Fox In Socks is a Dr. Seuss book I just read to my five year old son. I doubt Seuss based the book on a real fox, but if the good doctor were still alive he could write the true-life story, Doc In Socks, about Dr. Steve Gangemi. Gangemi is a chiropractic physician who has earned the moniker Sock Doc from his habit of wearing only socks or even going barefoot in his chiropractic office. Unlike other habits that could land you in jail, shunning your shoes isn’t only legal, it is good for you.

Gangemi has been trained in a variety of specialties ranging from functional neurology to applied kinesiology. Although he does not specialize in the treatment of foot ailments, he believes that healthy people have healthy feet which do not require cushioned, supportive shoes. Gangemi proposes the concept that feet can send you signs and signals about your overall health, and that these clues are well worth pursuing in order to arrive at a state of complete health, literally from head to toe!

Gangemi states that the feet are the foundation of your body. With approximately 7,000 nerve endings in each foot, feedback from your feet can affect your overall health. Any foot impairment, injury, pain, dysfunction, or the wearing of footwear can (and often does) impair sensory feedback, balance and y muscle-skeletal function. Given that we take thousands of steps a day, day after day, the end result can be injury, arthritis, pain or other problems.

Gangemi also explains that an ache in one part of our body may be (and often is!) the result of a problem somewhere else in the body. For example, he explains that pain in your knee may be due to a muscle imbalance in the foot, improper footwear, poor diet, or even stress.

One of the fundamental tenets of his practice is that rarely will an unhealthy person not present with problems in their feet, and it is these bases of the entire human anatomy which can reflect and influence the health of the organism as a whole. Wearing improper footwear can disrupt the normal walking gait, and that can have a knock-on effect which can point to problems being experienced elsewhere in the body.

Gangemi prides himself on dealing with his patients’ health problems on a cause oriented individual level, and highly recommends the barefoot lifestyle. He believes that everyone can benefit from walking barefoot, not just multiple sport athletes and dedicated runners. The wearing of built up shoes featuring supportive orthotics and plush padding benefits few if any people, since going barefoot equates with improved lower leg function and balance which has an impact on overall health.

Steve “Sock Doc” Gangemi’s website (http://sock-doc.com) is a treasure trove of information on every aspect of educating athletes and other interested people about injury, prevention, and treatment to help them live longer and healthier lives. Gangemi provides cutting edge information on injuries, training, racing, nutrition, gear and much more.  Dr. Seuss would be proud of him. And so am I.

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Dr. Nirenberg wearing his Vibram Five Fingers

Mark Anders is one of those top journalists who live the sort of romantic adventurous lives the rest of us can only dream about. Whether he’s surfing the Zambezi River, racing mountain bikes in the 24 Hours of Moab, or is embedded with Navy SEALs in desert war games, he brings to his readers a vivid portrayal of the esoteric experiences to be found in the most exotic locales on Earth. Mark’s work has been featured in Life, Wired, Popular Science, Outside, Men’s Journal, New York, and many other major magazines. He recently wrote an article for the American Council on Exercise Certified News which dealt with an University study of the benefits of minimalist footwear for runners.

Mark writes that John Porcari, Ph.D., and Caitlin McCarthy, M.S., researchers from the Exercise & Health Program at the University of Wisconsin, La Crosse, conducted a study on 16 young adult female subjects who were habitual joggers and free from injury. Two weeks before the testing each was fitted with a set of Vibram FiveFingers Bikila model, and asked to run with that minimalist footwear three times a week for two weeks. Once this “breaking in” period was passed, the test runners were brought into the laboratory at the University for 3-D motion analysis under three separate conditions: barefoot, with the Bikilas; and with New Balance 625 running shoes.

The results of the testing showed that all 16 subjects landed primarily on their heels when wearing the running shoes, while half of the subjects became forefoot strikers when wearing the Bikilas or running barefoot. Even though the researchers were encouraging all the runners to adopt a forefoot strike, the heel strikers were not able to make the switch. The reason for preferring the forefoot strike is that the ankle becomes more plantar-flexed at the moment the foot hits the ground, and it is this greater degree of flexion which seems to absorb the running impact forces to a greater degree. The research also showed that the barefoot and Bikila runners displayed a lower degree of flexion in the knee which is generally correlated to fewer injuries.
 
The research proved that when some runners adopt minimalist footwear they do not necessarily display the correct running stride, in which case the possibility of discomfort and potential injury actually increases over conventional running shoes. The reason for this phenomenon is that minimalist footwear such as the Vibram Bikilas have virtually no cushioning in the heel area and thus subject the foot to higher impact loads. Dr. Porcari concludes that runners “may need very explicit instruction and time spent practicing how to land on the ball of the foot” when first starting to run in minimalist footwear such as Bikilas as continuing to run in a heel strike gait pattern actually negates the benefits of ditching the running shoes. The increased flexion advantages displayed by the forefoot striking runners in both barefoot and minimalist footwear styles are notable as the impact loads are minimalized and that can lead to a decreased risk of injury.

The bottom line is simple: Minimalist footwear works but has to be matched with a forefoot strike. All you heel strikers out there, start practicing your forefoot gait pattern to gain the maximum benefit from your Vibrams!

Check out Mark Anders’ unique life experiences at http://www.markanders.com/markanders.com/home.html , and you can read more about the study at http://www.acefitness.org/certifiednewsarticle/1641/

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Here I am at work, feeling great in my Vivo Barefoot Shoes.

Al Gauthier of  ‘Living Barefoot’ just posted a frank, detailed audio interview with me about barefoot activity and barefoot running. Al and his partner, Tina Dubois, were a pleasure to speak with and they asked many insightful questions. In particular, they asked what I thought it would take for barefoot running to be accepted by the medical community—my answer may surprise you.

To hear this loose and open discussion about barefoot activity from the perspective of a podiatrist who has spent 20 years treating foot problems and has become a strong proponent of the benefits of barefoot activity, listen to the interview HERE.

I look forward to speaking with Al and Tina again in the future on more narrow aspects of barefoot activity.

Links: Living Barefoot
Living Barefoot Show Featuring Dr. Nirenberg

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Essentially, Sandler’s book is a great follow up to  Born to Run by Christopher McDougall. Sandler takes McDougall’s observations of the Tarahumara Indians amazing ability to run many miles regularly in flimsy sandals (Huraches) and adds the science of barefoot activity and a reasonable training regimen, and much more!

Sandler’s personal journey to barefoot running began with his realization that fewer injuries occur in less expensive running shoes than expensive ones, that there is a higher impact on the body in shoes than out of shoes, and balance is better in thinner, less cushioned shoes, and lastly, children who did not wear shoes were less likely to have fallen arches or other foot deformities. Starting slowly, Sandler describes his successful transition to barefoot running.

Barefoot Running is a comprehensive book, covering everything you could possibly want to know about barefoot running. Among the topics Sandler addresses: Barefoot running verses running in shoes, the philosophy and science of barefoot running, how to run barefoot, stretching exercises, foot care tips for barefoot runners, dealing with weather extremes, nutrition, minimalist shoes and much more. Other topics covered include:

• A brief history of barefoot running
• The latest science behind the benefits of barefoot running, including findings of Dr. Daniel Lieberman’s 2010 British Science Journal Nature study (very important!)
• How to heal and stay injury free
• Building balance, strength, endurance
• Building strong feet, legs, hips, muscles, tendons & joints
• Developing strong pads on the bottoms of your feet
• Training routines including cross training
• How to use shoes as a helpful tool
• Adjusting to different surfaces & terrain
• Children and Barefoot Activity (also very important!)
• Meditation, quieting the mind and connecting with nature

The book itself is well organized, beautifully designed and printed with an easy to read text, high quality paper, and great photographs (though I wish there was an index!).  

Critics of Sandler’s book will say that the scientific fact for barefoot running is thin, and it is, but scientific evidence that expensive, thickly cushioned running shoes are better for you is even thinner. 

Final Thoughts on Barefoot Running

Barefoot Running is not for everyone, nor is it safe for everyone, but if you are interested in learning about the incredible benefits of running bare or how to barefoot run safely, Barefoot Running is a must read!

I give Barefoot Running my highest rating — 5 Toes Up  

Links:

Michael Sandler’s Barefoot Running site

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Is this the Barefoot Walker’s Dress Shoe?

Vivo Barefoot Gives Balances Protection with Barefoot Benefits

More importantly, the Vivo Barefoot shoe provides basic protection for your foot, decent grip against the ground and mild foot support, but still lets your foot “feel” the ground. The best way to transition to minimalist or barefoot running or walking hasn’t been defined, but for those looking to make the leap, Terra Plana’s Vivo Barefoot may be the best way to go.

Vivo Barefoot Shoe's Removable Insole

To help with the transition to barefoot, the shoe is incredibly flexible to let your foot bend and flex naturally, has no added heel to throw your body forward, a thin sole, and the Vivo’s insole is removable. I recommend that those people who are new to barefoot activity wear the Vivo with the insole for a while, and then, as their feet adjust, they remove the insole.  As an aside, I removed the insole within a day or two to improve that great barefoot feeling (though, the insole was very comfortable).  

Vivo Barefoot Shoe's Sturdy Tread

A Minimalist Shoe that Feels GREAT

Speaking of comfort, this shoe has what it takes! It feels great on your feet. And, as a podiatrist, I liked the nice wide toe-box (that area at the front of the shoe). Plus, the roomy shoe let my foot breath (something that most shoes do not!).

Final Thoughts on Vivo Barefoot Shoe

The Vivo is a great shoe for stimulating barefoot activity that you can wear unobtrusively while at work, weddings and shopping. It is also a great intermediate shoe to help you on your journey toward barefoot walking or running. 

I give the Vivo Barefoot my top rating — 5 Toes Up 

Links of Interest:

Barefoot and Grounded Vivo Review

Barefoot Runner Vivo Review

Barefoot Walking Lifestyle Vivo Review

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2009: Year of the Barefoot Runner!

Historians will remember 2009 as the year barefoot running surged in popularity. Google Timeline reveals the huge increase in 2009 in barefoot running on the Internet.

Many factors account for this recent explosion of interest in barefoot running: runners realizing that running shoes are mostly hype/advertising, a general interest in alternative medicine and holistic healing, and a dedicated group of barefoot runners educating the public with websites, online discussion forums, and even barefoot running clubs. However, the biggest factor, in my opinion, was Christopher McDougall’s book Born to Run. 

McDougall’s book was released in May, and according to Google Timeline the dramatic burst in barefoot running occurred in July. Clearly, this isn’t just a coincidence. McDougall went on a one-man marketing mission to sell copies of his book and in the process, whether he had intended to or not, sold barefoot running. 

McDougall talked to any reporter who would listen. A Google search on him and his book brings up nearly a million hits (yes, I like Google). 

More than sell books, McDougall gave barefoot running credibility. He made running barefoot respectable, and he backed up his claims with first hand accounts of the Tarahumara Indians and their “running” way of life. His book is not scientific fact, but a compilation of interviews and observations with the Tarahumara and others, including respected scientists. It was also his journey. 

Runners and even non-runners will find McDougall’s transition to barefoot running fascinating. Clearly, if there is a barefoot education superstar in the fight to spur public interest, scientific research, and barefoot running credibility, it is Christopher McDougall. He is the barefoot runners’ Man of the Year.

Barefoot Runners' Man Of The Year

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Dr. Oz Promotes Barefoot Running

Barefoot running is gaining in popularity. Recently, Dr. Oz promoted barefoot running on his new TV show. He went as far as demonstrating the proper technique for barefoot running. Watch the video HERE. I am thrilled to see one of the most trusted and respected physicians of our time promote barefoot running. However, not everyone is happy about all this interest in barefoot running.

Late last month the American Podiatric Medical Association (APMA) released a position paper on the barefoot running:

APMA Position Statement on Barefoot Running:

“Barefoot running has become an increasing trend, and a possible alternative or training adjunct to running with shoes. While anecdotal evidence and testimonials proliferate on the Internet and in the media about the possible health benefits of barefoot running, research has not yet adequately shed light on the immediate and long term effects of this practice.

Barefoot running has been touted as improving strength and balance, while promoting a more natural running style. However, risks of barefoot running include a lack of protection–which may lead to injuries such as puncture wounds–and increased stress on the lower extremities. Currently, inconclusive scientific research has been conducted regarding the benefits and/or risks of barefoot running.”

I would love to hear your thoughts on the APMA’s position statement and/or Dr. Oz’s comments.

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CBS News reports that not only does Michelle Obama spin a mean hula-hoop, but she is also the FIRST First Lady to run barefoot across the White House lawn. On October 21st, she ran an obstacle barefoot during a Healthy Kids Fair. Prior to this event, Barack’s been seen walking barefoot. 

Michelle Obama Runs Barefoot

As a podiatrist who promotes barefoot activity (for healthy feet!), I was ecstatic to see Michelle prancing barefoot. It’s time for feet to come out of the closet—or more specifically shoes. 

In my office, sometimes people are embarrassed by their feet. Of course, as a foot doctor, I see feet that have problems, so many are not beautiful; however, few are ugly. Embarrassment drives people to hide their feet away in their shoes, which only weakens their feet and may even, contribute to worsening their foot problems. 

Another way that some women “hide” their feet is by using nail polish on their fungal toenails. Rather than treating the fungus, some women use nail polish to cover the fungus. Ironically, the nail polish traps moisture in the nail and promotes worsening of the nail fungus. 

Feet are nothing to be ashamed or embarrassed about.  The truth is, most feet are far from perfect. The idealized, petite, beautiful foot is rare (and thank heavens–otherwise, I would be out of business!) 

The best advice I can give someone who is shy about showing off their feet: don’t be. Accept your feet. They may be imperfect, but in their own unique way they are special. 

Barefoot activity for healthy people (without diabetes etc.) is the best thing you can for your feet–going barefoot promotes healthy, strong feet—and may even limit infection. Shoes are typically dark and damp, and as a result, the perfect environment to breed fungus and bacteria.

Perhaps, its time to take off your shoes and walk!

References:

A Case for Bare Feet

Barefoot Running Shoe

Which Shoes are Best for Children? Maybe None

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Is it time to take off your shoes?

Few people would deny that exercise is good for us, and our feet. Now, mounting evidence suggests that exercising the foot’s arch muscles can not only strengthen our feet, but may even increase the height of our foot’s arch.

Our feet are one of the most muscle-rich areas of our body. In fact, there are 18 muscles within the arch of our feet, with additional muscles originating in our leg, inserting into the arches.

It is well known that the more a muscle is worked, the stronger it becomes. Of course, the converse is also true (we have all heard “use it or lose it”).

Now, breakthrough research by Headlee and Fiolkowski shows that when the muscles within the arches of our feet weaken, the arches will actually lower and become flatter.

If the foot’s arch decreases when our foot muscles weaken, it reasons that strengthening the muscles in our foot will raise the arch. Anecdotal evidence from runners who run barefoot shows this to be the case. These barefoot runners relate stronger arches and higher arches. Research by Robbins supports these findings.

Robbins showed radiographic changes in the feet of runners who gave up their shoes and began to run barefoot. In his study, the bones that make up the ball of the foot were shown—radiographically—to move closer toward the rear of the foot. That is, barefoot activity shortened the length of the foot’s arch. Robbins paper did not say the arch increased in these barefoot runners, but when the foot’s arch shortens, it height must rise.

Recently, Mark’s Daily Apple commented on the beneficial effects of exercise on feet, and I second it. Shoes lessen the need for and use of most of our foot’s muscles. As a result, the muscles weaken and the arch will weaken.

It’s time to take off your shoes and start exercising your feet.

I have written previously about foot exercises HERE.

The best foot exercise is barefoot activity — walking, running and playing barefoot! Barefoot activity is the best way to strengthen the muscles of your feet (assuming that you have good health — that is, you are not diabetic or plagued with poor circulation or other ailments). 

Like any exercise, start slow. Let your foot muscles gradually adapt to barefoot activity, and only go barefoot in safe environments – there’s no point having good foot muscles if there is a nail in your foot!

References:

Fiolkowski P, Brunt D, Bishop M, Woo R, Horodyski M. Intrinsic pedal musculature support of the medial longitudinal arch: an electromyography study. J Foot Ankle Surg. 2003 Nov-Dec;42(6):327-33.

Headlee DL, Leonard JL, Hart JM, Ingersoll CD, Hertel J. Fatigue of the plantar intrinsic foot muscles increases navicular drop. J Electromyogr Kinesiol. 2008 Jun;18(3):420-5. Epub 2007 Jan 8.

Robbins SE, Hanna AM. Running-related injury prevention through barefoot adaptations.Med Sci Sports Exerc. 1987 Apr;19(2):148-56.

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