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Is Your Back Pain Due to Your Feet?

Recently, EmpowHer invited me to write a column – here it is!

Pain and problems in the female foot are common—four times greater than for men. One study found that eighty-two percent of U.S. women report having foot pain, seventy-two percent have a foot deformity, and of all foot surgeries in the U.S., women undergo ninety percent of them.

Incredibly, it isn’t just the woman’s foot that leads in pain and problems. Females suffer with more ankle, leg, knee, hip, back, and neck problems. Clearly, when it comes to pain, this is one place women have too much equality!

Don’t despair! You can do simple things to prevent and alleviate pain now. Before I get to that, I want to explain why women are more prone than men to experience muscle-skeletal pain and ailments.

The Feet Are Our Body’s Foundation

Feet are your foundation—whether you are man, woman or child. Strong, well-functioning feet and ankles are essential for support and balance. Working in unison with the body, your feet rapidly adapt to maintain balance over a variety of surface, whether you are running, walking, jogging, carrying a backpack, baby, purse, or all three, or even recovering from a sudden stumble. Feet do it all.

Having incredibly dynamic feet is great until something with them goes wrong. The smallest imbalance in your feet shows up as larger problems up above—in your knees, hips, back, and/or neck. Thus, a misaligned foot leads to a misaligned hip and/or back and/or neck.

Our body depends on agonist-antagonist muscles pulling against each other around our dozens of joints, and any joint imbalance will cause weakness of the muscles on one side of the joint and tension and strain of the muscles on the other side. The result is pain.

Further, these muscle-skeletal misalignments are more likely to occur due to the unique shape of the woman’s “normal” foot.

How is Woman’s Foot Unique?

Compared with males, the female’s foot is generally shorter, narrower, and the length of instep is not as long. The average woman wears a size 8.5 (her foot is approximately twenty-four centimeters or 9.5 inches in length, about an inch shorter than the foot of the average male). The woman’s heel is narrower when compared to the ball of foot, which is wider and has a larger girth relative to the rest of the foot. 

Overall, the woman’s foot is flatter than the male foot. This lower (or more pronated) foot is the root cause of the many of the body’s structural problems.

When feet flatten more than necessary (or over-pronate), the legs compensate by rotating excessively inward. This increased internal rotation creates abnormal stress on the knees causing them to become painful and deteriorate (osteoarthritis). With the knees now strained and out of alignment, a “ripple effect” can occur, causing imbalances, pain and arthritis in the hips, back and neck  Since a woman’s foot is already on the flat-side, she is more predisposed to this painful cascade of events. (For those people whose feet are high arched (or supinated), a similar cascade of joint misalignment occurs leading to pain, imbalance and osteoarthritis.)

To make this chain-of-events even worse, a foot—male or female—that is on the flat side (excessively pronated) is more prone to become even weaker through a vicious downward foot-flattening cycle. Ultimately, this progressive flattening of the foot results in even more foot problems and more muscle-skeletal problems throughout the body.

What You Can Do About Foot, Knee, Hip, Back and Neck Pain

To restore normal alignment to your body, you need to restore balance. The best way to do this is by strengthening agonist and antagonist muscles around your major joints with the goal of improving posture.

This sounds complicated, but there is a very simple way to start: walk barefoot. Shoes act as braces for your feet, altering the alignment of your body and negating the need for many muscles to work at all. Walking barefoot or in minimalist footwear (very flexible shoes such Terra Plana’s Vivo Barefoot), allows your body to “feel” the ground. Do as much walking barefoot as safely possible.

Barefoot activity allows your body’s muscles to develop and remarkably, an innate biofeedback system kicks in that tells your body how to make subtle, unconscious adjustments in the way you walk (your gait). To walk correctly takes a lot of work and study, and is beyond this article, but barefoot walking is a great way to start.

When you must wear shoes, less is more. As mentioned, wear minimalist shoes or very flexible, thin shoes that provide basic protection but still let your feet sense the ground beneath them.

Final Thoughts on Muscle-Skeletal Pain

Now, you can begin to understand the effect of foot misalignment and other joint imbalances on your body. The simplest way to start to strengthen your muscles and rebalance your body is through your feet, and how by losing your shoes, you will be on your way to losing the pain.

If you have any questions or foot, ankle or walking-related topics you would like to learn about, please post in our Forum Section.

References:

Bingefors K, Isacson D. Epidemiology, co-morbidity, and impact on health-related quality of life of self-reported headache and musculoskeletal pain–a gender perspective. Eur J Pain. 2004 Oct;8(5):435-50.

Stubbs D, Krebs E, Bair M, Damush T, Wu J, Sutherland J, Kroenke K.Sex Differences in Pain and Pain-Related Disability among Primary Care Patients with Chronic Musculoskeletal Pain.

Khang YH, Kim HR. Gender differences in self-rated health and mortality association: role of pain-inducing musculoskeletal disorders. J Womens Health (Larchmt). 2010 Jan;19(1):109-16.

Terrier P, Dériaz O, Meichtry A, Luthi F. Prescription footwear for severe injuries of foot and ankle: effect on regularity and symmetry of the gait assessed by trunk accelerometry. Gait Posture. 2009 Nov;30(4):492-6. Epub 2009 Aug 25.

 

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Everyone knows how exercise can give us tighter abs, a firm butt and great biceps, but exercise can also give you strong, healthy feet.

I know most people think their feet get enough exercise, but walking—even a lot—in supportive shoes, does NOT exercise your feet. It may exercise your legs and your triceps, but not the 18 muscles in each arch of our feet or  many of the other muscles entering our feet.

Supportive shoes, arch supports, and orthotics allow our feet to function without needing to work most of our foot muscles. As the saying goes, use it or lose it. Worse, without strong muscles our feet are at risk for injury.

In general, shoes are detrimental to feet. Scientists and doctors have known about the effects of footwear on our feet for over 50 years, but most of the public believes feet require expensive, supportive shoes. In fact, in 1949 The Journal of the National Association of Chiropodists published “Survey of Feet in China and India That Have Never Worn Shoes.” The researchers concluded:

“People who have never worn shoes acquire very few foot defects, most of which are painless and non-debilitating. Shoes are not necessary for healthy feet and are the cause of most foot troubles. Footgear is the greatest enemy of the human foot.”

Clearly, the first step to healthy feet is to give up supportive shoes—or at least limit the amount of time your feet are in shoes.

By simply walking barefoot, you will start to use your foot muscles and your feet will soon become stronger. (Note: Only healthy people should give up their shoes. Persons with diabetes, poor circulation, impaired sensation or other serious problems should wear shoes.)

The best way to wean off supportive shoes and increase barefoot activity is by going slowly, and by supplementing barefoot activity with foot exercises.

Now, there are two sources for foot exercises. One is the book Fantastic Feet by Aliesa George and the other is the FootBook by Dr. Paul Conneely.

Fantastic FeetFootBookFantastic Feet and the FootBook are both great little books with plenty of photographs and detailed, easy to understand instructions. Fantastic Feet is for the public, written in layperson’s terms. The FootBook is for physicians, written in medical terms. Some of the exercises in the books are the same but many are different, and for those who are serious about their foot health, both books offer unique and highly beneficial exercises.   

These books provide a superb workout for your feet, ankles, toes and arches. In fact, many of the exercises will benefit your entire lower extremity! From each book you can choose a handful of exercises that suits your needs and soon you will be on your way to healthy, strong feet.

References:

FootBook

Fantastic Feet

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