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Pronation is necessary for the foot to absorb shock.
But not all the shock is absorbed. Some of the shock caused
by the feet striking the ground is transmitted up the legs,
through the pelvis, to the lower back.
What is Underpronation?
Some people underpronate.
The foot does not roll inward enough to adequately absorb shock.
These people usually (not always) have a high, inflexible arch.
This leads to pain in the feet and/or knees and/or lower back.
Underpronators need flexible shoes with extra cushioning.
What is Overpronation?
Some people overpronate. The foot rolls inwards excessively,
which causes excessive internal rotation of the lower leg and
knee and places strain on the entire lower body, including the
lower back. Overpronators usually (not always) have low arches
and straight feet. Overpronators need shoes with built in support
features.
Adequate Cushioning:
Shoes with adequate cushioning in the soles help to
absorb the shock of the feet hitting the ground.
Cushioning is especially important when walking on hard surfaces
such as pavement or tile (sidewalks and shopping malls) or when
walking a great distance.
Cushioning is especially important to underpronators. Overly cushioned
shoes can, however, reduce the stability of the shoe and make overpronation
worse. Shoes that combine both support with lots of cushioning tend
to be heavy.
Support: Overpronators need shoes with adequate
support. Adequate medial (arch) support helps prevent the feet
from rolling in excessively while walking. Adequate heel support
is also necessary to control overpronation.
Shoes that incorporate these features are called stability shoes
or motion control shoes. Stability shoes are for those who overpronate
mildly or have a normal gait. Motion control shoes are for those
who overpronate severely. Extra support may also required if one
has gained extra weight. Motion control shoes tend to be are more
rigid than stability shoes and tend to be heavier. There is no
point in getting a shoe with more support than is required.
Shape of the Shoe:
The shape of the shoe should generally conform to the shape of
the foot. The soles of shoes can be straight, curved, or semi-curved.
For people who underpronate severely, a straight shaped shoe is
best. For people who overpronate mildly or have 'normal' feet,
a semi-curved shoe is best. For those who overpronate, a curved
shoe is best.
*It is best to go to a retailer that has employees
who specialize in fitting shoes. There they can look at
the shape of your feet, observe your gait to see if you
underpronate or overpronate or have a 'normal gait,' and
recommend the best shoe for you.
The Perils of High Heels: Wearing high heels cause the
pelvis to arch forward (causing sway back), placing extra stress
on the lower back pain. Time spent wearing heels over 1 or
2 inches high increasing the likelihood of lower back pain - not
to mention foot pain.
Orthotics:
Arch supports can help but many people find them
uncomfortable. Some people find more relief with custom
made inserts (orthotics) than over-the-counter inserts but
they are more expensive. They may be soft, rigid, or semi-rigid.
*Often, the footwear is not the main cause of the back pain, but
it certainly can aggravate it.
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