Aging & ArthritisFoot & AnkleJust PostedPain


Physician heal thyself. I often ask myself “Is this something I would do for myself or my mom, or my child?”

I often recommend stiff-soled-over-the-ankle-lace-up-hiking boots. I developed some pain in an arthritic joint in my foot. I knew I would get it someday. The sad, long-term result of bunions and high heels. Sure enough, about 8 months ago, the pain began. I followed my own advice, and went to a camping store, found the stiff-soled, over the ankle hiking boots, and began wearing them every day. Within two days, my pain was gone. But I also noticed how youthful and stable my gait felt. I felt I was walking like a 20-year-old again. WALKING mind you. Not necessarily FEELING or LOOKING twenty again. I’m not attributing any more than my loss of pain and youthful gait to those shoes, mind you.

A few weeks later, my mom developed a stress fracture in her foot. Stiff-soled-over-the-ankle-lace-up-hiking boots to the rescue, with similar results. We’ve both been wearing them ever since.

I recommend this type of shoe for a variety of conditions in the foot and ankle, including, but not limited to the following:

  • Achilles tendonitis
  • plantar fascitis
  • arthritis of the ankle, foot or toes
  • pain in the arch of the foot
  • chronic ankle sprains or instability
  • while recovering from ankle, foot or toe injuries, instead of wearing a cast boot long term
  • stress fractures or stress reactions of the foot
  • various repetitive strain disorders of the foot and ankle

Stiff-soled: When you try to bend the sole, it is stiff, and not flexible like your jogging shoe.

Over-the-ankle: It can be ¾, or just over the ankle if you have a foot problem, but should go higher if it’s an ankle problem. Tighten the laces all the way up.

Hiking boot: Lace-up work, combat or western boot as well.

Many will succumb to vanity. The rest of you…give it a try for any of those conditions. But don’t blame me if your hair keeps turning grey.

  1. Cindy

    I have very flat feet. My arch actually collapsed on on foot and my doctor prescribed an AFO. He’s ordered an AFO now on the other foot to try to prevent the arch in that foot to collapse. I wonder if the hiking boot would save the same purpose?

    1. Barbara

      It sounds like you have a condition called posterior tibialis insufficiency, a condition in which the tendons on the inside of your foot wear out, causing the collapse of the arch. I’m sorry, if that’s the case. It is a complicated problem. Yes, the hiking boots can help, and in fact could possibly even prevent the problem in early cases. I have used them for this purpose on my patients. However, in some patients, their foot is so flattened and the deformity so severe, that they cannot tolerate the pressure of the boot against their foot. The same can happen with arch supports. But give it a try. Don’t just go buy the boots. Try on several. Walk around the store in them quite a while before making the purchase.

      Also, read my Sit Like A Man post, as this is one of the conditions that is more common in women, and I believe is affected by the mechanics of our lower extremities, and exacerbated by our tendency to sit ladylike. When I Sit Like A Man and get in and out of chairs like a man, I pay attention to the alignment of my foot and ankle, as to diminish the pressure on those tendons that help support my arches.

      Best to you, and I hope this helps. Obviously, I haven’t examined you, and don’t know your case, so if this doesn’t help, or it hurts, then please don’t use this advice!

  2. Dianne Field

    Great article! I don’t have any of the specific issues you noted, per se, but I can see where hiking boots would be effective. I forget about mine, unless I’m actually going hiking,. 😉 I will definitely hang onto mine! Thanks.

    1. Barbara

      Thanks! Well, wear them sometime when you’re just tooling around and see if you feel more stable in them. They did a study on a bunch of older folks, having different groups try different shoes, and following them, recording the number of falls in a two year period. The groups wearing flats and flip flops had the most falls. The group wearing any shoe that came above the ankle had fewer! There’s no way I’m going down in these boots, unless someone pushes me!

  3. DONNA T.

    Great advice ~ I started wearing them after my knee replacement and revision due to being left crippled . They help me with balance & stability !

    1. Barbara

      I’m glad you discovered the hiking boots! So many patients, particularly women…are reluctant to wear them. But women, especially as we age, are most likely to benefit from not falling down!

  4. carol

    Dr. Bergen are you able to offer up some suggestions as to brands and style names? I have always felt like my ankles are “weak”. My whole life I have fallen easily if i step on an uneven surface. Just yesterday, stepped on a rock on our driveway, turned ankle and fell hard. It’s never concerned me too much – remarkably I have only had a mild break in my ankle after one of these falls – but now that I’m 70 I’m thinking I really need to minimize these falls! Perhaps the hiking boot is a good solution. Thanks!

    1. Barbara

      Yes I can make some suggestions, but in the end, you will have to pick the one that fits you best. My mom and I are both wearing Oboz. It’s a lovely boot. Very easy to lace up. Fits a moderately narrow foot. For a wider foot, you might look at Keen or Merrill. You will love the stability.
      Consider doing single leg standing exercises. They really help improve lower extremity stability, and they studied this in 80-year-olds, finding fewer falls and hip fractures I. The group that did single leg standing exercises. I do them every day. Read my post regarding Fall Prevention. If you have a lot of arthritis, you might not be able to do them though.

  5. Linda Thompson

    Dr. Bergin, you always have the most interesting posts. Thank you so very much. Always SLAM, ever since reading your post. Noticed it even helps to kneel like a man in church. There is no need to lean my butt back on the pew.
    Very similar to Cindy, have had Posterior Tibialis Dysfunction both legs, one year apart. Used walking boot three months each time. Have custom-made orthotics, and some good store bought ones, that wear without fail. Unfortunately, right foot bunion surgery years ago, and the podiatrist, unknown to me, did NOT repair the bunion as I thought, just shaved the bone. He also did not correct the hammertoe properly. That second toe now curls under. Actually, the corn that grows in between big toe and hammertoe is more uncomfortable than the bunion itself. I shave the corn down, or have the nurse do so in the doctor’s office. Of course, it is never totally gone.
    Went for a few opinions. Tried to talk the orthopedic and/or podiatrists into correcting just the hammertoe, due to the painful corn. But as you know, they said that will not work. It is all or nothing. So have two questions, if I may:
    1. Am afraid that the left leg will take too much weight, and while right foot heals from surgery the PTD could return. That leg had TKR about ten years ago as well, so is the weaker leg.
    2. One doctor said he would fuse the bunion. But am worried that could cause some issues with the posterior tibialis on the surgical leg. Fusing sounds so extreme. Want to be able to bend the big toe.
    Any thoughts would be appreciated. Of course, realize you cannot diagnose, but as all the doctors are male, perhaps there is something in the female bone anatomy that they are not taking into consideration. At this point, am thinking will just live with the situation, and continue to SLAM and KLAM. Will begin shopping this week for hiking type boots, inserting the orthotics. Thank you again.

    1. Barbara

      You have a complicated problem, and it’s hard for me to wrap my head around it. There’s really no simple answer for your foot problems. From what you tell me, I think I can figure out why your surgeon says he can’t simply correct the hammer toe. There is a primary problem which would have to be corrected or the hammer toe will come right back. PT insufficiency is a very complicated problem, with a complicated surgery to correct it. You can try the hiking boots. It’s not going to correct the deformities, but it might give you some pain relief. Keep in mind however, that you might have difficulty finding one to fit your foot. Try Keen or Merrill. They have a wider and deeper toe box, which might better accommodate your hammer toe and bunion deformities. Sorry I can’t be of more help. It’s hard when I haven’t seen your foot or X-rays.

  6. Pat Celaya

    I had a hairline fracture in my right foot. My local doctor put me in a fancy, inflatable walking boot. If you don’t have hip or back problems BEFORE wearing that thing, you WILL after your wear it for 5-6 weeks!
    Dr. Bergin suggested I try some stiff-soled-over-the-ankle-lace-up-hiking boots.
    I’m a believer! Much more comfortable than the walking boot.
    Thank you Dr. Bergin!

    1. Barbara

      Thanks Pat! For every action, there is a reaction, and while casts and walking boots are necessary, they can sometimes be a necessary evil, in terms of the secondary effects.

  7. Mark Goodman

    It’s rather funny that you suggest a hiker. I’ve worn them most of my adult life. I mostly wear house shoes these days though. You see, as a teenager I was hit head on by a drunk driver…..driving a Cadillac no less. My femur was pushed thru my left hip, smashing it into many pieces. Luckily there was a doctor on call that night that was able to help me and my girlfriend, who sustained numerous injuries that night as well.
    I’ve spent many wonderful years traveling & exploring, hiking & camping and hunting & fishing. But it’s finally time to replace the original reconstructed hip and I was wondering if you had any recommendations?

    1. Barbara

      Wow! You had a serious injury! Very dangerous. I’m glad things went well for you and your girlfriend. You probably have developed post-traumatic arthritis of your hip. When it’s bad enough, and you’re old enough, and you’ve tried an extensive course of co see stove treatment, then you can have your hip replaced, if that’s what’s causing your pain. Replacing hips that have been damaged by trauma is always more complicated than a routine total hip replacement. Look for an experienced total joint specialist.

  8. Sheila Rheaume

    I am very active physically, (elliptical and recumbent bicycle) but because of arthritis of the knee, I have developed Flexion Contracture. I work so hard with a physical therapist to keep the knee strengthened and to keep the permanent bend in my knee from getting worse. I wear lifts in the heel of my shoe to keep from putting so much pressure on my hip of that affected knee.
    I have come to realize it will never straighten and the only answer is replacement. Is that a correct assumption, or do you know anything else I can do? (I am not completely bone on bone laterally, but I worry about my hip.)
    What percent of patients with arthritis of the knee develop this contracture? It’s is weird.

    1. Barbara

      Unfortunately, it isn’t unique. Many patients with arthritis develop slight knee flexion contractures, and sadly, it just creeps up on them. You have to prevent it, which means recognizing it early. Most patients have a fixed contracture before they realize what’s going on.

      And for every action, there is a reaction. If you have one knee contracture, eventually the other one gets contracted, then the hips and back. Then the ankles.

      If there is still some flexibility, you can push it and try to stretch. That’s between you and your doc and physical therapist. Otherwise, it gets fixed when you have your total knee replacement. The surgeon will remove enough bone or release enough soft tissue to get your knee straight. However, BE WARNED that many of those patients still re-develop the contracture after the surgery, because their muscles aren’t used to straightening the knee, and because no one pushes them to do it, because they don’t really see it as a problem…if an older person walks around with a slightly bent knee. You have to work on it aggressively…in the face of that post operative pain! You have to remind your therapist that you want to get that knee straight! Don’t let it get contracted while you wait to have the other knee done! Do your exercises every day, until the straight knee just comes naturally, or else that contracture will slowly creep back!

      I’m going to do a post on this! Thanks for the reminder!

        1. Barbara

          Well, it really depends on the problem of course. If you need shoe lifts because of a leg length discrepancy, then yes. I sometimes use heel lifts for Achilles tendonitis. So, in some cases, yes I would, and I’d put them in hiking boots as well.

  9. B

    I know in a previous post you mentioned Dansko clogs as being a good shoe option. I have recently read that they are hard on knees. I had a meniscus root repair in August, prior to that I had worn a clog shoe to work in. I am a kitchen manager and on my feet for about 8 a day. I am 48 years old and the clogs made my feet and back feel great but I am concerned about if they are going to affect my knees, I would like to avoid ever having knee surgery again.

    1. Barbara

      More recently…mainly since wearing the stiff soled over the ankle lace up hiking boots (SOABs), I have stopped wearing the clogs, and for the most part have tossed almost all of them. I keep a few around for ease of application…like if I’m going to make a quick run for something and don’t have time for putting on the SOABs. Once I started wearing the SOABs, I realized, relatively speaking, just how uncomfortable and potentially unstable I had been in the clogs. Once your ankle starts to tip in the clogs, you’re biting the dust. There’s little room for recovery. I’ve been wearing them for a couple of decades! Oh well. Now I’m in a better place, and maybe it’s just because I’m 65, and need more coverage, more stiffness in that sole, more stability and more contact. Whatever it is…it’s all good.

  10. Lamia Kadir

    History of Plantar fixed by acupuncture. Post tib tendon helped with flat shoes. Now a failed ankle surgery as a result on Dansko-induced sprain causing an osteochondral lesion:( I dont have the time for the “big” surgery and not in pain, just cant run, and always protecting it:( NAME YOUR BEST hiking boot:) on a budget.

    1. Barbara

      You can find a good hiking boot on a budget, if you just search the Internet or go shopping at sales. If you live in the US, you can go to stores like Walmart, Target or even Tractor Supply and find cheap work boots. They work fine. When I send patients to search for stiff soled over the ankle lace up hiking boots, I usually don’t give a brand name. I tell them that the boot has to be lace up over the ankle, it has to have some firmness in that area, and they should test the sole by bending it, to make sure it’s stiff. I’ve had some patients find them at discount stores and websites for $25. My personal favorites are my Oboz, but they were expensive. But I’ve seen my patients in some very cheap boots that worked every bit as well and were pretty darn cute! For gals, that’s important! Look on Internet under work boots rather than hiking boots.

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