This is a good paper if you want to delve into the biomechanics of rocker bottom shoes (now termed “Hoka-type” shoes. The rocker effect is real to alleviate stresses across the ball of the foot (metatarsal heads). However, the components of rocker placement or apex of the rocker, softness or rigidity of the material used, and whether the shoe is true zero-drop or 4-6 mm can make huge differences. My patients are always experimenting with the heel height and rocker position to get pain relief. This can mean that they have different shoes for purely standing tasks, casual walking, exercise walking, and jogging. It sounds like a lot, but it typically starts with them getting one pair that works okay for one activity but not another. You can ask them when the shoe really helps or not at all. You can tell them all the components that make these shoes change the biomechanics, and how they can experiment. One easy way is to have a patient with soreness walking go to a store that sells the Hoka and Altra lines and try various ones on. See if they can tell what makes their foot better or worse at least standing and walking around. Both these shoe companies have various rockers, softness variations, and Hoka does vary its heel elevation some. In a patient suffering from foot pain, this can be as equally important as getting them in the right orthotic device.
Conclusion from the paper:
“Biomechanical implications of rocker-soled shoes arise not only from the characteristic of the rocker’s profile, but also from the shoe sole material stiffness and the locomotion mechanics. A rocker-soled structure designed with an optimal apex and stiffness suited to step speed can induce a longer period in which both curve rolling and ankle rotation occur simultaneously. The possible mechanism is due to the conversion from vertical kinetic energy into rotational kinetic energy, which can effectively absorb the plantar force produced by gait”.
