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Footwear, can it really help or hurt?!

Posted by on May 26, 2013

A rainbow of colors and source of more of your pain in your back, hips, knees and ankles

It is summer, or at least it’s suppose to be.  I’m sitting here in my kitchen with long sleeves on and a fire in my fireplace while it’s 54 and rainy outside.  For many people though they are breaking out the summer shorts and sunscreen and flip flops.  I’m gonna say it.  JUST SAY NO TO FLIP FLOPS!!!!!  I gave them up about 4 years ago and my body thanks me.  Yours will too.  Let’s talk about this for a minute ok.

I get it – the draw of flip flops.  They come in a 100 colors, they are cheep as can be, and you can step right into them without having to bend over, it’s fantastic!  Who wants to bend over to tie shoes when it hurts so much?  It’s nice to have so many color options when fashion has really gone to the wayside in light of other things like oh, being upright.  You get there is a trade-off right?  I was a HUGE flip flop wearer for years, barefoot and flip flops – until the snow fell.  Then one day my PT looked at me and said… let’s have the shoe talk ok… and we did.  I’m going to spell it out for you below and you can decide for yourself, but basically he said – you’re not helping your situation with your shoe choices.  You and everyone else in this world need shoes that SUPPORT their feet.  Flip flops are like walking on cardboard.  He encouraged me to consider a shoe with arch support for my feet.  I took the challenge and you know what… it helped.  Did it cure MY back/pelvic pain.  No, it didn’t, BUT it HELPED.  and in this battle, ANYTHING that helps is a win.  That summer I threw out all my flip flops and all my kids flip flops.  We are now a supportive shoe only household.  They are more expensive, but they are also better made.  I went down to my local “old lady we deal with real shoe” store and was shown a variety of quiet stylish shoes.  I have linked a few brands at the bottom of this post.  I bought myself a pair of Birkenstock sandals 4 years ago as a birthday present, and I have never looked back.  I have 2 sets of mid range orthotics that I wear in my dress shoes and my gym shoes and my body thanks me for it. So lets talk about why our feet and what they are doing can affect our hips/pelvis  or how our hips/pelvis can affect our feet!

Flip flops aren’t really great shoes for anyone, but for us or anyone with any type of back, hip, SI, knee or ankle pain – just say no.  Here’s the ugly truth about flip flops and our muscles.  If you have a need to find this blog, most likely your glute muscles are NOT in tip top shape. As one of our instructors at school liked to say, you probably have a “dumb butt” it won’t engage with the force and time you need it too, so other muscles take over the job, then they get tight.  Most people with SI/pelvic pain are dealing with a vast majority of muscles not playing nicely together.  The position of the hip effects both the alignment of the leg and foot bones as well as the way forces are transmitted through the leg. Hip weakness and poor control over the movement of the hip will lead to added stress being placed on the structures farther down the leg.  In standing, these hip muscles maintain the alignment of the leg. This alignment enables weight to be transferred efficiently straight through the leg and into the foot. When the angle of the hip the line of force no longer will be centered over the foot.   This is a problem!!!!! What ends up happening you ask…
Well, it commonly results in a pattern of the hips being off kilter and tilting forward( anterior pelvic tilt) ,  the femur rotates inward ( internal rotation) knees that roll inward (genuvargum) , and ankles that roll inward (pronation). So now nothing in our lower body is in neutral and we are putting more demands on our muscles, ligaments and joint capsules!!!

Here is a picture of what I am talking about.

When the muscles of the pelvis/ hip are weak this can contribute to a break down in the rest of the mechanics and alignment of the leg and foot. The muscles that control hip abduction (the outward movement of the leg) and hip external rotation are the ones primarily responsible for making sure the joints of the leg stay in proper alignment.These muscles include the glutues maximus, medius, and minimus and the group called the external rotators (piriformis and his buddies)  several of the smaller muscles contained within the pelvis.  In our population they tend to not work well, and that means the muscles in our feet have to try to counter act all that our hips are NOT doing.  Problem is those muscle in our feet are much smaller and can only fight back with so much force.  They are in a losing battle against the hips and knees.  This REALLY becomes a problem when we stand on one foot.  The hip abductor and external rotator muscles need enough strength to support the entire weight of the body in order to maintain proper alignment through the leg and foot. Once poor motor patterns are established they become difficult to break.  But Amy, I don’t ever stand on one foot you say.  Well ok, but every single time you take a step there are moments where your entire body is indeed supported on one leg.  So, you do stand on one leg, a lot!  When you don’t have the same amount of muscular support from each leg during the single leg part of walking your posture will suffer. This continues to contribute to the uneven foundation for your pelvis and spine and ends up resulting in INCREASED PAIN – especially in the sacroiliac joint.  Why oh why oh why would we want to do that to ourselves?!  We really shouldn’t.

My point is simple this: if we can help our bodies out a little bit by wearing supportive shoes… why wouldn’t we?!  We do a thousand other things to try to get relief and put an end to our pain, why not start with our feet?

Would you consider a challenge for me?  Would you find yourself a reasonably supportive shoe NOT heels or flats, but a gym shoe, something with support that can’t be bent in half and wear it for 2 weeks.. no barefoot, no flip flops, but really try wearing supportive shoes all the time your on your feet for two weeks.  Then go back to your flip flops for 2 -3 days.  See if you can tell a difference.  Share what you learn in the comments section.  I’d love to hear if it makes a difference for you like it did me!

Just a few brand names of shoes that will make your feet happy….

For further reading on this topic:


And for those wanting to know what exercises will strengthen those weak glutes in hopes of someday returning to the flip flop….
One of the primary indicators of hip weakness is the inward movement of the knee with activities like descending stairs or squatting.  If you don’t have a therapist you can ask to check you, have a friend video you and look at yourself.
There are many many many exercises for targeting the hip muscles required for stabilizing the leg.

A few include:
This is NOT a replacement for a PT program, these are merely examples of a variety of levels of exercise that work hip musculature. This is not meant to replace medical advise or be used as an exercises program.

lateral side stepping

Side-lying Leg Raises (start without band and DON”T roll forward or backward!)

clam shell (start without band and don’t worry if you can’t do it as well as this guy… start with the support and up against the wall- your working toward being able to do it his way.)


squats with abduction- only go as deep into the squat as you can CONTROL

bridges on stability ball with abduction

4 Responses to Footwear, can it really help or hurt?!

  1. Susan

    Amy, I love your blog! Thanks for all the info. My feet hurt so bad, standing is the worst. I have Dansko’s, Birks, & Crocs. Always looking for more comfortable options. My problem is that I have size 12 wide women’s, which are very hard to find. I am always barefoot in the house.
    Thanks again,

    • Amy

      Susan, thank you for stopping by and reading! I too have big feet – narrow size 11’s. Shoes are NOT fun to find! So I understand the draw of flip flops!!!

  2. Amy

    I would love to hear what types of shoes everyone DOES wear! I’m always looking for options! Thanks for sharing Debra!

  3. Debra

    Wonderful post. I also have had to give up flip flops. Favorite shoes are Naot flats with replaceable supportive footbeds. They also have flats with a footbed like Birkentstocks only cuter tops.

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