We are finally getting warmer weather in Toronto! Warm weather means footwear changes and walks outside in the sunshine! Summer footwear usually means sandals, flats or less supportive shoes. There is a lot of confusion on less supportive footwear, minimal, support and orthotics. I recently went to a Harvard Sports Medicine foot and ankle injuries conference and I want to share some information on the topic.
1. My Views on Minimal and Flat Shoes:
Firstly, I want to put it out there that I am not pro minimal and I am not against minimal. Minimal shoes take time to transition to. The transition can take anywhere from 9 months to 16 months of diligent strengthening and slowly weening into a less supportive shoe. The transition to minimal footwear is very intense and requires stages of gait retraining and strengthening the little muscles of the feet all the way up the chain in progression. This includes training your little foot muscles how to activate and stabilize then engaging movements then combine movements with balance then movements with balance and increasing weight load efforts. Then putting it all together to be active for longer duration.
2. How to Transition to Less Support, if you are Dedicated Enough !
My entire philosophy of practice is based on rehabilitation, finding imbalances, restoring function and getting stronger. However, I know this may not be a practical effort for people who want to wear some less supportive footwear when they change to spring and summer footwear. It is important to note that putting less supportive footwear on, does not simply make your foot stronger. You need to practice and dedicate time to strengthen all the muscles of the foot and lower limb. This has to be practiced regularly and should be guided by someone with knowledge how to do so . I know how to set up a program to strengthen the lower chain from the bottom up to the hips and can give advice on a program how to do so! This is important to do to avoid injuries when running or wearing minimal shoes for an extended period of time. The foot and ankle do adapt to repetitive use of footwear and sudden changes in a few mm of footwear can cause foot pain and an injury. Foot pain and injury can be prevented by wearing support while continuing to strengthen the feet and lower limb.
3.I Believe in Combining Support and Strengthening for Pain relief
My approach to treatment is that I give exercises for the foot and calf to restore foot function along with support. In an ideal world it would be excellent to have people diligent about strengthening their foot and lower limb to wear less supportive shoes. However, I do know sometimes it can be a challenge for people to find time doing their strengthening even when they are in pain. For those who have foot pain and need support, orthotics or support can help the tissues rest or take the load off, while continuing to strengthen the foot. The feet do not get much rest as we are always on them, so the little support does help alleviate some strain off the tissues. Additionally, the benefits of orthotics are that they are custom and provides the ability to have specific support in an array of footwear, even footwear of less support.
Those who want to wear less supportive footwear can do so if they take the appropriate measures to retrain and condition their feet to adapt to these changes. For those who experience foot pain when they wear a less support, they may find relief by wearing support/ orthotics to help them manage their pain. I usually recommend women who work downtown Toronto to wear sneakers or flats to the office and only wear their heels in the office. For those who experience pain in flats, I can make orthotics thin enough to go into flats! For trendy footwear commonly worn in summer, I do think a strengthening and stretching the program combined with the proper support can help those who have foot pain and also prevent foot pain from reoccurring.