Os Trigonum Syndrome and Rocker Bottom Shoes (who should not wear shape ups, tone ups, or mbts)

The frequent plantarflexing and dorsiflexing (extension and flexion at the ankle) of a foot can lead to Achilles Tendonitis, an inflammation from over-use and contraction of the achilles tendon, otherwise known as the heel cord. Recently, I’ve developed pain in my left achilles tendon by the heel. Being a physical therapist, I thought hey, I could do my runner’s stretches achilles stretches and I’ll be okay. For weeks, I struggled with the pain and the modalities at work (ultrasound, paraffin wax, ice pack) did not help. So I went to my podiatrist. After a few x-rays, it was revealed that I have os trigonum, an accessory bone in the foot from the talus bone, pressing on the heel-cord by the heel.

Signs of the syndrome include pain with dorsiflexion and plantarflexion at end range, pain with push off at the big toe with gait, swelling around the achilles tendon, tenderness with palpation and squeezing. Being a proponent of rocker bottom shoes like MBTs, of course I would like to continue to wear them even though the pain has gotten worse.

But the physical therapist inside of me knows better. With os trigonum (along with flat feet, over-pronation, cracked navicular bone leading to painful posterior tibial tendonitis and contracted ligaments– i am a foot surgeon’s dream patient, basically my entire foot needs to go under the knife, remodeling!), I should RICE my foot (rest, ice, compression, elevation) and actually stop wearing my rocker bottoms. I should actually immobilize the ankle from plantar and dorsiflexion until the pain decreases. (Should also take a week off from work, because it’s not fun for my patients when their therapist is in constant pain.)

So though rocker bottom shoes seem like miracle shoes, there are many instances in which people should not wear them. Painful achilles tendonitis that gets worse with wearing the shoes– stop wearing rocker bottoms. Painful Os trigonum syndrome– stop wearing the shoes. People with advanced diabetes and peripheral neuropathy, very weak and easily sprainable ankles, and people with bad balance to begin with (especially vestibular problems) should avoid these shoes until you get to practice walking in them with an experienced therapist or podiatrist (podiatrist hate these shoes by the way).

People are so into the fat-loss fad and mini-gym in a shoe that they think these are miracle shoes. And unfortunately, these shoes do not come with warnings. (And though you will tone your muscles with these shoes, you will not lose any weight in fat)

These shoes come from money-targeted companies such as Reebok, MBT, Sketchers, Avon. These shoes are great when worn in moderation by relatively healthy individuals. Many people who would want to wear these shoes, however, should probably not wear these shoes. Please do your research prior to buying an expensive pair of rocker bottom shoes. I am still a fan of them; however, I will start to use my own pairs in moderation. There are no miracle shoes out there yet, unfortunately, and hopefully, in the future, these big companies will start putting out warning labels about who should not wear these shoes and when these shoes should not be worn.

One thought on “Os Trigonum Syndrome and Rocker Bottom Shoes (who should not wear shape ups, tone ups, or mbts)

  1. Thanks for this timely info. We have quite a few clients who are seniors, many with diabetes and other disabilities from stroke related issues. We’ve had some ask whether shape-ups will help with therapy and rehab. We usually tell them they need something with good circulation and stability that also provides support and comfort. We never thought that flexing could be a problem but now we can pass that on. More people should know about this.

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