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Are Your Shoes "Killing" More than Your Feet?

Updated: Apr 2, 2019

Getting Relief from Foot and Other Musculoskeletal Pain Naturally

Your feet are the foundation of your entire body. When structure and function of feet are compromised, everything above is also at risk.

According to the American Podiatric Medical Association*, 80% of Americans have reported suffering foot pain. Knee, hip, back and other musculoskeletal issues are also associated with foot pain, and other structural problems rooted in our feet.

A 2006 Rush Medical College study*, for instance, found that “Since knee osteoarthritis (OA) is mediated in part by aberrant loading, and since excess loading has shown to be associated with pain and disease progression, these data suggest that modern shoes may exacerbate the abnormal biomechanics of lower extremity OA.” 

Four shoe features that distort and disable the feet

1.  A tapering toe box

Babies’ feet, and the feet of children and adults who’ve never worn shoes are widest at the toes

Curiously, our shoes are not shaped like the natural shape of feet.  Instead, our feet are made to conform to the shape of our shoes! The majority of shoes on the market, including athletic shoes, dress shoes and casual shoes for both sexes have tapering toe boxes.

The extremely tapered toe box seen on women’s shoe styles by designers such as Manalo Blahnik* can require surgical interventions. In these cases, toes are shortened or otherwise reshaped so that patients can squeeze more comfortably into them, according to the New York Times* and other sources. 

The Harm Caused by Tapering Toe Boxes

Dr. Robyn Hughes is a Naturopathic Doctor who trained extensively with sports podiatrist and creator of Correct Toes, Dr. Ray McClanahan. She writes in her article Problematic Shoe Design Features*, that tapering toe boxes “are the leading cause of toe and forefoot deformity in adults.  A tapering toe box leads to numerous musculoskeletal problems including…bunions, crooked toes…hammertoes…knee osteoarthritis, neuromas, plantar fasciosis (commonly called plantar fasciitis), runner’s knee….”  Dr. Hughes points out that “even many minimalist shoes still include this deleterious design feature.*”  Guys, this applies to you, too!

2.  Heels of any size

Podiatrist Dr. William Rossi dispels the notion of there being any “sensible heel” and outlines the debilitating adjustments the rest of the body must make to compensate for any size heel in his two articles "Why Shoes Make ‘Normal’ Gait Impossible" and "Footwear: The Primary Cause of Foot Disorders."  I highly recommend reading these two articles.

Any size heel* writes Dr. Robyn “causes you to develop contracted and shortened posterior leg muscles and tendons. Heel elevation impairs normal gait and propulsion and strips your foot of its natural arch support.”

A shortened calf will also inhibit the proper flow of venous blood from the feet and lower legs back to the heart.  Structural Reflexologist Geraldine Villeneuve writes in her book Put Your Best Feet Forward*, the extra strain the body has to muster to compensate for the inhibition of calf-muscle function caused by shoes is “similar to driving with the brakes on” – resulting in lower leg stagnation that may also have an impact on cardiac health.

Sports podiatrist Dr. Ray McClanahan*: “This feature, found in many types of shoes, can change the body’s overall alignment. Raising the heel above the ball of the foot can lead to Achilles tendonitis… back pain and ankle instability.”

And the higher the heel, the greater the pelvis has to tilt to resist the pull of gravity forward.  As podiatrist Rossi points out in the above-referenced articles, pelvic tilting not only impacts the back, but also the pelvic organs.

3.  Shoes that turn up at the toes (toe spring)

Dr. Ray McClanahan creator of Correct Toes states. "This design can weaken the feet by dorsiflexing the toes (extending the toes upward) and overstretching the plantar fascia. This foot position can lead to shin splints…neuromas and plantar fascia pain."

Dr. McClanahan gives a great video explanation (  how toe spring impacts the plantar fascia. If you have been diagnosed with, or think you have “plantar fasciitis,” this video is a must watch!

It’s easy to see from the adjacent photo how toe spring can also pull the protective fatty padding up off the heads of metatarsals, leaving the area vulnerable to trauma and causing pain in the ball of the foot.

“You can remove the toe spring from most shoes* (at least to some degree),” says Dr. Robyn Hughes, “by folding shoe in half (with the sole of the forefoot touching the sole of the heel) and placing the shoe under a heavy object, such as a bookshelf, for 24-48 hours.”  This assumes your shoes have a reasonably flexible sole.

4.  Rigid sole

“Rigid, inflexible soles, like arch support, actually prevent the natural – and necessary – flattening of your arch during gait. Rigid soles also reduce the tactile feedback between foot and the ground and can increase the likelihood of an errant (and injurious) footfall,” says Dr. Robyn Hughes.

When I hike in my Vibram Five Fingers minimalist trail shoes, I’m incredibly aware of how my feet are absorbing the rocks or pine cones I walk over that might otherwise have turned my ankle.  My balance is much better than it is in harder-soled shoes. I’m also aware of the tiny muscles in my feet getting exercised. Plus my feet are able to get reflexed naturally as I walk.

A rigid sole “acts like a cast, limiting the range of motion in the feet. This causes muscle atrophy and makes the feet dependent on extra cushion or orthotics,”   says  Dr. Ray McClanahan.

Professor of biomechanics and co-director of the Human Performance Lab at the University of Calgary, Benno Nigg states, “Orthotics can be useful in the short term but long term do not correct mechanical-alignment problems.” 

In a New York Times article about Dr. Nigg’s 30 years of orthotics research, orthotics can “Have large effects on muscles and joints, often making muscles work as much as 50 percent harder for the same movement and increasing stress on joints by a similar amount.” 

“As for ‘corrective’ orthotics,” Dr. NIgg says, “They do not correct so much as lead to a reduction in muscle strength.  That is a typical story.” In fact, he adds, there is no need to “correct” a flat foot. All [one]needs to do is strengthen his foot and ankle muscles and then try running without orthotics.”

There’s something called a proprioceptive orthotic that’s thin and flexible that can be used to transition from their rigid orthotics.

Natural Approaches to Alleviating Foot and Other Musculoskeletal Pain

1.  Correct Toes to encourage toes back into natural alignment

Dr. McClanahan, an elite distance runner and sports podiatrist, found that natural toe splay “is an essential component of long-term foot health.”*  Correct Toes “help the foot rehabilitate from the negative effects of conventionally shaped footwear. The device, made of soft, flexible silicone, encourages the toes back into their natural alignment found at birth.* With progressive and consistent use while active and weight bearing, toes align and feet strengthen, restoring your foot’s original position and function.”

2.  MELT Method

Another tool for reducing bunions and hydrating the fascia (connective tissue) of the feet is MELT Method Hand and Foot Treatment Kit*.  Some with bunions have used similarly thick rubber bands the likes of those found on broccoli to simply pull the two great toes apart.

3.  Stretch and Strengthen your feet

The Northwest Foot & Ankle and Natural Footgear websites have many exercises to stretch and strenthen your feet.

4.  Walk in optimal alignment

Learning to walk in optimal alignment is another step to alleviating foot and other joint pain.  You can seek out the help of a physical therapist, occupational therapist, Pilates instructor or another movement professional.

5.  Reflexology or massage from trained professionals

Several foot-pain patients receive relief from reflexology,* and I have found reflexology helpful while transitioning into my minimalist shoes. The mechanical aspect of reflexing the feet helps to loosen previously-bound tissue, and sometimes bones will spontaneously click into place during the process of applying the firm yet gentle pressure to the reflexes.

6.  Change your shoes

Get out of shoes with any of four features that deform the feet and impede proper function.  Get into shoes that have features that enable normal structure and function to help alleviate existing pain and prevent future pain.  Healthy shoes show wide toe box, no heel, no toe spring, and flexible.

A word of caution: transition slowly!

The feet and body require a slow transition* into both Correct Toes and a minimalist shoe.

For men and women transitioning from a standard athletic shoe heel or other modest heel, Dr. Tuttle at Northwest Foot & Ankle recommended either a transitional shoe, or a heel pad whose layers that can be peeled off in increments to help the Achilles tendon transition from a contracted state into the full stretch it will get from a zero drop shoe.

For gals transitioning from high high-heels, my MELT Method instructor Linda Meeks recommends dropping down 1 inch at a time – perhaps with each 1 inch drop over a couple of months, in and out a few hours a day in the manner recommended for the Correct Toes transition.   This would also apply to guys transitioning from cowboy boots.


I encourage you to spend time exploring the Northwest Foot & Ankle, Correct Toes, and Natural Footgear websites, and signing up for their newsletters. My yoga and MELT Method instructors also recommend Katy Bowman’s*  website for resources about shoes and transitioning, feet, movement, etc.

Here’s to healthier, happier feet… and better health.

Linda Frank is a state and national board certified reflexologist at Head to Heel Reflexology for Better Health.


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