The first time I recall taking notice of my feet was when I put on ice skates for the first time.
Learning to ice skate involves a lot of falling down. I watched more experienced skaters to learn their secrets for staying upright. Comparing myself to the other skaters I noticed something was off.
Instead of my ice skates being straight up and down, the insides of my ankles were caving in (particularly the right foot).
When I was in middle school I became involved in fitness and running. One of the greatest joys at that age was getting a new pair of running shoes. I associated new, fancy shoes with the ability to run fast.
I would spend a lot of time at the store walking around in the latest models, trying to find the perfect pair. Some felt great, like walking on cushions. Some were uncomfortable. I didn’t understand the reason for this difference at that time. I assumed the answer had something to do with the technology the shoe companies were using.
Once I was out of school and had some money to spend I decided to go to a specialty running store to get custom fit for shoes.
Despite having flat feet, there have been only two times in my life when I have had pain in my arch. The first was when I was very young and my family was on vacation in a beach town. Growing up inland, spending time by the ocean was usually reserved for a week or two during summer vacation. Whenever I got the opportunity to play on the beach I took advantage of it.
On our first night away, after a long day of running through the surf and building sand castles, the bottoms of my feet began to hurt. I was too young to diagnosis myself so all I understood was that walking caused pain right under my arch. I vaguely remember at the time being convinced that my soles had somehow been burned by the hot sand.
It was only years later that I realized what actually happened was that I had given the relatively weak muscles and supporting ligaments in my feet quite a workout by walking and running all day on the soft sand.
Now here is a case (and this is an all too common occurrence) that I wish had been more insightful in my youth. Instead of realizing the benefits of running around barefoot on the sand I bought into the conventional wisdom that proper footwear and arch support were the keys to good health.
I had seen enough commercials for arch supports that showed how the misalignment caused by improper footwear produced horrific results. Vivid images of a people standing without arch support suffering, their joints glowing red hot with pain. Then they were given shoe inserts everything was right with the world again.
Suddenly, the here-to-fore miserable flat footed person could walk, or even run again with comfort and confidence.
Not once growing up did I hear mention of exercise as a treatment for foot pain or flat feet. Even when I first starting practicing as a physical therapist I held on to the notion that arch supports for people with flat feet were a necessary part of treatment.
But then came my gait assessment at the running store.
Running is something I’ve done ever since I got into fitness at a young age. In my early 20’s I regularly ran between 20 and 30 miles per week. Around that time, I began noticing annoying aches and pains in my knees and hips. These symptoms didn’t occur every time I ran but often enough that I wanted to do something about it.
At the time I thought the joint problems could be due to not having adequate shoes to correct for overpronation. I decided to go to a store that specialized in running and have my feet evaluated by a trained expert who would steer me towards the right type of shoe for my gait.
Before the assessment, I filled out a two-page packet with my demographics, activity level, and running frequency. During the evaluation, I stepped on a pad that analyzed my footprint and fed the information to a computer that showed on the monitor where the weight was being distributed unevenly on my foot.
The friendly sales girl watched me run on the treadmill from all angles, with shoes and without, and took measurements of my foot length, width, and arch. After all this, she disappeared into a back room and emerged with three different pairs of running shoes.
She had me try them on and run with them on the treadmill. I chose the pair that felt the most comfortable. Now I realize comfort is a very relative concept.
She also recommended insoles to put in the shoes because of the overpronation, especially with the right foot. She said something along the lines of “the inserts that come with shoes off the shelf are where the manufacturer saves money”. I bought her story and bought the insoles.
I left the store feeling like I had made an important investment in my health. I couldn’t wait to start running in the new shoes. I was so excited in fact that after a couple of weeks I went back and bought a second pair of the same sneakers so I could have one pair for running and one to wear for work.
One of the perks of being a physical therapist is not having to wear dress shoes a lot of the time.
It was a few months later that the pain started in my left arch. It didn’t occur to me that the shoes and inserts I spent a good amount of money on might be causing the problem. I had all the classic symptoms of plantar fasciitis: pain in the arch very close to the heel, excruciating pain taking the first few steps when I got out of bed in the morning, etc.
Because I have a job that involves standing for the majority of the day I wanted the pain gone as quickly as possible.
I began icing my heels morning and night, rolling my arch on a tennis ball for 5-10 minutes every day, and stretching my calves and plantar fascia whenever there was a free moment. After a month with no signs of improvement, I began taping my arch just so I could make it through the day more comfortably.
The running completely stopped, thinking that maybe I was training too much (which really wasn’t possible but things were getting a bit desperate). Every morning I lay in bed hoping the pain decided to pack up and leave overnight, only to be rudely reminded with those first few steps of the bad shape my foot was in.
Luckily a change was soon going to come in an unexpected way. A change the helped me rethink the whole concept of flat feet.
Well, I changed jobs around this time–not because of the plantar fasciitis, but to relocate to a different part of California. The new job allowed me to wear different types of shoes, instead of just my running shoes every day.
I started regularly wearing different types of casual and dress shoes.
While at the mall I stopped at a shoe store to see if they had anything comfortable that I might be able to use for work. I owned a pair of desert boots from this brand which I liked. There is not much to them, and I doubt I’d want to trek across the desert with only them on my feet. But they look decent enough.
I ended up buying a pair of shoes from their Unstructured line. They seemed a lot lighter than any shoes I had ever worn.
I recently looked up what the Unstructured line is all about and, apparently, it has to do not only with being lightweight but also the enhanced flexibility of the shoe.
The website also mentions climate control technology and a bit about intake and exhaust vents which seems a bit over the top.
About two months after buying those shoes I woke up one day and realized that the heel pain was gone, and had been gone for at least a few weeks.
Now, there could have been a number of things that caused the plantar fasciitis to go away.
It may have simply resolved on its own as the condition is known to do.
I have a strong suspicion though that it was the change in footwear, from stability running shoes to more flexible shoes that sped up the healing process.
Growing up I never really paid attention to what type of shoe I wore in terms of neutral/stability/motion control. It was only the recommendation from the running shoe store that made me think I needed stability shoes and orthotics.
Knowing what I know now, the recommendation to put orthotics into a shoe already designed to control pronation borders on ridiculous.
I’m guessing that the rigid stability of the shoe and orthotic combination was too much support, preventing my arch from doing what it is designed to do. It’s also possible that the positioning of the arch support was adding compressive stress to the heel.
Switching to different shoes probably allowed my foot to move more and relieved pressure allowing the plantar fasciitis to heal. The flexibility of the new shoes may have also allowed the muscles in the arch to strengthen which could have played a role in the recovery.
So feeling whole again, I began running in whatever shoes felt the most comfortable to me.
About a year later I went to another running store in town to try out their shoe selector system out of curiosity.
After footprint typing and video analysis of my gait, I got a similar recommendation of stability shoes, except this time with custom-made inserts that they just happened to make right in the store!
Having lost faith in running shoe stores, I went dejectedly to browse the wall of shoes to see if anything was on sale.
One of the associates came over and asked me what I was looking for. I told him that I wasn’t sure anymore.
He showed me some of the shoes he liked to run in. He seemed friendly enough so I pulled out my paper of shoe recommendations that I got earlier and asked for his thoughts.
It turns out that this guy was a kinesiology major at a local university, with some interesting theories on the design and effects of running shoes.
He told me to disregard what was on the paper. Instead, he shared with me some exercises that he thought would be helpful for people like me who overpronate.
His employer might not too thrilled with his candor but I wished every sales person was as upfront and honest as this kid.
I left the store without buying anything, but a seed had been planted.
This was around the time that Nike Free shoes were becoming popular. What was unique about the Nike Free’s was their flex-grooved sole that allows the shoe to bend easily in all directions–a big departure from the rigid and supportive running shoes that seemed to dominate the market in years past.
I was not an early adopter by any means, but after getting a pair of Free’s and running in them a few times I knew I would never wear a bulky, stiff running shoe again. Despite having flat feet, and no matter what running shoe experts had to say about it.
After doing more research I discovered that there is little science behind the thinking that people who have flat feet need arch supports.
There has been more and more discussion recently about the benefits of going barefoot, and how highly supportive shoes may be doing more harm than good.
Now with the introduction of minimalist shoes and the ubiquitous Vibram Five Fingers, it appears that the running shoe industry is also catching on, or at least responding to a demand in the market for less constricting shoes.
So that was my journey from plantar fasciitis toward wondering if there might be a way to reverse flat feet.
The medical community generally seems convinced that there is no way to correct flat feet without surgery or arch supports, despite a lack of research to support that thinking.
One of the reasons not much attention is paid to flat feet is because often times they don’t cause any pain–at least not in the feet. Furthermore, the orthotic industry is a huge business and seems to dominate the discussion of treatment for overpronation with little attention paid to the benefits of exercise.
At one point having flat feet was considered an impediment, so much so that it would keep a person out of the military. This is no longer always the case.
What has yet to be determined is the long-term effect flat feet have on the body as a whole. It makes sense that if the alignment of joints is altered from an “optimal” position than the joints will wear down faster similar to the way car tires wear down when your car is out of alignment.
What really got me motivated to start this project was a physical therapy seminar on musculoskeletal problems I attended.
It wasn’t so much the material presented at the course, but more so what I discovered about the problems that I had with my own joints and muscles that my lab partner was happy to point out: flat feet, overpronation, unstable ankles, loose knee joints, knee caps that grind, inflexibility, weak hip muscles, excessive lordosis, etc.
As a physical therapist, I help other people with problems like these, but I had never really taken any time to focus on myself. And I’m getting to that age where injuries and long-term health become more of a concern.
So I’ve decided to devote more time to correct these issues–starting with flat feet.
