Boots, Anyone?

We are looking for foot-healthy and fashionable boot options for women.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!

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The Definition of a Healthy Shoe

A truly foot-healthy shoe incorporates several key design features.We all spend a lot of time on our feet, in shoes, so understanding what constitutes healthy footwear is absolutely crucial for building and maintaining optimal foot, toe, and joint health. Indeed, the health of our feet has profound implications on our entire bodies and lives. But what are the key differences between a truly foot-healthy shoe and the industry standard? Quite a bit, as it turns out.

A typical “conventional” shoe possesses a quartet of injurious design features, including heel elevation, toe spring, toe taper, and sole stiffness. These design features are usually incorporated (to varying degrees) into almost every type of footwear, from fashion shoes to boots to casual shoes to athletic shoes.

The athletic shoe category can be the particularly deceiving because people tend to think of athletic shoes as comfortable and healthy; but by and large, they are neither of these things. When one looks closely at most athletic footwear, the negative design features present in other shoe categories are still evident and still cause foot and toe problems.

So, what does a foot-healthy shoe look like? A truly foot-healthy shoe is completely flat from heel to toe to provide real stability for your foot and enable natural arch support. A foot-healthy shoe possesses a sole that can easily be bent or twisted, allowing your foot to become strong on its own. And (perhaps most importantly) a foot-healthy toe has a toe box that is widest at the ends of the toes, not at the ball of the foot. A toe box that is widest at the ends of the toes allows for natural toe splay (enabled, ideally, by Correct Toes in individuals with toe deformities caused by a lifetime of tapering toe box footwear).

A foot-healthy shoe is also devoid of “motion control technology,” or anything that attempts to “improve upon” or “control” the already inherently brilliant design of the human foot. Da Vinci said it best: “The human foot is a masterpiece of engineering and a work of art.” The job of footwear is simply to respect the foot and stay out of its way as much as possible.

Because we all spend enormous amounts of time on our feet in a weight-bearing situation (as well as enormous amounts of time in our shoes), the shape and orientation of our feet and toes within our shoes is crucial. Bad shoes (i.e., shoes with the negative design features already mentioned above) can lead to toe deformities and pain, discomfort, and frustration. It’s impossible to rehabilitate the foot to the way nature intended while wearing conventional footwear, as conventional footwear itself is the underlying cause of most foot problems and deformities.

Good shoes (i.e., shoes with the positive design features already mentioned above) allow our feet and body to function as nature intended. These shoes help reduce our likelihood of foot and ankle injuries, eliminate pain in our lower extremities, and allow us to get the most out of our years (especially our later years).

Our feet and toes were naturally designed to enable optimal balance, gait, comfort, and longevity. Unfortunately, the vast majority of footwear on the market includes problematic design features, so we all need to be extra diligent when shopping for footwear. Seek out shoes that respect nature’s brilliant design instead of dominating it.

Examples of foot-healthy shoes can be found in the Northwest Foot & Ankle Shoe List. You’ll notice two seals of approval next to many of these footwear options. One of these seals is our “Natural Foot Approved” seal, which means that the product does not possess heel elevation, toe spring, or a rigid sole, and allows for natural toe splay. The other seal is our “Correct Toes Approved” seal, which means that the product conforms to the above criteria and also works well with Correct Toes toe spacers.

Authors: Dr. Robyn Hughes & Dr. Ray McClanahan

Transitioning From Conventional to Minimalist Shoes

It's important to transition to minimalist shoes slowly, over time.Many people are aware that a transition period is required when switching from conventional, PECH-style (Pronation control Elevated Cushioned Heel) shoes to minimalist shoes. In fact, this is one of the most common topics we hear about from patients and customers. Most people want to know the proper protocol for transitioning to foot-healthy footwear—shoes, boots, or sandals that are widest at the ends of the toes, have flexible soles, and possess no heel elevation or toe spring. Though every individual is different and has unique factors or circumstances to consider, we’ve come up with eight general suggestions to heed that are important for everyone making this transition. And here they are:

1. Take a Slow, Progressive Approach

It’s perfectly normal to be excited about this new approach to foot health and function. After all, countless people have already benefited from true minimalist shoes and natural foot health approaches. But it is possible to be overzealous in the adoption of this new footwear, and failing to transition slowly from conventional-style shoes to minimalist shoes might lead to problems.

Consider wearing your new minimalist shoes for a very short period at first, such as 30 minutes per day, and then gradually increasing wear time by 30 minutes per day as your feet and body adapt to the changes. If you’re a runner, consider wearing your conventional shoes for the first part of your run, then switching to your minimalist shoes toward the end. As your feet and toes get stronger, you can begin wearing your minimalist shoes for longer periods during your run, eventually phasing out entirely your conventional running shoes.

2. Proceed in a Stepwise Fashion

Many people benefit from a stepwise approach to minimalist shoes that involves a gradual transition from a built-up conventional shoe to a transitional type of shoe to a true minimalist shoe. There are two main considerations as it concerns this stepwise approach: the sole of the foot and the Achilles tendon.

The sole of the foot is extremely sensitive (which is great for sensing the ground and making appropriate micro-adjustments during gait). But after a lifetime of wearing thick-soled shoes, the sole of the foot (skin, muscles, nerves) is not properly adapted to the ground, and being barefoot or using thin-soled shoes can be uncomfortable. The best way to build up your foot’s sole is to start with thicker-soled footwear, such as Altras and Lunas, and then move to thinner-soled options over time. Note that your thicker-soled footwear selection should still possess all the other foot-healthy characteristics that we recommend, specifically, a flat platform (no heel elevation, no toe spring, no arch-propping inserts), a wide toe box (widest at the ends of the toes), flexibility, and light weight.

Having worn conventional shoes with heel elevation for years (decades, in many cases), the Achilles tendon often becomes contracted, or shortened (sometimes up to three-quarters of an inch!). A shortened Achilles tendon will return to its normal length after conventional footwear is abandoned, but this process takes time. Heat, ice, physical therapy modalities, and warming or cooling gels can help with this transition and rehabilitation. Shifting from a shoe with heel elevation to a “zero drop” shoe can place a tremendous amount of strain on your Achilles tendon, and overdoing it, especially at first, can cause damage and pain in this structure. Again, a slow, stepwise shift to transitional footwear (e.g., Altra shoes, Luna sandals, etc.) can make the leap to ultra-minimalist shoes (e.g., Lems Primal 2 shoes, Vibram FiveFingers shoes, Xero Shoes, etc.) a much lower risk.

3. Allow Time for Adjustments to Occur

The changes and deformities that happen in feet and toes exposed to conventional footwear take many years to occur. It’s no surprise, then, that positive, healthy changes and true foot and toe rehabilitation will also take some time to occur. Some people who transition to minimalist shoes do not allow enough time for the soles and muscles (in the feet and the rest of the lower body) to strengthen. Transitioning to minimalist shoes will, in most cases, work your foot and lower body in a very new and unique way, leading to initial soreness and fatigue in many before the longer-term strength gains and other favorable adaptations occur. Be patient, monitor your body’s response to this transition, and take it slowly! Changes are afoot.

4. Address Gait Changes

It’s extremely common for gait changes to occur when switching from conventional shoes to minimalist models. Most people who wear conventional shoes are heel-strikers (thick, elevated heels make it almost impossible to be anything else). People who wear minimalist shoes, on the other hand, often first contact the ground with the mid-foot or forefoot—a very different gait pattern that has wide-ranging effects throughout the body. This change in gait pattern tends to happen naturally upon moving to footwear with a completely flat (and thin) support platform. But sometimes there is a lag in gait changes that occurs during this transition, such that some individuals still continue to heel strike even after shifting to minimalist footwear.

Heel striking in minimalist shoes may cause some heel discomfort, as there is no longer the same level of cushioning in place to absorb the shock. Using heel cups (please see the next section for further details about heel cups) can be helpful in reducing or preventing this discomfort. Another helpful approach is to pay a lot of attention to how your feet and body feel during the transition phase. Consider paying extra attention to your feet during this time, and walk in a way that feels right to you (avoid “pushing through the pain” or limping in order to avoid pain). Forcing a forefoot strike is not ideal either. Basically, just feel and listen to your body and avoid distractions (chatting with friends, listening to music, etc.) while you’re walking or running during this transition period.

5. Use Met Pads and Heel Cups, if Necessary

Metatarsal pads are a fairly unobtrusive way to restore muscle or tendon balance in your feet and restore the position of your forefoot fat pad to a place that supports your metatarsal heads in the ball of your foot (a common pain point in many people with foot problems). Metatarsal pads, if placed properly, can also help spread your transverse foot arch, which helps take pressure off the structures that run through the ball of your foot, such as nerves and blood vessels.

Heel cups are another helpful (and unobtrusive) natural foot product that alleviates point tenderness in the heel that may develop in minimalist shoe adopters. This point tenderness can happen early in the transition phase or later on, after you’ve been wearing minimalist shoes for a period of time. Point tenderness in the heel is relatively rare in minimalist shoe adopters, but it can be uncomfortable and, in some cases, lead to abandonment of natural foot health approaches. A simple heel cup is often enough to address this discomfort and keep a person in footwear that lets his or her foot function the way nature intended. Setbacks may happen from time to time, but in most cases, there is a simple solution or tweak possible that can help you stay on the path to natural foot health.

6. Use Correct Toes Toe Spacers

Using Correct Toes is one of the most powerful ways to support the transition from conventional footwear to minimalist shoes. Correct Toes naturally curbs overpronation and enables proper weight distribution. This extremely helpful product also encourages a natural strengthening of the muscles and tendons that act on your feet and toes. Correct Toes toe spacers work well in minimalist shoes with anatomically appropriate toe boxes (i.e., toe boxes that are widest at the ends of the toes, not the ball of the foot as in conventional—and many minimalist—shoes).

7. Add Barefoot Time to Your Regimen

Adding some barefoot time to your foot health and minimalist shoe transition regimen can be extremely helpful in ensuring a smooth (and injury-free) shift. Spending at least some time barefoot, even if only around the house, can help condition the soles of your feet and strengthen your foot and toe muscles, accelerating the foot adaptations that occur with minimalist shoe wearing in a safe and constructive manner. If appropriate, you may also consider walking outdoors in your bare feet, weather permitting, starting with as little as one block.

8. Perform Key Home Care Exercises

Performing certain exercises at home (or work) can help with your transition from conventional to minimalist shoes. The most helpful exercises you can perform include the Toe Extensor Stretch, the Bunion Stretch, and the Ball Rolling Exercise. These exercises, when performed in series, help relax tight muscles and tendons and build foot strength. For the best possible outcome, perform these exercises at least several times each day.

Conclusion

Using true minimalist shoes—shoes that are widest at the ends of the toes, have a flexible sole, and possess a completely flat support platform—offers the possibility of profound and enduring foot health benefits. Like most aspects of health, it’s always best to exercise caution and restraint in transitioning to a new and natural approach. Your feet and body are amazingly adaptable and will indeed strengthen if treated appropriately. But this remarkable adaptation process only works well with time, patience, diligence, and a progressive approach. It is an investment well worth making, as it will pay foot health dividends for an entire lifetime. If you have any questions about any aspect of transitioning from conventional shoes to minimalist footwear, please consider meeting with your natural healthcare provider. And now: onward, to excellent foot health!

About the Authors:

Dr. Robyn Hughes is a naturopathic physician; the Director of Medical Education for Correct Toes; a foot health educator in Asheville, North Carolina; and the co-founder of NaturalFootgear.com. She is an avid cyclist, trail runner, and yoga student.

Dr. Ray McClanahan is a sports podiatrist; the founder and physician of Northwest Foot & Ankle in Portland, Oregon; and inventor of Correct Toes. He’s a former elite cross-country racer and regular participant in various running events throughout the Pacific Northwest.

Are You Ready to Train?

Are_You_Ready_to_Train_Here’s a common scenario some of you may find yourself in this spring: It’s been a few months since you last pulled on your athletic shoes and you’ve been wearing cold weather footwear that, though it keeps your feet and toes warm, is kind of constricting. There is a big annual walking or running event coming up in the not-too-distant future that you always participate in, or you’ve found a new event or long hike that you’re just dying to try. But you’ve got a nagging foot problem that started over the winter and you’re wondering if you can begin your training. If this is the situation you find yourself in, this article is for you!

The question at the heart of this discussion is this: “When is it appropriate for me to begin training in earnest for a race, walking event, or multi-day hike if I have a foot problem that is causing me pain or discomfort?” As fellow runners and walkers, we understand the urgency that comes with preparing for a big race or event, and we also understand how frustrating it is to wait out a foot problem before ramping up our training volume and intensity (or even to miss an event due to a foot injury). We’ve been there, and we sympathize with your situation. But trying to train with an existing foot problem is not an appropriate course of action, as it usually ends up compounding your problem and leading to a more deeply entrenched foot issue.

The pain or discomfort associated with plantar fasciosis (commonly mislabeled ‘plantar fasciitis’), interdigital neuromas, bunions, and other foot problems is your body’s way of telling you that something is wrong and needs to be corrected. Perhaps it’s an impediment to natural foot health that needs to be removed (think conventional footwear) or a longstanding foot or lower extremity issue that was never properly addressed. Whatever the issue, it’s important that it gets resolved before you start any serious weight-bearing exercise routine. We know this may sound unappealing, but don’t despair, as there is every reason to believe that your foot issue can be helped in a timely manner, if you allow your foot to function the way nature intended.

The answer to most common foot problems, including the ones that keep you from participating in the activities you love, is elegantly simple and universally applicable. The first step in restoring natural foot health is understanding what shoe features deform your true foot shape and alter the dynamics of your feet and toes. Heel elevation, toe spring, toe box taper, and rigid soles are all injurious design features found in most conventional footwear. Using shoes that are flat from heel to toe, flexible in the sole, and widest at the ends of your toes allows your feet and toes the freedom to act as nature planned. Many people also benefit from using our toe-spacing device, Correct Toes, to realign their toes to the splayed position commonly seen in the healthiest feet in the world—the feet of barefoot or unshod populations in Africa, Asia, and Latin America.

Many patients find that their foot pain or problem dissipates once the barriers to natural foot health are removed and proper toe alignment is restored. How quickly this occurs depends on numerous factors, however, including the tissue types involved (e.g., nerve, muscle, tendon, ligament, etc), the mobility of the involved tissues or structures, and how long you’ve been experiencing the problem. Most people will experience at least some immediate relief from performing these simple actions, with additional beneficial results occurring over several weeks, with good compliance.

Some light training may be appropriate during this initial recovery phase, as long as your foot pain or discomfort is not made worse with weight-bearing activity or does not alter your gait. Compensating for a foot injury by changing your gait can lead to problems in other parts of your body and further downtime away from your passion. If you are limping, have severe pain, or your pain increases as you walk or run, you should avoid walking, running, and hiking. Consider getting on your bike or into the pool for your workout instead.

So, are you ready to train? Regardless of your current situation (free of foot pain or currently experiencing foot problems) we encourage you to carefully consider your footwear and how it can help or hinder natural foot health. For more information about how you can restore foot health and anatomy to treat and prevent common foot health problems, we encourage you to meet with a naturally minded podiatrist or other foot care expert. You can also visit the Northwest Foot & Ankle and Correct Toes websites, which contain plenty of helpful information about how best to achieve lasting foot and toe health.

Enjoy the spring, and happy training!

Robyn Hughes, N.D. & Ray McClanahan, D.P.M.

About the Authors:

Dr. Robyn Hughes is naturopathic physician; the Director of Medical Education for Correct Toes; a foot health educator in Asheville, North Carolina; and the co-founder of NaturalFootgear.com. She is an avid cyclist, trail runner, and yoga student.

Dr. Ray McClanahan is a sports podiatrist; the founder and physician of Northwest Foot & Ankle in Portland, Oregon; and inventor of Correct Toes. He’s a former elite cross-country racer and regular participant in various running events throughout the Pacific Northwest.