Pain Relief For Arthritis Happy Valley, OR

Footwear: When The Other Shoe Drops (Part II)

Footwear Footwear: When The Other Shoe Drops (Part II)No Really, What Shoes Should I Wear?

Firstly, if you haven’t read part I, go back and do that so we can all be on the same page, or at least refresh yourself with these finer points:

  1. Shoes should reflect what you are doing with them.
  2. Pronating or “over pronation” is not a thing, but a process and it doesn’t actually lead to injuries (see the research).
  3. The shoes you wear can change the structure of your feet (choose wisely).
  4. Making educated shoe choices can improve the feedback you get from your feet, allowing you to modify how you move.
  5. Using your feet smartly can help you change how the rest of your leg and hip move.

Shoes change how our feet interact with the ground, that’s all. Our feet are the foundation of our body and an expression of what the rest of the body is doing. For that reason, modifying this point of contact should be thought of not only as something that enhances what our feet do, but also how our entire leg senses what is going on at the ground. We know that over and under pronating wont predict injuries, much more important than pronation is the information the foot provides the rest of the body via musculature of the foot. This is done by by the stretch of the muscles, controlling how fast the bones move, and distribution of pressure on the bottom of the foot.

To make a long story short, it really doesn’t matter what shoe you wear as long as the shoe does not cause you discomfort and doesn’t hinter your activity. We should realize that if we use our feet and legs well we can pair nearly any activity with any shoe without limitations. That being said, specialized footwear can give you advantages, given certain conditions (cleats on a muddy field, racing flats for a 5K, lifting shoes for 1000lb back squat).

Okay, What Should I Do?

Get to know your feet. Are you able to control the basic motions of your feet?
Can you control the arch of your foot? Standing on flat ground, can you pull the knuckle of your big toe toward your heel? Can you do it while you are standing on them? Can you do it standing on one foot? Do you have to curl your toes with this or can you separate these motions (you should be able to)? Controlling the arch of your foot uses powerful muscles inside your feet that is an important factor in feeling how the foot is moving and slowing down the impact of the foot hitting the ground.

Footwear1 Footwear: When The Other Shoe Drops (Part II)

Here is a picture of a foot with a very low arch, the muscles of the feet are relaxed and the pressure of the body flattens the foot. This position is a more loose position of the ankle and allows the shin bone to move with less sensation to the rest of the body.

Footwear2 Footwear: When The Other Shoe Drops (Part II)

Here the muscles of the foot have been forcefully activated to raise the arch and it prevents the weight of the body from flattening the foot. The motion between the two and the resistance of the flattening of the feet is a large part of how the body perceives what is happening underneath.

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resisted exercise for arch strength, starting by drawing the knuckle of the first toe toward your heel.

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finish the exercise by curing your toes and repeat. Place a small weight on the end of the towel to increase resistance.

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standing on one foot and feeling the position of the arch of the foot is a great way to not only progress the strength and stability of the foot but is a good progression from the seated exercise.

Can you pull your ankle up and in? Up and out? Down and in? Down and out? Can you do this against resistance in a way similar to walking on uneven ground? When your foot lands on uneven ground or as your body moves over a planted foot these muscles help control that motion.

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Lifting the band and pulling out uses the muscles along the outside of your leg and help keep the foot from being pushed in (how most ankle sprains happen).

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lifting the band and pulling in helps control the foot and ankle, especially when you are on sloped ground and also plays a special role in controlling the arch of your foot.

Can you walk without lifting your toes past your foot or are the muscles that lift your toes lifting your entire foot? The ability to move the ankle up without moving the toes up allows your toes to continue to balance the foot when you start pushing off off the ground or step up onto a raised surface (stairs etc).

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Lifting your ankle can be done from muscles that only attach to the foot or with muscles that attach to the toes. It is important to be able to and use the muscles that attach to the ankle only. This allows the toes work independently of the ankle.

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A common mistake when lifting your foot is extending or flaring the toes. This will limit your foots ability to control the position of the toes and also tends to force the foot to flatten.

Can you lift your heels off of the ground and maintain firm pressure through your toes? Can you do it on one foot? Can you lift your foot off of the ground without losing the ability to flex your toes? Much like the photo above and to the right, this is about being able to let your toes move independently of the ankle which allows you to continue to stabilize the foot while the rest the ankle manages motion.

Footwear10 Footwear: When The Other Shoe Drops (Part II)

lifting your heels while keeping even pressure through all five toes and the ball of the foot just behind the toes is an essential skill for walking and running.

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the ability to control arch position while raising fully onto your toes is a way to progress strength of the muscles in your feet and is a good way to test stability of the foot and ankle through the entire range.

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actively gripping the ground (placing a pencil under your toes) as you lift your heel help support a strong and stable foot as you push off of the ground with walking

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continuing to curl your toes as you lift your foot and ankle off of the ground not only further strengthens the toes, teaches controlled activation of the toes but helps develop patterns of raising the ankle without extending the toes.

What does it all mean?

Firstly, you should be able to do all of these things. If you can’t or it takes an extreme amount of focus then you need a little practice. Because your foot is an important part of your body its worth the effort. Yes, I know that these exercises are a little odd, but you’ll thank us later. This blog post is meant to help you start considering how your foot works. While it is possible to fix foot, ankle, knee and hip pain by changing your footwear alone, it is very unlikely. It is much more likely that if you want to change how you move or reduce pain you really should be changing how you use your foot and choosing shoes that fit the shape, function and demands on your feet. Physical Therapists have advanced training to helping you decide if you changing your shoes will stabilize your foot, if an insole will control pain, or if a restriction in your leg is forcing you to lose basic motion.

Our advice: take the first 5 minutes of a workout (warm-up) and start thinking about how your feet work. If you are a running, start jogging and feel how the feet move under weight. If you are lifting in the gym, do some light squats and start considering how the position of your feet move under load. After that warm-up period, forget about it and go on with your day. If you find that this is a difficult task, then start with more basic activities like walking around the office. Let’s be clear, don’t spend your day thinking about your feet, but pick a specific part of a hallway, or just the first 5-10 steps and focus on what you do with your feet.

In other words, there is no wrong type or position of your foot, but there is a wrong way to use them. Without true foot engagement the rest of the body is left”flying blind,” due to a lack of activity in the muscles of the foot and ankle. What shoes you wear is much less important than what you do with your feet. Their is no reason you cannot wear Converse All-Stars at the gym; just know that because it is a flat shoe, the entire responsibility of the motion of the foot comes from the foot and position of the leg, so you had better know what you are have some foot awareness.

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