Oct 23, 2013

Minimalist or Zero Drop Shoes Are NOT a Cure-All.

My old running shoes

Today's post is kind of half personal story/half conjecture/half observation(wait, that doesn't add up!). To begin, I have now been wearing a minimalist/zero drop type shoe everyday for both casual use and exercise/running. The only time I wear a shoe that is not completely flat is when I wear my dress shoes with my suit for basketball games.

One of my current favorites
I am a huge proponent of wearing zero drop shoes with a wide toe box and the absence of a "toe spring". I feel this shoe design interferes the least with proprioception, normal foot mechanics, and proper tissue length. Think of non-zero drop shoes as being like a mini-high heel.

These shoes kill my feet so I try to avoid spending more than a couple of hours in them.
They sure do make my deep squat look great, though.

Now here is where my personal experience comes in to play. Despite having now worn shoes of this design for over 2 years, I am still short of having adequate ankle mobility. Specifically, I am referring to ankle dorsiflexion. I will be the first to tell you that the intrinsic muscles of my feet feel stronger, my feet are wider, and I have better control of the movement in my toes. Nevertheless, I still fail the basic test from this video for ankle dorsiflexion range of motion.

There are a few reasons why I think this is and why I think this is important to discuss. A major reason I see or hear of people switching to minimalism is because they want to fix or prevent injuries. I don't think that just changing the shoe-type being worn or lack thereof will be the sole fix needed(instances where it was and wasn't exist). Injuries are multifactorial and can result as a combination of many different issues working together or just one or two simple broken links in a chain.

It is evident to me through an objective measure that wearing these shoes hasn't increased my ankle mobility alone. However, wearing these shoes hasn't caused a regression or loss of mobility. What has made a difference for me is the identification of a tissue mobility restriction and the proper use of manual therapy and corrective exercises to improve this weak link. This has vastly improved my previous issues with plantar fasciosis/fascitiis but still is not a 100% resolved issue.

The biggest reason for this continued problem is not that I am a slow responder, using the wrong manual techniques, or my footwear choice. The real problem exists in my own personal compliance. I spend so much time working on other people that I give myself an excuse (but not a good one) to avoid working on myself. The only time I find myself being devoted to working on this issue is when it comes to pain being the driving force. The take-home and importance of this is that my patients will find excuses to avoid being compliant if I do not drill home the importance of compliance with proper education...and some accessory cattle prodding.

In conclusion, don't be naive and expect to take off your shoes or buy a fancy pair of minimalist shoes to fix your running problems. Properly evaluate your patients or find a person that can give you a proper assessment and decipher if you have any mobility or stability problems that could potentially be an issue for you whether or not you are changing your choice of footwear. The next major steps are choosing the proper intervention and securing compliance. Don't expect miracles, you need to have proper movement. A failure to fix pre-existing dysfunction may leave you predisposed to hurting yourself more or developing new ailments.


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All content on this blog is meant as instructional and educational. The author and guest authors of this blog are not responsible for any harm or injury that may result. Always consult a physician or another proper medical professional for medical advice.
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