Since podiatry school, "why feet?" is the number one question I get on a daily basis, and it's usually followed by a statement of disgust by the asker. It's true! Yes, my wife does usually ask me daily how my day was, but I get asked at least two, three or fifteen times a day: "why would you ever want to look at feet all day?!"
I've always thought feet were fascinating from a mechanical standpoint; they hold our entire bodyweight and move us around the earth. DaVinci marvelled at their engineering. Unlike other podiatrists, I've never had a major foot problem that pushed me into the field. The connection between medicine and mechanics, as well as being able to treat children to athletes to the elderly persuaded me into the field. (I'm going to print this to make handouts for the office).
Why is it that we hate feet so much? Here are the typical reasons:
1. They look gross. Well, that foot of a chinese foot binder definitely looks gross, but I guess culturally attractive in context. Our feet definitely look gross in part due to our shoes.
2. They smell. The average smelly foot doesn't make me flinch, but the average person is very self-conscious about how their feet smell (once they've smelled a raging diabetic foot infection teeming with maggots, they may re-evaluate though). Why do feet smell? Because they sweat, like other parts of our body, but we cover them with moisture-absorbing socks and boxes because society tells us that its proper and civilized to incubate fungus on our feet. Those lovely conditions allow fungal skin and nail infections that most of the shoe-wearing population deals with at some point.
3. They're ugly. (different from gross, I'll explain). Who tells us what's ugly and what's pretty? Because, back in 1200, the skinniest, tannest women were not in the king's court but out toiling away in the fields. We think a foot crammed and mangled in a $1200 shoe is pretty. We need to forget fashion and focus on functionality.
So, I think shoes are a big reason to blame for why we hate feet so much. Just for kicks, lets visit an alternate reality and see how we'd think about hands if they were treated like feet.....
In this parallel universe, people have placed rigid gloves on their hands for hundreds of years. We don't need our hands anymore because robots do everything for people in this alternate course in the space-time continuum. Men wear really big and bulky gloves to give the appearance that they're larger then they are; women wear gloves that pinch their hands into little points and bend them outward at fixed 90 degree angles, to give them the look of beauty that's popular at this time and place. They go to the hand doctor and ask why he/she would ever want to look at disgusting hands all day. Taking the gloves off exposes a small, moist little hand, often with fungal infections of the nails and skin. The average hand is clammy and weak; it can barely make a noticeable squeeze on exam. Some people wear a light glove that exposes their flimsy, frail little "hammerfingers" within when the weather is nice and there is nothing dangerous around that may result in a devastating splinter or paper cut (paper has been banned for public fear of inadvertent digital amputation). But typically, someone not wearing gloves in public is villified, and on occasion men, women and children vomit at the sight of an exposed hand. Many years ago, poor people and people in other countries used to be uncivilized and gloveless, but now everyone can afford gloves and a robot! Typically people don't question why they wear gloves, since its the only reality they've ever known, and they don't question why they spend millions on gimmicks to make their frail hands feel better. They don't think of ever using their hands again, because the robots make life so easy. Why walk when you can drive, and why go through the difficulty of using your hands when you have a robot to do everything. It frees up time to use the voice-activation system to look for new gloves on the internet, and catch up on "what not to wear...on your hands" and "jersey shore gloves" on the television.
Why hands, indeed....disgusting.
The barefoot running debate has brought many issues and arguements to life. The most disturbing of which has been the anger and attacks from opposing viewpoints, which I don't believe are mutually exclusive. As I most wholeheartedly believe that the human foot was designed to function normally without any intervention, humans are adaptable. If anything, this debate has given us two important advances: 1. running shoe technology has no to little peer-reviewed research behind it, and any shoe company claiming one thing or another should be questioned. 2. As has always been the case, people are different and capable of adapting to new circumstances, as seen in the evolution of different human groups making regional adaptations due to temperature, food, tools, etc.
As humans, we have this uncanny ability to adapt to different environments and situations. Most plants and animals cannot be compared; they have evolved very specific requirements of food, habitat, form and function, to which a very small imbalance in an ecosystem can destroy the parts and the whole.
Humans are more like starlings, crows, racoons, rats, etc--opportunists that can adapt to a wide range of food and environment. There will be no one shoe, orthotic, or other gimmick that can fix problems, and even in a less-than-ideal situation, people have the ability to adapt to their circumstance. Amputees can function without a leg, albeit having a tougher life as a result. The person without arms can learn to write with their feet. The blind person can use thier sense of hearing to adapt.
On the other hand, we can adapt back to the way our foot was made to function--a re-evolution of sorts--but it is not easy. Regaining the natural form and function of the foot is what I aim to do with my patients who are open to this, but those not all are. There are a range of solutions that may work for a given person based on different variables.
Consider what I believe to be the most untalked-about element in Chris McDougall's 'Born to Run' book. The Tarahumara indians showed us how we can run naturally, with good form. We should all copy them, says McDougall (which I do agree with). But why no one talks about their diet is beyond me. They live on cornmeal and beer. Carbs and carbs. They don't seem to have any ill-related health effects because of this, yet McDougall wasn't pushing this diet in his book.
Just like any group of people who has adapted to a particular way of life, the Tarahumara have adapted to a lifestyle of daily long runs and eating corn and drinking beer. Humans are adaptable, in this day and age we can choose to change our lifestyle to fit a certain form and function.
With so many claims from companies looking to make money off ideas, we can get fooled into taking quick-fixes. There may be a particular answer for each one of us, but there is almost never a quick-fix. But if we want to change our diet, lifestyle, running form, or footwear for what we believe is the better, it is possible. If you want to regain the natural function of your foot without relying on shoes and orthotics, you can. Like anything worth something in life, it takes hard work and time.
Stuck in an office all day? Make it a place to get in your foot and leg strengthening exercises to transition to a minimalist/barefoot lifestyle!Milton here's got it all wrong. Look at him there; sitting slouched at his desk, probably in terrible men's dress shoes.
The first thing Milton needs to do is get himself a standing desk at work. http://www.marksdailyapple.com/standing-at-work/
A standing desk allows us to engage our core, keep good posture, prevent hip flexor tightening and muscular imbalance down the kinetic chain. Milton will be in a much better position to defend his swingline stapler too.
Now, we can strenghen those legs and feet. The first suggestion is always copious calf stretching. Eccentric calf stretching off the edge of a stair (forefoot on the stair, slowly lower the heel as far as you can go), or just do the classic and prop the forefoot against the wall and lean forward.
Our ability to strengthen the muscles of our core has benefits for every lower extremity exercise. For running, balancing on one leg like a flamingo is one of the easiest and best exercises you can get in at your desk. Focus on maintaining pelvic stability and neutrality when you do this; don't just let the hip bear the weight and allow drop on the opposite side. From this position, you can do one-legged squats as well.
Do sets of calf raises from a standing position (or as part of the eccentric calf stretches I mentioned before, if you have a step) Then do sets of 30 seconds standing on your heels (raise the forefoot up and bear all weight on your two heels). This strengthens the anterior leg muscles and challenges your heels to bear weight on their own.
If you can take your shoe off at work, also stretch the top of your foot by curling the toes downward, plantaflexing the ankle (downward) and stretching the top of your foot and anterior leg using the floor. While you've got your shoe off, toss a golf ball on the floor and do deep tissue massage to the bottom of the foot to the plantar fascia and deep layers of muscles in the foot. Go extreme and do the "Laird Hamilton Foot Torture" and put as much weight on the golf ball as you can tolerate. Work up slowly, but challenge the foot.
With your shoes on or off, get some toe exercises in. First, crunch your toes up in sets of 10-20, as if you're grabbing the ground or bottom of your shoe. Next, push your big toe down into the shoe or ground with force for approx 20 seconds. Repeat and try to lift your lesser toes UP at the same time you're driving your great toe DOWN.
So listen to Uncle Rico and use that time at work productively!
"Might as well do somethin' while you're doing nothin'!"
So lets review:
FIRST, get a standing station at work!
1. Eccentric calf stretches (and calf raises)
2. Top of foot/anterior leg stretch
3. Wall calf stretch
4. Whatever other lower extremity stretching you can think of! I suggest hip flexors, but you're already pushing it! Save those for after work!
1. One legged balance, focusing on maintaining pelvic stability and not letting the hip drop
2. One legged balance with squat
3. Heel standing for 30 sec at a time
4. Foot massage with a golf ball/ Laird Hamilton Foot Torture
5. Toe crunches
6. Big toe "pushes" and big toe pushes with lesser toe raise
Keep strengthening those feet for natural foot function and health!!!!
I bought a pair of the stem footwear shoes for my wife, but one of the advantages to being married to a woman "a handful" of inches taller than yourself is the ability to share shoes. Through my colleague, Dr. Ray McClanahan, I had heard of the stem shoes. There has been an explosion in the market for barefoot-style and minimalist running shoes, but not in the casual/dress shoe market. As a podiatrist, I believe this is the most important market to corner. As a runner, I can get many natural form shoes, but what do I do for the rest of the day for foot health?! Before the stem, the only shoe that met most of my specifications as proponent for shoes that allow natural foot function were Crocs. Crocs have started to create many other casual models, but they've neglected their original design that is ideal. That ideal is as follows:
1. The shoe enables, best as possible, a natural feel of the ground with a minimal sole
2. It has a zero heel drop, meaning the rearfoot and forefoot is the same height, allowing the ball of the foot and heel to bear an equal load in weightbearing
3. It does not have a toe spring (the end of the shoe doesn't curve upwards). This is important because a toe spring allows the metatarsophalangeal joints and toes to be a passive component in the gait cycle. A toe spring essentially prevents the toes from gripping the ground and the first metatarsophalangeal joint from pushing off; prohibiting the natural function of the foot.
4. It has not only a wide forefoot, but a wide TOE BOX. This is ideal to prevent the wedging of the 1st and 5th digits inwards, which can contribute to bunion and tailor's bunion deformities as well as neuromas.
Like I mentioned before, many minimalist running shoes have applied these concepts, but Stem footwear applies these for regular daily use shoes. These are the type of shoes we should be wearing on a daily basis to make full use of the natural function of our feet.
Before you spring in to the stems, as I fully recommend, you must realize that they are a shoe that will change your gait and function drastically if you havent already been transitioning to barefoot and minimalist shoewear. Transition exercises focusing on stretching your achilles tendon and strengthening your instrinsic foot musculature as well as the muscles in your lower leg are essential to prevent injury. Please come see me if you are interested in making the minimalist/barefoot transition and finding out what your feet are capable of!
I finally got a chance to visit a fantastic new running store in the heart of New England, Good for the Soles, in Northampton, MA. Tim and Jill Murphy had opened this store last spring, as the second natural running store in the US after Dr. Mark Cucuzzella's Two River Treads, in Sheperdstown, WV.
Jill and Tim not only carry the minimalist-type running shoes, but casual brands as well. Here you can find vivobarefoot, stem footwear, altras, newtons, inov8, and more. They are not only a shoe store, but like Dr. Cucuzzella's Two River Treads, a community education center. With a downstairs 'classroom,' fit with screen and projector, they not only teach and distribute medical and popular literature that supports the evidence for the natural function of the foot, but they are certified instructors of chi running and walking. This methodolgy aims to teach the most natural and efficient form for running and walking.
Jill and Tim will help you transition your life into a more natural footwear whether you aim to walk or run, or just live free of general foot pain. I highly recommend you stop by!
The only part of the body that's neglected by most people at the gym is the foot. We do this because we wear the wrong shoes to the gym. Would you do a bicep workout with an above the elbow cast on? Of course not. Shoes act like casts to the feet, preventing development of smaller musculature here. Shoes also interfere with ground proprioception and balance. Besides ignoring foot and ankle musculature, you do harm to your posture and technique if you are wearing the wrong shoes while in the gym. See here for common shoe mistakes and shoe recommendations for the gym:http://stronglifts.com/weight-lifting-shoes-squats-deadlifts/
In addition, any of you who want to transition to obtaining natural foot health and wellness and make a move to minimalist or barefoot lifestyles should be starting in the gym. Doing your typical workout barefoot or in minimal shoes will help you to do necessary foot strengthening.
At the gym, forget what you learned about weightlifting (sets/reps of specific weight-lifting exercises) and do functional movement exercises that incorporate whole body fitness:
weightlifing complexes http://www.youtube.com/watch?v=ZfQajtUOtgM&feature=related
(forget about that guy's shoes though)