foot pain

November 9, 2011 Posture

How to fix flat feet

Are flat feet genetic? Do people with flat feet face a lifetime of supportive shoes and corrective orthotics? What causes flat feet, exactly?

Actually, about 20% of the American population has so-called “flat feet.” This is defined as a foot that has no discernible medial arch. If you ask a flat footed person to step in paint and then make a footprint on butcher paper, you’ll get an imprint of the entire surface of his foot.

But how do we get flat feet? Many people attribute it – incorrectly, in my opinion – to genetics. If your parents had flat feet, you will, too.

The reality is that we’re all born with flat feet. Arches are created, not born. We develop our arches by standing and walking on our feet, preferably barefoot. When shoes enter into the picture, that’s when things get a little caddywompus.

Back in 1905, Dr. Philip Hoffman did a survey comparing the feet of people who wear shoes to those of people who grew up barefoot. The study was published in the American Journal of Orthopedic Surgery. Fortunately for us, Hoffman also took a lot of photographs to illustrate his point.

Exhibit A – The feet of a non-shoe-wearing native hominid (or, in plain English, a barefoot person)

As you can see, this person’s feet look a bit like hands with the toes splayed wide and lots of space between each digit. Also, note the line drawn through the foot on the right; it runs directly from the big toe through the heel.

If we compare this to the feet of a shod person, or someone who’s worn shoes their whole life, we can see a massive difference:

Notice how the feet in this photo have taken on the shape of the shoes and there is no direct line from the big toe to the heel. How do you think this affects the functionality of the foot, let alone balance? Not so good.

Even more disturbing is the fact that shoes make this change to our feet relatively quickly. Here’s a photo showing a comparison between an adult who has never worn shoes and a child who has only had shoes on for 3 months. 90 days is all it takes to completely inhibit the natural function of your feet!

Researchers in India found that wearing shoes before the age of 6 is correlated with a higher incidence of flat feet. 8.2% of children who wore shoes had flat feet compared with 2.8% of children who ran around barefoot.

So, if it seems that shoes are the root cause of flat feet, why are flat footed people constantly hearing recommendations for arch supports, orthotics and other foot-altering technology?

The reality is that we’re a shoe wearing society (why we wear them is beyond me…what’s the first thing you kick off when you get home and are ready to relax?). We also love technology, and thanks to Nike, we’re conditioned to believe that our feet need tiny pillows under them to function properly.

Also, there’s no financial investment in the advice to “just” strengthen your feet, no $100 sneakers or constantly changing custom orthotics to purchase. When you put your feet into these supportive devices, however, it’s like putting your arches in a wheel chair. The orthotics do all the work and the muscles of your feet become flaccid.

Your arches are meant to expand and contract with every step. They’re built in shock absorbers, plus they launch you forward as you walk, making your gate much more efficient.

Orthotics, arch supports, sneakers and shoe inserts make you feel better temporarily. Collapsed arches are correlated to collapse through the core, so giving your feet a lift will result in you feeling lighter…as long as you’re standing still. The problem is, as soon as you take a step, your arch’s natural function is inhibited, meaning you have to compensate with other, less efficient muscles.

This contributes to tight quads and hip flexors, which cause lower back pain…but before I go on a rant about the importance of the foot in postural health, let’s take a look at what you can do to strengthen your flat feet and avoid the money pit of built-up footwear.

First, and most importantly, ditch any footwear that is is stiff, inflexible or provides arch support in any way, shape or form. While you’re at it, toss out your high heels (okay, you can keep a few pairs for special occasions, but if you’re serious about fixing your flat feet, you’ll want to stay as close to barefoot as you can 98% of the time). This includes, but is not limited to, the ugliest shoes on earth, Dansko clogs.

Despite their clever branding and endorsements by nurses in hospitals everywhere (who, despite their numerous and admiral medical accomplishments, have zero training in posture or structural function), these are perhaps the worst shoes you could possibly wear. Not only do they not bend, they also have a molded foot bed that promotes inversion of your transverse arch which makes natural toe function completely impossible. 100% of my clients with lower back pain have inverted transverse arches.

Next, go barefoot as often as you can! Going barefoot is the best way to stimulate the sensory perception on the bottoms of your feet, which in turn causes different muscles in your lower legs to fire. These muscles are the ones that support your medial arch, so as you wake them up, your arch will also come alive.

Walking barefoot in sand is great extra credit because it’s an ever changing surface and causes you to flex, extend, invert and evert your foot. These movements will stimulate the proprioceptors in your ankle joint, which will in turn cause your posture to shift for the better without you having to do any additional exercises or training.

Once you’ve instituted these first two changes, you can start strengthening your feet with specific drills. Spreading your toes as far apart as you can is one way to flex your foot muscles. Hold the stretch for as long as you can. If you can’t spread your toes (like me when I first started this), check out Yoga Toes. It’s a great aid to use until you have a little more control over your foot movement.

Another fantastic arch builder is to use your toes to pick things up and move them. Try spreading a bunch of marbles on the floor and put a bowl next to the marbles. Using your toes, pick up the marbles and drop them into the bowl. This promotes dexterity and strength in your foot.

You can also try standing on your toes for periods of 30 seconds to a minute. Most of us have weak toes because, as you can see in the pictures above, our shoes squish our feet together and make toe function difficult. Standing on your toes will, again, wake up the sensory perception and get the muscles of your feet firing differently.

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February 16, 2011 Pain Relief

What Every Plantar Fasciitis Sufferer Must Know

What is Plantar Fasciitis?

Plantar fasciitis is a painful foot condition where the plantar fascia – a thick band of connective tissue extending from the heel to the ball of the foot – becomes inflamed due to overuse or too much tension. Plantar fasciitis causes a lot of pain to those who suffer from it, and it makes it difficult to perform normal daily activities like grocery shopping, walking and carrying purses or briefcases. Athletes who suffer from plantar fasciitis have to limit their workouts, making it difficult to stick to an effective training schedule.

You know you have plantar fasciitis if you have a sharp pain in your heel or just in front of the heel that is usually worse first thing in the morning but gradually lessens as your foot warms up throughout the day. Stretching the plantar fascia along the bottom of your foot will be painful, and increased activity may make the foot pain worse.

But what causes this painful foot condition?

There are a number of potential causes of plantar fasciitis, but in general, the inflammation and degeneration of the tissue is caused by excessive strain on the bottom of your foot. Of course, “excessive strain” can be anything from being overweight to pregnancy, high level athletics (especially running) or poor body mechanics due to old injuries or surgeries.

Those who stand and walk for long periods of time, especially on concrete, are more likely to develop pain in the bottoms of their feet. Tight calf muscles, illiotibial band tension and imbalances in the hips can all contribute to imbalanced body mechanics that place excess strain on the plantar fascia over time.

People who pronate (roll their feet inward) chronically overstretch the plantar fascia and may develop plantar fasciitis, especially if they are active in dancing, running, or other sports that put a lot of strain on the feet.

Plantar Fasciitis Treatment

While most practitioners recommend supportive shoes to eliminate symptoms of plantar fasciitis, I disagree. While arch supports and rigid shoes can be helpful when the symptoms are acute, the human foot is a marvel of engineering that is brilliantly designed to support the weight of your body and facilitate walking and running.

With the advent of athletic shoes, we’ve become addicted to cushion and support, believing that our feet cannot function properly without a lot of extraneous material holding us up; however, the world-record for a 26 mile marathon was set by Ethiopian Abebe Bikila who ran the entire race BAREFOOT.

When you add too much support to your feet, you inhibit their natural function, causing them to be lazy and flaccid. Here are a couple of exercises you can start to perform now to eliminate the symptoms of plantar fasciitis and prevent future foot pain:

Practice picking up objects, such as pens or marbles, with your toes.
Lay a towel on a hard surface, like a hardwood floor. With your bare foot, scrunch the towel up using your toes, then spread it out and repeat.
Roll the bottom of your foot on a tennis ball to alleviate tension in the plantar fascia.

No matter how long you’ve suffered with plantar fasciitis, you can get relief. Do these simple exercises daily and you’ll be back on your feet in no time.

December 15, 2010 Pain Relief

Arnica: The Pain Reliever No Household Should Be Without

Aches and pains happen, especially when you’re training at the gym or exerting yourself in any heavy lifting activity, like moving. And as we age, we’re prone to other painful conditions like osteoarthritis.

But you don’t have to suffer with muscle soreness and stiffness. You can get relief without risking some of the frightening side effects of NSAIDs (non steroidal anti inflammatory drugs) such as nausea, upset stomach, shortness of breath, heartburn or skin rashes.

There is a natural solution that I highly recommend instead: Arnica Montana. Arnica is a plant native to mountainous regions of Europe and North America that has been used for centuries as a topical pain relieving agent.

A controlled randomized study from 2007 found that daily applications of arnica gel were just as effective as ibuprofen for relieving pain from osteoarthritis.

There is a slight risk of allergic reaction to a compound called hellanin found in arnica, so test on a small bit of skin before rubbing it all over. If you do experience a slight rash, simply stop using the gel.

While arnica gels abound in health food and supplement stores, the brand that I most recommend is Traumeel. It’s widely available and extremely effective with a synergistic blend of arnica and other anti inflammatory homeopathic agents.

So, the next time you find yourself stiff, sore and achy, get yourself some arnica gel, rub it on, and breathe a sigh of relief as the pain melts away!

December 4, 2009 Pain Relief

Could Your Feet Be the Source of That Pain In Your Neck?

“The human foot is a work of art and a masterpiece of engineering.”

-Leonardo DaVinci

Okay ladies, I know you love those cute shoes you scored for a screaming deal on Black Friday! The cute heels (that really aren’t too high), peep toe, patten leather…how could you resist, right? Shoes absolutely make the outfit! And, believe me, as a 6’0″ woman who spent years wanting to minimize my height, I’m very aware that finding an attractive flat shoe is much easier said than done.

But, your feet are the foundation for your entire body structure. The human foot is comprised of 26 bones, 33 joints, and over 100 muscles and tendons. All of the tiny structures of your feet combine to create a supportive yet resilient structure that carries you in standing and moving.

Unfortunately, Western society suffers from “Urban Foot Syndrome;” our feet are habitually crammed into poorly designed footwear that cramps and limits the movement of our bones, joints, tendons and ligaments. Further complicating the issue, when our feet fail us and plague us with pain and inflammation due to the fact that they’re squished into faulty footwear, we add more devices, lifts, arch supports, and other “corrective” paraphernalia to our shoes in an effort to prop the foot into a natural position.

All of this stabilization of the foot negates is natural purpose: movement! Have you ever felt a cat’s paw? Have you worked your fingers between their toes, squished around the tiny little bones? If you have, you’ll know how soft and malleable their feet are. If you haven’t had this experience, quick, find a cat, preferably one with clean paws and trimmed claws!

Our feet should be as soft and pliable as the cat’s paw. This would allow us to adapt to uneven surfaces, like rocks, dirt paths, hillsides, tufts of grass, etc. Urban warriors live in a world of paved roads and paths, staircases built into our city trails. Everything is smooth and even, so our feet don’t have much of a chance to feel what it’s like to walk with the earth.

The images below are from a study published in 1905 by the American Journal of Orthopedic Surgery.

Notice how the shod feet have restructured themselves to look exactly like the shape of the shoes. That’s not a natural shape for a human foot! Even more frightening is the below image comparing a modern, high-heeled shoe and ancient Chinese foot binding.

“When a woman wears a high heeled shoe, the anatomy is changed and the pressure is put on the heads of the metatarsals rather than the base where it is designed to be (shown in the picture).” Beverly Hills Aesthetic Foot Surgery

High heels are a form of modern day foot binding. They make our feet appear smaller, cuter, and make women look taller. Rarely does a trip to Nordstrom or Macy’s reveal hot new trends in flexible, natural footwear. Our footwear is mostly driven by the fashion industry, and stilettos aren’t showing any sign of vanishing soon.

Raising the heel any amount affects the posture of the entire body, shifts the balance of weight in the foot, and causes changes to spinal curvature. As you can see in the diagram below, there is a natural plumb line that falls down the lateral side of your body (Figure A). When you are standing with your weight properly balanced over your feet, the spine and back are relaxed and balanced, allowing freedom of movement.

In Figure B, the addition of high heels shifts the plumb line. It’s impossible to stay upright with weight centered over the eye of the foot (the space just in front of your heel) when wearing heels. Instead, it’s necessary to contract the muscles of the lower back, pulling your weight over your center of gravity again. As you can see in Figure C, this causes increased curvature of the lumbar spine (lower back), resulting in back pain and other tension throughout the body.

What does a natural foot look like? Studies done by the American Journal of Orthopedic Surgery show that in native barefoot population of the Philippines and Central Africa, the toes spread easily and naturally to create a wide base of support for standing and walking. Also, you can draw a line from the big toe through the ball and heel of the foot. No such line exists in the shod foot.

The world-record for the marathon was set by Ethiopian Abebe Bikila. He ran it in 2:15:17 at the 1960 Olympics in Rome.

Barefoot.

“People have been running barefoot for millions of years and it has only been since 1972 that people have been wearing shoes with thick, synthetic heels,” said Daniel Lieberman, a professor of human evolutionary biology at Harvard University. Studies and anecdotal evidence alike have shown that the thick-soled, highly supportive shoes popularized by companies such as Nike have done nothing to decrease injury and incidences of plantar fascitis. From a purely functional standpoint, these shoes just don’t make sense.

Your foot was created to be the perfect springboard, propelling you forward with every step. There is a highly sophisticated system of ligaments connecting the bones of the foot. Three arches transfer weight during walking: medial, lateral, and transverse. The medial arch is the one most people are familiar with and is found on the inside of your foot. The lateral arch runs parallel to that, and the transverse arch is just behind your toes.

Your medial arch collapses with each step as the weight of your body comes over it. The ligaments stretch, triggering proprioceptors (cells that tell your body where it is in space and how much each muscle fiber has been stretched). The proprioceptors send a signal to your brain that they’ve been stretched, causing a contraction to take place that propels the arch upwards, and your body forwards.

When you insert an arch support under this amazing structure, it defeats the whole purpose of having an arch in the first place. Yes, now your foot is lifted and you may temporarily experience less back pain, but in the long run, you’ve taken away your gas pedal. Now every step costs you extra tension and more work; you’re no longer moving forward efficiently.

That increased level of tension results in new, different aches and pains. The quadricep muscles become hypertonic – overly contracted – pulling your pelvis forward and causing your hamstrings to shorten in response. This results in…you guessed it! More back pain.

Natural walking feels like floating. It’s as though your body is suspended from an invisible hook in the sky as your feet glide across the earth, stepping effortlessly on hillocks, pebbles, curves and dips in the ground. The Native Americans commented with European settlement that the “white man bruises the earth with his step.” Natural walking allows you to walk with the earth, feeling the texture of the ground beneath your feet.

So how do you get the natural walking effect in an urban jungle?

The challenge for most of us is that, even if it were acceptable to go barefoot everywhere, it’s just not safe. The streets are littered with debris like broken glass and rusty nails, and no one wants a fungal infection from traipsing barefoot through gyms, grocery stores, and other high-traffic locales. But if you’re looking for that barefoot feeling, you’re in luck!

Lately, shoe companies have gotten hip to the fact that the Africans are kicking our butts in the Olympics…barefoot. They’re developing shoes that mimic the experience while still providing protection from the elements. Some of the best picks include the Vibram 5 Finger Technology and Nike Free.

“But I have flat feet…”

So do babies. Arches aren’t created until we start walking as children – and the key word there is created. Adding arch support to flat feet doesn’t create an arch, it props the foot up, like putting a jack under a car with a flat tire.

Arch supports may be appropriate for a time while you work to create a more functional foot, but you’ll want to wean yourself off of them by increasing the time that your foot is without support. Arch supports cause the muscles in your foot to become flaccid and lazy because the wedge is doing all the work. Strengthen your feet by walking barefoot (or in barefoot technology shoes), starting with 15 minutes a day and increasing the time by five minute increments each week. Also, simply laying a towel on a slick floor, such as tile, linoleum, or hardwood, and using your bare foot to scrunch the towel and then spread it out again will work the muscles of the foot, building your arch.

For athletes and other active individuals, I highly recommend training barefoot. I competed in kettlebells and always lifted barefoot – squats, deadlifts, cleans, snatches, keg walks, jerks…you name it, I was doing it barefoot. During competitions, I used a thin, bendable shoe that closely mimicked barefoot lifting. I even traded in my stiff, rigid riding boots for a flexible, moccasin-like boot that protected my foot while still giving me sensory perception and mobility for horseback riding.

You’ll be amazed when you begin to restore your relationship with your feet how your entire body shifts; tension melts, pain disappears, and you have more energy.