The choice of footwear is often based on appearance; however, some types of footwear are better than others since they affect the musculoskeletal system differently. Even though high-heeled shoes are fashionable, and people like their appearance, they are not the ideal footwear.
Our choice of footwear can affect the entire interconnected musculoskeletal system.
Running sneakers (shoes) are best if much walking is required. However, running shoes do not give much lateral (sideways) support. For lateral support, we recommend cross-training or tennis sneakers.
High heels, although fashionable, are not good for the musculoskeletal system. They can affect the lower extremities, hips, and spine.
Long-term use of high heels can cause increased curvature in the neck (cervical) or low back (lumbar) areas.
What are the structures that make up the musculoskeletal system?
The musculoskeletal system is made up of various structures:
- Ligaments connect bone to other bones
- Tendons connect muscles to bones
- Cartilage, is the firm and flexible tissue in the joints, between the bones
An intricate, balanced system connects all these structures. Therefore, if any structure is thrown off balance, it can affect other structures.
In other words, shoes can affect the feet, lower extremities, hips, and spine.
What steps do you need to take in choosing footwear?
Have your feet measured by a trained salesperson to measure both feet' length and width since some people have different sizes of the two feet.
It is advisable to check the length and width periodically since our feet become longer and wider as we age. Aging causes decreased strength and elasticity in the arch tissues, causing flattening; this eventually leads to elongation and widening of the foot.
Unfortunately, many people continue to purchase the same size shoes their entire life, not realizing the foot changes in size and shape.
The time of day you try on your shoes can be significant. Feet tend to be smallest in the morning, then enlarged by the afternoon and evening, especially in warm weather. Thus, we recommend you shop for shoes in the afternoon or evening, when your foot is largest.
What kind of footwear is best to choose?
Regarding the musculoskeletal system, the best type of footwear is sneakers (athletic shoes), with different kinds of sneakers for various activities. In addition, sneakers are based on different foot types (shown below), consisting of the normal arch, flat foot (fallen arch), and hollow foot (high arch).
Running sneakers (running shoes) are highly cushioned since running involves much force between the sneaker and the ground (surface). When running, the heel hits the surface first, then the foot rolls forward, with the front of the sneaker being the last part to touch the ground. Therefore, running shoes have extra support in the sneaker's toe and heel areas, along with a more uniform thickness for the rest of the sole. For people that do much walking, running shoes are a good choice.
Even though running shoes are designed for forward and backward stability, they do not have much sideways (lateral) stability. Thus, a different type of sneaker is recommended for specific sports or walking on uneven surfaces (gravel) when lateral stability is needed.
Some sports, like tennis, require significant sideways stability and have specific sneakers, fittingly (no pun intended) called tennis sneakers.
Cross-training sneakers are a mixture of running shoes and tennis shoes. They are designed for all types of sports and have stability in all directions.
Minimalist shoes were introduced into the mainstream culture in 2005 and were designed to simulate barefoot running. These shoes have very thin soles and allow a full wide span of the toes; some even have special sockets for each toe, like the way a glove has a separate area for each finger.
Sandals or flip-flops may be easy to slip on, but they are not suited for walking long distances. The types with ankle straps provide slightly more support than those without straps.
Work boots have very thick soles and provide good support. Most of them are durable and protect from accidents, especially the steeled toe types.
Cowboy boots have firm soles but are not good for prolonged walking due to their tightness in the heels and toes.
Women’s dress shoes can be very stylish and flashy; however, they are not very good as far as the musculoskeletal system is concerned.
The bad news for women who like to wear high heels is the more the foot is angled, the more likely to have adverse musculoskeletal effects. In addition, studies have found that wearing high heels causes lower extremity and spinal issues, including increased cervical and lumbar lordosis.
In the diagram below, you can see the increased curvature of the neck (cervical) and low back (lumbar) areas caused by wearing heels. When wearing heels, the smaller the heel, the less likely the development of musculoskeletal issues.
Flats (flat shoes) originally got their name from ballet shoes, which are patterned like ballet shoes with very thin, flexible soles. Nowadays, flats encompass any shoes that have no heel.
We understand that high heels are stylish, and many women like the created attractiveness and appearance; however, we suggest using walking shoes if it is a long walk to your destination and then changing into heels. If that is not feasible, consider using lower heels if a long-distance walk is required.