How can your footwear impact your back pain?


Feet are the foundation of our body; they are responsible for posture and the alignment of our back while holding up our body weight as we stand or move from one place to another. It is therefore important to evaluate the impact of footwear on the back as improper shoe gear can lead to back pain. 



  1. Shoes with specifically engineered foot beds and molded EVA midsoles such as Brooks Beast, Mizunos, Asics, and New Balance are designed to help mitigate foot, heel, and arch support for superior comfort and support of the foot, ankles, knees, and back.


  1. Rigid shank: In order to tell if the shoe is rigid enough, you want to take the shoe and bend it in half. You shouldn't be able to, because the shank is the actual structure of the shoe and should be rigid to hold up and support the arch.  The flex point of a walking shoe should be the point at which it bends while walking. For optimal comfort, the flex point of the shoe should match the bending point of your foot; when it doesn't align with your foot it can cause problems like arch pain or plantar fasciitis.  You can check the flex point of the shoe by holding it by the heel and pressing the toe of the shoe onto the ground. The point where the shoe bends and creases is the flex point.


  1. Rigid heel counter: Squeeze the heel of the shoe to see how firm it is. There should be a good bit of padding called an ankle collar which is intended to protect and cushion the rearfoot. You shouldn't be able to compress it – so when you are running it supports the heel which will help prevent ankle sprains in people with high arches.  The heels of the shoe should be a little wider on the bottom to add stability.


  1. Spacious toe box that allows your toes to move freely with no restrictions therefore minimizing discomfort placed on the arch of the foot.


  1. Well-cushioned comfortable footbed and anatomical arch support  with memory foam or EVA (ethyl vinyl acetate) anti compression insole to hold up the arch and prevent it from collapsing to minimize fatigue and pain of the back.


  1. Shock Absorbant outsole made of rubber will help alleviate the impact of each step on the spine far greater than a shoe with a hard sole.


  1. Deep heel cup to maintain proper foot realignment and maintain pressure relief of the plantar fascia with heel strike.  This will help maintain proper sagittal motion and minimize frontal plane motion which can affect posture and alignment of the spine.




High heels: I recommend looking for a shoe that has a 1.5 inch heel or wedge height rather than one that is completely flat as it places less tension on the Achilles tendon and will feel more comfortable. High heels or stilettos are also very harmful to your feet.  A square toe is better than a tight confined shoe with a narrow toe box, but generally these stilettos exceed the recommended heel height of 1.5 inches. The higher the heel, the shorter strides, which means more pressure is placed on the balls of your feet. This throws off your center of gravity putting unneeded and unnecessary stress not only on your feet, but also on your knees and lower back.  When a woman wears heels her sway is longer, her chest is pushed forward while her buttocks is further back. The body weight pushes forward so the center of pressure is moved towards the balls of the feet. The walk translates to be a more jerky stride rather than smooth which translates upwards affecting the alignment of her back.


Flip Flops: Walking with flip flops for prolonged periods of time allows our foot to collapse affecting our gait and posture, which can lead to a tremendous amount of stress not only to the foot but to the rest of the body. Our feet naturally pronate during the gait cycle, however when we wear flip flops we pronate for a longer period of time which then alters the biomechanics and distribution of pressure and weight across the foot. This imbalance may increase the progression of underlying foot deformities such as bunions and hammertoes and lead to painful conditions associated with excessive pronation such as arch/ heel pain, shin splints/ posterior tibial tendonitis, and Achilles tendonitis. This imbalance can then translate upward affecting other parts of the body such as our knees and back.

Dr. Miguel Cunha Dr. Miguel Cunha, Board Certified Surgical Podiatrist, founder of Gotham Footcare, and leading podiatrist in Manhattan is a highly trained and skilled foot and ankle surgeon with experience treating a wide array of foot and ankle conditions from minor problems to complex reconstructive foot and ankle surgery. Dr. Cunha takes pride in having a genuine interest in each and every one of his patients while providing them the utmost compassion and exceptional care.

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