Footwear, Gait, and Posture: Addressing Foot Issues to Relieve Lower Back Pain

This is Part II of Dr. Amanda’s series on the Foot-Shoe Connection

Low back pain? Take a look at your feet.

As we addressed in Part I discussing the connection between foot mechanics and pelvic health, we see very similar impact on low back and hip pain. In short, issues with our feet can create other, more noticeable physical symptoms:

1. Alignment and Posture

Arch Support: If you have flat feet (fallen arches) or high arches, the alignment of your legs and hips can be impacted, leading to an imbalance. This misalignment can cause your pelvis to tilt and put extra strain on your lower back. Although shoe companies would prefer we address this issue with their products, we have to learn to STRENGTHEN our feet to allow them to support our bodies instead of relying on our shoes. 

Pronated or Supinated Feet: Overpronation (feet roll inward excessively) or supination (feet roll outward excessively) can alter the way your body weight is distributed. This can lead to uneven stress on your knees, hips, and lower back. This has a lot to do with compensatory strategies we see in the clinic that actually start “up the chain” in the hips and core.  If you notice your feet consistently are wearing through the inside OR the outside of your shoe significantly more than the opposing side, you are definitely compensating for something. The question is, what?!

“We have to learn to strengthen our feet to allow them to support our bodies instead of relying on our shoes.”

Many times, when we assess a client both above and below their area of complaint, we will unravel the actual root cause of the issue! That approach along with assessing the entire body and how a patient progresses through functional movement (squatting, bending, lifting) is critical to resolving the pain.

2. Gait Mechanics

Abnormal Walking Patterns: Issues like overpronation or supination can lead to abnormal gait patterns, such as limping or walking with an uneven stride length. Over time, this can cause muscle imbalances and strain in your lower back, which will continue down the cycle of more pain.

Shock Absorption: Your feet act as shock absorbers for your body. If your feet don’t absorb shock properly due to poor foot mechanics, the impact can travel up your legs to your lower back, leading to pain.

3. Footwear

Inadequate Support: Wearing shoes with poor arch support, inadequate cushioning, or high heels can exacerbate foot problems and contribute to lower back pain.  Your feet and ankles should be trained to be able to accommodate any footwear for a short duration, and the footwear should not dramatically affect your pain.  The only reason why this would continue to happen is if additional compensating issues need to be resolved. [Find more on shoe selection here.]

Orthotics: Custom orthotics can help correct foot imbalances and improve your posture, which may relieve lower back pain. The catch-22 with orthotics and overly supportive shoes, however, is they create dependency.  Instead, we challenge our patients to strengthen their ankles and feet, as well as wear shoes appropriate for them. 

4. Muscle and Tendon Connections

Tight or Weak Muscles: The muscles and tendons in your feet are connected to muscles in your legs and lower back. Tight or weak foot muscles can lead to compensatory movements and imbalances that contribute to lower back pain.

Click for more! Want specific shoe recommendations? Find Dr. Amanda’s favorites here>>