Today I’m talking with Dr. Ray McClanahan of NW Foot and Ankle in Portland, Oregon about the four perils of modern footwear, how our feet have been negatively affected, and how that contributes to back, hip, foot and knee problems.

Together, Ray and I look at the effects of running on the feet and body, the Vibram controversy and how modern footwear causes many of our modern day foot distortions.

Dr. McClanahan hits on the important topic of transitioning from the unnatural to the natural when it comes to footwear and how we change the anatomy of our feet over decades of shoe use.

Also covered is high heels, flip flops and going barefoot and what place these have in our daily lives. Be sure to visit the NW Foot and Ankle web site (linked below) for great articles and videos to help you transform your feet and change your life! 

4 Perils of Modern Foot Wear:

1) Toe Spread– avoid shoes with a tapering toe box. Look for shoes that allow you to spread your toes without the sock liner.

2) Toe Spring– the side profile of the shoe should not have the toe box lifted above the ball of the foot.

3) Heel Elevation– causes shortening of the calf muscles. Look for a shoe with a lower heel drop. 

4) Torsional Rigidity of the Sole- a shoe that does not bend or twist. Look for a shoe with flexibility. 

Mentioned on the Show:

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Have thoughts on this episode or questions for Dr. Ray? Share below…  

Bumper Music: “I’m Gonna Be” – The Proclaimers


  • Kevin Geary says:

    From Michael Nevin: Am listening to you interview with Dr. McClanahan and want to add my experience to the argument in favor of zero drop shoes: while backpacking with boots which had about an inch heel I found myself stumbling all over the trail. Before we left I borrowed a saw and used my knife to cut the heels off and did not stumble once on the walk out. I had created my own zero drop boot.

  • Andy says:

    Thanks so much for your wonderful podcast; I love your thoroughly integrated approach and your inspiring positivity (tempered by an endearing humility)—and I appreciate that you are such a thoughtful, prepared, and effective interviewer as well. In particular I was fascinated by your discussion with podiatrist Dr. McClanahan. I have struggled with ill-fitting shoes—and uncomfortable feet—for as long as I can remember. My situation with ‘fashion footware’ (tapered toebox, elevated heel) has definitely taken its toll in all the predictable ways he described—unaligned ‘squished’ toes, the beginnings of a bunion, a falling arch—but in my case, it has been compounded by a problem I hear so frustratingly little about: I have long arches. This means that even as a child, wearing lace-up oxfords as a part of my school uniform, I had aching tired feet because the inner part of the arch (which should, as Dr. McClanahan stated, be ‘unsupported’ according to the principles of architecture) was SEMI-supported, leaving a whole extra gap of awkwardly unsupported arch in the front. I think it also means the widest part of my foot (I forget the term) was also squished into the ‘wrong’ part of the vamp. The most comfortable shoes I have ever owned (except for flat ballet shoes) was a pair I bought that were at least a whole size too large for me, which I took to the shoemaker and had him literally lop off the pointy toe to ’shorten’ the shoe. In that case, the arch of the shoe, made for a larger foot than mine, actually filled my entire arch, and my toes fit comfortably in the toebox. Besides that one pair of modified shoes, I have never… never…. had a pair of shoes that ‘fit right.’ I’ve played with all kinds of variations of makeshift padding/fillers to lengthen the arch in misc. pairs of shoes. For sport shoes, I’ve pulled out the sock liner and replaced it with custom [soft] orthotics. None of it feels right. In recent years I have tried to do right by my feet (I am in a circus troupe and our daily trainings include an hour of ballet-floor work; I do regular yoga; I use Yomuna balls every morning; I pad around at every opportunity in bare feet with toe-spacers) but sadly the worst is happening: my left arch is falling. There is actually a bone that two different chiropractors have identified as ‘out of place’ which they have whacked back into place with their special little hammer tool. It gets sore and achey and mildly swollen. My balance on that foot is almost nonexistent (it used to be rock-solid on both feet) and certain dance moves, turns in particular, seem to have disintegrated when initiated on the left foot; this is unspeakably frustrating. At the moment I am playing with Kiniseo tape (taping for arch support and also taping the 3rd and 4th toes together—which produced instantly [surprisingly!] visible results in my turns) and targeted exercises to try and build up the muscles and ‘save’ the arch. I stretch regularly (I am above-average flexible). But I am losing hope. So…. all of this to say, if you do have Dr. McClanahan on as a guest again, I would be so eager to hear him address the following specific issues: 1) long arches, 2) how to proactively address an arch that is on the point of collapsing but may still be salvageable. The first issue, in particular, is one which I think might resonate with many who share this problem. Shoes in the past couple of decades have become even more ‘generic’ than ever in terms of their last, and if you don’t have the wide, short-arched foot which is the LCD, it seems you are doomed to a lifetime of miserable feet. I have googled it many, many times, hoping for some kind of tag or discussion list that would identify brands geared to longer-arched feet… but to no avail. The second point I do realise was already addressed in your podcast—but apart from transitioning footwear and stretching, I would love to hear Dr. McClanahan’s other targeted strategies, and what he feels about Kiniseo tape as a gentle support that will [I hope?] allow for correction rather than dependency.

    • Hi Andy, I am friends and colleagues with Dr. Ray McClanahan and while I will not speak for him, I do understand (and believe very much in) his approach to footwear, foot problems, and foot health. First I want to say I’m sorry you have had such a hard time with shoes throughout your lifetime, but I do think there is hope! Dr. Ray has a shoe list on his website, while not specific to long arches, that lists recommended shoes. I would suggest looking over the list and trying on as many as possible to see which are most comfortable. The great thing about these shoes is that most of them are zero drop, do not have toe spring, have wide toe boxes and do not have a built in arch support – so there will be nothing interfering with your arch. I know Dr. Ray would recommend getting a comfortable pair and start wearing Correct Toes in them. This is allow your feet to work they way nature intended them to.

      The second thing, when thinking about your falling arch we have to remember that the body is a unit and everything is connected. It is very likely that your left knee, hip and many even shoulder are out of proper postural alignment and are not able to support your foot and arch from above. There are several way to show you this is happening. The first is just by logical thinking: if your footwear alone was the cause of your fallen arch, you would have the exact same fallen arch on both feet. You do not. This means that something else is contributing to the falling arch. The second way to realize more is going on than just your feet is to look at the rest of your body. Stand in front of a mirror (barefoot, shorts, and sports bra) and look at yourself. Do your knees point the same direction or does one turn in or out more than the other? Are your hips level or does one appear higher or more forward? Do your hands and arms hang evenly? Is one shoulder lower or more forward than the other? If you notice any imbalances in your body you can assume that they are playing a role in why your left arch is falling. When these postural imbalances are corrected by addressing the underlying muscle imbalances, your arch will have the best chance to strengthen and lift itself to a normal position again. To read more about the posture connection check out my website and blog: http://www.oregonexercisetherapy.com and I’d be more than happy to give you a free postural evaluation and help you understand what is going on in your body and how you can fix it. Best – Matt

    • Kevin Geary says:

      Thanks so much for your kind words Andy — I’ll let Dr. McClanahan know your questions are waiting and see if he has some time to jump over and comment.

      • Andy says:

        Thank you so much, Kevin! (Not sure it matters, but given that we’re talking heels and fashion footwear, I suppose it’s worth me clarifying that I am female.) ~A

  • Heather says:

    Who was mentioned in this article in the discussion about whole body alignment? It sounded like they have a blog or videos. Thanks.

  • Andrea says:

    Do you think it’s possible a severe case of Morton’s foot/toe could cause trigger points in the posterior tibialis and IT bands that don’t seem to respond to TPT, foam rolling, dry needling, PT, etc? Is a toe pad the best way to go about getting a handle on it?

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