The common person’s shoe found on the remarkable foot

The human foot is a marvel of biomechanical engineering; it is able to be flexible, rigid, responsive and sturdy. Unfortunately it is also not built for walking on tile, cement, nails or many of the other unnatural surfaces of our world. Shoes have become something of a necessity for modern life.

However, the human foot is not designed to be in shoes. Many of our footwear choices lead to injury and loss of function throughout the hips, legs and feet. It is simply not possible for the foot to function optimally in shoes.


Perhaps nothing symbolises island living like the flip-flop. When we slip on our flip-flops, we are leaving our worries behind and living the island life. Unfortunately, flip-flops are not as friendly to our feet as they are to our psyche.

The single strap that holds the flip-flop on the foot does a very poor job. To compensate, we instinctively bunch-up our toes to hold the flip-flop on the foot. That constant gripping changes the correct walking biomechanics of the foot.

The arch of the foot can no longer flex properly during weight bearing to absorb the impact of foot-strike while walking nor can it spring into the next step correctly. To compensate the knees and hips are now forced to absorb more of the impact of walking.

The stride length is also shortened meaning your gluts and hamstrings are not fully exercised – which leads to weakness over time. This weakness can lead to imbalances of your muscles that affect the biomechanics of your hips, knees and feet.

Have you ever been stuck walking behind someone who takes incredibly slow shuffling steps? That person is now you, thanks to flip-flops.

Research and experimentation has delivered a new type of orthotic based flip-flop that does not lead to this type of problem. These new flip-flops feature a contoured arch and thicker form fitting straps. Look for the brand names Orthaheel or Vasyli. These brands can be found in specialty foot stores or some chiropractic and podiatrist offices.

Leave the flimsy flip-flops that look like they were cookie-cutter stamped out of cheap plastic at home or decorate a dead tree on South Sound with them.


Women will come into the clinic in so much pain they can barely walk. They will swear to do whatever they need to do to get better… except give up their high heel shoes.

And what is there not to love about the high heel? It makes you look taller, thinner and lifts the rear-end like no Brazilian dance class ever could.

There is of course a trade off for all these perks. A 2011 Danish study found that heels can increase the risk of a variety of arthritic joints 600 per cent. The Society of Chiropodists and Podiatrists in the United Kingdom found high heels can negatively affect posture and increase pressure on the foot, ankle and knee joints.

Standing on your toes also causes muscular imbalances. To compensate for tipping your body forward, it is natural to bend your knees slightly and arch the back.

The quadracep muscles in the thigh works overtime leading to tightness and injury. Walking with the knees bent does more than give you a funny walk, it also doubles the load on the knee-cap, which means more wear and tear on the knee.

Shin splints are also more likely, thanks to high heels. The added height puts extra strain on the shin muscles which usually support the foot.

As good as heels make the calves look, the gains are temporary. Heels place the calf muscles in a shortened contracted position and over time this can become permanent. Tight calves with knots are only the start of the fun. When it is time to walk without heels, it will feel uncomfortable due to the shortened muscles and loss of a normal stride.


If high heels are bad, then flats must be wonderful, right? Wrong, biomechanics is never that simple.

Flat shoes lead to their own set of problems. Flats tend to lack the support that we need when standing for prolonged periods on hard surfaces.

Without arch support, the ligaments and tendons can overstretch leading to collapse of the arch. This, in turn, can lead to the painful condition plantar fasciitis, a condition that feels like a deep ache on the bottom of the foot.

Many flats have even less cushioning than the notoriously bad heels. This lack of padding can trigger pain in the heel or ball of the foot when walking, especially if you have high arches.

Try to choose those flat shoes that have an insole that curves along the same contour as your foot and especially the arch. Then try to fold the shoe in half — it should bend only at the ball (the same place your foot naturally bends as you walk). Also avoid pairs that fold right in the middle or roll up easily.


When I first heard of rocker bottom shoes, I pictured high-platform boots like the members of KISS wear. It turns out this shoe’s trend finds its origins in a much less glamorous setting.

The rocker bottom shoes were originally developed as an orthopaedic shoe for people with pain at the balls of their feet.

Rocker bottom shoes are shoes where the sole is convex like a rocking chair. These shoes were the new answer to everyone’s foot and saggy butt problems.

They are made by a variety of companies under different names and promised to increase muscle activity in the butt and legs while providing a better environment for foot mechanics. The manufacturers promoted these shoes as a way to exercise and tone the legs and butt while going about your daily routine.

However, not every tool can be used for every job. The rigid soles of rocker shoes prevent the arches of the foot from naturally flexing. Eventually, this will lead to the arches flattening. This results in the feet absorbing less shock, transferring more stress to the knees and the back.

Rocker bottom shoes are also less stable. The Consumer Product Safety Commission’s website is loaded with complaints about injuries from toning shoes (including tendinitis, foot, leg, and hip pain, and even broken bones resulting from falls). Reebok agreed to hand over $25 million in consumer refunds for overstating the benefits of its toning shoes.

The average person takes 3,000 steps per day – up to 10,000 steps if they are active. Our shoes can protect us on this journey or be the source of many of our problems.

Finding the perfect fit is not easy. The benefits of making the right foot wear choices can have a significant impact on many different areas of your body.

Dr. Jemal Khan is a chiropractor practising in the Cayman Islands.