Falling Flat

While high heels are obvious culprits for foot pain, flat-soled shoes are proven to cause just as much damage.  

Women today recognize the negative health effects of high heels, which explains why comfortable Converse and strappy sandals practically fly off the shelves at shoe stores. But many women don’t realize that not all flat shoes are created equal, and most come with their own range of health problems that affect the feet, legs, back, and hips. It’s time to reevaluate your collection of riding boots, ballet flats, and rubber-soled sneakers.

An Aching Pain

The problem with flat shoes stems from the lack of arch support, according to Ernest L. Isaacson, a doctor of podiatric medicine in New York City. Shoes that position your feet perpendicular to the ground also don’t have adequate shock absorption or motion control. Added together, these factors place stress on the muscles, tendons, ligaments, and joints of the feet. “When you have a flat shoe, it kind of stretches everything out in the bottom of the foot,” says Isaacson. “Tendons in the back of the foot are really the most affected.” Specifically, shoes without adequate arch support strain the Achilles tendon (which runs from the heel to the calf) and the posterior tibial tendon (which runs along the inside of the ankle).

When these tendons become stressed, they trigger other complications. Stephanie Hook, a doctor of podiatric medicine and surgery with the Podiatry Services of Central New York, says the consequence seen most often in her office is plantar fasciitis, “an inflammation and strain of the band of tissue that stretches from the heel to the ball of the foot and helps support the arch.” Severe heel pain characterizes the condition, and professional treatment is often necessary to resolve the issue. With the onset of plantar fasciitis comes a whole range of health conditions, like a domino effect, since the foot must function in a different way. The knees become unstable as they try to compensate, which makes the hips stray out of line and thus affects the back as well.

Isaacson mentioned that in addition to plantar fasciitis, flat soles can also cause posterior tibial foot tendonitis, Achilles tendonitis, and generalized aching along the bottom of the foot. People with naturally flat feet are generally more at risk for all conditions associated with flat feet.

A Sure-Footed Solution

To prevent damage to the feet and tendons, buy shoes with an adequate arch support. Jennifer A. D’Amico, a doctor of podiatric medicine at the Western University of Health Services in Pomona, CA, has three general criteria that people should consider when buying new shoes: a stable back, a somewhat rigid structure, and bendability only at the toes. Similarly, Isaacson firmly believes that most people need to wear a low one- or two-inch wedge or heel for their feet to function properly. “It decreases the strain on the plantar fascia and tendons, and relaxes the back of the foot,” he says.

However, don’t throw away your trusty Ugg boots, boat shoes, or Converse just yet. Hook says that people suffering from foot pain can look into custom-made orthotics, which are “inserts made by your podiatrist or pedorthotist that can slide into your shoes to offer support.” Flexing the calf and Achilles tendon may also alleviate pain. Hook stresses, though, that anyone experiencing pain should first visit a podiatrist.

Next time you’re admiring the cute new boots in the store, take a minute to examine the arch. You may save yourself some pain.

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