These Shoes Are Killing Me!

These Shoes Are Killing Me! - Freakonomics Freakonomics

"SEMMELHACK: When I think about Chinese foot binding — which resulted in women’s feet being around three inches in size — it seems like such a profound body modification. But the fact of the matter is that all of us who have grown up wearing footwear have bound our feet to some extent. If we were able to meet our non-shod selves in a different dimension and look at what our feet would be like naturally, they would be much larger, much more splayed, rougher. In some ways the foot would become the shoe needed to make it through daily life because the body has the ability to build up calluses at the bottom of the foot...

DAVIS: One group stayed in a pair of cushioned shoes and the other group were given this five-dollar — in U.S. dollars — pair of shoes that were highly flexible. And what they found is, number one, their mechanics were more normal in the minimal shoe.

LIEBERMAN: In those barefoot populations, we find almost no incidents, for example, of people having flat feet. They just don’t exist.

DAVIS: But more importantly to these patients, they had significant reduction in their pain medication, and significant improvement in their functional outcomes. That’s just with a pair of minimal shoes.

LIEBERMAN: We look at incidence of musculoskeletal diseases. The evidence appears to be that they have really considerably lower rates of diseases like arthritis. It doesn’t mean that these people don’t have problems, of course they do. But they have fewer problems, it seems, in their feet, their knees, and possibly their hips...
When Osterman says that “getting over the fashion aspect” of shoes is hard for people, you may have thought he was referring to women’s high heels or men’s dress shoes, with their narrow toe boxes. He wasn’t. He was talking about his basketball patients...

OSTERMAN: When you’re in that higher heel, and anything really over an inch and a half, [it] throws your body forward enough that it puts a lot of stress on the front of the knees. The four muscles, the quadriceps — that come in the front of the knee that attach just beyond the knee, in the front of the shin — they have to fire constantly to give you some stability. Also, you will arch your back to try to keep you from not leaning forward. That combination puts stress on the knees and the low back. The short-term effect is overuse where the muscles are just not capable of handling it. The long-term is it affects the entire mechanics of how a foot works.

DUBNER: Have you ever had people come to you who want their foot surgically altered so that they will fit the fashionable shoes they want to wear better?

OSTERMAN: Once a week.

DUBNER: You’re kidding.

OSTERMAN: Most of them are just asking because when you tell them what’s really involved they really don’t want to have it done. You know, because once you start changing joints and re-aligning toes, then you really are throwing the foot into a whole different functional capacity."