Are The New Rocker Sole Sneakers Worth The Hype?

Patrick DeHeer DPM FACFAS

If you are like me, you have had patients and nurses ask you about Shape Up shoes (Skechers). My first impression of these shoes was negative since Masai Barefoot Technologies (MBT, Masai Group International) shoes came out. My experience with a rocker sole shoe was singular for my postoperative ankle fusion patients.

With increasing numbers of patients asking me about these shoes or wearing them, I thought I would do a little research on them to either confirm my judgment or change it.

These shoe technologies are based on our walking on hard surfaces, resulting in an unnatural gait and subsequent inefficient muscle utilization. These shoes with a rocker sole, kinetic wedge and soft foam inset in the Shape Ups and the Masai sensor beneath the heel and rocker sole in the MBT shoes create a natural instability. This natural instability is much like using an exercise ball or dumbbells to engage your stabilizing muscles. This works your muscles harder to maintain natural balance.

A common scenario is that these shoes simulate walking in sand, which engages core muscles and reduces shock and stress on lower extremity joints and the back. In an independent study commissioned by Skechers, Steven Gautreau, DC, NASM, showed that Shape Ups lead to an average weight loss of 3.25 pounds, reduction of body fat by 1.125 percent and an average improvement of glutei strength and low back endurance by 41 and 37 percent respectively.1

With these types of results and others supporting MBT shoes, what are the concerns? The first thing that stands out when reading reviews from users on various sites is the weight of the shoes is a big detriment to many people.

The main concern I have had with both of these shoes is they make equinus worse. I think equinus is the root of foot evils and most of the population has equinus. You might think the recessed heel would put a stretch on the Achilles tendon but most people who wear these rocker sole types of shoes tend to hit the start of the rocker sole at heel strike instead of the heel itself. I think this will make equinus worse. Additionally, the active engagement of the Achilles tendon will also cause the Achilles muscle to hypertrophy and contract.

Like many things, there are good and bad qualities for these shoes in my mind and their use should be based on individual patient needs. I do think if patients are going to use these shoes, an active Achilles stretching program is required.

I am interested to hear what readers have to say on this topic.

Reference

1. Available at http://www.skechers.com/info/shape_ups_clinical_case_study4

Comments

The rocker sole shoe category is exploding. By my count, there are over 40 brands of shoes incorporating some type of rocker.

The most common rocker sole shoes are heel-to-toe rockers, and the advertising is heavily skewed to the Skechers and MBT brands. These brands are designed to induce instability in all planes of motion. While these shoes are well-tolerated by many, they are less suited for those with ankle instability, loose ligaments, excessive pronation and other pathologies where better medial/lateral support is needed.

Other brands, like Ryn, Mephisto Sano and Finn Comfort "Finnamic" are heel-to-toe rockers with exceptional medial/lateral stability, and have sufficient depth to accept custom or over-the-counter orthotics, if needed.

Here is a video comparing and contrasting rocker-sole shoes:
http://www.youtube.com/watch?v=20mc99zOiwc

Regarding your concern about the Achilles tendon, I am not a doctor but I do know from wearing my shoes that MBT shoes can be used to stretch the Achilles by lengthening your stride and striking your heel fully. By doing that, you start at a dorsiflexed position and roll into the rocker motion. However, that should only be done for a short period of time (2 to 3 minutes)to avoid overstretching the Achilles tendon.

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