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Could Your Shoes Be Causing Your Back Pain?

Low back pain is kind of like butt holes, every one has it.

According to the Global Burden of Disease in 2010, low back pain is the single most common cause of disability worldwide.

Some experts believe that 80 percent of the population will experience some sort of back pain in their lives.

So with such an epidemic, what could be the cause of this condition?

Having been working in the field of physical therapy and now making the transition into the fitness side of things, I have seen my fair share of low back pain complaints. Both with a specific mechanism of injury (i.e. lifting with bad mechanics) or having pain from no specific reason.

Some individuals may be predisposed to low back pain, because there is some connection to arthritis or degenerative disc disease being heredity.

With some people having this link to back pain there are factors that we can change that can significantly reduce your risk and help prevent development of said epidemic.

When it comes to low back pain, or any pain for that matter, it comes down to posture. There different ways that we can improve someones posture. That could be through postural exercises, stretching, and strengthening.

One change that we can make that could help a lot over time is by simply looking at our shoes.

The basic function of the shoe is to create a protective barrier from the rough terrain that our ancestors navigated thousands of years ago. Today, shoes are flashy and very thick with a huge heel lift putting our ankle in a state of constant plantar flexion with a forward weightshift.

 Shoes with any type of heel lift will effect our standing and walking posture negatively by putting excess stress on different areas of the body.

Even with the slightest of heel lifts, our foot is more plantar flexed, the knees stay slightly flexed, pelvis is forwardly rotated, lumbar extension increases with the rib cage flaring, the thoracic spine flattens out, and our head comes forward with our mid to upper cervical spine going into excessive extension as well.

With such a minuscule accessory it sure does cause a laundry list of changes.

To focus on the back pain, the constant state of lumbar extension will eventually over time cause low back pain. It was found that the psoas muscle will become hypertonic and is causing the increased lumbar extension (1).

Due to many of us wearing shoes for 8+ hours a day we end up getting stuck in this posture. Our hip flexors and low back extensors get tight while our abs and glutes/hamstrings become weak.

When it comes to our walking posture/mechanics we continue feeding into this pattern.

When walking, we end up pulling forward with our hip flexors rather than pushing through our glutes. Generally, our left glutes are weaker than our right so as a result we will see a bigger left calf from having to push off more through our toes.

Shoes can also create lazy and stiff feet. The more supportive footwear that you choose, the less work your foot has to do. The foot has 33 joints, 26 bones, and 19 muscles (2). All of these joints and muscles are have some mobility one way or another and supportive shoes don’t allow normal movement to occur. People end up developing flat feet, which can cause problems up the chain with knee, hip, back, and potentially neck pain.

So what can you do if you have back pain or look for prehab options to decrease your injury risk?

The obvious answer to that question is to spend more time barefoot. But don’t go barefoot right away! Work your way down into more and more minimalist shoes until you get a solid foundation of strength gained. New Balance has a nice selection of different options of different heel lift sizes and sole thicknesses.

We can start off building strength by doing what I call gripping exercises. Just as you try to grab the floor with hands when doing a push up, do the same with your foot. This will help create an arch in the foot. You can do this exercise either sitting or standing.

 

I love doing balance activities for foot strength. Specifically, single leg stance without shoes. When standing on one leg you have to create an arch in the foot in order to keep your balance. If your arch collapses then so will you. You can start off very simple by standing on one leg without moving. Progress by having someone pushing you in different directions to try and knock you off balance. We can then go into more dynamic things like single leg stance with med ball throws of some sort. The possibilities are then endless from there.

We all could be doing a little bit more when it comes to taking care of your feet. It is literally the foundation and like a foundation of a house, the stronger the foundation the more stable the structure.

So get out of your shoes, and work on building the foundation of our bodies and decreasing your risk of back pain now and into the future.

References

  1. Kumar NV, Prasanna C, Sundar VS, Venkatesan A. High Heels Footwear Causes Heel Pain and Back Pain: Mythor Reality? Int J Sci Stud 2015;3(8):101-104.
  2. Franklin, S., Grey, M., Heneghan, N., Bowen, L., & Li, F. (2015, June 03). Barefoot vs common footwear: A systematic review of the kinematic, kinetic and muscle activity differences during walking. Retrieved August 27, 2018, from https://www.sciencedirect.com/science/article/pii/S0966636215004993
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