I love feet!
No, not in the foot fetish kind of way but from an engineering perspective.
Looking at the foot helps confirm my faith in an intelligent designer.
Call it God, nature whatever.
It's very clear the foot is a miracle of architecture and function.
You have 26 bones, 33 joints, and over 100 muscles, tendons and ligaments in your foot.
Your feet absorb 8 times your body weight when you walk and 11 times that when you run.
Let's look at what happens when you walk.
And where I'm going with this is that most of us because of modern day shoes are walking and running all wrong.
When
you walk barefooted, the way you were meant to, your toes should splay
outward in order to process that force transferring through them.
In modern shoes your toes can't do that. Shoes are basically like having a cast on your feet.
Imagine
if you wore a pair of tight mittens on your hands all your life. You
should not be surprised that you would lose the ability to move your
fingers very well. Same thing happens with your toes.
Over time they stay essentially glued together, (adhesions) which creates instability and does not allow for proper distribution of force through the foot.
Have you ever seen someone who has either lost their hands or was born without them?
They can usually do all the things with their toes we can do with our fingers.
The second thing shoes do which create problems for us is the padding in your shoes.
Comfortable shoes are actually not good.
You were meant to "feel" the ground when you walk. The more cushioning your shoes have the less you feel the ground.
As a result, we tend to strike the ground too hard with the calcaneus bone, your heel bone.
We were meant to graze the heel as we walk.
I
often have my patients take their shoes off and walk on the concrete.
They usually stop landing so much on their heels real quick because it
hurts.
We now know most of the common structural problems long
distance runners have are the result of excessive heel strike. Again,
the only reason we can run or walk like that are because of modern
comfey shoes.
The other thing that happens with soft comfey shoes
is that the process of pronation which is the arch of your foot
flattening out when you walk and then going back into supination, (the
arch reforming) is speeded up which throws your gait cycle off.
The third thing wrong with modern shoes is the arch support most shoes have.
The arch in your feet, of which you actually have three, is made by the muscles and fascia of your feet.
With arch supports in your shoes your giving the muscles in your feet no reason to work.
So they eventually just go by-by. Called disuse atrophy.....Use it or lose it!
This also applies to the strength hence stability of all the muscles in your feet.
The best predictor of fall risk as we age is lack of strength in your toes.
Practically everything that can go wrong with your feet, be it hammer toes, bunions, neuromas are a result of weak foot muscles.
Another issue with modern shoes is the heel of the shoe being elevated.
This
throws your weight forward and without you noticing it all the muscles
in your posterior chain now have to work overtime to keep you from
falling on your face.
And lastly but not leastly is the material your shoes soles are made out of.
If you read my last article one of the causes of chronic pain I talked about is the lack of grounding we need to make with the negatively charged earth.
Remember that some of the insulators to that vital electron flow is rubber and plastic.
The stuff most shoes are made of.
So.....How do we fix this?
The issue of foot orthotic's is complicated.
I believe as therapists we need to always meet the patient where they are in life.
Say
for instance if I do a digital scan of a kids feet and they show a loss
of arch, I would be very reluctant depending on the individual case to
prescribe orthotics.
I would rather work the muscles and address the proper alignment of feet first to see if we could avoid the inserts.
Now
if I'm dealing with a patient who is older or I just know their not
going to follow through with the exercises and soft tissue work I
recommend then again depending on how bad their scan is I might
prescribe orthotics because at some point in life no matter what you do
your just not going to be able to get your arches back again. ( Doesn't
mean you shouldn't try because even with orthotic's you need to
strengthen your feet ).
And remember, your feet are your foundation. If your foundation is unstable the whole structure will be unstable.
So in some cases orthotics are necessary for proper function.
As always, watching your back.........Dr. Steve