe-off” phase of gait) and not using the full ankle and foot joint ranges of motion can lead to a common problem I see in my practice. That is, many people develop very tight, overly-contracted hamstring muscles (in the back of the thigh), when they don’t use their toes and full foot and ankle range of motion during gait. In this situation, all the stretching in the world won’t help to relax these muscles and return them to their normal length. Last and certainly not least, the tone of the plantar muscles in the feet (the muscles that attachment only within the foot and not crossing above the ankle) help to determine the function of the extensor muscles of the body. These are the muscle that extend the neck and limbs backward, in addition to the spinal muscles that allow one to do a back bend. Essentially, when the plantar muscles are overactive, because a person is walking improperly (again, not fully using the ankle muscles that are designed to hold up the arch and flex and extend the foot) or has “flat feet”, the extensor muscles will become inhibited. Over time, this can lead to spinal joint and disc degeneration, in addition to having a bent over posture. It’s very hard for these individuals to stand upright naturally because their all of their extensor muscles have inhibited, causing a hunched over (head down and rounded shoulder) posture.
Lastly, I’ll mention a few words on flip-flops. The main problem with flip-flops is, again, you typically don’t use your full joint ranges of motion. Most people need to curl their toes down and keep their foot muscles constantly contracted just so the flip-flops don’t fall off when walking. This is a big problem because it alters gait and lower extremity muscle function in general; and not for the better.
So what’s the ideal shoe? Well, I suppose that can vary, however flats and lace-ups are usually ideal. With these shoes, the foot is kept in a neutral position, you can easily land on your heel and push off with your toes, and the laces provide good arch and sometimes even ankle joint support.
The feet are the foundation of the body, and some estimates say that we take about 6,000-10,000 steps a day. A rule of thumb that I go by when treating patients is: “Whatever the problem, look to the feet” and the shoes! Since walking is such an integral part of most people’s lives, it’s very important to have good foot function.
FYI: Despite bringing a cameraman, etc. into my office, they had to cut the segment and they decided to only use the live studio footage (of which I wasn’t a part). The woman who interviewed me said the following via email: “so sorry – Unfortunately, due to the timing within the show, we had to make it a much shorter set-up piece than originally planned for. But, you were wonderful, and I’m so glad (name left out for privacy) put us in touch. Would love to be in touch about other potential shoots.”
Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiologist