Point-Counterpoint: Can Toning Shoes Have A Legitimate Impact?
Aside from the toning shoes’ benefits on muscle toning and core strengthening, this author says one can also incorporate the shoes into treatment plans for numerous podiatric conditions.
By David Y.S. Yee, DPM, FACFAOM
In recent years, rocker-sole toning shoes have garnered an increasing share of the athletic shoe market. Patients in my practice have asked about them on a weekly basis and many new patients have presented wearing toning shoes when establishing care with my office.
Just as television and magazines have heightened patient interest in brand-name prescription drugs and driven physician prescribing habits, media impressions have driven patient interest in rocker-sole shoes. This has forced us to look into the possibility of prescribing these shoes or at least have a working knowledge of them.
How do they work? Rocker-sole shoes, according to advertiser messages, improve balance, improve muscle strength and tone, maximize calorie burn, reduce joint impact, improve circulation and improve posture.1,2 Their effect is a result of the inherent instability of the shoe’s design, which facilitates sagittal plane motion. The foot and lower leg “rock” forward as weight transfers from the heel to toe during gait in a smooth progression. This changes the forces acting on the joints and activates muscles to control some of the instability.3,4
While the recent, highly publicized American Council on Exercise study refutes the claims that rocker-sole shoes impact exercise intensity, calorie consumption, muscle strength and muscle tone, be aware that the study design had many shortcomings.5 The test subject group was small, the timeframe of the study was short and the study only measured the shoes’ effects on muscles proximal to the ankle joint instead of the smaller extrinsic foot muscles that researchers believe are neglected when people wear more traditional athletic shoes.6 By comparison, numerous studies have confirmed the small but definite benefits of rocker-sole shoes in the areas of muscle workload, postural sway and metabolic activity.6-9
What The Literature Shows About The Clinical Benefits Of Rocker Sole Shoes
In addition to their advertised, exercise-associated benefits, rocker-sole toning shoes can also be helpful in treating a variety of foot problems.
Metatarsalgia. Whether due to bursitis, capsulitis, neuroma or osteoarthritis, metatarsalgia is aggravated by abnormally high forefoot pressures during weightbearing and gait. The use of rocker-sole shoes can allow for a smoother, faster progression of weightbearing pressures across the foot and distributes weightbearing pressure onto the heel and arch, away from the metatarsal heads.10
Digital fractures. Rocker-sole shoes decrease forefoot pressures during gait but paradoxically increase pressures on the tips of the toes.11 While this finding would suggest that this would cause pain and inflammation in patients with digital fractures, the stiff midsole of the rocker-soled shoe will prevent movement of the fracture fragments. Whether patients use it alone or with a forefoot “stiffener” made of cardboard or wooden tongue depressors, the rocker-sole shoe can be an “inconspicuous” postoperative shoe.
Hallux limitus/hallux rigidus. The stiff midsole and rocker sole allow smooth transition of weightbearing pressures from heel to toe without causing dorsal jamming of the first metatarsophalangeal joint.10
Plantar fasciitis. The raised heel elevator/soft rearfoot wedge relaxes the tension on the plantar fascia and reduces heel strike pressures. The raised heel elevator also relaxes the Achilles tendon and therefore reduces the tension on the plantar fascia from the windlass mechanism.10