As a practising osteopath, patients consult me for all sorts of aches and pains. Back pain is the obvious one, but patients complaining of foot, ankle, knee or hip pain is also common.

As footwear can be responsible for some of these symptoms, I always take note of the shoes patients wear. But before you decide to not read on, I am not going to be a complete killjoy by telling you never to wear certain footwear, but merely advise you on how you might minimise potential damage.

So where do we go wrong?

High heeled shoes put your foot into a pointed downward position, putting your forefoot under increased pressure. The lower part of your body then leans forward and the upper part has to lean back to maintain your balance, resulting in an abnormal posture.

When you then try to walk your knees stay more bent resulting in overuse of leg and back muscles that can lead to pain. Shortening of the calf muscles and Achilles tendon is common and your foot and ankle turn outward with the risk of losing your balance and spraining your ankles.

Backless shoes result in you subconsciously gripping your toes to keep them on. This leads to an altered gait and an increased workload on muscles in your legs and back and again lack of ankle support can lead to strained ankles. Flip flops are the worst!

The facts

Osteoarthritis of the knees is twice as common in women. Research has shown that walking in high heels, on average, puts a 23% greater force through the inside of the knee and so may predispose you to degenerative changes in the joint.¹

Tips for good footwear

Placing your feet at any angle will cause damage so if you do wear heels, reduce the height and try reserving those very high heels for special occasions.
If you suffer more back pain after wearing high heels my advice would be to not wear them.
If you wear backless shoes, try to find ones that have straps over your midfoot as well as your forefoot to minimise any toe gripping.
If you are a fan of flip flops, try just using them at the beach, pool or in the shower at the gym.
Be honest, if your ankles do wobble around in your footwear, to be safe you need a shoe with better ankle support.
Allow your toes plenty of space to move around in your shoe to avoid developing problems like bunions and neuromas.
Stiff shoes are not good so go for shoes that are flexible and well fitting.

If you are in pain and concerned about the shoes you are wearing, osteopathy could help and I would be happy to provide pain relief or just some advice on posture and footwear. Alternatively, if you do have a specific foot problem, podiatry/chiropody is also available at The Odiham Clinic.

So consider adopting better footwear habits today to make your walking healthier and safer.

1. Kerrigan DC, Todd MK, Riley PO. Knee osteoarthritis and high heeled shoes. Lancet. 1998 May 9; 351(9113):1399-401.