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  1. With the recent production of specialty shoes that are on the market, there have been many questions about the unusual designs that claim to be beneficial for foot health. The two most controversial of these designs are the MBT shoes and the Vibram Five Finger Gel shoes.

    The MBT shoes have an anterior and posterior rocker sole bevel. The midsole is cushioned. This shoe design is ok for people who have excellent muscle balance and good ankle/foot alignment, but can be problematic for people who have various musculo-skeletal imbalances and/or orthopedic issues.

    From an alignment perspective, the shoe is unstable. According to MBT, this is intentional: “the ground no longer feels flat and stable, so the body has to compensate and create stability” (http://us.mbt.com/Footer/Company/About-Us.aspx)

    The argument implied here is as follows: if the support surface is unstable, the body will become more aware of which muscular action to initiate to create stability, and in the process, will develop better muscle balance. Of course this is good if one is physically able to accomplish stability through using one’s own musculature, however, not everyone can accomplish this. It is unfortunate that the population of patients who have lower extremity orthopedic imbalances may gravitate toward this shoe with the idea that they will be able to restore normal function by wearing the shoe. It is in this light that I suggest consulting with your physician and/or orthotist prior to buying a pair of these shoes so that you can make an informed decision as to whether or not this shoe will be good for you.

    The Vibram Five Finger Gel shoe is another in the line of specialty shoes. This design was introduced as the trend to run barefoot became prevalent. The shoe has some cushioning, and integrates a separate space for each toe in the forefoot of the shoe. It doesn’t have a traditional toe-box.

    Here again is a shoe that might work well for someone who has good muscle balance and ankle/foot alignment. The feature of this shoe that is potentially problematic is the negative heel height. The standard for heel height in athletic shoes has hovered between 5/8″ and 1/4″ for many years now. This standard heel height range has been intended for runners who have a heel-to-toe style that is common in distance running. Sprinters, on the other hand, run toe-to-toe. For a sprinter, a low heel can be beneficial for performance in competition. The Vibram shoe may be a wonderful option for sprinters, but may cause stress on the calf and hamstrings in distance runners.

    Folks who will often have a problem with this shoe design are those who have tight posterior musculature and tight achilles tendons.

    I suggest consulting with your physician and/or orthotist prior to buying a pair of these shoes so that you can make an informed decision as to whether or not this shoe will be good for you.

    There are many other shoes out there that are touted as being the next big thing. If your foot and ankle health is excellent, you can probably try them all. However, if you develop symptoms of any kind that correspond to when you began using the new shoes, it is worth discussing this with a member of your healthcare team.

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