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Shoes for Plantar Fasciitis?

Plantar Fasciitis is a painful condition that affects millions of people. It is caused by inflammation or tightening of the foot's plantar fascia - a layer of tough connective tissue on the bottom (plantar) aspect of the foot. It generally presents as an intense, burning pain on the bottom of the foot, especially in the morning when first getting out of bed.

Plantar Fasciitis can be caused by a number of factors, but overuse and/or repetitive stress (running, etc.) are the main causes.

Choice of footwear plays a major role in the prevention of plantar fasciitis. To understand why, you need to understand the foot mechanics of walking:

When walking, the foot has three distinct mechanical processes:

1. Heel strike: your leg is extended in front of you, and your heel is just hitting the ground
2. Flat foot: your foot is directly under your body, and is essentially flat on the ground
3. Toe-off: your leg is extended behind you, your heel is lifted, and only your big toe is on the ground.

Of these processes, toe-off is the most important to preventing plantar fasciitis. This is because as your foot rolls forward, it stretches the bottom of the foot, and thus the plantar fascia.

A shoe that supports the foot though all phases of walking mechanics is the best choice to avoid the type of dysfunction that leads to plantar fasciitis.

Athletic shoes are generally the best choice. This type of shoe is designed to support the foot properly throughout vigorous activity.

A dress shoe that provides arch support is also a good choice. But this DOES NOT apply to high-heels! They are terrible for your feet and can contribute to other foot ailments like bunions.

Going barefoot, when applicable, is also a solid choice. You’re born that way, and Mother Nature knows what she’s doing.

Flip-flops are the WORST thing you can wear for plantar fasciitis. Don’t get me wrong, I have nothing against flops. Living in Florida means it’s pretty much a birthright to kickback in your flops. Heck, I got married wearing flip-flops. But flops have one fatal flaw: they do not support toe-off.

Because flip-flops are only held onto the foot by a strap on the front of the shoe, if you attempt to perform a normal toe-off, your foot will slide out the back of the shoe. To compensate you must abbreviate the toe-off portion of gait and are therefore not stretching the bottom of the foot, which leads to… plantar fasciitis.

Don’t believe me? Remember your first pair of flip-flops? Remember how you had to practice walking a while before you could really get the hang of them? That’s because you had to retrain your gait (and shorten your toe-off).

No matter what anyone tells you, there is no such thing as an “orthotic” flip-flop that will help with plantar fasciitis. It may have a nice, orthopedic foot bed, but it is the fundamental design of the shoe that makes it unsuitable for the prevention of foot problems.

Treatment for plantar fasciitis can be provided by chiropractic physicians, and generally takes the form of ultrasound, manual therapy, gait training and manipulation of the foot.


Joseph Pate, D.C. Doctor of Chiropractic

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