The NWFA/Correct Toes team is seeking input from our readers about BOOTS! Specifically, women’s “fashion” boots (i.e., boots that are suitable for casual-to-semi-formal occasions). We would love to know if anyone has found a fashionable boot that meets our foot health criteria? If so, we would love to hear from you. Please leave your comment below so that we can follow up on your recommendation. Thank you!
From restaurants to offices to hospitals to healthcare clinics, clogs are ubiquitous footwear in work and casual environments alike. A traditional clog is made solely from wood, while contemporary clogs incorporate wood soles (or no wood at all) with upper materials such as leather, which allows for more versatility and greater comfort. Today’s clogs (such as Danskos) are inspired by that original wood-style design, and they are sometimes backless, almost always have a heel and pitched toe box, and are usually stiff.
Clogs are a traditional part of many cultures throughout the world, including Dutch, Swedish, and Japanese cultures, and are worn for several key reasons, including protection, fashion, and for certain types of dance. The popularity of clogs has increased in recent years, as many consumers have been persuaded that clogs are a practical and foot-healthy option.
But is this belief fact or fiction? And are clogs really any different from “conventional” footwear? Let’s find out.
Many doctors (including podiatrists) recommend clogs to patients who have foot ailments. In fact, the American Podiatric Medical Association (APMA) has given its Seal of Acceptance to Dansko (a leading brand of clogs) after rigorously evaluating their products and determining them to promote “quality foot health.” Some of the features that earned Dansko this “high praise” include anatomically contoured arch support, rocker-bottom soles, and heel elevation—a feature that some doctors believe eases strain on leg and back muscles.
It’s no wonder, then, that clogs have gained an almost mythic reputation for being foot-healthy footwear. Sadly, this reputation is built on an incredible amount of misinformation, aided and abetted by the APMA and other groups who, unbelievably, tout arch support, bizarre sole construction, and heel elevation as beneficial shoe design features. The idea of clogs as beneficial footwear has gone mainstream, but the underpinnings of this belief are nothing more than regurgitated shoe industry myths about what constitutes a healthy and stable home for your feet.
The Truth About Clogs
Some people who wear clogs do experience a degree of foot pain relief. Unfortunately though, the relief is often temporary, mainly because clogs fail to address the true underlying cause of most foot and toe problems. So while the diminished pain makes it seem like the problem has been resolved, wearing clogs on a regular basis actually sets people up for further (and often worse) foot ailments down the road.
The truth is, clogs are among the most harmful or injurious shoe types available to consumers. Most clogs share many of the same unfavorable design features that other conventional shoes possess (please see the section immediately below). Clogs, like other conventional shoes, strip your foot of its inherent power, destabilize your main foot arch, and contribute to common toe deformities and problems, such as hallux valgus, bunions, tailor’s bunions, hammertoes, clawtoes, among others. Clogs also make it difficult for you to experience much (if any) tactile feedback from the ground you walk on, due to their extraordinary thick and rigid soles.
You won’t hear this truth about clogs from many other sources, which is why it’s so important to heed this warning: Clogs, like other types of conventional footwear, cause or contribute to many foot and toe problems, including neuromas, plantar fascia pain, and ingrown toenails. And they do this because they place your feet and toes in unnatural, compromised positions for many hours at a time. It’s only by examining the harmful design features included in most clogs, though, that you’ll get a better sense of how clogs impair foot health and cause problems.
Harmful Shoe Design Features
The following design features are common inclusions in most clogs. These features, either individually or collectively, alter foot anatomy or function in an unfavorable way and should be avoided:
- Rigid Soles. Thick, rigid soles make it almost impossible to get a sense of the ground you’re walking on, which may predispose you to errant footfalls and ankle injuries. The biggest problem with rigid soles, however, is that they hold your feet and toes in a compromised and deformed position for prolonged periods. When you wear shoes with rigid soles, it’s like putting your foot in a cast and expecting it to get stronger. In most cases, only a very thin layer of material between your foot and the ground is all that’s required to adequately protect your sole.
- Heel Elevation. Most clogs possess a design feature called heel elevation that raises your heel above your forefoot. Heel elevation is problematic for several reasons. First, it destabilizes your inherently strong principle foot arch (your medial longitudinal arch). Second, it places excessive pressure on the ball of your foot and the many important structures located in this part of your foot (bones, nerves, etc.). And third, it increases your likelihood of an ankle sprain, as an elevated heel is less stable and rolls more freely from side to side than a heel that is flat on the ground. A foot-healthy shoe has a completely flat sole, from your heel to your toes.
- Tapering Toe Boxes. Toe box taper—and the wedge-like position it forces your toes into—is a major problem associated with most conventional shoes, including clogs. There is a common belief that clogs possess a “wide toe box,” and that this is good for foot health. While it’s true that a wide toe box is a foot-healthy design feature to look for in footwear, most shoes that claim to have a wide toe box—including many varieties of clogs—are actually widest at the ball of the foot, not at the ends of the toes, where you need it the most. A true foot-healthy shoe possesses a toe box that allows your toes to splay properly, the way nature intended.
- Toe Spring. Toe spring is another major design flaw built into most conventional footwear, including clogs. Toe spring, also known as toe ramping, is a design feature that elevates your toes above your forefoot. When combined with heel elevation, toe spring effectively acts to invert your main foot arch, destabilizing your arch and putting excessive pressure on the ball of your foot. When it comes to toe spring, what’s especially pronounced is most clogs (even more than other types of footwear) is both the toe spring itself and the rigidity of this toe spring. The rigid toe spring built into most clogs holds or immobilizes your toes in an unnatural, extended position, which contributes to foot tendon imbalances and tight toe extensor muscles over time. Tight toe extensor muscles and tendons can cause various toe deformities, collectively known as crooked toes.
Lasting Effects of Clogs (& Other Injurious Footwear)
Clogs unnaturally alter your weight distribution and immobilize your foot joints—two circumstances that can (in some cases) contribute to temporary pain relief. But wearing clogs “kicks the can down the road” and leads to chronic foot problems later on. Many of the foot problems that eventually befall clogs-wearers develop painlessly and are masked (at least initially) by the reduced foot sensitivity that comes from wearing such an extremely rigid-soled shoe.
Clogs and other conventional footwear can cause both immediate and long-term discomfort and foot problems. Some research indicates that the loads on hip and knee joints are significantly higher in people who wear conventional footwear than in those who walk barefoot. A 2006 study published in the journal Arthritis and Rheumatism states that conventional footwear may be contributing to the prevalence and progression of hip and knee osteoarthritis in our society. Osteoarthritis is an extremely painful joint problem that’s associated with excessive joint wear and tear. This health problem can significantly affect your quality of life and keep you from enjoying your favorite physical activities.
Clogs are not what they are touted to be. And wearing clogs is not a way for you to improve or preserve your foot health, as most clogs include design features that cause foot pain and problems, either now or down the road. To truly preserve foot and toe health, seek out footwear that is flat from heel to toe, possesses a toe box that’s widest at the ends of your toes, and has a sole that can be easily flexed and twisted. It’s also important to restore normal, healthy foot and toe anatomy after years of wearing conventional footwear. A toe-spacing device, such as Correct Toes, can help you do just that.
- American Podiatric Medical Association. Dansko, LLC. http://www.apma.org/Learn/company.cfm?ItemNumber=1432. [accessed 2013 Jun 20].
- Shakoor N, Block JA. Walking barefoot decreases loading on the lower extremity joints in knee osteoarthritis. Arthritis & Rheumatism. 2006. Sep; 54(9): 2923-2927.
A Foot and Toes Survival Guide for Today’s Fabulous Fashionista.
Written by: Dr. Robyn Hughes, ND & Dr. Ray McClanahan, DPM
You’re a contemporary fashionista who dresses to impress. You faithfully don your high heels to conform to business dress standards, impress your employees, boss, or coworkers, and look fierce, maybe even sexy. You’re aware that wearing your fashionable heels may result in painful footsteps, but well, you’re willing to squeeze them on for the sake of good looks. If this
description mirrors your experience and thoughts, you may be well on your way, unfortunately, to birthing a bunion (you know, that unsightly bump that appears at the base of the big toe) not to mention developing hammertoes, clawtoes, interdigital neuromas (ball-of-foot pain), and plantar fascia problems (heel and/or sole pain), all of which are associated with prolonged high heels use. Ouch.
So what’s a fabulous fashionista to do? Ignore the demands of fashion and cold turkey your heels habit? Strike a bold new fashion path? Succumb to the fashion dictocrats and accept your lot in (business) life? Boldly continue wearing high heels and deal with the pain (and possibly surgery) later?
We at Northwest Foot & Ankle / Correct Toes certainly understand the draw toward beauty, creativity, and self-expression that’s provided by fashion. But we’re also a sports podiatry clinic, and so we experience first-hand, all day long, our patients’ foot pains and deformations that are caused by long-term use of fashion footwear. So while we enjoy fashion’s runway shows as much as anyone, we find that as we pan head to toe, we delight in the innovative hair, makeup, shirts, dresses, pants, accessories… but once our gaze reaches the high-heeled pointed-toe footwear, we cringe inwardly. We just know, too well, the negative implications of this style of footwear.
In this article, we offer several top tips on how to safeguard your feet and toes from the perils of a contemporary woman’s urban existence. We discuss a middle path that will allow you to maintain office decorum and retain your femininity yet spare your digits the devastation commonly wreaked by women’s conventional dress footwear (not to mention the footwear that will be seen at the upcoming New York Fashion Week). Please proceed with an open mind and an adventurous heart. The truth will set you (and your toes) free.
Practice Clandestine Foot Health in Your Cube
If you spend a good portion of your day sequestered in your office or cube, you have the perfect opportunity to practice clandestine natural foot health. Away from the gawking leers of your peers, and under the cover of your designer bureau, you can let your feet run as wild and free as these true marvels of human anatomy were designed to be. That’s right. We’re talking about ditching your heels and going barefoot in your office as often as possible [a collective gasp is heard throughout the corporate world]. If the idea of baring your feet while on the clock is beyond comprehension, consider a constructive alternative: Bring a pair of flats or sandals to
work and wear them outside of business meetings or high-powered exec lunches. If you can’t eliminate high heels from your business life, minimizing your time in them certainly is the next best option.
Consider, too, taking a few minutes for yourself several times each day to perform key stretches at your desk or console. Chief among these stretches (and especially important for heels-wearing women) is the bunion stretch—a stretch that can help you prevent that much-feared and loathed
bunion. Check out our bunion stretch video in which Dr. Ray McClanahan, inventor of Correct Toes toe spacers, demonstrates proper bunion stretch technique and explains why this exercise is so important for big toe health. Two other office-friendly foot exercises we recommend include the toe extensor stretch (for ball-of-foot pain) and the plantar fascia release exercise, which helps massage your plantar fascia (the thick band of tissue that runs from your heel to your forefoot). Perform the plantar fascia release exercise by rolling the bottom of your foot back and forth over a hacky sack or golf ball.
Stand (or Sit!) Corrected
All fashionistas can benefit, to some degree, from Correct Toes—a revolutionary toe-spacing device that realigns your toes in their normal anatomical position. Even if you can’t permanently retire your heels, you will undoubtedly enjoy spreading your toes on a regular basis when sitting
at your desk or living your life outside the office. You can use Correct Toes to help treat or prevent many common foot and ankle ailments, including bunions, hammertoes, and Achilles tendinitis, among other problems. Wearing Correct Toes during weight-bearing activity should be done in combination with compatible footwear (i.e., footwear that is widest at the ends of your toes, not the ball of your foot).
Consider placing metatarsal pads in your non-work shoes to help preserve your foot health. A metatarsal pad—a small, soft, and unobtrusive pad that sits within your shoe—helps spread your transverse foot arch and stretches tight toe extensor muscles. It also helps realign your forefoot
fat pad to a position that cushions the heads of your metatarsal bones. Without proper cushioning for your metatarsal heads, and with the excessive stress and pressure high-heeled shoes place on this region of your foot, you are vulnerable to several common foot problems, especially
interdigital neuroma. We’ve put together a helpful video demonstrating how to optimally position your metatarsal pads.
Educate the Powers That Be
Your boss or coworkers need to be sympathetic to your situation and support your decision to wear the healthiest possible footwear for your feet, even if your shoes stand out in the office like a cravat on casual Fridays. If your office has a dress code in place that requires you to wear foot-deforming shoes, consider making an earnest plea to your employers about the necessity of appropriate footwear for long-term foot and lower extremity health. Impress upon them how much more productive—not to mention pleasant!—you could be if you were allowed to wear comfortable shoes all day long. If appealing to their hearts doesn’t work, appealing to their wallets might: adopting foot-healthy footwear may save your firm, office, or agency big dollars in health care expenses, especially if your foot problem gets you bounced to a podiatric surgeon.
We recognize that fashion exerts a strong influence on what’s acceptable and what is not, and that office realities certainly do exist, but there is no harm in becoming an advocate for reasonable footwear in your office, and possibly much to gain. Nature intended your foot to be widest at the ends of your toes, possess excellent toe splay, and have strong, sturdy arches.
Crooked and mangled toes, bunions, and ingrown toenails do not need to be your destiny, Fabulous Fashionista, as long as you respect nature’s brilliant design by using tools (such as Correct Toes) and footwear that allow your foot to function like a bare foot inside your shoe. It’s time to redefine what’s beautiful in feet and footwear and put conventional office footwear in its place (i.e, something only seldom worn). So, we ask you, what’s uglier? A wide toe box shoe with no heel elevation, or crooked toes and a big, throbbing bunion at the base of your big toe? Just sayin’.
Lead a Double (Foot) Life
So your boss refuses to grant your feet immunity and insists you wear high-heeled shoes while at work. Bummer, yes, but all is not lost. You can still lead a double foot life. The minute you punch out at work, slip on your Correct Toes and wide toe box footwear for a gym workout (we
recommend Altra running shoes for most athletic activities, including gym sessions, due to the spacious toe box and other beneficial design features included in this brand’s shoes). Spending as much weight-bearing time as possible in Correct Toes and healthy footwear will go far in countering the deleterious health effects associated with conventional office footwear. Weight bearing activities conducted with your toes in their proper anatomical arrangement can have a profound corrective effect on many shoe-induced foot deformities.
The strategies mentioned above can help slow the progression of foot problems and foot degeneration. It’s difficult to completely undo all the damage caused by years of conventional footwear use, especially if you keep wearing the shoes that cause the damage, but our best advice
as doctors to help prevent and resolve chronic foot problems is always to quit wearing foot-deforming shoes (or wear them only minimally). Men (if you have read this far), you are not exempt! Men’s dress shoes (even the ones that claim to be healthy), cowboy boots, and the tennis shoes that perhaps some of you less fashion-savvy gentlemen think pass for high fashion: all contribute to foot and toe deformation and problems.
We do recognize, as did natural foot health expert, podiatrist William A. Rossi, the powerful hold fashion has on our psyches. Rossi notes:
“Fashion plays an enormously influential role in our lives, often involving and affecting our health physically, emotionally, psychologically and psycho-sexually. And this applies particularly to fashion footwear … Fashion has been with us since earliest civilization, even before, because it serves a vital role by feeding two of human nature’s most powerful motivating forces: status and sex attraction.”
We appreciate fashion and respect the artistic expression and creative genius of fashion designers, though we wish foot health was a higher priority in the fashion industry. We excitedly await a paradigm shift in the fashion and footwear industry toward more natural footwear for the
preservation of normal, healthy foot anatomy. Until that happens, practice the above-mentioned strategies to keep your toes in line and your feet feeling fine!