Once upon a time, cardiologists looked at exercise like they now look at poor diet. Don't exercise!!, it'll send you to an early grave. Orthopedic physicians did the same with arthritis: Don't move!!! It'll hurt. We now know just the opposite for both. Studies show exercise prevents cardiovascular disease and those that are the most active have the least poor outcome from osteoarthritis. (That doesn't stop naysayers or the media ever pointing out the rare fit person dying from congenital heart problems or exercise induced cardiac events, but not the thousands dying daily who have never made an attempt at making a literal step in the right direction. In full disclosure, my own father found a new, very fulfilling life in being fit--eating healthy and exercising regularly, but nothing could stop the 15+ years of coronary disease from being stationary and eating extremely poorly, and partly from having genetic predisposition, from causing his exercise-induced death.) What medical researchers study is disease, not health!! Our treatment protocols are structured on what we know of disease; of the average sick person. We tend not to look at healthy populations and what they do right.
In my profession, we do the same. Podiatrist see foot problems. Where are there foot problems? In Western society. Where was the first podiatrist? Royal Medieval England. Why? The upper class was the first to wear fashionable and ill-fitting shoes. They were also the first to wear shoes full-time. Continue 700-800 years. Where do podiatrists exist? USA, UK, Australia, Canada. What do they have in common? Ex- or current British influence. What persists? The idea that shoes are fashionable. The idea that shoes=higher class. The idea that shoes prevent communicable and musculoskeletal disease. The only thing proven in medical literature to pass communicable disease are the nose, mouth, hands and privates. Not the feet.
Beyond just shoes, we have come to decide, that bulkier shoes are necessary for human survival. 'Supporting the arch' is a tenet known to the average person. Expensive shoes are the best shoes. Why does the arch need to be supported as we now all believe? It's never been supported for millions of years. There are entire countries without arch support. Why do we need such a thing?
We've created a new world with hard, flat floors, which are unlike natural substrates. We stand for long hours. We are very unfit. Arch support does work for many people, but it's akin to encouraging a 400 pound person to sit if they are in pain; it's akin to telling a person with osteoarthritis to never move very much again; it's akin to telling someone with cardiovascular disease to never exercise.
Evolutionary biology is a fact. Not a theory, not something that can be co-taught with creationism. Different disciplines of science, especially medicine, forget this or ignore it. But in this fact of evolution, we can find solid answers to medical problems. Humans did not evolve to eat sugary foods; it's caused epidemic disease. Lineages of bacteria evolve to superbugs as we speak to avoid oblivion from our ever shrinking arsenal of antibiotics. Certain genetic lineages may have always been predisposed to cardiac disease, but exercise is not to blame, our modern lifestyle and diet is. Podiatry has come to see foot problems in the light of only modern society. In this approach, we've found treatments to make people comfortable, but not to solve problems. To solve a problem requires work. Foot problems, like cardiovascular problems and obesity, require a dilegence to return your body slowly, over time to a healthier form by changing your lifestyle. Think.Evolve.Move.Take off your shoes!
On a rare relaxing weekend that included watching television (which consists of a digital antennae that allows us to receive 4 channels here in Ellsworth Maine. Fortunately, not one, but two of those channels are PBS), I happened to come across a Globetrekker episode highlighting Papua New Guinea, with which I fell in love. Vacation huts on the beach with empty surf breaks in 80 degree water, mountain treks and cycling trips among a largely still traditional society. The host, an American, wore some type of hybrid watershoe/hiking shoe at all times. Except for one. He went fishing in a lagoon with children, all of whom were barefoot. Only one could barely walk in the water without pain. Obviously that was our host, and he was a very fit, young man. And his footsies were so tender he could barely walk on the surfaces these children were sprinting on. Most of the adults he encountered were barefoot or wearing thin sandals. I did not see a bunion among the bunch. These were some impressive feet, and this is what I hope we will embrace in foot health in America. One of the exercises I encourage my patients to perform is the "Laird Hamilton Foot Torture," which I took from an interview I read with him several years ago. This consists of plantar foot massage on a golf ball under full bodyweight. Obviously, for nearly everyone, this takes some time to work up to. This man is a rarity in western society; A person with strong feet. On a later interview with a colleague of Hamilton's, the writer expressed fascination with his ability to scale a technical mountain in flip flops. Why? Why do podiatrists whip out the cross and silver bullets every spring and summer when people start living in flip flops? They are not inherently the problem, it's your WEAK FEET! Not only are westerners feet overly weak and sensitive, they likely lie under an overweight body. This is the reason my profession only exists in countries like the US, the UK and other former colonies. It is the reason why the US military could be crippled with the lack of one item--not weaponry, but shoes. Steven Robbins, a Canadian MD, whose scientific body on the benefits of being barefoot is impressive, but far from extolled, also explains reasoning for the use of modern shoes. It began with the Middle Ages plague and the belief that disease was spread through bare feet (an assumption that remains until today with very little evidence). This lead to widespread shoe wearing. This also lead, he posits, to obesity. The shoe allows us to obviously bear more weight on more uncomfortable surfaces, though the potential for damage from those surfaces still exists. Shoes at the same time became staus symbols, and still remain so today. These ideas outweight the scope of this post, so I digress. My point remains the same from the beginning of this website: our feet are weak, and this is at least partly to blame for many foot problems. To see a young, athletic man, incapable of the simple act of walking with young children in Papua New Guinea is eyeopening. Now, someone get me a travel show on PBS, so I can study and highlight natural foot health in those currently living it!