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Some research out of Rush University in Chicago suggests that flip-flops or other flexible shoes may be easier on the knees than clogs or supportive walking shoes. I have to admit that I found this news contrary to what I have learned and what I usually advise patients. However, given all the recent interest in the running community about barefoot running, I must say I’m not entirely surprised. After reading the article, I asked for some advice from one of my foot and ankle orthopaedist friends on Twitter (@thomasleemd) and if you follow him, you can read his personal impressions of barefoot running. From the article,
“Stiffness is also a factor. We’ve shown in earlier studies that barefoot walking is associated with lower knee loads than walking with conventional footwear. It may be that the flexible movement of the bare foot is mechanically advantageous. The natural flex of the foot when it contacts the ground probably attenuates the impact on the joint, compared to the artificial ‘stomping’ movement created by a stiff-soled shoe.”
In the present study, Shakoor said, flip-flops and the walking shoe were flat, flexible and lightweight and seemed to mimic the mechanics when walking with bare feet.
“Clogs and stability shoes, conventionally believed to provide appropriate cushioning and support, actually increased the loading on the knee joints, as opposed to shoes with less ‘support,’ flatter heels and more flexibility,” Shakoor said.
Will this change how I counsel patients? I suppose I won’t be quite so hard on flip-flop wearers. However, those with foot pain or “fallen arches” may need the stability of athletic shoes or shoes that accommodate orthotics. Personally, I have so far tried out a few dog walks in plain old flip-flops instead of putting on my running shoes as I would have done otherwise.