Choosing the Right Shoe

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Do You Have Lower Back Pain?

By Bill Fetterolf. MPT, MDT
80% of adults suffer from low back pain. This pain can range from mild to severe and it is increased (agitated?) by common activities such as getting out of a chair or car, stair climbing, twisting activities such as vacuuming, shoveling, or raking, and even standing on one foot to put your pants on or rolling in bed while you sleep. The pain can radiate into your buttock, thigh, calf, or foot and causes sensation changes like pins & needles or numbness in your foot and ankle. Sacroiliac dysfunctions or misalignments are characterized by right, left, or central low back pain along the belt line.

So, what is the sacroiliac joint? The sacroiliac joints are along the belt line, about 2 to 3 inches from the midline of your spine. The pelvis is a ring of bone composed of three bones: two hip bones (ilium) and the tailbone (sacrum). The sacrum is an inverted triangle of bone, about the size of your fist. There are three joints in the pelvis: the pubic symphysis where the hips come together in the front, and two joints in the back where hips meet the tailbone. Those joints in the back are the sacroiliac joints (SI joints). (What happens to the SI joint that causes pain) A skilled manual therapist can correct the alignment to help reduce pain, and teach you exercises to correct your own alignment and strengthen your core, to maintain a healthy strong back.

If you go into an

If you go into any running store, shoes will generally break off into many categories, neutral or pronation control (also called stability shoes), minimalist or maximalist, shoes with large drops or none. Choosing a shoe that will help your body perform at its best isn’t just about which one is more comfortable in the store. There is a lot more to it! The right shoe can increase your performance, prevent injury, improve balance and even protect you from wearing out your joints.

Let’s look at a few of the common features of exercise shoes. First, consider a neutral shoe versus a pronation control or stability shoe. The difference is that the neutral shoe is neutral, neither biased toward rolling your foot out nor rolling your foot in. A shoe with pronation control will have a “post”, sometimes one that you can visibly see around the midpoint to the back of the heel or a little plastic little bridge that will prevent the shoe from rolling in. Pronation and supination are natural motions that occur in the foot. Still, overpronation is that rolling in motion that can be uncontrolled and, therefore, too much can occur, which can cause problems in your ankle, hip, or back.

Another big difference between shoes is shoe shock absorption ability. The minimalist or barefoot running style shoes have little shock absorption and a lot flexibility. Flexibility allows the shoe to bend and twist and does not protect your foot, but gives you a natural feel that some people like because of increased sensation of the ground beneath your feet. A shoe with high structure will bend only where your foot does – at the toes. This type of shoe will protect your foot joints. Some shoes have a cut out at the back to prevent pressure on the achilles, while some are high top and may bother your achilles –- or help in supporting the ankle. Which one it does depends on you and your foot type. And the list goes on.

If you would like to get the most out of your shoes or if you are experiencing any type of pain, we recommend you find a professional who can do a biomechanic exam. They will take data t from your bone structure within your foot, the alignment of your foot to your leg and the alignment of your body all the way up “the chain”. From this information, body mechanic professionals can recommend what type of shoe is best for you.

For people with pain, one shoe we often recommend is HOKA, they orginally specialized in maximalist shoes, they blasted onto the market with a higher cushion, and firmer shoe. Urban legend has it that it was invented by one of those runners who do the 100 mile races, he invented it to protect the knees. If you are doing a longer road run, it can reduce the toll on your back and knees because of that extra cushion. It is also incredibly light, which is something we love as well. Now many shoe makers have followed suit. There are shoe manufacturers that are more conscientious about foot structure and function, such as New Balance, Asics, Brooks, and a newer kid on the block, Topo. Some sneakers are more about style than function. So watch out for exercising in those – they are just for posing and smiling!

At the end of the day, it all comes down to foot mechanics. At BioMechanic Physical Therapy, we can help you determine what shoe option would be best for you. Come in today and let us help you, whether you are trying to perform better or eliminate foot pain!

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