Are You Treating Your Pain with a Shoe Store Doctor Wannabe?

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5 suggestions I would question.

Due to high deductibles and other reasons, many people are resorting to treating themselves by depending on information provided by the internet and even shoe stores!  Shoe stores? Yes, especially athletic shoe stores.  How is that?  Well let’s say you have pain, in your back or lower extremity, even your foot.  Many times the condition is biomechanically induced. That means structurally you are walking/running with your body improperly aligned.  Just like your car, if it is out of alignment, balance, etc. something is bound to wear out abnormally or even break.  Shoe stores will typically check your feet or even watch you walk.  At this point they are now diagnosing which should be left to those with more education than simple employee training or an online course by a shoe vendor.  As a former foot surgeon and now dedicating my entire practice to biomechanical treatments – including shoe wear-I find myself sometimes cringing at what I hear others have told patients.  Unfortunately, many “Tips” are given solely to sell or even upsell.
  1. “You can prevent surgery if you buy these shoes” (or orthotics).  For example, I have heard this for a patients’ Morton’s neuroma.  Yes an ideal fit shoe may help but it is usually from abnormal foot motion that causes neuromas.  The “Menu Treatment” for a neuroma is to get a wide shoe with a low heel. I have had patients tell me they feel better with a heeled shoe and even the tighter the better.  Why? Their foot needed to be in a more supinated position. That prevents the metatarsals (long bones in your feet) from excess movement pinching on the nerve.
  2. “I see you rolling in (pronating).  If you buy a pair of our premade orthotics, it will stop this.”  Indeed it may help but essentially they are selling you a premade pair of glasses. The same pair for every person and problem.  If it is in the direction of correction you need, it may indeed help and feel better.  However, all feet are not created nor function equally.  Different feet require different types of orthotics.
  3. “You don’t need expensive custom molded orthotics, our shoes with a built in orthotic are all you need.”  No shoe has an orthotic that can match the exact contours of your feet as a custom molded orthotic can.  This is as bad as saying “All you need is our shoe and our premade insert.”  I suggest not listening to them, especially if they haven’t examined your feet!  This happened to one of my patients who was doing fine with her custom molded orthoses until she was told this and unfortunately followed the advice.  Subsequently she returned to me relating pain with her severe flat foot and resultant tendonitis-that can rupture without the ideal support.
  4. “Walk on this treadmill and we can examine your walk and show you how you can walk better with our shoes and premade orthotics.”  Although they may pick up some abnormalities, when walking on a treadmill you are not replicating your normal gait.  You are pushing more with your feet rather than “Normal” walking.  This can exaggerate “Ankles rolling in” (excess pronation) and even prevent evidence of some imbalances or motions.  Result: False confidence.
  5. “The newest thing is …….”  (Toe shoes, flexible and natural shanks, zero heels, natural shoes, flexible shoes without shanks, one inch thick soft soles, etc.)  You fill the words in the blank. Many times, “New Technology” in foot wear has very little premarket testing.  Many fall for it as they see a high paid athlete wearing something and of course we want to be like them, right?   Over my life time I’ve seen many latest and greatest ideas come and go.
Keds, Out!  Shoes with a rigid sole that bends at the ball and counters felt better.
Toe shoes-Out! They lost a major court case for unproven claims.
Earth shoes-Out!  They may have helped the back because the center of gravity was changed but caused increased Achilles tendonitis and pronation problems.
Memory foam-Out in the 90’s!  By the time you take the next step, the memory does not come back up resulting in your feet still hurting.
Thick cushy soled shoes like moon boots-Out!  Feet still hurt as they do not control abnormal motion.  If cushion was the answer for everyone, then why haven’t all shoes been developed with one inch thick soles?  Too much cushion is not good. Try walking on the beach for a long time, too much motion.
American business likes to reinvent and remarket.  Unfortunately, nowadays, remarketing and rebranding is a successful detailed science yet lacks the real truth of the evidential science of the product.  So if you hear the above or “Something New and Big,” Proceed with caution.  Like pharmaceuticals, many are pulled from the market after the fact.  Is foot wear like this? I think so.
Be cautious on who you are listening to.  Consulting with an experienced professional typically works best.
David J. Sables, D.P.M., C.Ped
ArchMasters-Orthotics, Shoes & Footcare, LLC
ArchMastersTN.com