This morning on my commute into work I noticed that the season for sandals has begun. As I sit on my subway ride, I noticed a row of feet filled with espadrilles, flip-flops, and strappy sandals of all kinds. I then realize it is also the season when I like to inform my patients of the trouble their footwear may cause. Whether my patients are spending more time outdoors hiking, playing golf or just strolling along the city streets, there is usually a certainty that foot pain will be on the rise.
For some of my ‘high-arched’ patients, there may be less of a threat when it comes to flat sole shoes. However, for some of my more pronated individuals, it can be a different story. That is not to say that some of the ‘higher-arched’ individuals are free from pain and breakdown – in fact they too have their fair share of plantar fasciitis, bunion and mid foot pain to name a few ailments. But with the more compensated supinated or pronated patients, knee, back, and even jaw pain may be a result of poor footwear in the long run. The flat nature of the sole will often cause lengthening of ligaments that are responsible for binding and stabilizing foot structures. Consequently, weakness of intrinsic foot and ankle musculature will occur, doubling the demand and vulnerability of this area. Unfortunately, pain may ensue along the great toe, sole of foot and heel and with time, this over pronation or flattening of the foot can create asymmetrical forces throughout the chain creating abnormal stresses to the joints and shutting off important muscles found in the pelvic floor, abdominals and even into the neck.
As a fellow pedestrian, I can relate with my female patients who may want to show off those new summer sandals with the pretty buckle. However, even I try to proceed with caution and follow a simple rule of thumb. Wear sandals for a nice dinner or a show or any event where you will not be found having to stand or walk for a prolonged period of time. When taking long strolls, resort to a more supportive shoe wear that is of course if you are able to plan ahead. Luckily there are more options these days with footwear that can be both supportive and semi chic. Look for a shoe with an arch support, a straight last (a line should be relatively straight when drawn from the middle of the heel to the middle of the toe) and a soft but firm sole especially along the inner part of the heel.
If you have found that you are having increasing foot pain this summer, do not hesitate to come in for a physical therapy consult. In fact, don’t wait until the pain starts. Make an appointment for a full evaluation where a physical therapist can evaluate your posture, gait and foot mechanics in hopes of preventing pain. Protect your feet and enjoy your summer!
-Flora Cohen MS, DPT, CFMT