Your Feet are the Foundation of Your Castle
As physical therapists, we see many folks coming to us with knee, hip or back pains that seem to appear without evident trauma and often start during attempts to regain physical fitness through walking, running or hiking. While the symptoms of pain are obvious, the correlating causes sometimes might not be as clear. X-rays might indicate arthritis, age and wear-and-tear and are often the write-off explanations for most problems.
One thing that often seems to be forgotten is that your feet are the foundation of your whole being in this physical world. Your feet are the first contact of your body to the ground with every step you take. Your feet are also the first buffering element of the impact of your body on the ground. I often compare our legs to a car’s strut system. There are many shock absorbing elements in a car, such as tires, springs, shocks, bushings and cushions that allow you to drive over a small rock at 60 miles per hour without immediately enduring a head concussion. Our bodies have an alike system, with the feet, ankles, knees, hips and intervertebral discs buffering the shock of every step. With that awareness, it is absolutely essential to make sure that your feet are in good health, alignment and strength, so they can uphold the strains of one of the toughest jobs of any joints in your body.
If your feet hurt when stepping on them, you will naturally compensate to move away from the pain. Those compensations, in turn, will cause strain, through twisting and shearing, on all the other weight-bearing joints. Corns, calluses, long toenails and cracks in the heels or toes are all examples of avoidable issues that affect the way you make contact with the ground.
Corns and calluses form through friction, which is often caused by wearing shoes that do not fit properly. The general rule is, if you can’t wiggle your toes freely, your shoes are too tight. Shoe shops can stretch shoes to relieve areas of tightness. Should you feel the need to buy new shoes, try them on during the later part of the day, when your feet are slightly swollen, to assure best fit. Should you already have issues with calluses or corns, you might want to use protective coverings, such as moleskin, felt pads, corn pads or bandages over the affected areas, so friction is reduced and the area can heal.
Cracked heels are painful and can occur from excess pressure from heavy impact with walking, obesity, prolonged standing or from walking barefoot on the very dry and highly mineralized soils of Nevada County. Regular soaking of your feet, removing excess build up of skin with a pumice stone, and use of moisturizing creams on your feet daily are all good means to avoid the dry skin layers from cracking and causing unnecessary pains and compensations.
Should you already have formed deep cracks, or have painful corns or calluses, make sure to keep them clean and soft. If you have diabetes or generally poor blood flow in your feet, please consult with your primary care provider before self-treating, since even a minor injury could lead to an open infected sore.
Proper foot alignment is also essential for the protection of all the other weight-bearing joints in your body. The ground reaction force (GRF) is the force exerted by the ground on your body as you make contact with it. The way your feet hit the ground defines how the GRF will travel through your body. If you have high arches, flat feet, bunions, hammertoes or other acquired or born-with foot alignment issues, your knees and hips will have to compensate for that alignment. Podiatrists assess foot alignments and often provide custom fabricated insoles to afford a more neutral foot position. For less complex alignment issues, you might benefit from over-the-counter arch supports. Some local shoe stores, such as Empire Shoes, have computerized equipment to assess how your feet align and can provide some more specific insoles.
Strength is needed for stability. If your ankles are weak, they will not be able to counter the forces of your body’s weight with each step, hence, leaving it to the ligaments, tendons and other joints to do the job. Everybody should generally be able to come up on their toes while standing on one foot repetitively for at least 15-20 times. If you can’t, practice it, starting with both feet together, and eventually progressing to standing on one leg. Sideways ankle stability is equally so important and might have been lost from a prior injury, such as an ankle sprain years ago.
We all have “our” walk. Some might remember Monty Python’s “Ministry of Silly Walks,” illustrating that there is not necessarily one way of walking or running. However, some ways are more impactful than others and might be cause for repetitive strains. Walking is a learned pattern and is often difficult to change without proper cueing, as we all do what we do until that does not work for us any more. If you are wondering if your walking patterns might be harmful to your knee, hip or back joints, I encourage you to consult a movement specialist, such as your physical therapist, to analyze your patterns and provide you guidance to create a lighter walking or running flow.
Remember, the best support comes from the ground up. Love your feet, and your body will love you. Please see below for some further references, as well as some tips and tricks to improve your overall ankle stability.
Move better, live better!