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!

9/20/2012 04:35:02 pm

I enjoyed reading you post. I am sharing it with my other friends as the information is really very useful. Keep sharing your excellent work.

5/23/2013 08:44:44 am

Great post, Dr. Claire, thanks! It's always heartening to hear from progressively-minded podiatrists like yourself. Cheers!

5/24/2013 02:52:19 am

Thanks so much, Dr. Hughes! It fascinates me how intensely most podiatrists hate this viewpoint. When you think of the potential of the human body, why can't we include feet?


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