BiG TeA PaRtY

posted by: VaLerie K

How to Keep Your Feet Happy

by Allison Aubrey, NPR

If you’ve ever had heel pain when you first put your bare feet on the floor after waking up in the morning, it’s very likely the beginnings of a common condition known as plantar fasciitis. And shoes can contribute to the problem.

Walking Down a Painful Path

Elizabeth Kinkel has never had heel pain or heard much about plantar fasciitis.

But a quick inspection of the 24-year-old architect’s work shoes of choice do not make podiatrist Steve Pribut happy.

When we approached her on the street in Washington, D.C., she was on her way to work and wearing flip-flops.

“They’re pretty comfortable,” she says, adding that they keep her feet cool. “I just wear them walking back and forth to work, and then put on heels once I get into office.”

Pribut, who is not a fan of flip-flops, interrupts her, “I notice a Band-Aid on that foot. Is that from a heel?”

“Yeah,” says Kinkel, “they’re from some really cute wedge sandals. But they dig in because they’re new.”

Kneeling down for a quick examination, Pribut explains that both of Kinkel’s workday shoe choices — the flip-flops and the backless sandals — pose the same potential problem and could lead to plantar fasciitis.

He says when your heel doesn’t stay attached to your shoe, there’s too much extra motion in the foot.

“Wearing an open-backed shoe, when the heel lifts off the ground, there’s a lot of tension that develops in the plantar fascia, and it increases the angle that the whole foot makes with the ground, and toes bend up further and that just stretches the plantar fascia more.”

Vulnerable Tissue

The plantar fascia is a band of connective tissue in the foot, similar in texture to a ligament. It runs all the way from the heel up through the ball of the foot, and strands wrap around each toe.

It’s vulnerable to injury, especially as people age. But shoe choice can make a difference.

To prevent injury, people don’t have to toss out flip-flops or high heels entirely. But when walking a lot, presumably on hard sidewalks, Pribut says it’s better to wear shoes with some support.

Back at his office, he picks up a pair of Asics jogging shoes that he says are ideal. They’re lightweight and don’t have too much heavy cushion. Most important, they do not bend in the middle.

“When I take this shoe and press it down, it bends just at the ball of the foot, where the toes attach to the foot. That’s right where the shoe should bend,” he says.

When shoes have too much bend in the middle, Pribut says it puts tension on the plantar fascia.

Biggest Foot Offenders

One of the biggest offenders among fashionable shoes today is the ballet slipper, or very thin flats. Out on the street outside Pribut’s office, we see lots of women wearing them.

Dominque Arvanitis says she likes them because they’re comfy.

“I walk around a lot, so the flats are good for me,” she says.

Perhaps they are, compared with heels. But Pribut says swapping them out for Crocs or sandals with a little support and a strap around the back would be an improvement.

“The ballet slippers scare me just about as much as the flip-flops do,” he says.

If you’re now wondering whether there are any fashionable dress shoes that may actually be good for your feet, it might be time to ask a different question: What can you do to strengthen or stretch your feet when you’re not wearing shoes?

That’s where foot doctor Colleen Schwartz comes in. She has merged podiatry with Pilates for a more preventive approach.

“We ask a lot of our feet,” says Schwartz of Pleasanton, Calif. “There are so many bones, there are 26 bones, 33 joints and 100 muscles, ligaments and tendons. And in order to give them the attention they deserve, spending a little time every day can be so beneficial.”

A little time means just three or four minutes of stretching and toning. And Schwartz says the best time to do this is first thing in the morning, before you even get out of bed.

Before even getting out of bed she starts with an Achilles tendon stretch.

The idea behind a good toe stretch is that the fibers of the Achilles tendon go all the way to the heel. So there’s a strong connection between a limber Achilles and a healthy plantar fascia.

Schwartz says all the foot exercises she does at home, she does barefoot. When she goes about her daily life outside the home, though, she does advocate shoes

Pribut says the barefoot movement may be gaining some attention for its novelty. And the idea that thousands of years ago, shoeless civilizations had healthier feet could be true.

But back then, he notes, the average life expectancy was about 30 years. And cavewomen didn’t have to contend with glass, nails, hard concrete — or fashion.

NPR June 19, 2008

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The Bryant Park Project, NPR

It took 4 million years of evolution to perfect the foot, and humans have been wrecking that perfection with every step since they first donned shoes, New York magazine’s Adam Sternbergh says.

“Everyone who wears shoes walks wrong,” he says, echoing the headline of his recent article, “You Walk Wrong.”

Sternbergh calls the ubiquity of footwear a “conspiracy of idiocy.” He points out the probability that at no point did any shoemaker say, “Let’s design something that works with your foot.” In the Middle Ages, for example, people began wearing shoes with higher heels to avoid stepping in other people’s excrement. Today, high heels are considered sexy. Whatever their reasons for wearing the shoes they wear, people don’t usually consider whether a shoe actually works with their foot, he says.

The human foot works pretty well on its own, Sternbergh says, and it doesn’t need a lifetime of help from shoes. He explains the basic illogic of footwear by comparing the concept to a perpetual cast. “Imagine if someone put a cast on your arm when you were 3 years old and you never took it off,” he says. “Your arm would stop working. That’s kind of what’s happened with our feet.”

Sternbergh cites a 1940s study of barefoot rickshaw drivers in India. Scientists found that the drivers had unusually healthy feet. Sternbergh says subsequent evidence supports the conclusion that feet don’t need shoes.

Why are shoes on virtually every foot, then? Sternbergh says the rationale that most urban and suburban people use is that the ground is hard and our feet need the cushioning of footwear. “But in many places in the world, the ground is quite hard,” he says. “[Our ancestors] were able to absorb the shock.”

Sternbergh concedes that in most settings, some form of foot covering makes sense. “I’m not going to convince anyone to walk barefoot,” he says, acknowledging that he continues to wear shoes as a bulwark against glass, grime and gross things.

He may still wear shoes, but Sternbergh has switched to a model from England called the Vivo Barefoot from the Clark shoe family. Galahad Clark, son of the inventor of the Wallabee — a particularly successful, if traditional, shoe — helped develop the Vivo Barefoot. Sternbergh says the shoe is basically a slipper with a Kevlar sole, to prevent puncturing.

“They kill your heels,” he says. “A traditional shoe advocate would say you need to switch back to sneakers that have a big cushiony heel.” But a barefoot-walking advocate would say, “You’re walking wrong,” Sternbergh says. He asked Clark for advice or instruction, but Clark said walking in the shoe is instinctual.

“You’ll find that your walk starts to change,” Sternbergh says. “You land on your heel, but it’s a much softer landing. … A traditional shoe with a lot of cushioning is designed to allow you to walk with the bad habits that you have because you’ve been wearing shoes all your life.”

For those who cling to their typical footwear, Sternbergh is sympathetic. “Shoes perpetuate shoes,” he says, referring to the cycle of coddled feet forever needing high-tech swaddling. “It’s a classic self-perpetuating system.”

NPR, April 22, 2008

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