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I am sure that you have heard about the various shoe trends that have come out over the years, from the rocker bottom shoes to the minimalist and toe shoes.  But are these different fads good for you or are they harming your body?

Let me start by saying that every person is different.  People are built and conditioned in different ways throughout their lives.  As I’m sure you have noticed, some of the most amazing runners in the world are from Kenya, but if you look at the form used by some of these athletes, it is not necessarily the textbook definition of efficient or “perfect”.  So why does it work for them?  Their form works because they are built and conditioned for it to work.  If you grew up in Kenya with a completely different physical environment and job tasks, then you may be conditioned the same as those athletes.  If, however, you grew up in “big city USA” with the constant force of concrete to run and work on, then you likely will have very different body mechanics than the Kenyan athlete.  With that being said, even individuals who grew up in the same environment can have different foot mechanics.  One person may have a very rigid foot while another person has a very mobile foot or even a flat foot.  These differences can also effect which shoe choice is the best for you.

Obviously, not everyone is looking for a “running shoe.”  Some of you may just be looking for a fitness shoe or simply a shoe for daily use.  A variety of shoes have been manufactured for these reasons.  Let’s start by discussing rocker bottom shoes, also referred to as “toning shoes”.

These shoes were initially intended as a specialty shoe that podiatrists would prescribe for various ankle and foot problems, issues with walking, diabetes, or deformities.  Now they have been mass produced for all to use.  The big marketing campaign for these shoes is based on the claim that they help to tone the body and improve calorie burning simply by wearing them regularly.  So is this claim accurate?  The unstable nature of this footwear does cause the wearer to activate muscle that may not have regularly been activated by simple stance positions.  They can also assist with training balance stability by challenging balance due to their unstable base, thus causing the wearer to have to balance more efficiently in order to stay steady.  Posture may also be assisted due to the wearer staying more upright in order to maintain balance.

If all of this is true, then what’s the down side?  One down side is that the claim that these shoes improve muscle tone and burn calories may not be accurate.  More research is needed to substantiate these claims, but currently conflicting evidence is present; meaning that there are studies that show positive benefits and others that show no difference than other footwear.  Another negative is that these shoes cause greater instability.  Yes, they could cause the wearers to challenge and improve their balance; but if a person does not have good balance to start with, then that person will be more prone to fall in an unstable shoe.

The moral of the story is that rocker bottom shoe may be beneficial for some, but not for all.  Our next blog will discuss toe shoes. 

Resources:

http://www.aapsm.org/toningshoes.html

http://www.webmd.com/fitness-exercise/guide/truth-about-toning-shoes

 

 

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I have heard plenty of people complaining recently about how expensive health care costs are especially after a hospital stay or surgery.  So what if you could avoid an expensive surgery?  

What if you could see a healthcare professional, receive exercises that help to decrease your symptoms, and then utilize the knowledge you learned to manage your symptoms without having to continue to pay for treatment and without having to pay toward a ridiculously high hospital bill?  Well the research shows that physical therapy can be just that remedy versus surgery for spinal stenosis.  If cost is not your concern, then perhaps time is.  When properly managed, patients that undergo back surgery should then be treated with physical therapy for improving function, strength, and stability in the back. 

For those of you who don’t understand what spinal stenosis is, it occurs when there is a narrowing of the spaces between your vertebrae (bones that make up the neck and back) resulting in pressure on the spinal cord or nerves.  This pressure can result in pain, numbness, tingling, or weakness in the arms or legs.  Occasionally, it can also affect bowel and bladder function. 

According to a study recently published in the Annals of Internal Medicine, physical therapy was shown to be just as effective as decompression surgery in terms of relieving symptoms and improving function in individuals with lumbar spinal stenosis.  This means that if you skip the back surgery and attend physical therapy, then your overall outcomes are nearly the same.

In this particular study, the physical therapy regimen that was used followed an evidence-based, standardized program.  Patients were treated with instruction on lumbar flexion (bending forward at the waist) exercises, conditioning exercises (ex. stationary biking or treadmill walking), leg strengthening exercises, and education on avoiding aggravating postures like excessive extension (bending backward).

The most important thing to note is that physical therapy can be used as a cost effective and less risky treatment for low back pain like stenosis.  Before going under the knife, an episode of physical therapy is worth considering.

Resources:

http://www.apta.org/Media/Releases/Consumer/2015/4/8/

http://www.moveforwardpt.com/symptomsconditionsdetail.aspx?cid=5e4daaa0-cb21-4eee-8484-e728617397aa#.VZLqA_lViko

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Wearing high heels has become almost like a rite of passage for young girls entering adolescence and adulthood.  The problem is that this particular fashion trend holds so many negative side effects both immediately and later on in life.  As with so many choices we make when we are young, we must often pay the consequences as we age.

Believe it or not, high heels began as a means for wealthy men to protect themselves from the mud and muck on the ground back in the 14th century.  Now, women have adopted the trend simply as a fashion statement.  While those pretty pumps may make your calves look great, the negative effects may not be worth the looks.  So why do high heels get such a bad rap? What problems do they actually cause?

First off, when you stand on your toes and lift your heels off the ground (known as plantarflexion); your ankle is placed in a less stable position which leaves you more prone to spraining the ankle ligaments.  This position also places increased stress on the peroneal and lateral gastrocnemius muscles which are located in the calf and help support the outer side of your ankle.  If these muscles are already weak, then placing more stress on them by wearing high heels can leave you prone to injuring the muscles.  This also leaves you more prone to spraining the ankle ligaments due to having less muscle support to prevent you from “rolling” the ankle.

In addition to ankle injuries, the feet take quite a beating from wearing heels.  Due to the effects of gravity, the toes are forced to take an excessive amount of pressure through a typically narrow toe box.  The pressure placed on the toes from frequent high heel wearing contributes to hammertoes, bunions, corns, calluses, and toe nail problems.  These deformities can become so severe that surgery may be required to realign the joints of the feet.

It is not always the feet and ankles that suffer from the effects of high heels.  The back is often involved as well due to changes in standing posture while wearing heels.  The back ends up in an extension position (bent backward) which places increased strain on the back muscles and can lead to nerve compression if the position is extreme enough or other preexisting back conditions are present.  Due to the changes in posture and pressure while walking in heels, increased torque is placed on the knees. Dr. D. Casey Kerrigan, an engineer and Harvard Medical School graduate, found a direct correlation between knee arthritis and wearing high heels.  Another study found that the degree of heel height made a large difference on the amount of stress placed on the body.  As heel height increased, the amount of stress on the tibialis anterior (a muscle that assists with supporting the arch of your foot and lifting your ankle upward) and the low back increased, thus increasing a person’s risk for pain in these regions.

I know that heels can be very pretty and make you look more feminine, but it is important to weigh the risks.  You might not notice the effects of frequent heel wearing now, but it will likely hit you later in life.  Try to save yourself some future pain. 

Resources:

http://www.sciencedirect.com/science/article/pii/S0169814101000385

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.306.3473&rep=rep1&type=pdf

http://www.logan.edu/mm/files/lrc/senior-research/2012-apr-18.pdf

https://www.nsbe.org/getmedia/bcd209d7-b07e-466f-b911-5da7fd2ffba2/Whats-New-NB1012-(NSBE-Web).pdf.aspx

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Disclaimer:  The information in this medical library is intended for informational and educational purposes only and in no way should be taken to be the provision or practice of physical therapy, medical, or professional healthcare advice or services. The information should not be considered complete or exhaustive and should not be used for diagnostic or treatment purposes without first consulting with your physical therapist, physician or other healthcare provider. The owners of this website accept no responsibility for the misuse of information contained within this website.