Metatarsalgia, Morton’s Neuroma, Shoe Construction, and OESH

I know, that’s a lot but this post that I’ve been promising to write on behalf of all you OESHers who have told me that OESH has helped with metatarsalgia and Morton’s Neuroma, has been a long time in the waiting.

Pain in the forefoot, specifically pain in the ball of the foot, occurs far more often in women than it does in men. Metatarsalgia, Morton’s neuroma, and a loss of the fat pad under the ball of the foot are some common diagnoses associated with pain in the forefoot area.

Why does pain in the forefoot occur more often in women than in men? The obvious answer is that we women tend to have poorer choices in footwear. But perhaps not so obvious is that it isn’t just high-heeled and narrow and pointy-toed shoes that place greater pressure under the balls of our feet.

The sole in a typical women’s shoe, be it a dress, casual or athletic shoe, cradles the bottom of the foot. By cradling the bottom of the foot, I mean that the shoe sole curves up along the outside and the inside parts of the foot where we place our bodyweight. This cradling of the sole, which isn’t really noticeable until you dissect apart a shoe, has been standard to shoe construction for, well, a long, long time.

During the course of my 20+ years of research studying the biomechanical effects of footwear, I was observing that this cradling in the shoe sole adversely affects the forces up through the foot. Essentially, the cradling tends to bunch up the ball of the foot and focus pressures under the areas of the forefoot that most commonly become painful.
This cradling in a shoe sole gets more pronounced as the cushioning in the sole starts to break down – which occurs almost immediately with wearing a new shoe. The cushioning under the ball of the foot quickly becomes compressed, which creates even more pressure in that area.

What OESH uniquely does is provide compliance under the ball of the foot where pressures are most concentrated. The carbon fiber cantilevers that run across the width of the forefoot compress and release in tune with how our foot naturally wants to move — from the outside to the inside and back to the outside again. The side-to-side orientation of the cantilevers ensures that they compress and release when the forces and pressures through the ball of our foot are at their maximum.

What does that feel like? Well, many OESHers describe walking and standing in OESH like walking and standing “on a floating floor.” The compliance (compression and release) of the cantilevers is consistent across the bottom of the forefoot so that over time, throughout the life of the shoe, the compliance that OESH provides remains consistent and evenly distributed.

But back to the issue of cradling in the typical, non-OESH shoe sole, which I am sure is a contributor to forefoot problems in women. In developing OESH, I was relentless in making sure that it did not cradle the bottom of the foot like most shoes do. The cantilevers, which are flat from side to side, help ensure that the forces are distributed evenly across the width of the forefoot.

Eliminating this cradling effect in OESH entailed changing what is called the “last” of the shoe, which is the standard, uniform shape of the foot that shoes are constructed upon. The bottom of a typical shoe last is curved from side to side. This curve in shoe-manufacturing speak is called the “crown,” which in turn, forms the cradling in the shoe sole. I learned that virtually all women’s shoes, not just dress shoes, but women’s “comfort”, and athletic shoes have a fairly pronounced crown, especially in the forefoot.

I began asking all the many people I’d gotten to know in the shoe industry why this pronounced crown was standard when clearly it wasn’t good biomechanically. Most people outside the shoe industry assumed that it had some sort of biomechanical basis so I expected to hear what that basis might have been. But instead the typical response was “that’s just the way it’s always been done.”

Then I learned from one of the oldest people I’ve met in the industry what is probably the real answer. In the old days, when the shoe upper was attached to the sole, it was considered more elegant, especially in women’s shoes, to hide the stitching and the ends of the shoe upper material on the inside part of the shoe. Putting a crown in the shoe last simply provided the room to hide the stitching and excess material. Nowadays in shoe manufacturing, with sophisticated means to attach the upper to the shoe sole, that extra space really isn’t needed anymore, so the crown, from a shoe-making perspective, is completely unnecessary.

But the standard crown in shoe lasts and the resultant cradling in the typical shoe sole has become a longstanding tradition that is now very hard to break. Getting the factories I was working with to eliminate the crown and cradling in OESH was not easy. It involved new tooling, new equipment and new protocols. I wish all shoe manufacturers would eliminate the crowns from their shoe lasts and the resultant cradling in their shoes but I realize that doing so would be very costly given their current manufacturing infrastructure.

At least with OESH, I can ensure that there is no unnecessary cradling of the foot, as there is no crown in the OESH last and consequently all OESH footwear. And of course, OESH is the only shoe that compresses and releases under the forefoot at the precise time that the pressures in the forefoot are at their peak. It took a little tradition breaking to make OESH, but mostly it took some sophisticated materials (carbon fiber) and a lot of hard work.

OESH doesn’t specifically target any one condition. Nonetheless, more and more women who have specific conditions such as metatarsalgia and Morton’s Neuroma are going out of their way to tell us how much they enjoy their OESH. Many women have told us that they are able to stand and walk longer in OESH than in any other shoe. Clearly, they appreciate the unique construction of OESH and all the hard work behind it.

If you have metatarsalgia, Morton’s neuroma or pain associated with a loss of fat pad under the ball of the foot, please join in and let us know your OESH experience by writing us at service@OESHshoes.com.

2 Responses to Metatarsalgia, Morton’s Neuroma, Shoe Construction, and OESH

  1. Elaine Bell says:

    I had surgery on both my feet for severe Morton’s Neuromas in 2010. I also have a neuroma remaining in each of my feet, and very little padding on the balls of my feet. Too many years of bad shoes and high heels… Needless to say, I had trouble with walking, and had not been able to walk more than half a mile since the surgeries.

    I have to admit, I had doubts that the shoes would be any better than all the things I had tried in two and a half years – from Dansko through UGGs and so much in between. When I put the shoes on, I was shocked by how comfortable my feet felt. That day, I was able to walk further than I had walked since 2008. Over the last two months, I am building up my distances and am regularly walking three or more miles at a time again, which makes me more than grateful – and my dog is happy too!

    I have now had my OESH Lizards for about two months, and I can’t say enough about them! My friends and family have all gotten the “you MUST try these shoes!” and I know at least a couple have purchased. I am looking forward to the day when there is a “dress OESH” so that I can wear them 100% of the time!

    Thank you so much, from the bottom of my sole!

    Elaine

    • Casey says:

      Elaine, thank you for sharing this. And you’re right. Just letting your friends know about your experience is what OESH is all about!

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