Can Flat Shoes Cause Back Pain?
by Dr Shaila Callaghan
I get asked this question a lot in practice, especially in the summer. You try to wear your flat shoes for the day because you had read somewhere that heels are bad for you – (perhaps even in one of my earlier articles). The problem: your feet and back hurt even in your flats!
So why all the back and foot pain?
Many flat shoes have little to no support and, if they do have built-in arches, they are rarely suited for your specific needs. The arches in a human foot works like a shock absorber – they reduce the impact of the ankle, knee and hip joints, as well as the joints of the low back. People who have flat feet will often have back problems because their feet and arches are not able to handle and distribute the stresses of their body weight properly. The arches also attribute to balance and posture and are the keystone of your body’s foundation and base of support. Flattened arches are very common in the general population, so it is no surprise that so many women and men complain about pain when wearing flat shoes without a supporting insert or orthotic. Below are some of the most common complaints by those with flat feet, apart from back pain:
High heels force you onto the balls of your feet, activating an arch-strengthening built-in mechanism. In this way, high heels provide more support for your arches than your flats!
Our bodies adapt to the stresses that are placed on them, especially repetitive ones, like wearing high heels every day. Stand on your toes. Can you feel the muscles in the back of your legs contract? If you wear heels all the time, these muscles are in a constant state of contraction and can physically shorten (this is why daily stretching is so important).
When you take your heels off and switch to flats, you are asking these muscles to lengthen out for you; however, after much repetition, the muscles are not as malleable as they once were and the tight muscles in the back of your legs pull down on the back of your pelvis, as depicted in the photo above. Your upper body has to move forward to balance your center of gravity, causing the curve in your low back to flatten out. We have these curves for strength and support and, when they are lost, our muscles act on the spine in a disorganized fashion to keep us erect so we end up with pain.
Your feet contain 25% of the bones in your body and they are all connected through multiple joints. Ensuring that your feet are moving properly and actively supporting the rest of your body is very important to your overall posture and health. Think about your feet as the foundation of your body’s home: if there is a crack in the foundation, the upper floors cannot stay erect for long!
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Dr. Shaila Callaghan
Toronto Health and Physical Rehabilitation Clinic