How to Pick Healthy Shoes with Dr. Conley

Shopping for healthy shoes is a bit different than shopping for your typical, conventional footwear.  While you may be used to focusing mainly on getting the right shoe size, there are a number of characteristics to be on the look out for with minimalist footwear. Some of the key elements of barefoot shoes are a wide toe box, a minimal stack height, a flexible heel counter and upper, and a zero drop sole.  These aspects all contribute to healthy feet by giving them the freedom to move naturally.

wide toe box

First, having a wide toe box is essential, so that the forefoot can splay.  When we walk the splay triggers a cascade of stimulation of receptors in the foot that allow it to be stronger when propelling us forward.  Shoes that don’t allow the splay inhibit the mechanisms of the foot that allow it to move more efficiently.

There is a difference between a wide shoe and a wide toe box.  The last of the shoe (the bottom of the shoe) is expensive to alter.  So unfortunately, a lot of shoe companies change the depth of the shoe instead of the width.  So, it may feel like there is lots of room, but it is just in the depth and not necessarily the width. If you are wondering if your shoe has a wide toe box, take out the factory insert and put your foot on it.  If your toes are expanding over the factory insert, then your foot is getting squeezed at the forefoot, which is where the foot needs to splay.

minimal stack height

The next piece is the stack height, which is from the bottom of the foot to the ground.  We want to have a minimal stack height.  In comparing the Splay shoe and the Altra, both are zero drop shoes, but you can see the difference in the stack height.  The Altras have more cushion.  If there is more padding between the sole of your foot and the ground, you won’t be able to take advantage of the 200,000 sensory receptors on the bottom of those feet that allow us to become efficient movers.  So, with footwear, we want to have a thin flexible sole and a wide toe box. 

heel counter

The next part of the shoe is the heel counter.  It should be flexible.  A rigid heel counter can cause problems, such as insertional Achilles tendonitis, from pushing into and irritating the Achilles tendon. That’s something to be aware of in the shoe.

seamless vamp

The next part is the upper or the material on top of the shoe.  The vamp is the material that is over the forefoot of the shoe.  A lot of companies are starting to catch on and are putting a mesh material on the vamp, so we can have more give for splay of the forefoot.  Those who have hallux valgus or tailor’s bunions should pay attention to the seams of the shoes. Seams over the ball of the foot will be very uncomfortable. 

zero drop

The last aspect is the heel to toe drop. Zero drop is when the heel and toe sit on the same plane.  Believe it or not, most athletic shoes are NOT zero drop.  They can have anywhere from a 2mm to a 10mm drop.  Any kind of heel is not fun for someone with Morton’s neuroma, or pain in the forefoot.  The foot operates more functionally in a zero drop plane, but if we transition down to zero drop too quickly, the Achille’s tendon and the plantar fascia will take a beating.  Dropping the heel down puts tension along the posterior compartment, which creates a tugging on those tissues. So there needs to be a slow transition from higher heeled shoes to flat or zero drop shoes.  If a runner, for example, was in a 10mm shoe, I’ll take them to a 4 or 5mm shoe. They’ll run for a couple minutes, put their old shoe back on and then slowly transition so that we’re giving the tissue a graded exposure to improve tissue tolerance.

correct toes

Lastly,  we have Correct Toes, designed by one of the other founding members of the Healthy Feet Alliance, Ray Mcclanahan, to help alleviate foot pain while being active.  These fit nicely into shoes that have a wide toe box and are designed to hold your toes in a splayed position.  All of these things are geared towards improving your foot health and that is our goal at the Healthy Feet Alliance.  Thank you for tuning in and please join us on Facebook at Healthy Feet Community.  If you have questions, please post them below!

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