Vibrams Are Out, High Heels In
Clinic system dress code changes
Kelly Milano, DC Student
Beginning in the summer quarter, new dress code changes, developed and recommended by the Student Council’s Clinic Committee, will be implemented in the clinic system at LIFE. While most of the changes to the dress code may be minor, one change that continues to concern me involves Vibram’s 5 Finger shoes. The CC-HOP (a.k.a the student clinic) banned them several quarters ago. However, the C-HOP (a.k.a. the outpatient clinic) had continued to allow them, as long as they were the more conservative styles of black or brown. According to the new rule, this type of footwear will no longer be acceptable in either clinic, despite their reputedly beneficial proprioceptive and postural effects on the body. 
In my opinion, this is a mistake. According to the testimonials of individuals who have worn Vibrams, including myself, many report a large decrease in their low back complaints. As a chiropractic student, this is what I strive to do on a daily basis – reduce my patients’ pain complaints, realign their spines and bring them into optimal health. When I began wearing Vibram 5 Finger shoes, I began to notice that all the pain in my L4/L5 area was greatly diminished. As long as I wear my Vibrams, I am pain free. As soon as I begin to wear other shoes, I start to slowly notice the return of the pain in this area, ultimately leading to an antalgic posture to try to reduce the additional stress being placed on these vertebrae.
As chiropractors, we pursue an understanding of how posture affects our body and overall health. Thus, when we consider the importance of the biomechanics of the foot, it is easy to see how by simply allowing our feet the freedom to function as they were created to function, we could effect changes throughout our bodies. When we have a dropped arch, for instance, it can have an effect on the ankles, the knees, and ultimately into the hips and spine. Within these two feet are 52 bones, 66 joints, 40 muscles, ligaments, tendons and hundreds of proprioceptive and sensory receptors. The thousands of neurological receptors within the foot continually send important information to the brain regarding the type of surface the body is walking on, which signals alternative muscles to fire in response. According to Vibram’s website, “Actively stimulating these receptors improves balance, increases circulation, and enhances overall foot health. There are more bones in the feet than any other area of the human body with the exception of the hands. When our feet are confined in shoes, it’s as if we are placing them in casts. The toes, which are designed to evenly disperse the weight and force of our body and help us balance, are placed tightly together and not allowed the freedom of movement they were designed for. Eventually our toes lose their ability to move individually as the tiny muscles weaken and potentially atrophy. The muscles and ligaments that hold the arch up are so used to being supported by the arch of a shoe that without the shoe on our foot, the arch drops and results in flat feet
A foot in a normal shoe. Notice the angulation of the 1st metatarsal
as well as the position of the 5th. This leads to altered biomechanics through the
whole body and into the low back and spine.
Feet in Vibrams, showing a much more proper alingment of the toes.
As students, we are taught the importance of proper foot kinematics and the importance of adjusting and taping dropped arches to help offer support, but we continue to encourage shoes with ‘arch support’ instead of understanding the importance of creating and maintaining the health of our arches on our own, independent of the shoe’s support. Vibrams encourage the creation of proper foot biomechanics and arch development. Because the shoe does not have a strong arch support, it preserves the natural demands on
the musculature within the foot, allowing the body to strengthen the arch without additional support of a shoe or tape. New research is currently suggesting the importance of not putting young infants in ‘walking shoes’ as our mothers did to us. Not wearing shoes allows children just learning to walk to feel the floor underneath their feet, helping them to establish better balance as proper gait cycles and proprioception develop.1 The reasoning is that a minimalist shoe will continue this process in the adult foot, as well.
Postural compensations are unavoidable while wearing shoes that elevate the heels and most shoes do this to an extent. Even ‘flats’ and men’s shoes have a heel on them and most tennis shoes have a thick pad in t
he back, again elevating the heel. These postural compensations and distortions are necessary to maintain balance when the heel is elevated off of the ground and the body weight pushed forward from the center of gravity. It’s part of the reason why, when we do postural analysis, some chiropractors have their patients to take off their shoes, as having shoes on will alter our findings. Chronic use of a heel often results in some degree of kyphosis in the lumbars and lordosis in the thoracics, thus leading to additional pain in the low- and mid-back.
While we, as students, understand the importance of maintaining a professional look in clinic, we also understand the importance of proper postural alignment throughout the body. We understand that being barefoot is the best option, but due to hygiene and safety issues, being barefoot in public is not acceptable. Those who have worn Vibrams in the clinic have found them to be a great teaching tool for our patients.
It is ironic that high heels are considered acceptable in clinic and but students are no longer allowed to wear shoes that improve our posture and benefit our body’s biomechanics.
The horrible positioning of a shoe in high heels. Notice the pressure and put on the metatarsals.
1. Rossi WA, Children’s footwear: launching site for adult foot ills. Podiatry management 2002; 83-100.
