This information is intended as a general introduction to footwear. As each person is affected differently by balance and dizziness problems, speak with your health care professional for individual advice.

It is important to give your feet special attention. They are the foundation of the body. They keep us balanced when standing, walking or running.

Balance and feet

We maintain balance by controlling the centre of mass of our body relative to the base of support (our feet). This is done through 3 parts of the balance system:

• vestibular (inner ear balance mechanism)
• visual (eyes)
• proprioceptive (skin, muscles and joints)

Proprioceptors are nerve endings that send signals to the brain from the muscles and the sense of touch. They relay information about position, motion and equilibrium.

The proprioceptors in the feet are a critical part of the balance system. Many nerve receptors give feedback to the brain based on the pressure exerted at various points of the body. This allows the body to automatically make suitable movement patterns, including adjusting for balance. If proprioception is compromised, the ability to balance is reduced.

Mechanics of walking

Mechanics refers to the motion of the feet and legs during the gait cycle. There are 3 phases to this cycle:

• Contact – the leg is swung forward and the foot hits the ground on the outer corner of the heel
• Mid-stance – the arch and foot collapse inward allowing the foot to absorb the shock and maintain balance
• Propulsive – the foot pushes off to start the next step

There are 3 main types of pronation (inward roll of the feet while walking):

• Neutral pronation (normal gait) – feet roll in the optimal amount
• Over pronation (flat feet) - feet roll in too far and the arches collapse
• Under pronation (high-arched feet) – feet do not roll in at all

As well as to putting undue stress on bones and muscles, balance is compromised when feet over or under pronate.

What is your pronation type?

Moisten your sole and step onto a dry surface such as a paper bag – look at your footprint. Refer to the diagram below to decide your degree of pronation. Which pronation type most closely matches yours?

Problems caused by over pronation

If you are flat-footed (over pronator), your foot collapses inward too much. A chain reaction happens. Your knees also turn in too much, as do your hips. This puts your back out of alignment. Undue stress is put on your joints and muscles as hey need to work harder to keep your body in alignment. Overuse injuries or undue fatigue are often the result. About 70% of people over pronate to some degree.

Problems caused by under pronation

If you are high-arched (under pronator), your foot does not collapse in at all. It stays rigid, providing minimal absorption of the shock when it strikes the ground. This is hard on the other joints in your body as well as the muscles in your legs: they have to absorb too much of the shock. About 10% of people under pronate.

Tips for buying shoes

Choosing the right footwear to complement your foot type helps correct for abnormal pronation mechanics. Making a good choice goes a long way towards reducing pain and discomfort. Suitable shoes are especially important later in life. Buying shoes is not as simple as looking at a wall of shoes on display and asking to try your size in the pair that you think looks the most appealing.

There are many more things to consider when buying shoes. These include:

• Correct fit – if you measure as a size 8, it does not necessarily mean that you will be an 8 in every shoe. Shoes are manufactured in many different lengths, widths, depths and shapes. Each model is built on a different last (form on which shoes are constructed) and the size can vary.
• Correct flex point – feet bend the most at the balls of the feet; this is where shoes should flex when you bend them. It is also where the shoe begins to “rocker” (flex) to assist with pushing you forward (propulsion).
• Suitability for chosen activity – do not wear a dress shoe to take your dog for a walk, for example. Instead, choose a proper walking shoe. If you mainly walk your dog on hills or grass, consider a trail shoe with more tread and a better grip.
• Snug fit – shoes that are too loose or sloppy are a tripping hazard. Chose a suitable closure (laces or  Velcro®) to make sure your shoes are secure on your foot.
• Be aware of shoes that are too soft – soft shoes may feel comfortable when you try them on in the store, but your feet may be unstable in them. Shoes need to have the right amount of ability to withstand twisting (torsional stability) to suit your specific needs.

Orthotics

Depending on foot type and mechanics, you may benefit from orthotics (shoe inserts). Orthotics can help improve the efficiency of your mechanics and keep you in good alignment when you walk or run.

They can also help to distribute your body weight more evenly, which will reduce the ground reaction forces and maximize cushioning. All of these can help with balance.

Orthotics can be bought over-the-counter or custom made depending on the needs of your feet and type of footwear.

Different orthotics may be needed for different pairs of shoes. As shoes have different shapes, an orthotic that corrects one pair of shoes may not be useful for another.

Source

Neufeld M. Effects of Footwear on Gait and Balance. 2016. Presentation to Balance & Dizziness Canada.