Oh to be a foot, used and abused all day without much thought to your health and well-being. Our feet are one of the most under-appreciated body parts that can influence anything from low back and hip pain to knee pain, “plantar fasciitis”, as well as Morton’s neuroma and bunions. While many blame these conditions on high arches, flat feet, genetics, and not having the perfectly supportive footwear, there is much that can be done to prevent and treat the aforementioned conditions that have become commonplace in modern history.
The human foot was made perfectly. It was meant to act as the base of support for the body, with bones, tendons, and ligaments designed to create support, balance, and power. The problem comes in when, from a very young age, we bind our feet into shoes, and they lose their strength, flexibility, and their ability to work in multiple planes of movement (like our hands). This malfunction of the feet can lead to gait changes, a tight posterior chain, and issues with knees, hips, and spine.
How do we regain the innate ability of our feet to support use properly? How do we undo the tightness and ingrained patterns of dysfunction as a result of improper foot use? Well, the answer is simple, yet not always easy or quick to integrate. We have to change the way we think about footwear and how we use our feet. We must stretch that which has been chronically tight and strengthen under-utilized muscles. These changes should be integrated slowly for the least amount of discomfort, as our feet come out of their shoe coma.
Let’s start with footwear. Obviously, it is not practical or safe to be walking around certain areas in our bare feet, so we need some footwear that creates a barrier (and potentially warmth) but doesn’t hinder our stride. Footwear should be foot-shaped. This sounds like it should be obvious, but 90% of the footwear out there is not foot-shaped. In fact, most people don’t realize that they’re wearing heels and shoes that are encouraging their toes to cram together. Even athletic shoes have heels (typically about 1-1.5-inch heel lift). This lift creates tension in the whole posterior chain, starting with the Achilles and calf muscles in a state of shortening. This causes the back to arch unnaturally, leading to back pain and dysfunction.
Footwear should be wide from the midfoot to the toes, allowing the toes to spread out. Try that in your shoes right now, can you spread out your toes? Does your foot cramp when you do this? Or is the dexterity to do this action hindered? Proper shoes should allow plenty of room for your toes to be dexterous. Shoes should have been “zero-drop”, with a heel that is in the same plane as the sole, so there is no lift, although there may be plenty of cushioning. Brands like Altra, Xero Shoe, Lems, and Vibrambarefoot oﬀer great athletic and leisure shoe options. Hoka shoes have a smaller heel to toe drop than most popular brands but are not ideal.
There is too much to talk about in regard to foot rehab to mention in this article, but there are some great free and inexpensive resources out there. Check out nwfootankle.com (they also have an educational YouTube channel). This site has vast amounts of information about specific foot conditions and what you can do to treat them with simple rehab exercises. They also have a great section on recommended shoes, and how to transition smoothly from your current shoe. Another helpful resource is any book by Katie Bowman, biomechanist. She wrote one specifically about footwear, but many of her books are focused on taking back our health with a functional movement for lifelong vitality. She also has resources for good (and fashionable!) footwear. She also gives tips about post-wear rehab for those times we want to wear our fabulously fashionable shoes but still maintain good foot and back health. See all her good work at Nutritious Movement.
We care about you! Be healthy and stay safe.
Amanda (AJ) Baron is a state and nationally certified Acupuncturist and Chinese Medicine Herbalist. She received her master’s degree from the Oregon College of Oriental Medicine in Portland. After graduate school, AJ continued her clinical practice with the Acupuncture Relief Project in a comprehensive health clinic in rural Nepal. AJ treated patients as well as teaching tai chi and adjunct Chinese Medicine modalities to local practitioners.