So let talk about Flip flops/Ugg boots/trainers and bare feet.
The foot is designed to strike the ground, dissipate the bodies weight as it strikes, the structure is designed to “give” and pronate/flatten in order to shock absorb. Then as one rolls forwards with the body over the foot one goes onto the toes and so causes a bend at the big toe joint. This bend then tightens the spring ligament under the arch of the foot and so creates tension in the sole of the foot, which tensions up the leg and into the hip and stabilises the structure of the foot and also tensions the ankle joint, which in turn creates an external rotation in the lower limb. The rotation stabilises the knee and the stabilisation journeys up the leg to the hip and so creates better support to the pelvis and lower back.
When one is barefoot or in normal shoes that are tied/attached to the feet, this method and the above system falls into place. Provided the foot is walked on in line with the direction of travel and not with the toes turned out. Years of walking on the outside or inside of the feet will cause degeneration in the ankle joint and so stability up the leg will be lost and the knee and or hip will have a substantial amount of wear and tear. It is a bit of a catch 22, whether the foot structure causes the hip issue or whether the lack of glute control causes the ankle/ foot issue. The first thing to establish is do you have correct foot/ ankle alignment throughout the walking cycle.
When one wears shoes such as Flip flops or Ugg boots the shoe is slopping around on the foot. Several things happen:
1.The foot “claws” in order to hold the shoe on. This firstly causes a raise in the forefoot which can lead to calluses on the top of the foot and sores under the midfoot. It causes stress on the end of the bone that is designed to lie flat to the floor not at an angle into the ground.
Due to the forefoot arch, there is no way that the big toe joint can work as it is designed. So tension is lost in the spring ligament, under the arch of the foot and there is no support to the knee from the ground up. The problem with this is the knee gets worn and tired and unstable from constant walking with no structure from below.
2. The second thing that happens is that often the shoes have no grip on the sole and are slippery so to avoid the foot sliding in the shoe, the feet start to turn out like “a duck”. When this happens the ankle often collapses in and the foot flattens or pronates because the push-off in the gait no longer comes across the foot and off of the big toe, but it comes from the sideways push off the inside edge of the ball of the foot. The spring ligament cannot be tensioned and so the ankle becomes lax and the knee is not stabilised either, because when walking there is no bend in the big toe joint.
So the argument that flip flops are closer to being barefoot than shoes is nonsense. They cause the foot to work in an incredibly dysfunctional way which is detrimental to the knee and hip and lower back.
The foot is designed to be used straight on. Toes pointing forwards, so that the ligaments can work correctly. When this is done the hip stabilising muscles – the gluteus muscles will activate and then control the knee from above and so the leg functions correctly and injury is avoided.
The discussion about shoes versus bare feet – is a different one. Shoes do inherently have a heel. The problem with a heel is this causes a shortening in the calf muscle and will by the nature of lengthening the back edge of the leg make it easier to heel strike. The conversation here is then about landing on a jarring straight leg. This is not what my conversation is about. My conversation is about making sure the big toe can work properly and so trigger the spring ligament and look after the knee. Years of walking with toes out and slumping into the hips will cause a weakness in the ankle and so a weakness in the knee. Toes turned out means the upper leg is turned out – which means it is wearing incorrectly in the hip joint as well. So if the person is not into exercise and correction it would be much more advisable to wear decent shoes to protect the leg and hip joints.
Take a look around you at how people walk and stand. It is fairly shocking and we are feeding these surgeons a huge meal ticket!!
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