Rocker Shoes Can Help With Lower Back Pain & Postural Problems

Rocker shoes or rocker bottom shoes incorporate a rounded sole that increases instability, thus activating muscles that help stabilize the lower back. This can reduce pain, improve posture and balance.

They come in shoes, boots, sneakers and sandals, offering solutions for exercise as they can be used in daily life and work activities. No special routine or equipment other than the shoes themselves.

Unstable rocker shoes were developed as a walking device for strengthening the leg muscles and reduce damaging effects of joint loading. In a study, those wearing these unstable shoes showed significant decrease in pain scores compared to those wearing regular shoes in participants suffering from chronic low back pain.[1]

In another randomized controlled trial, registered nurses with back problems and related disability wore unstable shoes for 36 hours per week for a month. The authors concluded, “Wearing unstable shoes reduced low back pain and disability in nurses and might be helpful as part of the back pain rehabilitation process.”[2]

By measuring the effects of unstable rocker bottom shoes on trunk muscle activity in patients with chronic low back pain, the authors of a cross-sectional study were able to conclude, “Based on these findings, the use of unstable shoes may be implicated in promoting spine stability, particularly in improving neuromuscular control of the trunk muscles in CLBP [chronic low back pain] treatment.”[3]

I have had my MBT’s for years and they are like new. One of the benefits I found was decreased back pain with prolonged standing. Consideration for one’s condition is important. Standing in the rocker shoes produces a 21% reduction in pressure under the midfoot, with an 11% reduction under the heel. So, it takes pressure off the midfoot and heel, but increases pressure under the toes. So, there is a shift in pressure towards the front of the foot.[4]

There some documented effects in pain reduction in patients with moderate knee osteoarthritis when wearing rocker bottom shoes due to a reduction in the side to side center of pressure.[5] They can effectively reduce variability in walking throughout the reactive forces of the body or kinetic chain from the foot to the shoulders, while increasing lumbar spine motion, promoting dynamic joint stability.[6]

Unstable footwear designs simulate an unstable surface, requiring activation of stabilizing muscles to maintain balance. It is common to see devices like rocker boards for performing exercises in an unstable environment to induce the stabilizing and synergistic muscles around a joint system.

For the lower back, co-contraction of the erector spinae of the back and the rectus abdominis muscle if the front (antagonist muscles) is a strategy for lumbar spine stabilization. This is a reasonable strategy using unstable shoes, compensating for trunk instability, challenging the postural control system, strengthening the leg and trunk muscles for exercise and rehabilitation, with just a new pair of shoes.[7]

Lumbar spine posture is associated to the angle between the trunk and the hips. With decreased median hip flexion and a reclined trunk, back stability may increase and help prevent back pain. Using rocker sandals was able to reduce moderate lower back pain in golfers without negatively affecting performance.[8]

Do Rocker Shoes Help

I would say they may be worth a try. If you have just sustained an injury, it is not the time, but if you are healthy and looking to prevent back pain, influence posture or have a chronic or long standing issue, rocker bottom shoes may be a piece of the puzzle towards managing back pain through promoting spine tissue health.

Spine stability may be increased due to better neuromuscular control of the trunk or core muscles, which has proven benefits in some cases of lower back pain. It has been shown that unstable shoes contribute to improvements in disability related to decreased lumbar spine motion and trunk muscle activity.[9]

For posture or we can relate it as standing or gait ergonomics, the destabilizing effect of an leads response of more efficient and accurate postural commands. Prolonged usage increases performance and effectiveness of the postural control system reflected by center of pressure variables around joints and in reorganizing postural control commands and related influences on the nueromusckuloskeletal system.[10]

Reference:
1. Joint Bone Spine. 2014 Dec;81(6):527-32
2. Clin Rehabil. 2016 Feb;30(2):167-73
3. Gait Posture. 2018 Jul;64:165-168
4. Gait Posture. 2007 Apr;25(4):648-51. Epub 2006 Aug 9.
5. Med Sci Sports Exerc. 2006 Oct;38(10):1701-8
6. Gait Posture. 2019 Mar;69:60-65
7. Eur J Phys Rehabil Med. 2016 Aug;52(4):440-6
8. Clin J Sport Med. 2009 Nov;19(6):464-70
9. Clin Rehabil. 2018 May;32(5):654-662
10. Hum Mov Sci. 2016 Feb;45:142-53