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Feet First


As every dancer knows, the feet deserve care and respect. After all, they support the weight of the body throughout our entire life-time. When you stop and think about it, the foot is truly remarkable. Our feet are flexible shock absorbers, propel us forward and adapt to all terrain. With its 26 bones and 33 joints, feet accommodate to all manner of different terrains: sandy beaches, bumpy ground, rocky ridges and slippery mud. If you saw the movie, Man on a Wire, recall how Philippe Petite’s feet wrapped around the tight rope as he walked between the twin towers of the World Trade Center.

Foot Evolution
Our evolution from primates resulted in the big toe changing from being opposable, helping our ancestors climb trees and grasp branches, to being in line with the other toes, stabilizing the foot and allowing us to walk upright. The big toe can no longer move from side to side (as our thumb is able to do) but has instead evolved as the prime force driving the body forward in the last phase of gait, push-off. It is our big toe that propels us, giving momentum. The other toes have their jobs, too. The outer three toes give support in standing still and the other two aid in balance.

There are two arches in the foot: a longitudinal arch and a horizontal arch. The arches act as shock absorbers during gait, protecting our knees from impact.

During walking the bones, muscles, and arches of the foot orchestrate a series of intricate transitions. Walking is a complex behavior that involves balancing on one foot while simultaneously moving the opposite foot forward. When we walk the foot’s majestic design is clearly revealed. As our heel strikes the ground, the mid-foot collapses slightly, the arch absorbing the impact. As we roll to the middle of the foot, the foot’s arch flattens more. The toes bend to push off. Off the ground again, the arch springs back ready to absorb the shock of the next landing.

During running, we land more towards the mid-foot. Sprinters run entirely on the balls of their feet. By landing on the ball of the foot, the arch is maintained – allowing for greater shock absorption. Don’t forget: running causes a joint impact of three times the body weight – by running on the balls of the foot the foot’s arch helps lessen the strain on knees. Your well-designed foot protects your knees. That’s a tidbit you might want to remember if you are a runner with sore knees!

Oh, My Aching Feet!
Our feet’s biggest enemies are shoes and pavement. In societies where people are barefoot, the shape of foot is quite different. Without shoes, the shape of the forefoot becomes broader and the toes do not touch each other. But by wearing shoes, the forefoot is compressed, molding it into the shape of the shoe. All those beautiful shoes in fashion magazines are foot destroyers! Walking on paved surfaces caused the fat pad on the bottom of the foot to thin and weakens the foot’s arches.
Whenever assessing a patient, I make it a point to ask about foot pain. The reason for this is simple, I want you to begin exercising and if your feet are bothering you, you will be held back. You simply cannot walk or run aerobically with sore feet. In most cases, the common disorders are 100% preventable.

Common Foot Problems:

Flat feet. Flat feet are common, especially if people are unaccustomed to standing or those who gain weight rapidly. This results from added stress on the muscles and increased strain on the ligaments supporting the arches. But flat feet can be present from an early age as an anatomical variant. While in the past flat feet kept you out of the army, this is no longer the case. There are soldiers, dancers, and athletes in every sport with flat feet. Flat feet should not hold you back!

  • My advice: Without the foot’s joint protective arch, it is a good idea to use orthotics for walking and during sports. Properly fitted orthotics will create an arch, restoring the alignment of the foot and knee. Buy sneakers designed to accommodate a pronated or, flat foot. Foot exercises are a good idea, too. While exercises will not restore the arch, strengthening the muscles can prevent damage to the joints of the foot. Try this: Put a towel on the floor and scrunch your toes to bring the towel toward you. Do this while sitting. This exercise is very effective for strengthening the muscle of the arch.

Plantar Fasciitis. Any activity that involves jumping, sudden starts and stops, can lead to plantar fasciitis. Plantar fasciitis is caused by overstretching the ligament that runs from the ball of the foot, straight through the arch. It comes on gradually, rather than being a sudden event. The pain is felt along the bottom of the foot at the heel and is worse in the morning.

  • My advice: Prevent the condition from occurring by warming up before an exercise routine, and gradually increase your workout intensity over time. Wear shoes that support your arch. Try these stretches: Before your workout, stretch the underlying fascia in your foot by flexing your toes against a wall, keeping your heel flat. Hold for 15 seconds on each side. Next, put a golf ball under your foot while standing, starting from the front of your foot and working your way backwards. Put good pressure on each part of your foot - middle, sides, and all the way to your heel- allowing the ball to stretch the plantar fascia. Try Kinesio tape – apply across the bottom of the foot.

Neuromas. A neuroma is a painful condition involving a thickening of the sheath surrounding the nerves between the metatarsal bones. It most commonly occurs between the 3rd and 4th or between the 2nd and 3rd metatarsal bones. The neuroma develops as a protective response to excessive squeezing of the toes by shoes that are too tight or from running on pavement.

  • My advice: Properly fitting shoes are essential for walking and for exercise. Shoes that are just a half size too small are unacceptable! Custom made orthotics are expensive but are worth it, if you spend very much time on your feet. Once a neuroma develops, anti-inflammatory drugs, ice, and steroid injections can reduce the pain. It is easy to prevent a neuroma from developing.

It makes sense to take good care of your feet. Healthy feet allow you to move without pain to get the daily exercise your body needs. You don’t want to be held back by anything – let alone foot pain!

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