#849 How dress shoes with long toe box act as a lever to stress plantar plate - DOC

#849 How dress shoes with long toe box act as a lever to stress plantar plate

Today on the Doc On The Run Podcast, we’re talking about how dress shoes with a long toe box can actually work as a lever against your plantar plate.



I recently did a consultation with a runner who had gotten a plantar plate injury and he treated it himself doing a lot of the things that I teach in the plantar plate course for runners. He got better, he was protecting it, he reduced the stress and strain on the ligament, and he got back to running. He was wearing running shoes that he knew protected it better than his old running shoes and he was doing great.

But then he had a setback and he said that what happened was he actually went to the synagogue one day, and he was dressed up and just going and wearing some fancy dress shoes, he started to get pain again and that pain has persisted since. We were having a discussion and I said, “Well, I don’t know what shoes you’re using. But there has been a trend in fashion that you have these dress shoes that have this exceedingly long, narrow toe box and from the side, they look much longer than regular shoes.”

There’s a famous quote, you may have heard it. It said, “Give me a lever long enough and a fulcrum on which to place it and I shall move the world.” And that’s from Archimedes and what he was saying is really simple is that the more leverage you have, it’s a simple thing with mechanical advantage. And what does shoes and plantar plates have to do with this quote?

Well, it’s really simple. Let’s imagine you’re changing a flat tire, you get your spare tire out, you have to take off the tire, you have lug nuts that hold it on. Lug nuts are very big, and they’re very tight. So, if you have a lug wrench that comes in the back of your car, in a little kit that comes with a spare tire, it’s probably about a foot and a half or maybe even two feet long. And the longer it is, the easier it is to crank on those lug nuts and get them loose. If instead you had a regular wrench that fit on the lug nut, but it was only four inches long, it might be 100% impossible for you to get those lug nuts off because it’s not enough leverage.

The shoes work against you in exactly the same way. When you have a shoe that has a short toe box and it’s stiff and it has curvature on the toe box, you roll across the shoe. When you have a shoe that is fashionable, flat, leather, has flexible soles, and if the soles are flat, it has to bend, otherwise you couldn’t walk. And if the toe box gets narrower and narrower, narrower as it ends out being longer than a normal toe box and you put it let’s say next to your running shoes and the toe box looks longer than your running shoes, that is a lever at the end of your foot.

Where does it bend? Right at the plantar plate ligament under the metatarsal phalangeal joints. And so, if you have a shoe that has a long pointy toe box, and it’s flexible and it’s flat, then every time you take a step and your heel comes off the ground, you’re actually stretching the plantar plate ligament apart and the longer the toe box, the more force it’s applying to do that.

He actually said, “Well, those are exactly the kind of shoes I was wearing.” And we know that that’s what really messed him up. So, if you get a plantar plate injury, you want to look at your shoes very carefully make good decisions about that.

I go through that detail on the plantar plate masterclass as well where I talk about all the strategies I use with runners who get plantar plate sprains like this and who want to get back to running. It’s the same stuff I teach to physicians and medical conferences as well. If you want to check it out. You can join me in the plantar plate masterclass. You can even send questions to me in advance, and I’ll discuss those during the masterclass. You can join me for free www.docontherun.com/plantarplatemasterclass. So, go check it out, and I’ll see you in the training.