Hi. im a male 48 years abt 178 cm wt 80 kg. i walk almost everyday as a n exercise as running etc i wish to avoid due to old wear and tear of my knee joints in my military career.i however have a few probs regrding my feet-my right foot has some alignmnet issues as normal sneakers when i wear i get a deep impression under the right toe which deteiorartes with every passing day and the sort of a pit there becomes a tear tearing away the sole as also my socks from there.my bro gifted me uk made INOV 8 shoes which i started to use with socks-now these havent torn a sock in my rt foot so far after abt almost 2 months but i have another problem which is recurring plantar fascitis(PF) -will these INOV 8s worn with socks make my PF worse or less or shud i wera them witout socks.please advice
ive had even dr scholls usa made inserts torn under my rt toe after a few days of use.hence what should i prefer-barefeet shoes like inov 8 and ue them barefeet or else socks with normal shoes.my size is 91/2 UK
The wear pattern you describe points to severe pronation, which explains the knee problems you are attempting to recover from. Inserts under the toe do not address this problem directly.
A foot pronates to achieve stability by rocking the foot outward and shifting weight to the great toe. This focuses most of the impact onto the largest/strongest metatarsal of the foot. Your wear pattern shows that this movement is done to excess, which is why the wear pattern is uneven. An even wear pattern, on the other hand, would show more even distribution of weight throughout the structure of the foot.
Excess pronation can also stress the plantar fascia, which is another symptom to confirm my assessment.
The best walking shoes for you may not exist in over-the-counter form. Inserts such as you have used can make the problem worse, because they exert more pressure on the great toe when walking.
There are three ways to approach therapeutic footwear, which are often used in combination, but not with equal efficacy. One can control pain, control movement, or control biomechanics.
Putting a cushion under a painful and overused area controls pain, but does nothing to address the cause of pain.
Stiffening the shoe to control or limit pronation can deliver temporary relief, because it resists the natural biomechanics of the foot and leg. Eventually, other problems can result from the limitation of natural movement.
Controlling biomechanics is a more complicated approach, but the only one that delivers lasting benefits. To be effective, it must take individual bone structure, posture, muscle tone, and elasticity of tissue into account. This means it takes more time and costs more. Such an approach is not often directed towards the sedentary population, but necessary for those who wish to remain active.
The length, shape, and geometry of bones, especially in the foot and hip, must be understood in order to explain individual biomechanics such as excess pronation. The action of muscles depends on the leverage supplied by bone structure.
Posture often adapts to bone structure, but also to working/resting habits and circumstances. Posture is somewhat dependent on bone structure, but also on muscle tone. While it is nearly impossible to change bone structure, the tone of individual muscles can be changed with exercise, by avoiding certain activities, and by how we choose to rest, eg: use of chairs, which alter muscle tone and posture.
Unexercised muscles may become weak, may experience spasm or tightness during exercise, and may have developed excess tone during rest, when they may shorten to match habitual posture.
Genetics and other factors, including exercise and nutrition, may have an impact on one's innate flexibility, which also determines natural movement. While some attempt to affect flexibility through yoga and stretching, there are always those whose flexibility is naturally superior to others'. One should make the most of what one has, but too much flexibility can be just as potentially injurious as too little. For example, high rigid arches may be painful, but so are flat feet with little structure. Hyperextended knees and hypermobile hips may also be problematic. There is a happy medium that can be trained somewhat with appropriate physical therapy.
Back to the shoes, you may be suffering from a shortened first metatarsal, which causes the foot to roll onto the great toe to gain stability. While you can't lengthen the 1st metatarsal, you can apply a small amount of stiff padding underneath the ball of the foot to supply the stability missing when it is too short. This allows weight to be shifted away from the great toe and spread out more evenly across all five metatarsal heads, as in a normal foot. This is different from limiting movement, in that it changes the perception of bone anatomy, which influences how muscles will be used to pronate the foot in response. Bone too short=more need to pronate. When enough bone appears to be in the right position, whether by anatomy or padding, the action of the muscles -hence the movement- changes accordingly.
Determining the position of the foot via pressure on its points of contact, and the relative stress on the controlling bones, muscles and tendons, immediately interpreted by the spinal cord and brain to inform muscle control, is called proprioception. Biomechanics are the movements that result.
This simple padding solution could be contraindicated if there is a problem with a bone spur or degradation of the fat pad at the ball of the foot (the distal end, or head, of the 1st metatarsal). In most cases however, this can be an effective counter to excess pronation, by altering proprioceptive biomechanics.
If you have not discussed your condition with a podiatrist or physical therapist, you may or may not confirm what I have explained so far when you do. It depends on the training, experience, and typical clientele of the healthcare practitioner. If you seek professional guidance, make sure it is with someone familiar with the needs of active, not merely sedentary, clients. Healthy people do not often seek healthcare advice, so one's experience with the unhealthy can dilute one's approach to enhancing the active lifestyle. Make sure you do not get trapped into remedial interventions that exclude healthy activity, such as stiff orthotic shoes and the like. Healthy movement is key.
Here is a link to a podiatrist's lengthy discussion of a common foot malady, how complex the possible side effects, and how simple the solution can be. It could well be relevant in your case. PODIATRIST'S DISCUSSION OF FOOT STRUCTURE.
hi james what should i do-plesae suggest-change my footwear or else see a sportsmedicene doc-im based in INDIA.im seriously thinking of starting bycycling as an alternative fitness regime
A bicycle will give you time to figure out the shoe problem. I'm not sure what your situation is in India, whether or not it is convenient to try out several pairs, but if you are a severe pronator, which I suspect, I still believe it wil take more than a shoe change.
A sports-med doc could be expensive, but there are others well-qualified to evaluate over-pronation, or any other biomechanical alignment problem. In the US, physical therapists ("physio" in UK) can evaluate your biomechanics and develop a suitable exercise protocol. I would be careful, though, about any prescription for orthotic shoe inserts. While they often work well in the short term, the typical orthotic is not suitable for athletic use, or as a long-term solution.
I'm not sure how health treatment and counseling is paid for in your country, but you may have limited choices for insurance or other affordable care. I hope you are not completely on your own, but if you are, there is a lot of information on self-treatment out there. Unfortunately, it is not all scientifically based. Remember to distinguish between merely controlling pain, or controlling movement, and solving the causes of any biomechanical flaws. Everything from back, through hip, knee, ankle, and foot is important to running and walking biomechanics.
Meanwhile, bicycling, other cross-training, and targeted exercises will develop your strength and endurance, and help prepare you for a return to walking, if that is your chosen sport.
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