Many patients with fibromyalgia don’t think of their feet as an area, that needs special care. But there are common foot problems in fibromyalgia patients. Many of us have:
- Poor mechanical alignment
- Insufficient shock absorption
- Poor weight distribution over the bottom of the foot
But wearing good shoes is one way we can ease the pain. Cushioning is essential for patients with chronic pain. Therefore, don’t get rigid-soled shoes with hard rubber or leather soles. Look for a shoe with adequate cushioning that you can compress with both thumbs. If you can compress the sole with your thumb, the shoe will compress adequately when your heel strikes the ground.
The sole of your shoe should be at least as wide as the sole of your foot. Wider soles give you better balance and weight distribution. Hence, high-heeled shoes with narrow soles reduce your balance and focus pressure on small areas of the foot—namely, the center of the heel and the ball of the foot.
When assessing a shoe, hold it at the heel and the toe, and then bend it. It should bend at the ball of the foot, not in the arch. That’s because your foot needs support through the heel and the arch, while it needs flexibility at the ball to allow proper function during the gait cycle.
I am often asked how high the heel should be for a patient with chronic pain issues. There is no simple answer. The lower the heel is, the more even the weight distribution. Yet, with a very low heel, many patients feel tipped backward. Therefore a slight heel with a 1/2 in difference between the height of the heel and ball of the shoe respectively is sufficient and often provides adequate stability. Avoid heels that pitch you forward and focus your weight on the ball of the foot.
Walking versus Running Shoes
The shoes that seem to work best are running shoes or walking shoes. What’s the difference? A running shoe has a “rockered” sole, which is sloped at the heel and at the ball of the foot to promote a smooth gait pattern. A walking shoe has a flatter heel and is rolled at the ball of the foot. Each type of shoe is optimized for the appropriate speed. But the rockered sole of the running shoe does offer some help for gait problems, because the rollover at heel strike is important to maintain a running pattern. I personally favor a running shoe, because it has a wider base of support, a rockered sole, and more cushioning.
What type of shoes do you wear? Is there a brand you can share with us?
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