Back Clinic Foot orthotics These are shoe inserts that are custom-made to medical specifications. Custom-made orthotics are considered more effective and made of higher quality than pre-made orthotics.
Custom-made orthotics can:
Correct abnormal walk or gait
Reduce pain
Prevent and protect foot/feet deformity
Better alignment
Take away pressure on the foot/feet
Improve mechanics of the foot
Foot pain can come from an injury, disease, or condition, but the cause of the foot pain is what the doctor wants to know to know what type of orthotic to design. The inserts are made by taking an impression of the foot/feet with a 3-D scan.
Suffering from foot pain, that can lead to leg, hip, and spine problems, then orthotics could hold the key to optimal health. By starting from the bottom up foot orthotics can prevent any problems/issues and relieve any pain. It is an option to be considered and should be discussed with your physician.
Children walking with their toes pointed in may be pigeon-toed. What are the causes, conditions associated with it, and treatments?
Pigeon-toed Walking
If a child walks with their feet turned inward at the toes, it is usually described as being pigeon-toed. This pointing inward of the feet occasionally occurs as a child learns to walk and may continue through toddlerhood. It is noticed more often in children than adults, but older individuals can experience it. Pigeon-toed walking is rarely a major orthopedic problem and usually disappears without treatment. However, there are times when it may impact a child’s lower extremities and hips. Bracing or surgery may be necessary in these cases to correct the problem. (Paramanandam V. et al., 2019) This condition is common and typically is caused by abnormal birth positions in utero. Sometimes, slight issues may lead to noticeable functional characteristics. Mild changes in bone shape and positioning usually cause pigeon toes. Often, it subsides in a few years as the child continues to develop.
What Does It Mean?
There is usually no need to worry, as this condition is likely not permanent and will go away in a few years. (Paramanandam V. et al., 2019) However, it is recommended that you check in with your healthcare provider to ensure the child is developing normally. Some adults walk with their toes turned in. This may be due to a birth defect, a weakness, or a rare case of pigeon-toed walking as a youth that was left untreated or did not go away.
Causes
There are various reasons for pigeon-toed walking. To determine the cause, a healthcare provider can assess the child’s condition and make a diagnosis, including:
Metatarsus Adductus
A condition where the front part of the foot is turned inward.
The metatarsals are the long bones of the forefoot.
This is when the bones of the foot point inward, leading to pigeon-toed walking.
A clinical examination and X-ray can confirm the metatarsus adducts as a cause of pigeon-toed walking.
Tibial Torsion
A twisted shinbone (tibia) can cause the feet to turn inward in younger children.
The shinbone/tibia in some children may be slightly twisted.
The tibia can either turn outward or inward.
When it twists inward, it may manifest as a pigeon-toed gait.
Tibial torsion may accompany femoral anteversion.
It is diagnosed with an X-ray.
Children with tibial torsion typically grow out of the problem, and the pigeon-toed disappears by age 4. (Uden H., & Kumar S. 2012)
Femoral Anteversion
A common cause, especially in older children, is when the thighbone/femur is twisted inward.
If the femur turns inward and forward unnaturally, where the femoral neck meets the body of the femur, it is called femoral anteversion.
An outward and backward rotation of the femur is called femoral retroversion.
Many children with femoral anteversion appear knock-kneed with a large gap between their feet when standing with knees together, and when they walk, they appear pigeon-toed.
A clinical examination and X-ray diagnose it.
Symptoms
In most cases, the child does not complain of any pain. However, if pain is felt, it can include:
Tightness in the calf muscles
Aching on the outer edges of the feet
Knee pain
Usually, parents will notice pigeon-toes when their child is first learning to walk. Rest assured, the child most likely is not experiencing pain. They have feet and knees that turn inward when they walk and run. (Uden H., & Kumar S., 2012)
A pediatrician or primary care provider can assess the situation and make recommendations. Most pigeon-toed children begin walking and running normally after age 3 or 4, so a watch-and-wait approach is used. Parents may have to take their child to a specialist, like an orthopedic surgeon, if they complain of pain while walking. A specialist may be referred if the child cannot walk due to the inward turn of their feet.
Risk Factors
Pigeon-toed walking is not a preventable condition but rather one that develops during pregnancy. Causes may include: (Scorcelletti M. et al., 2020)
A pregnancy with twins or multiple births
Large fetus
Breech position in utero when the baby is positioned feet first.
Typically, a normal gait will appear by age 3 or 4. Other treatments may include:
Physical Therapy Exercises and Gait Training
Exercises to stretch tight lower extremity muscles and strengthen hip and leg muscles can help improve walking gait.
See a pediatric specialist before starting, as research shows that parental stretching of a newborn with metatarsus adductus offers little benefit. (Eamsobhana P. et al., 2017)
Bracing or Casting
Braces
Serial casting is a procedure that helps children improve their range of movement and may be done to place their lower extremities in an optimum position as they develop. (Uden H., & Kumar S., 2012)
Surgery
For cases in which tibial torsion is the cause, osteotomy surgery, which involves cutting and/or removing bone, may be recommended to correct the structural deformity of the shinbone.
Injury Medical Chiropractic & Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Foot Pronation
References
Paramanandam, V., Lizarraga, K. J., Soh, D., Algarni, M., Rohani, M., & Fasano, A. (2019). Unusual gait disorders: a phenomenological approach and classification. Expert review of neurotherapeutics, 19(2), 119–132. doi.org/10.1080/14737175.2019.1562337
Uden, H., & Kumar, S. (2012). Non-surgical management of a pediatric “intoed” gait pattern – a systematic review of the current best evidence. Journal of Multidisciplinary Healthcare, 5, 27–35. doi.org/10.2147/JMDH.S28669
Scorcelletti, M., Reeves, N. D., Rittweger, J., & Ireland, A. (2020). Femoral anteversion: significance and measurement. Journal of Anatomy, 237(5), 811–826. doi.org/10.1111/joa.13249
Eamsobhana, P., Rojjananukulpong, K., Ariyawatkul, T., Chotigavanichaya, C., & Kaewpornsawan, K. (2017). Does the parental stretching programs improve metatarsus adductus in newborns?. Journal of Orthopaedic Surgery (Hong Kong), 25(1), 2309499017690320. doi.org/10.1177/2309499017690320
Can incorporating an exercise program like the Alfredson Protocol help athletes and individuals who have hurt their Achilles tendon find pain relief and healing so they can return to regular physical activities?
Exercise Protocol Achilles Tendonitis
Achilles tendonitis occurs when the tendon at the back of the ankle gets injured. It is common in runners. For individuals who have Achilles tendonitis, walking and running can be painful. You might have to stop engaging in exercise and physical activities like sports. Depending on your job, having the condition may make working harder. Here are a few of the signs and symptoms of the condition:
Pain in the back of the lower leg, just above the heel.
Pain with running, jumping, or pointing the toes.
A small lump on the Achilles tendon just above the heel.
The first line of treatment is to rest and ice the tendon. Anti-inflammatory medications can help reduce pain. (American Academy of Orthopaedic Surgeons, 2022) Physical therapy can include strengthening exercises, ultrasound heat therapy, and deep massage. Exercises stretching the nearby muscles will help gradually increase the stress the tendon can handle, eventually reducing inflammation and swelling. Stretching and flexibility exercises will help an Achilles tendon heal. (University of Michigan, 2023)
The only way to determine if an individual has injured their Achilles tendon is to see a doctor. If the injury is Achilles tendonitis, a physical therapist may be recommended. A physical therapist can train individuals on the Alfredson protocol, an exercise protocol program for those with Achilles tendonitis (tendinopathy) that research has shown is helpful for those with the condition. The therapist will train on how to exercise to strengthen the tendon. The exercises stretch the Achilles tendon to help it handle forces and stress, known as eccentric loading. (Stevens M., & Tan C. W. 2014)
Inflammation
Tendonitis is inflammation of a tendon. However, studies have shown that the tendon might not be inflamed in those with the condition. When an area of the body is inflamed, inflammatory cells are present. Individuals usually feel pain in the inflamed area. For those with Achilles tendonitis, the tendon will present with pain, but not necessarily because the tendon is inflamed. Under a microscope, researchers examined tissue from the tendons of those with Achilles tendonitis. They did not find inflammatory cells in the tissue. (Stevens M., & Tan C. W. 2014) This means that although individuals felt pain, they were not inflamed. If there are no inflammatory cells in the tendon, this could explain why those with Achilles tendonitis often do not find relief from the anti-inflammatory treatment of non-steroidal anti-inflammatory drugs (NSAIDs). Studies have shown that gentle exercise protocols for the tendon are more helpful. However, researchers are not sure why these exercises are so beneficial. (O’Neill S., Watson P. J., & Barry S. 2015)
Eccentric Exercise
A chiropractic physical therapy team can help individuals heal the injury with eccentric loading exercises. Eccentric loading exercises work the muscles and tendons to help them get stronger. Once healing has begun, they can help strengthen the tendon. Individuals start slowly with easy exercises and then work up to harder ones. They will have the patient lengthen or stretch out the muscle. As the patient moves, the muscles and tendons contract or shorten. The Alfredson protocol consists of eccentric loading exercises for the Achilles and the muscles that support it.
Alfredson Protocol
Before exercising, talk to a doctor or physical therapist to know if it’s safe. How to do the Alfredson protocol:
First, stand on a small step or curb.
Stand with the balls of your feet on the edge.
Your heels should hang over the edge.
Hold onto something for balance.
Keep the knees straight.
This will load a muscle part of the Achilles tendon called the gastrocnemius.
Using both feet, lift the heels and rise onto the balls of the feet.
Keep the foot with the painful Achilles tendon on the step.
Lift the non-injured foot off the step.
Slowly lower down using the injured ankle.
The heel should move towards the floor.
The ball of the foot should remain in contact with the edge of the step.
Return the non-injured foot to the step.
Repeat the exercise.
Do three sets of 15 reps with the knees straight. Then, do the Alfredson protocol again with the knees slightly bent. This will work a muscle called the soleus, which connects to the gastrocnemius. Perform three sets of 15 repetitions. Perform both exercises twice a day. This could be in the morning and the evening. The Alfredson protocol is most beneficial when done for about 12 weeks. (Stevens M., & Tan C. W. 2014)
Injury Medical Chiropractic and Functional Medicine Clinic
The Alfredson exercise protocol can be done at home with a step or raised platform to put the feet on safely. Individuals should consider working with a personal trainer to ensure safety and get the most out of the workouts. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Stevens, M., & Tan, C. W. (2014). Effectiveness of the Alfredson protocol compared with a lower repetition-volume protocol for midportion Achilles tendinopathy: a randomized controlled trial. The Journal of orthopaedic and sports physical therapy, 44(2), 59–67. doi.org/10.2519/jospt.2014.4720
O’Neill, S., Watson, P. J., & Barry, S. (2015). WHY ARE ECCENTRIC EXERCISES EFFECTIVE FOR ACHILLES TENDINOPATHY?. International journal of sports physical therapy, 10(4), 552–562.
What are the treatment options for individuals dealing with foot overpronation when the foot and ankle move too much downward and inward?
Overpronation
Pronation is the normal foot and ankle movement when taking a step and is usually associated with flat feet. Overpronation is a movement pattern in which the ankle rolls inward and downward, causing the foot’s arch to collapse with each stride. Overpronation can strain the muscles and ligaments in the feet and legs, leading to heel pain, ankle pain, shin splints, and low-back pain. (Pedorthic Association of Canada, 2023) Orthotic inserts for shoes, prescribed stretches, ankle braces, physical therapy, and surgery can all help alleviate the impact of overpronation. (Sánchez-Rodríguez, R. et al., 2020)
Signs and Symptoms
Some individuals with overpronation can have no symptoms at all. (Pedorthic Association of Canada, 2023) while others experience pain or other symptoms in their legs and feet. Overpronation is not a medical condition but a movement pattern that, if left untreated, can increase the risk for certain medical conditions because it strains the feet and leg muscles, joints, and ligaments. (Sánchez-Rodríguez, R. et al., 2020) Certain medical conditions can be a sign of overpronation and include: (Pedorthic Association of Canada, 2023)
Bunions
Heel pain
Plantar fasciitis
Achilles tendon pain
Posterior tibial tendonitis
Shin splints
Knee pain, including patellofemoral pain syndrome
Pain in the iliotibial or IT band
Lower back pain
Arthritis in foot and ankle joints
Stress fractures
Individuals may also experience pain in the midfoot or hips, which can be a symptom of flat feet.
Underpronation
Pronation refers to the normal movement of the foot and ankle while walking. Overpronation and underpronation are both abnormal movement patterns.
Overpronation – when the ankle rolls too much inward and downward.
Underpronation – occurs when an individual’s foot lacks flexibility and moves too little. This condition is called supination and is often associated with a high-arch foot type.
Overpronation can be caused or worsened by flatfeet. However, some individuals have overpronation because their feet and ankles are very flexible, so they tend to move more. Risk factors for flatfeet can also increase the chances of developing overpronation and include:
Age, especially individuals over 40.
Wearing shoes like high heels and shoes with a narrow-toe box.
Women are more prone to overpronate because of the various shoes and high heels worn.
Being overweight
Doing repetitive, impactful movements like running.
Correction and Treatment
Treating overpronation focuses on alleviating strain on muscles in the foot, ankle, and leg to relieve symptoms in the heel, ankle, knees, hips, or back. Common treatments are wearing supportive shoes and/or using foot orthotics. Exercises and stretches are also recommended to maintain flexibility and strength. Surgery is rare, but correcting flat feet that can cause overpronation may be recommended. (Sánchez-Rodríguez, R. et al., 2020) Individuals with overpronation are advised to see a podiatrist who can explain the best treatment options.
Supportive Shoes
The first course of treatment is to wear added supportive footwear. This can include specialized shoes or inserts that support the foot and reduce ankle movement. Individuals are advised to use shoes with firm heel and midfoot support to help prevent disproportionate movement. (Pedorthic Association of Canada, 2023)
Orthotics
A healthcare provider can recommend orthotics for individuals with moderate overpronation. These are meant to support the foot, especially the arch, and reduce overpronation. (Naderi A. Degens H. and Sakinepoor A. 2019) Individuals can purchase orthotics from shoe stores and elsewhere, but those with severe overpronation may need custom orthotics molded to the foot to provide individualized support.
Exercises and Stretches
Exercises and stretches can also help. A study found that exercises targeting the feet, core, and hips helped correct pronation over nine weeks. The exercises included: (Sánchez-Rodríguez, R. et al., 2020)
Toe pickups in which the individuals grab small objects with their toes and move them from one position to another.
Flexing and pointing the toes using a resistance band placed around the toes.
Hip abduction exercises to target the hip and glutes.
Abdominal and oblique muscle exercises to stabilize the torso.
Short-foot exercise raises the foot arch off the ground, drawing the toes toward the heel. (Sulowska I. et al., 2016)
Surgery
Rarely will surgery be needed to treat flat feet and severe overpronation. But if necessary, reconstruction realigns the bones to support the arch better and reduce overpronation. A metal implant is used for flatfeet to stabilize the area. Surgery can also repair torn tendons or other damage contributing to overpronation. (Healthline, 2020)
Injury Medical Chiropractic and Functional Medicine Clinic
Individuals with overpronation but no symptoms don’t necessarily have to see a healthcare provider since this may be the body’s natural movement pattern. But if the feet, legs, hips, or back begin to present with pain and other symptoms, see a healthcare provider who can evaluate gait and recommend treatment options. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Enhance Performance with Functional Foot Orthotics
Sánchez-Rodríguez, R., Valle-Estévez, S., Fraile-García, P. A., Martínez-Nova, A., Gómez-Martín, B., & Escamilla-Martínez, E. (2020). Modification of Pronated Foot Posture after a Program of Therapeutic Exercises. International journal of environmental research and public health, 17(22), 8406. doi.org/10.3390/ijerph17228406
Naderi, A., Degens, H., & Sakinepoor, A. (2019). Arch-support foot orthoses normalize dynamic in-shoe foot pressure distribution in medial tibial stress syndrome. European journal of sport science, 19(2), 247–257. doi.org/10.1080/17461391.2018.1503337
Sulowska, I., Oleksy, Ł., Mika, A., Bylina, D., & Sołtan, J. (2016). The Influence of Plantar Short Foot Muscle Exercises on Foot Posture and Fundamental Movement Patterns in Long-Distance Runners, a Non-Randomized, Non-Blinded Clinical Trial. PloS one, 11(6), e0157917. doi.org/10.1371/journal.pone.0157917
For individuals who enjoy walking for exercise and health, can knowing when to replace walking shoes help protect their feet and prevent musculoskeletal injuries?
Replacing Walking Shoes
The best walking shoes must be replaced to ensure musculoskeletal health and prevent injuries. Wearing worn-out shoes during prolonged standing, distance walking or running, and high-impact workouts can exacerbate lower back stiffness, soreness, and pain. Comfortable walking shoes offer substantial support and superior cushioning, working to alleviate discomfort and prevent injury. However, they break down cushioning and support with each step. When an individual walks or runs 500 miles, most athletic shoes are ready for replacement and should be recycled or saved for non-exercise purposes.
500-Miles
Most athletic shoes are built to last 350 to 500 miles. (Cook, S. D., Kester, M. A., and Brunet, M. E. 1985) Walkers’ feet don’t impact their feet as hard as runners’, but individuals are unlikely to feel support and cushioning past 500 miles. Weight is also a factor; the more an individual weighs, the faster their shoes wear down.
It is recommended that individuals who walk 30 minutes daily or an average of three to four hours a week replace their shoes every six months.
Individuals who walk 60 minutes daily or seven hours weekly replace their shoes every three months.
Replace walking shoes every three to six months or every 500 miles.
Shoe Wear
When athletic shoes are glued together, they start to wear from the factory to the stores as the adhesive dries out. The air pockets in the cushioning slowly begin to dissipate. Walking shoes are often on sale when old models are discontinued and may already be over a year old. To get the longest life, buy the current model and ask staff how long they have been on the shelf.
Shoe Care
Shoes can last longer by following a few guidelines:
Use walking Shoes only for Walking Exercise
It is recommended not to wear them for daily use.
Use them only for walking.
Wearing them all day exposes them to foot moisture and bacteria, breaking them down faster.
Air Out Shoes Between Uses
Store walking shoes where they are exposed to air so they can dry out completely between uses.
Keeping them in a gym bag won’t allow them to breathe.
Wash Shoes and Air Dry
When washing walking shoes, use gentle soap and cold water to prevent the glue from breaking down.
Always air dry rather than placing them in a dryer.
Avoid heat, as this will contribute to faster glue breakdown.
Replace the Insoles
Individuals who prefer custom insoles should replace them each time shoes are replaced.
However, changing the insole is not a substitute for replacing the shoe.
Cushioning insoles do not provide the same support.
A new insole will not fix a broken-down walking shoe.
Rotate Walking Shoes
Alternate walking shoes every one to two months. The feet sense the difference when the older pair begins to break down. For individuals who walk one or more times daily, alternating shoes allow each pair to dry out fully between uses. Having two pairs of walking shoes to alternate will keep you from replacing them more frequently.
Signs It’s Time
Many wait until their shoes look worn out, with holes and torn laces, before considering replacing them. Here are a few guidelines for when to replace walking shoes:
Worn Tread
Many of today’s walking shoes change color through the sole to alert the individual.
If green turns to pink or some other combination, it’s time to replace the shoes.
Overpronation or Supination
This can lead to the heel of the shoe being worn down on one side more than the other.
This can affect your gait, making it important to replace your walking shoe.
Wrinkles On The Side or Bottom Of The Sole
The breakdown of support and cushioning can cause this.
Weak Ankle Support
This is usually from the uppers being broken down around the ankle.
Wear Patterns
Where and how the soles and heels of walking shoes are worn can tell a foot and shoe professional which shoes the individual should wear. It is recommended that used shoes be taken to the shoe store. They can indicate overpronation, a neutral gait, or supination.
Risks
The risks of wearing worn-out walking shoes include:
Lack of cushioning and support can lead to foot, knee, or leg pain.
Individuals who notice new soreness and aches may indicate that the shoes need replacing.
Recycling
Keeping one or two pairs of used walking shoes is great for household chores. They can also be recycled or donated. Recycled walking shoes are used to make playground and track surfaces. Look for a shoe bin at a community recycling center or athletic shoe store. Shoes in decent condition can be donated to charity clothing centers.
Injury Medical Chiropractic and Functional Medicine Clinic
At Injury Medical Chiropractic and Functional Medicine Clinic, our areas of practice include Wellness & Nutrition, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Functional Medicine Treatments, and in-scope care protocols. We focus on what works for you to achieve improvement goals and create an improved body through research methods and total wellness programs. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.
Custom Foot Orthotics Benefits
References
Cook, S. D., Kester, M. A., & Brunet, M. E. (1985). Shock absorption characteristics of running shoes. The American journal of sports medicine, 13(4), 248–253. doi.org/10.1177/036354658501300406
Rethnam, U., & Makwana, N. (2011). Are old running shoes detrimental to your feet? A pedobarographic study. BMC research notes, 4, 307. doi.org/10.1186/1756-0500-4-307
Could stability running shoes help correct foot pronation for runners, athletes, and physically active individuals who tend to have foot pronation issues?
Stability Running Shoes
Stability is having firm, steady balance in the feet and ankles. Individuals with flat feet or feet that tend to pronate or turn inward can seriously compromise their running stability, potentially increasing their risk of injury and making running uncomfortable. Stability running shoes can help because they stabilize the feet and ankles that roll inward. They combine the right alignment, arch support, and cushioning, and this specialty footwear helps hold the feet and ankles steady and can help maintain a straight gait.
Pronation
Pronation occurs when the foot and/or ankle roll inward when running or walking. It’s a common issue, typically caused by pushing off the ground with a big toe and a second toe. Arches can be excessively strained when pronation or overpronation occurs, resulting in ankle or shin pain. Eventually, overpronation can even cause the feet to flatten. Many runners find that the instability of an inward-rolling foot makes them more prone to strained muscles or falls. However, a study determined that foot pronation was not associated with increased injury risk in novice runners wearing non-specialty shoes. (Nielsen R. O. et al., 2014) However, another study found that foot pronation contributed to joint loading or increased stress on the joints of the lower limbs after long-distance running. (Mei Q. et al., 2019) This extra stress could be a factor in the development of osteoarthritis.
Supination
In contrast to pronation, some runners experience the opposite problem of supination. Supination occurs when the ankle or foot rolls outward from the center, which can cause pain or injury as it increases the likelihood of ankle rolls or sprains.
Features
Stability running shoes with the right features can help stabilize the feet and ankles for safer, more efficient running. This could make a major difference in how individuals feel after a run. For example, those with weak ankles should look for ankle support shoes with motion control, arch support, and grippy traction. Stabilizing shoes offer the following structural supports.
Arch Support
The foot is less likely to turn inward with a firm, high arch support.
Midsole Cushioning
Like arch support, cushioning the entire mid-section of the foot helps hold it steady.
For example, in walking shoes for flat feet, extra supportive cushioning in the midfoot helps prevent further arch collapse.
Stability running shoes may advertise having bars, rails, or medial posts to help maintain balance and reduce pronation.
Heel Cups and Heel Counters
A deep heel cup sits under the heel, correctly aligning the foot and ankle.
Heel counters are hard plastic inserts that reinforce the back of a running shoe, increasing overall support and holding the foot in place.
Wider Base
A wider platform underneath the foot is another key to preventing the inward rolling of overpronation.
It’s a common feature of walking shoes for seniors that provide stability for balance issues.
Choose the Right Shoes
Selecting the best shoe for pronation issues does not have to be complex. At many athletic stores, customers start with an in-store gait, foot shape, and running style assessment. Overpronators should look for a shoe with at least some of the features listed, such as arch support, cushioning, heel cups, counters, or a wide base. For narrow or wide feet, seek out shoes made specifically for these issues. In any running shoe, comfort is the number one priority. The feet should feel firmly supported with no pinching, and the toe shoes should have plenty of wiggle room and be able to lace up without hassle.
Benefits
Stability running shoes may also improve performance. A well-cushioned, well-fitting stability shoe can enhance running comfort, making workouts more enjoyable. When running without pain, individuals are more likely to continue running long-term. A stability shoe that prevents overpronation can improve form, allowing faster and more efficient running. A study in the Journal of Orthopaedic and Sports Physical Therapy explored the potential of motion-control shoes, which are somewhat more stabilizing than stability shoes regarding running injuries. The authors concluded that these shoes may reduce the risk of injuries related to overpronation. (Willems T. M. et al., 2021) Another study compared stability shoes to neutral and motion-control shoes in female runners with various degrees of foot pronation. Those who ran in stability shoes missed the fewest days of training, an indicator that they experienced fewer injuries, but those who wore stability shoes reported more pain while running than those who wore neutral shoes. (Ryan M. B. et al., 2011)
Conclusion
Stability running shoes might be the solution for jogging pain and injuries. The only way to find out is to try them for yourself. Look for footwear with sturdy arch support, plenty of cushioning in the midsole, heel support, and a wide sole. At Injury Medical Chiropractic and Functional Medicine Clinic, we focus on what works for you and strive to create fitness and better the body through research methods and total wellness programs. These programs use the body’s ability to achieve improvement goals, and athletes can condition themselves to excel through proper fitness and nutrition. Our providers use an integrated approach to create personalized programs, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles.
Correct Foot Pronation
References
Nielsen, R. O., Buist, I., Parner, E. T., Nohr, E. A., Sørensen, H., Lind, M., & Rasmussen, S. (2014). Foot pronation is not associated with increased injury risk in novice runners wearing a neutral shoe: a 1-year prospective cohort study. British journal of sports medicine, 48(6), 440–447. doi.org/10.1136/bjsports-2013-092202
Mei, Q., Gu, Y., Xiang, L., Baker, J. S., & Fernandez, J. (2019). Foot Pronation Contributes to Altered Lower Extremity Loading After Long Distance Running. Frontiers in physiology, 10, 573. doi.org/10.3389/fphys.2019.00573
Willems, T. M., Ley, C., Goetghebeur, E., Theisen, D., & Malisoux, L. (2021). Motion-Control Shoes Reduce the Risk of Pronation-Related Pathologies in Recreational Runners: A Secondary Analysis of a Randomized Controlled Trial. The Journal of orthopaedic and sports physical therapy, 51(3), 135–143. doi.org/10.2519/jospt.2021.9710
Ryan, M. B., Valiant, G. A., McDonald, K., & Taunton, J. E. (2011). The effect of three different levels of footwear stability on pain outcomes in women runners: a randomised control trial. British journal of sports medicine, 45(9), 715–721. doi.org/10.1136/bjsm.2009.069849
Proper shoes are highly recommended when playing sports, whether professional or recreational. Can wearing pickleball footwear help increase optimal performance and prevent injuries?
Pickleball Footwear
Pickleball has become quite popular because individuals of all ages and abilities can play it. Although it is a relatively new sport, it emerged in 1965. (USA Pickleball, 2021) It’s now one of the fastest-growing sports, with over 8 million players nationwide. (Brandon, 2023) The game can be played with most shoes designed for sports, like running or cross-fit shoes. There are shoes specifically for pickleball that improve traction, enhance stability and cushioning, and increase impact absorption. For those getting into the game long-term, investing in high-quality pickleball footwear is a worthwhile investment that can contribute to long-term enjoyment and injury prevention.
The Demands of Pickleball
Like tennis or table tennis, pickleball involves dynamic and fast-paced movements, including lateral strides, pivoting, and quickly changing direction. The body has to move forward, backward, and side to side across the court and pivot. When chasing the ball, to control the shots, produce power, decrease the risk of injury, and change direction while maintaining balance, the feet, body, and shoes must work together to make all this possible. One consideration depends on where the game will be played, whether flat ground or a harder surface. Wearing sneakers or tennis shoes is recommended for flat-ground play, as they provide supportive cushioning and shock absorption. For harder surfaces like concrete or hardwood courts, specialized shoes like those designed for pickleball are recommended.
Benefits
Some of the benefits of investing in pickleball footwear include.
Optimal Traction
Traction is incredibly important in pickleball. Optimal traction can help players execute quick movements, maintain stability, and prevent slips and falls. When looking for the right shoes, consider traction-specific materials like rubber, nylon, and leather. Individuals are most likely to find rubber pickleball shoes because they’re cheaper and commonly used in other outdoor sport-specific shoes, such as soccer. Nylon is more expensive but offers better traction than rubber and is often used in high-tech sneakers because it provides significant shock absorption and long-term durability. Leather is the most expensive material but offers the best grip. Because of its natural look and feel, it is also becoming more popular in sneakers.
Stability and Support
Moving from side to side in a lateral fashion requires players to be on top of their balance and maintain steadiness when making shots. Pickleball shoes are designed to support stability and can help reduce injuries like sprains.
Impact Absorption Cushioning
Pickleball footwear is designed similarly to running shoes, with cushioned comfort and a midsole that offers shock absorption and reduces the impact felt in the joints, including the knees, lower back, and feet. Individuals can find pickleball footwear that utilizes various sports technologies, like gel inserts or responsive foam, which can help cushion and reduce the impact on the joints. When cushioned, the body can maintain more balance, promote positive movement habits, prevent muscular fatigue and joint pain, help reduce overall stress, and allow individuals to play harder without experiencing pain. Long-term benefits result in a stronger, more flexible body.
Proper Fit and Considerations
Make sure that the pickleball shoes fit well and provide adequate support. Measure your feet using a ruler or measuring tape, and have the measurements handy while shopping. Suggestions include:
Look for shoes that fit snugly but don’t allow the feet to move around too much during play.
Pay attention to arch support.
Individuals with high arches should look for shoes with adjustable straps or more supportive materials built into the sole.
Using an integrated approach to treat and prevent injuries and chronic pain syndromes, improve flexibility, mobility, and agility, and help individuals return to normal activities, Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized fitness program. Each case is different and requires reviewing individual medical history and physical examination to determine the proper training plan. Dr. Jimenez has teamed up with top trainers, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments if other training is needed.
Footwear can cause lower back pain and problems for some individuals. Can understanding the connection between footwear and back problems help individuals find the right shoes to maintain back health and relieve pain?
Footwear Back Pain
The back provides the strength for physical activities. Back pain affects daily life and can have various causes. Unhealthy posture, walking, twisting, turning, bending, and reaching can contribute to back problems that result in pain. According to the CDC, 39% of adults report living with back pain (Centers for Disease Control and Prevention, 2019). Improper footwear can also contribute to back pain. Selecting footwear carefully can help bring pain relief and help maintain spinal health. Individuals can enjoy less pain and manage symptoms by choosing shoes that maintain spinal alignment and protect the feet from blunt impact.
Understanding the Back Pain-Footwear Connection
Improper footwear could be the cause of lower back pain. What impacts the bones at the bottom of the neuromusculoskeletal system radiates upward and affects the spine and back muscles. What footwear is used travels upward, impacting gait, posture, spinal alignment, and more. When back problems originate from the feet, these are biomechanical issues. Biomechanics means how the bones, joints, and muscles work together and how changes in external forces impact the body.
Movement
When the feet impact the ground, they are the first extremities to absorb shock for the rest of the body. Individuals will start to walk differently if they have a problem or change in their feet. Wearing shoes with improper support can increase the wear and tear on the muscles and joints, leading to awkward and unnatural movement. For example, consider the difference between standing on tiptoes in high heels and the natural flat-footed state. Well-cushioned shoes help absorb impact and lessen pain sensations. The pressures on each of the joints shift balance, which causes instability problems with less pressure on some and more on others. This creates an imbalance that leads to pain and joint conditions.
Posture
Maintaining a healthy posture is another factor in preventing or alleviating back pain. With the right footwear, the body can maintain a healthier stance and the right curvature throughout the spine, and it helps distribute the weight evenly. This results in decreased stress on ligaments, muscles, and joints. (Harvard Health Publishing. 2014) It’s recommended to see an orthopedist to get to the root of an individual’s condition. For some, a herniated disc, sciatica, automobile collision, fall, unhealthy ergonomics, or a combination, as well as other underlying issues, may be contributing to their back pain.
Shoe Types and Their Impact on The Back
How various shoes impact posture, potentially causing or relieving back pain.
High Heels
High heels can definitely contribute to back pain. They change body posture, causing a domino effect on the spine. The body’s weight is shifted to increase pressure on the balls of the feet, and the spine’s alignment becomes altered. High heels also affect how the ankles, knees, and hips move when walking, balance, and how the back muscles operate, all of which can worsen back pain.
Flat Shoes
Flat shoes may not be the best choice for spinal health. If they lack arch support, they can cause the foot to roll inward, known as pronation. This can contribute to misalignment, which can strain the knees, hips, and lower back. However, they can be a decent choice if they provide arch support. When wearing flat shoes with healthy support, the weight is distributed evenly on the feet and the spine. This helps maintain correct posture, which can help prevent and/or alleviate back pain.
Sneakers, Tennis, and Athletic Shoes
Sneakers, tennis, and athletic shoes can relieve back pain with thorough cushioning and support. Choosing the right ones involves determining the activity that will be done in them. There are tennis, running, basketball, pickleball, skating shoes, and more. Research what features will be needed for the sport or activity. This could include:
Heel cups
Insole cushioning
Wide base
Other features to meet individual foot needs.
It is recommended that athletic shoes be changed every 300 to 500 miles of walking or running or with any signs of unevenness when placed on a flat surface, as worn-out soles and degraded materials can increase the risk of injury and back pain. (American Academy of Podiatric Sports Medicine, 2024). If a certain pair puts the legs, hips, or ankles into an unnatural position or impedes regular movement, it may be time to replace them.
Choosing the Right Shoes
The ideal solution for choosing shoe wear is to get a gait analysis and a review of how you walk and run. Various healthcare professionals may offer this service to tailor each individual’s search for the right shoes for back pain. In gait analysis, individuals are asked to run and walk, sometimes on camera, while a professional notes physical tendencies, like when the foot hits the ground and whether it rolls inward or outward. This provides data on affected posture, movement, pain levels, how much arch support is needed, and what type to wear to help prevent back pain. Once the analysis is complete, it will guide you on what to look for, such as what level of arch support, heel height, or material is best for you.
Injury Medical Chiropractic and Functional Medicine Clinic specializes in progressive, cutting-edge therapies and functional rehabilitation procedures focused on clinical physiology, total health, practical strength training, and complete conditioning. We focus on restoring normal body functions after trauma and soft tissue injuries. We use Specialized Chiropractic Protocols, Wellness Programs, Functional and integrative Nutrition, Agility and mobility Fitness Training, and Rehabilitation Systems for all ages. Our programs are natural and use the body’s ability to achieve specific measured goals rather than introducing harmful chemicals, controversial hormone replacement, unwanted surgeries, or addictive drugs. We have teamed up with the city’s premier doctors, therapists, and trainers to provide high-quality treatments that empower our patients to maintain the healthiest way of living and live a functional life with more energy, a positive attitude, better sleep, and less pain.
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
Shoe Types and Their Impact on The Back
