Posture doesn't matter, until it does.

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Awareness is key. Does this person know they are doing this ?  Do they have pain? If they do not have pain or awareness is it a problem and does it need addressed ? These shoes did not make this person load like this, the person broke the shoes into this pattern.  There is something going on, the question is what drove this ?  Most likely, this is not a footwear problem, this is a person problem in the footwear.

What we see is not the problem most of the time. We are seeing their strategies , coping mechanics and their ultimate failure to load more cleanly most of the time.

There are people out in the fields that are saying posture doesn't matter, that your next posture is your best posture. This is a bit curious to us.  Sure, if you are not in pain then is a given posture a problem? One could argue that, but not with a strong argument, we believe.  Take this foot-shoe posturing for example, is this a problem if it is not painful ?  Do we leave it alone if it is not painful? Or do we "head this one off at the pass" before possible pathology or pain presents itself? There are certainly no guarantees, however, one can use some educated and calculated logic and make some reasonable decisions that things are going to go off the rails at some point (or in this case, the heel is going to actually go off the shoe!).  Same for the anti-posture nazi's out there who say posture is not a factor in people's lives.  We are not going to call out people on there personal beliefs, but for us, that is just too extreme thinking. The concept gets some great social media attention, but if you are slouched 90% of your day in a chair or standing at a job, those postures might carry over into other activities and thus matter in time, carrying into aberrant tissue loading.  In our minds, posture does matter, because movement on postures that foster challenging mechanics, lead to challenging loading responses on tissues, and over time, that means change.  Change can be good or bad, sometimes it is how you drive the bus.  Posture can matter in many cases, dismissing if fully is foolish.

So, are you going to change this person's footwear ? Bring it to their awareness ? Look for problems in there body mechanics locally and globally? Or are you just going to say, "foot posturing doesn't matter". Saying it is not a problem, until it is a problem, seems awfully negligent, doesn't it?