I’ve been training for my 3rd marathon testing my theories about foot mechanics by running in Chuck Taylors (Converse) shoes. And no, I’m not sponsored by Converse! I’m up to my 20-mile runs and am feeling very good about my foot strike mechanics (although wish I was a faster runner!). I’ve had no, foot, knee, hip, or back pain since switching. Previously, I would always have to correct a pelvic rotation which contributed to back and hip pain but no longer. I’m feeling very good about my new theories regarding our walking (running) patterns.

Yesterday saw a woman with bunion problems and we were able to temporarily reduce the size of her bunions by changing how she stood. Now the trick will be to get her to walk better, thereby correcting the mechanical issues, I believe to be behind her foot, hip, and back pain issues. I’m really enjoying experimenting with this as I believe our anatomy supports my theory. Of course, I have a lot to learn, however, to tweak it and make it applicable to everyone.

I’ve been experimenting with my theories about walking mechanics and chronic pain conditions such as plantar fasciitis, bunions, heel spurs, hammer toes etc. Although it has been simple to remove the pain of bunions through improved gait training, I haven’t yet been able to reduce the size of the bunions–until now (I think). The problem is I took pictures of my client’s bunions but mistakenly sent them to my trash. She believes (as well as I) they are reduced–dramatically. But I have no proof without those pictures!

The plantar fasciitis has been more difficult to treat. I can make the pain go away with my simple taping technique but getting people to actually alter their gait pattern consistently has been the problem. I’m now also experimenting with a simple knee taping technique to help change their gait mechanics even if they’re not thinking about it. This is an interesting mental leap for me as I generally haven’t considered the knee affecting the foot. Instead I’ve always thought of the foot affecting the knee. I think this should help though. We’ll see! I’m also understanding that, for those with chronic plantar fasciitis, the foot mechanics are in a “deep hole” of poor function and so taping right off the bat is the right way to go instead of just altering gait patterns.

Ultimately my theory is that we should not need foot orthoses to fix our foot mechanics given the proper guidance.  This, in light of the fact that I cast for foot orthoses, would be a major revelation in the industry. What I am learning, however, is that changing foot strike patterns on a regular basis is more difficult than I expected. For those unable (or unwilling)  to change their patterns, foot orthoses are a good choice–assuming they are casted correctly (which many are not).

Anyway, my experiments continue and I am heartened by my results!

I’ve been  working on an upcoming book, Fixing You: Foot & Ankle Pain, and have been experimenting with a new approach to fixing foot problems. The interesting thing is, since I’ve been trying this new approach to walking, my pelvis has not become rotated,  resulting in no back pain. Before, I’ve always been able to prevent or fix my back pain with the techniques from my book, Fixing You: Back Pain. But one thing I hadn’t been able to do is identify the habit that is continually causing my pelvis to become rotated, contributing to recurrence of my back pain. Now I think I’m on to it! This is an unexpected benefit I hadn’t counted on. Of course, we all know that everything in the body is connected but we don’t know yet, the best way to use these connections to reduce pain. I think, in the course of applying a new understanding of our foot and lower leg anatomy, that I’ve figured out a way to reduce chronic pelvic rotation which is often at the root of pelvic pain, sciatica, SI joint, and back pain.

This was reinforced when I asked one of my clients with a perpetually rotated pelvis and a history of back and sciatic pain to try this new walking technique. He also has hip pain due to arthritis that has gradually become worse over the years of his pounding sports. Additionally he has knee pain on the same side. We’ve been able to fix all these aches and pains but I have not been able to get him to fix his walking pattern which is contributing to the recurrence of these problems. Immediately upon fixing his gait (walking) pattern his leg and pelvis corrected themselves without his even thinking about it! He also reported his hip pain had vanished! We both looked at each other stunned.

I’m still experimenting with this and working out the nuances for different foot types but I’m excited at what I’m finding. Finally, I think I might be getting to the bottom of a more complete approach to fixing ailments from head to toes, beginning with the toes!

Plantar fascitis or heel spur pain is a stubborn issue to get rid of.  Plantar fascitis’ classic symptom is a searing or tearing pain on the bottom of the foot when you first wake up and walk which then resolves after more walking. Anything with “-itis” after it simply means inflammation. So plantar fascitis is an inflammed plantar fascia. Like many medical labels, this term does not describe the underlying reasons for plantar fascitis. Hence you see all sorts of remedies out there which have little effect.

Typically heel pain presents as an exquisite tenderness on the heel when walking. It’s often referred to as heel spurs. Both diagnoses are somewhat related because of their anatomy. In order to get rid of these issues it’s important to understand why they occur.

The plantar fascia is  a broad fibrous tissue on the bottom of the foot, extending from the heel to the toes. Fascia isn’t like a muscle–it doesn’t contract on its own. It merely stretches slightly and then rebounds like a tough rubberband. Pointing blame at the plantar fascia is like yelling at the bowling ball that just dropped on your foot. It’s not the bowling ball’s fault, it’s your hand’s fault for letting it go. In plantar fascitis, the plantar fascia is just responding to abnormal stresses being placed on it.

The purpose of the plantar fascia is to assist with the spring-action of the foot. When you step on the foot it slightly flattens out. As your body passes over the foot, it springs back into shape with the help of the plantar fascia. Understanding this will help you visualize how to fix the problem.

There’s a multimillion dollar industry out there making products to stretch the plantar fascia. These products evolved because of the tearing feeling in the morning on the bottom of the foot during those first steps. Well, if there’s tearing, then the fascia must be too tight, right? Wrong. The plantar fascia merely returned to it’s normal length during the night and your foot excessively flattened out while walking which abruptly stretched the plantar fascia. Stretching the fascia during the night won’t correct the underlying problem–that of a collapsing foot.

Heel pain typically occurs near the insertion point of the planar fascia on the heel bone. I’ve found heel pain occurs in people with a history of plantar fascitis or that plantar fascitis follows heel pain. Both are caused, and helped, by the same thing.

So what’s at the bottom of these issues (so to speak)? The problem actually has to do with a third issue we haven’t mentioned yet. There is a muscle deep to the plantar fascia called the flexor digitorum brevis . This muscle runs from the heel bone to the toes and helps maintain the arch of the foot (see figure below). It supports the plantar fascia. When this muscle begins to fail, the foot flattens more than it should, stressing the plantar fascia and its insertion at the heel. Strengthening this muscle has fixed the majority of the plantar fascitis and heel pain patients I’ve seen.

Flexor digitorum brevis (Copyright 2009 Boone Publishing, LLC)

How to do this? It’s simple. Sit down with a towel under your foot. Now scrunch the towel with your toes keeping the heel down on the floor. Bunch it up under your arch and then spread it back out to start again. Repeat this 3 times. Perform this 5-10x per day for one week and you should feel a significant difference in your pain. You can also do this while standing, scrunching the toes up in your shoe. No one will even know you’re doing it.

The reason you need to do so many repetitions and sets is because each step you take, lengthens and weakens the flexor digitorum brevis muscle. You take many steps during the day so you’ll need to perform a lot of repetitions to counter that. After a week of this, your muscle should be on its way to restoring its normal length and tension.

This information and exercise can be found in my book, Fixing You: Foot & Ankle Pain. Let me know how it goes!