Dr. Jacqueline Gerhart: Feet Pain Could Be From Getting Used To 'Five-Finger' Shoes

UW Health Family Medicine physician Dr. Jacqueline GerhartMadison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears Tuesdays on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.


Dear Dr. Gerhart: I'm getting pain in the bottom of my feet, and I think it's from the five-finger shoes I've been wearing. The shoe store said these shoes are good for my feet and reduce injury. Should I expect the pain to go away as my feet get used to these shoes?

Dear Reader: The "five-finger" shoes — by brands like Vibram and FutGlove — are popping up at stores everywhere. They have many claims, but while running stores can look at your old running shoes to see what parts are worn out, they can't necessarily predict how you will respond to a new type of shoe.

To help answer your question, I went on the Vibram website. Three quotes from the site that I found interesting were:

1. "Stop and let your body heal if you experience pain. Sore muscles are normal; bone, joint, or soft-tissue pain is a signal of injury."

I would guess for most people it's tough to know the difference between sore muscles, sore joints and sore "soft tissues." In fact, one of the most common foot injuries in runners is plantar fasciitis, which is not a muscle/joint/soft-tissue problem.

Fascia is a fibrous connective tissue that surrounds muscles and often is anchored on bone. Plantar fascia starts at the calcaneus (heel bone) and extends along the sole of the foot toward the toes. With long periods of standing or weight bearing and with increased impact sports, the fascia can get micro-tears, which can cause pain.

Plantar fasciitis occurs in 10 million Americans per year. About 10 percent of Americans will have it at some point in their lives.

2. "In the beginning, remember to carry your traditional footwear in your hands as a backup."

I find this amusing. I already have a phone in one hand, and a pager and my keys in the other when I run. Adding a pair of shoes on my hands would only be helpful if I wanted to practice juggling while running.

Instead, I suggest you use the "FIT" approach to breaking in your new shoes. "FIT" stands for frequency, intensity and time.

At first, only use the shoes once per week, and then slowly increase your frequency. Next, work on your intensity — first starting with just walking and low-impact use, and then transitioning to jogging and high-impact use.

Finally, increase time. Start with 5-10 minutes, and then increase slowly.

3. "An adjustment period is normal at first. ... For some it is a matter of weeks, for others months, and for a few it could be a year or more."

So the website says to expect some growing pains. But how are you supposed to know if it's a "good pain" or not?

To find out, try stretching, physical therapy or decreasing your five-finger shoe use. If these strategies lessen the pain, then chances are good that you are, indeed, just adjusting to using your foot and lower leg muscles in new ways.

However, if the pain doesn't improve with these strategies, then you may have plantar fasciitis or another foot injury. See your primary care physician sooner rather than later for tips and guidance.

Not every foot is made for the minimalist approach that these shoes provide.

This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.

Date Published: 08/28/2012

News tag(s):  jacqueline l gerhart

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