Simple Steps to Foot Pain Relief. Katy Bowman
habits to ensure their long-term health.
The good news is this: the current state of your feet is influenced by many habits that are easy to identify and modify. The two habits we have that most significantly impact the structure of the foot’s tissues are the shoes we wear, and the way we move our body. Footwear, as you will continue to learn, is responsible for a host of problems that directly contribute to foot pain and tissue degeneration. You have total control over what is in your closet, so footwear is really the easiest thing to change. When it comes to walking, you’ll have to start paying a little more attention to your body in order to make lasting changes, but the payoff is worth it.
If you are reading this book, you have probably been walking for longer than you can remember. Even though just about everyone walks some amount every day, few consider how they actually do it. They just do it. Yet your gait pattern affects your body similarly to the way wheel alignment affects your car. And your feet are the best indication of where your foot “wheels” are pointing—and how many miles they have left!
NOBODY WALKS EXACTLY LIKE YOU
Your particular gait pattern (which is a fancy way of saying the way you walk) is an extremely complex, whole-body coordination system that is completely unique to you. Walking patterns are very similar to talking patterns. In the same way that the speaking accent you have is similar to that of your parents, the first influence on your “walking accent” was the way others around you moved. Like all animals, humans learn a lot about movement through observation. This is also why so many of us end up walking in a manner similar to our parents. After the initial pattern is set, your walking style is further enhanced by other activities you have done with regularity. Ballet dancers tend to develop a “ballerina turnout” even after they’ve left dance class. Those with military training keep the “at attention” feet long after anyone is checking. Walking with chronic pain, or even limping along after an injury—especially after a stint on crutches—can leave a person with an altered pattern that goes unnoticed (and thus uncorrected). And finally, many add a bit of their own walking “flair.” These are little postural adjustments of choice. We mimic the style of people we admire, or demonstrate an attitude or emotion we’d like to convey via body language.
All of these factors influence the position of our joints (including our foot joints!) and eventually, our alignment becomes a habit.
Your gait pattern can be measured and quantified with a lot of expensive and highly sophisticated biomechanical equipment. But here’s a secret: you can also just look down to see what your feet are doing. This is a low-tech evaluation for sure, but still a highly effective way to see how you are moving. One interesting biomechanical tidbit about your body is that the position you have learned to acquire in order to balance while walking is the same alignment you maintain while standing. Analyzing your stance is easier when you’re first starting—trying to walk and analyze your gait can be challenging.
WHAT SHOULD YOUR FOOT BE DOING?
As your body moves through each stride, many things are happening at the same time. The foot, in particular, should have four distinct positions it passes through while walking over flat ground. These positions are:
1. Heel strike—only the heel is planted on the floor.
2. Foot flat—the front of the foot comes down to join the heel and now the entire foot is on the ground.
3. Heel off—the heel leaves, but the front of the foot remains.
4. Toe off—the straggling forefoot and toes finally leave the ground and move toward another step.
In order for the foot to achieve each of these four specific points, the lower leg, foot, and toes have to be mobile enough to allow it. Tight calves, stiff ankles, and inflexible foot joints make this more difficult, and some of the points may be missed occasionally, or left out entirely! The “senior shuffle” is a walking pattern that bypasses most of these points, with the walker simply sliding a flat foot along the ground, or raising it minimally. Not only does a stiff lower leg and foot mean less muscle mass and less circulation, but it also increases the risk for tripping because it greatly reduces the clearance the foot has over rogue objects like cords and cracks in the sidewalk.
TAKE A LOOK
The best way to start off your foot analysis is to examine the position of your feet while standing in bare feet, in your normal, comfortable, everyday stance. I suggest you don’t look at your feet until you have taken a lap around your room, looking straight ahead. Now stop, and settle into your comfortable stance without looking.
Now look down and take a moment to observe your stance.
First, check for symmetry. Are both feet doing exactly the same thing, or is one foot turned out more than the other?
Symmetry is just as important to maintain in the smaller segments of the body as it is when considering whole-body posture. As in any machine, working some parts harder than others results in different wear patterns. When it comes to your feet, even wear of and between the feet is the key to strengthening underloaded areas and giving overloaded areas a break. A lack of well-distributed use can create skin patches that differ in resilience, bones that have spurs or less density than they should, and muscles that are used more or less frequently than what is optimal for the long-term function of the foot. The results of over- and underloading are typically considered to be ailments, but really, they are the tissue changes a biomechanist would expect to see based on use patterns. Your physiology isn’t broken—it’s working correctly! It’s the way you’re using your foot that’s creating the problem.
Would you drive a car with wheels aligned like this?
The way you use your body on a daily basis changes its shape. We’re a fairly sedentary culture compared to other human populations on the planet, and when we do move, it tends to be comprised of many asymmetrical activities, like driving, writing, or dominant-sided sports. Activities that use one side of the body more than the other affect how the musculature develops, and these muscle patterns, in turn, can pull on our bones in a way that reduces the overall effectiveness of our joints.
Symmetrical doesn’t always mean that both sides of your body need to be positioned in exactly the same way. It means that the use of your body is fairly even over the course of a day or month, or even a year. For the corrective exercises in this book, you’ll want to position yourself evenly, as the instructions will suggest, but keep in mind that the most balanced or symmetrical use of your feet doesn’t only mean feet straight ahead all of the time, but that you are walking a lot, over different types of terrain, at different rates, on different surfaces. This is what truly challenges all of your foot parts and keeps most of your body used evenly!
There are other things that influence our general movement symmetry as well; an injury, for example, can cause us to shift our weight to the uninjured side to allow us to keep functioning while we’re healing. All too often, however, a freshly healed person will fail to return to a more symmetrical pattern of movement. Or, perhaps when learning how to walk, you mimicked the nonsymmetrical pattern of someone in your household. No matter the reason, noticing the symmetry (or lack thereof) is the first step to reconciling your gait.
Second, check out the direction your feet point. Do they look like the wheels on a car, both pointing fairly straight ahead (better for the ankles and knees), or do they veer away from the center of your body (harder on the ankles and knees)? Maybe you’ve got one going forward and the other veering off.
Your wheels point forward on the car because this is how a wheel propels your car straight forward. When wheel alignment is off, the motion of a misaligned tire against the road pulls the car forward and sideways at the same time (i.e., diagonally). As a driver, you can correct, or compensate for, the sideways pull by constantly turning the wheel in opposition, but this takes a toll on both you and the car; as you force the car to straighten