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Pick the right shoe to prevent foot injuries

| Monday, July 31, 2017, 11:00 p.m.

Feet and shoes are an age-old pairing that have undergone many changes over the years. One of the newer concepts is the use of a more minimalist approach, including going completely barefoot for activities such as running. Now there are many things to consider in determining the best shoe wear for your specific activity, but one thing is for sure, some kind of shoe wear is better than none. It is not that the foot is not a very adequate structure on which we carry ourselves every day. It is like any other structure: With lots of use, it fatigues and needs help.

The foot is an incredibly dynamic group of joints, tendons, tissues, bones and muscles that propels us forward and keeps us moving. It absorbs our point of impact as we contact the ground and translates that force up through our legs, pelvis and lower back. Some of the most common injuries in the foot for people between the ages of 30 and 65 include plantar fasciitis, Achilles tendonitis, Metatarsalgia, just to name a few. Many foot problems begin with any combination of the following: poor genetics, downright abuse, repetitive use, arthritic changes over time and shoe wear! The type of shoe you wear can also affect the joint health of your foot and ankle; high heels, poorly fitting shoes, lack of shock absorption and arch support all contribute. Poor foot support can also lead to knee, hip and low back joint issues. Thus, don't let just “comfort” lead your choice of shoe wear. No amount of cushioning can replace good support in the right places. Take it from Dr. Nicki Nigro, a podiatrist and practice owner in the Pittsburgh area (Nigro Foot & Ankle Care).

Barefoot running has been claimed to assist with prevention of injury because it supposedly allows the foot to use its muscles more effectively. The evidence appears to be murky on whether this may be the case dependent on the type of foot strike pattern used. There are other studies that report that barefoot running causes a higher risk of forefoot injury, including metatarsal fractures and an increase in plantar pressure in the forefoot.

So, what should you do? Well, as a physical therapist, I would tell you, if you do not prepare for an activity, you are more likely to injure yourself. Thus, if you choose to run barefoot, take heed and train slowly to allow your body and your foot to adapt. But, if you have a previous foot injury or you happen to be above the fourth decade of life, I personally would not recommend minimalist running shoes. Injury changes the tissue and joint play, and if it advances, joint destruction or arthritis may begin. Then, once you get foot surgery, there is no going back; the joints work completely differently even after rehabilitation. Train smart and seek advice from a podiatrist or physical therapist if you have questions about what type of shoe wear you should be using. Health is important, but we only have one body, and one set of feet. Look after them so that they can go the distance for you.

Nuket Curran has been a physical therapist for nearly 20 years and an educator in health care for over a decade. Her physical therapy and fitness practice, Fightin' Fit Physical Therapy LLC, offers customized PT and fitness programs. She can be reached at drnuket@nuketcurran.com.

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