My personal health issues, combined with frustration with lack of results using the current common answers, continually take me to new and interesting places. In the past year most of what I know about metabolism, nutrition, and now feet is shifting drastically. It all comes back to evolution.
I’ve had intermittent right foot pain for about 7 years, focused at the 1st MP joint (where the big toe joins the foot). I walk a lot, and the more I walked, the more it hurt. It had been diagnosed as a stress fracture years ago, and and for years I would wear Danskos* (hard soles, so my feet didn’t flex) when the pain got bad. Basically the Danskos acted as a walking boot. I am heavy (180lbs, due to muscle and bone from my bodybuilding days, plus all the extra padding I’m currently carrying) and have small feet and a stompy gait… It just refused to heal.
The pain had been interfering with my workouts, but it was getting worse and now messing with my weekend fun, too … that’s no good! So I started investigating and it turns out the solution was simple. I didn’t have a stress fracture at all.
Wearing tight shoes, especially heels, can cause bunions and hammertoes, too. Fortunately my problem was easier to fix than these poor feet!
I just had to change my shoes.
That wasn’t all of it, of course – I also needed some fascial adhesions stripped out, and the minimal shoes I transitioned into have had the cool side-effect of forcing me to soften my gait. I wear CorrectToes spacers when I remember. But mostly it was the shoes.
Rolfer Karin Edwards-Wagner does a lot of work with feet, and she pointed me towards the brilliant Dr. Ray McClanahan. He’s got a bunch of videos and articles on his site, so rather than reinventing the wheel I’ll just let you look at his stuff.
Compare the lines of these bones with the ones at the ends of your legs!
Here’s the deal: See those bones on the top of your foot? Your toes should extend in a straight line from them. For centuries we have crammed our feet into shoes that gathered the toes together, creating a sleeker pointed look instead of the spread “duck-foot” that nature intended.
Under your big toes are tiny floating bones called sesamoid bones, which provide leverage and assist in tracking as a tendon moves over bone. The knee cap is a sesamoid, too – in fact you can imagine a miniature knee cap under that joint in your foot. The bones have grooves that the sesamoids are supposed to follow. If the toe angles inwards, the bone is pulled off track. Ouch!
The funny thing here is that my feet look pretty “normal.” I don’t have bunions or any obvious deformation… just a few degrees was enough to cause that pain for me. I haven’t really worn heels for years. Even so, I have a huge pile of shoes and boots (some of them practically new) that I need to sell, donate, or toss. The trick is finding shoes that:
1) Have flexible soles across the ball of the foot and also longitudinally, for twisting.
2) Have the heel at the same level as the toe. Now that I’m used to “zero-drop” shoes, even a half-inch heel feels weird.
3) Fit well in the heel and instep, but have lots of room in the toebox. This is why regular “wide” shoes don’t work for me – the rest of my foot isn’t wide.
4) Don’t have a lot of “toe spring” – that’s when the toe of the shoe comes up off the ground. It pushes you into an unnatural position all the time.
Standing on the bottoms of the soles of shoes is a good way to assess how much room you’ll have. For boots, you can take out the inserts and stand on those instead. My Keens are great. Some of my Merrells and other shoes are just a smidge too tight in the toe box. I have removed the inserts on those, which gives me a few more millimeters of room to stretch out, so they are okay for now. I suspect that as my feet continue to adapt, they will be less comfy in the future. I bought a pair of Lems (the black Primals – the sad truth is that most of the anatomically correct footwear out there is hideous – these were a relatively inoffensive option).
My happy feet in rainbow toe socks.
In addition to going shoe shopping, I also got some socks! The regular “mitten” sock can encourage toes to gather together, especially if they get pulled tight as you slip into your shoe. When I wear those, I stretch out the toe seam to give myself some room. Sock Dreams is a fun local company that carries a variety of toe socks, and they ship for free.
So… the real question is, did it work? My emphatic answer is YES! A week after switching, for the first time I finished a LARPing weekend without being in agony. My foot and knee may have grumbled a few times (I run for miles during these weekends) but that searing pain was gone. At the end, instead of waiting miserably for Robert to be done cleaning, I was out doing extra trash sweeps, because I felt that good! Plus, at my next workout, I had to ask Brandie to throw extra weights on for the leg extensions and squat press, because the weight we were doing before suddenly felt ridiculously easy. Correcting my foot function helped my knee normalize, too, which is a bonus I hadn’t expected. :)
The next adventure is the perfect intersection of SCA / LARP / craftiness, and healthcare: I’m going to try making my own shoes, Viking style!
*Setting aside the issue of the heel height for the moment, it’s true that Danskos and other hard clogs make it easier on your feet. The trouble is, they make it too easy. It was obvious once I thought about it…
When a patient comes in with a brace (on the wrist, knee, back, whatever), we always have this discussion: “Immediately after an injury, a little support is very helpful. As you heal, though, you need to wean off the brace. It’s good to wear it for sports, or challenging events, but not all the time. If you baby the muscles, they won’t work and get stronger, which is what you really need to heal. Eventually you should be brace-free.”
I’d been over-bracing my feet. *headdesk*
Wearing softer, more flexible shoes that allow / force my feet to get to work will make them stronger. I still need some shock absorption when walking on man-made surfaces like concrete, but for dirt and carpet I prefer to go more minimal.