Healthy Feet Rx

Friends, our feet are the hardest working parts of our bodies. Standing, walking, running and jumping use the feet as both a lever for propulsion and a cushion for landing. When the feet are not working properly, the muscles inside the foot - called the intrinsic muscles - become weak and dysfunctional. The effects can be felt throughout the body in the form of fatigue, inflammation and pain. The knees, hips and low back start to protest vehemently while bunions, plantar fasciitis, hammertoes, neuropathy and other foot problems are created or exacerbated.

What Leads to the Above Dysfunction?

Quite simply, it is our shoe choices, gaits and postures that contribute to the atrophy, deterioration and weakening of the delicate structures of the feet. 1 in 4 of us suffers from chronic foot pain but are completely unaware that we are creating our own discomfort and injury with the shoes we wear and the ways in which we walk and stand. However, the good news is that if we are the source of our aches and ailments, then we can certainly improve our foot health just by becoming more cognizant of our shoe selections and our everyday movement habits.

Fix-the-Feet Rx:

1.) Foot Position - Every step we take is a result of our gait cycles. Thus, proper foot position is critical so that our gaits do not produce trauma. Very few of us walk with the bones of our feet pointed directly in front of us, and this stresses our musculoskeletal systems. It is helpful to walk with the toes straight ahead and to adjust the feet in this position gradually if we are unaccustomed to it.

Furthermore, when we walk and stand, it is ideal to feel 4 points of contact under each foot: under the big toe, under the pinky and under each side of the heel. This maintains neutral foot alignment and prevents the foot and ankle from excessive inward rolling patterns (pronation) and excessive outward rolling patterns (supination). Finally, let us remember the 4 distinct phases of the gait cycle: heel strike, foot flat, heel off and toe off. This permits a smooth and efficient “heel, ball, toe…” action to prevent shuffles, trips and falls.

2.) Barefoot Walking & Toe Spreading - 25% of the number of muscles and bones in the body are below the ankle. This means that the human machine has a ton of tissue meant for freedom of movement, not for the confinement of shoes. It also means that the feet are able to be just as dexterous as the hands. However, the feet are rarely worked to their full potential because they are bound up in shoes all day. This leads to overuse of the ankles as they are put in charge of the hinging and balancing movements that the feet are created to do. It also contributes to pain, injury and a lack of balance.

Imagine how ineffective we would be if we wore shoes on our hands while performing activities of daily living! We habitually handicap our feet the same way. When we begin to take our shoes off more often and walk barefoot, or even in socks, we will reactivate the muscles of the feet. In addition, if we wear toe spreaders (as the photo of this blog depicts) for a few minutes daily, we will regain what shoes take away: the lost art of toe spreading. Teaching tight toes how to spread improves the circulation, function and neurology from the brain to the feet. Balance improves, and pain diminishes. Nutrition to the Feet = Less Foot Pain = Less Whole-Body Pain!

Toe spreaders are widely available and can be used as we sit and relax. I recommend starting with short, frequent bouts - 5 minutes / 3x per day. It is normal for the muscles of the toes and feet to respond by cramping because they probably have not contracted in such a manner in years -if ever! With consistency, we can expect to tolerate 30-60 minutes or more at a time, and the feet will function and feel great.

Caution: Do not sleep with toe spreaders on, and please consult your physician before using toe-spreading devices.

3.) Shoe Choices - All shoes are not created equal, and the body has to compensate for various types of shoes in different ways. Slip-on shoes, for example, do not attach well to the heels of the feet. In order for the shoes to remain on, the toes have to grip and squeeze very tightly. Gripping toes lead to balance deficits, hammertoes and neuropathy AND are the very movement habit that toe spreaders are trying to eliminate from our repertoire. Slip-on shoes are also slip-off shoes! They absolutely increase the risk of falling.

Shoes with narrow toe boxes are another concern. As with slip-on shoes, a narrow toe box trains the toes to remain very tight, immobile and “squished together.” The fancy name for this “squished” muscle action is toe adduction. The bottom line is that if we cannot freely move our toes in our shoes and engage in the gentle stretching motion of toe spreading - also known as toe abduction - then our footwear is damaging our feet. This will be evidenced by toe, foot and calf cramping; poor balance; neuropathy and the formation of hammertoes and bunions.

High heels should also be avoided at all costs. Any shoe that elevates the heel puts undue strain on the body by producing torque. This forces the musculoskeletal system to produce counter torque. Now the feet are wearing out just to compensate for poor shoe choices. It is wise to choose negative-heeled shoes where the heel is slightly lower than the ball of the foot. This returns the mass of the body over the heels and away from the front of the foot.

4.) Posture - As we honor the proper foot-contact principles discussed above, we will be better equipped to stand properly in neutral spinal alignment and avoid the very common but unhealthy posterior pelvic tilt position. We can recognize this detrimental posture when we observe our stance from a side view. We will note that our hips and torsos are pushed forward and that our bottoms tend to tuck under. The hips also drift forward of the shoulders. In other words, the shoulders and the hips are NOT aligned vertically.

This asymmetry decreases foot function because the majority of the body weight shifts onto the small bones of the feet, and they are not designed to sustain such load. Learning to hold ourselves with the ears over the shoulders, the shoulders over the hips and the hips over the ankles is the most nutritious posture.

5.) Exercise Therapy - While traditional foot correctives (orthotics) can provide some pain relief, restoration of foot function through exercise is required to improve and maintain the overall health of the feet. Treatment of ANY foot condition is incomplete without practicing corrective exercises to increase circulation, stimulate muscles and nerves and remove waste from damaged tissues.

Our Prognosis: The Rx to fixing our foot pain is here! A bit of exercise, some modified shoe habits and a change in the way that we move our bodies throughout the day will dramatically improve our pain-free mobility AND ability to live well. Let’s do this together!