Rocker Bottom Shoes Make The World Go Around
Rocker bottom shoes are one of the most common type of shoe I recommend. They are very helpful for specific foot and ankle problems. There are very effective in offloading the forefoot area. When you view these shoes from the side you will notice that the sole curves upward from the mid-foot to the toes. The greater the curving or “rockering” (I just made that word up) of the sole the less the foot has to bend.
Before rocker bottom shoes were available, regular shoes had to be modified by adding a special sole. This would be done at a shoe repair shop. Unfortunately the neighborhood shoe repair store has gone the way of the full-service gas station and telephone booth. Now they can be purchased at most running shoe stores or specialty shoe stores.
Rocker bottom shoes were really trendy from 2000 – 2010. You could hardly turn on the TV without seeing commercials for these shoes. They claimed that they would make your behind look better and burn more calories. Unfortunately these claims were not true. Thanks to this deceptive advertising campaign a few of the manufacturers had to pay big fines ($40 million) for atonement. Don’t even get me started about advertising claims made by shoe manufacturers!
Most of the rocker bottom shoes vanished from the market shortly after this. These shoes became very hard to find. Although they are not as trendy as they once were, rocker bottom shoes have found a very niche market. The resurgence is generally due to ultra-distance running. These are the people that warm up with a marathon (26+ miles). Fortunately there are a few manufacturers that have reentered this niche market.
The “rocker” part of the sole allows the foot and ankle to roll forward and reduce the force of impact. The more aggressive the rocker, the more protection and offloading will be noticed. The trade-off is a different “feel” when walking. This is barely noticed by most people but some may find it awkward or notice an unbalanced feeling.
Few Run Marathons, But Most Us Have Foot Problems!
If the foot bends less, the body has to work less. This is the big attraction for ultra-distance runners. The athletes that use rocker shoes notice greater comfort and less injuries. This is important for people that do not run. Rocker bottom shoes also provide comfort for specific foot and ankle problems. Hallux Limitus (stiff big toe joint) is the most common problem that benefit from a rocker shoe. Typically great toe joint should have 70 – 80° of upward movement (dorsiflexion). Walking down the street requires 30 °- 40° of movement. When a person has less than 30° of dorsiflexion, every step produces a collision of bone, discomfort, and joint damage. If the shoe can produce a virtual improvement of 10 – 15° of movement, the joint no longer gets beat up. More motion means more activity. Just ask Patrick Mahomes.
This protection can also help metatarsal pain as well as midfoot and ankle arthritis. Additional indications include previous stress fractures and neuromas. The benefit are found with walking, running or standing for long periods of time. I have noticed that over half of my surgical team wears this type of shoe. (They stand all day long).
In addition to the rocker bottom, a stiff insole also limits motion in the forefoot. See this video to find out how to test a shoe.
Protection vs Correction
Not all rocker shoes are created equal and some will have more aggressive curves than others. For some of my Hallux Limitus patients, adequately protecting the joint motion can actually delay the need for surgery. I have also noticed that many of my surgical patients continue to wear rocker shoes after surgery. That is a testament to how comfortable these shoes are.
Other problems that a rocker bottom shoe can help:
Capsulitis is discomfort under the metatarsal head(s). This is generally accompanied by hammertoe deformities. Most rocker bottom shoes will also have extra depth that make room for contracted toes. It is very common for pain in this area to be misdiagnosed as a neuroma.
A Neuroma is a nerve irritation between the third and fourth toes. It produces tingling or burning that extends into the toes. A Capsulitis will hurt under a met head but does not extend into the toe.
Rocker bottom shoes have been used to treat Plantar Fasciitis. Any relief from the rocker is most likely related to a heel raise. Unfortunately this may be a temporary effect. If the Achilles tightness is not addressed with an aggressive stretching program symptoms will eventually return. Plantar Fascia relief is through a rigid heel counter. Not all rockers have this. (I hope you watched the video).
The rocker protection can also be found in other footwear. Work boots may have a rocker bottom as well as hiking/backpacking boots. As a rule, they will also have a rigid sole (another plus).
Remember, one shoe will not solve ALL foot problems. If the goal is to put surgery off as long as possible, a rocker bottom shoe may be a good option. Some of the rocker shoes are designed for extreme activity, but they may also let you be more comfortable with every day walking. When it comes to treatment, there are two choices – protection versus correction. Protection may win the battle but we are dealing with a long war.