By Jennifer Lang
When my third daughter was born with six digits on each foot, I knew I could never look at feet the same way again, especially my own. I might only have 10 toes (and so does my daughter after surgery), but my feet are fraught with problems. I have only the wryest of arches, two hammertoes, a growth on one nail that even pedicures can’t prettify, a bunion that rubs me wrong, and a bone spur that bedevils my ankle.
My only consolation? I’ve got plenty of company. According to a 2006 survey by the American Podiatric Medical Association, 50 percent of Americans have experienced a foot ailment at some point in their lives. “We put so much pressure on them every day but don’t take care of them like we do the rest of our bodies,” says Colleen Schwartz, DPM, a podiatrist and pilates instructor at Pilates on Spring in Pleasanton, California. But what does it mean to really take care of our feet?
Feet first into fitness
Heredity may be the root cause of some common foot complaints, but ill-fitting shoes, poor posture, sprains or an uneven gait also play an active role in miseries of the sole. “You have to know the cause to be able to treat the symptoms,” says Schwartz. “If the problems stem from the genetic structure of the foot and/or shoe gear, then orthotics and exercise can help reduce pain.” But if the foot pain has developed over time, then you have to look at function—how you walk, what muscles you use and don’t use, where you bear your weight. “We need to train that part of our bodies using disciplines like pilates and yoga to strengthen them.”
In Schwartz’s preventative and rehabilitative pilates-based practice, she firmly believes some foot problems can be avoided. She urges her patients to wear supportive shoes most of the time rather than going barefoot—even though she advocates barefoot exercising. “More importantly,” she says, “you should do foot strengthening and stretching exercises every day, as well as massage in the morning and evening.”
Genetics and function aren’t the only factors that affect our feet. Robert A. Kornfeld, DPM, who practices podiatric medicine in Lake Success, New York, thinks that most foot ailments relate to diet and lifestyle. “We look at the patient’s overall physiology to determine if there are deficiencies in the immune system that lock the body in a chronic inflammatory state,” he says. His advice: Everyone—even those who are symptom-free—should see a podiatrist for an evaluation every few years. That way, if you have an issue, you’ll know whether it is structural, functional, or metabolic.
Kornfeld recommends doing specific foot exercises and practicing yoga. “Yoga teaches us to create optimal alignment, both with muscular strength through muscular contraction and organic extension through maximizing flexibility and relaxation in the muscles.”
If the shoe fits
Many a sore foot would hurt a whole lot less if you simply wore shoes that provided better arch support and had a wider toe box and good heel cushioning. If that doesn’t soothe your aching tootsies, you might also consider purchasing custom-made orthotics. “A good orthotic device is one that’s been fit to correct your balance,” says Ken Green, a certified prosthetist/orthotist in Hicksville, New York. “If made properly, an orthotic will change the alignment of the whole leg, which can help alleviate problems in other parts of the body, such as ankles, knees, hips, and back.”
Stretch and Strengthen Your Feet
Preventive and rehabilitation specialist Colleen Schwartz, DPM, recommends this daily foot fitness regimen of 8 exercises to help keep your feet flexible and strong now—and prevent pain as you age.
Intrinsic muscle exercises (for toes)
1. Towel curls: Sit on a chair with a towel under your feet. Your legs should be parallel and hip-width apart, and your abdominals should be engaged. Distribute your weight evenly between the heels and the balls of the feet and between the big toe and pinkie toe. Lift up your toes and spread them wide. Slowly lower them to the floor. Curl your toes under to grasp the towel and release. Repeat eight times. Advanced: Lift all 10 toes and slowly lower them to the floor, one at a time, starting with your pinkie toes. Curl your toes under to grasp the towel and release. Repeat eight times. Then do the same exercise, starting with your big toes.
2. Pencil pull ups: Stand with your spine lifted and abdominals engaged. Place a pencil on the floor in front of your right foot. Spread your toes and try to pick it up, grasping it with all of your toes at once. If picking up a pencil proves too difficult, try a marble instead. Advanced: Clutch the pencil with the pinkie-toe side, slowly moving it to the big-toe side; and reverse direction. Release and repeat three times with each foot.
3. Toe control: Place soft foam spacers (try Yoga Toes; www.yogatoes. com) between your toes. Squeeze your toes together, taking care to lengthen the toes and avoid curling. Release, and repeat five times.
Plantar fascia exercises
4. Ball massage: Standing or sitting, slowly roll a golf or tennis ball or a frozen 8-ounce water bottle back and forth from the heel to the ball of your stocking foot. Alternate the pressure—hard then soft—and roll three to five minutes on each foot.
5. Pedal presses: Standing or sitting, place your heel on the ground with a ball or bottle in front of it. Keep your leg straight as you gently press your foot over the ball to stretch the calf and plantar fascia. Slowly move the prop toward the ball of your foot, and repeat the stretch. Repeat five times on each foot. Advanced: Once you feel stable, do the same routine while standing.
6. Toe spread: Lie on your back with your knees bent, feet flat on the floor, and ball or bottle nearby. Lift your hips and buttocks off the floor and clasp your hands underneath (or place them palms down by your sides). Place the prop under the toes of your right foot. Lift your toes up, spread them wide, and place them down on the prop one at a time, beginning with the pinkie toe. The position of the hips, knees, and feet should not move. Repeat five times on each foot.
Exercises for Achilles tendonitis, plantar fasciitis, and bunions
7. Leg lassos: Sit tall on the floor with your legs straight in front of you. Loop a towel or Thera-Band around one foot and gently flex your foot toward you to stretch the back of your calf. To make the stretch more intense, lift your leg straight up while keeping your foot lassoed. Keep the other leg elongated, and align the second toe with the knee to assure good alignment in the knee and ankle. Hold for three breaths. Release and repeat five to eight times on each leg.
8. Down Dog tread: Kneel on all fours with hands under shoulders and knees under hips. Slowly lift your buttocks up and back to straighten your legs, keeping your heels off the ground. Hold your pelvis stationary and engage your abdominals as you bend the right knee slightly and lower the heel of your left leg to the ground for three breaths. Release, and repeat on both feet five to eight times.
Troubleshooting the Foot
Problem: Plantar fasciitis: Heel and/or arch pain caused by inflammation of the arch
Reason: Nonsupportive shoes; hereditary structural problems; excessive pronation (rotation of the foot inward and downward); flat feet; a gait that puts too much pressure on the heels; tight calf muscles; arthritis.
RX: Stretch Achilles tendon, calf, hamstring, and plantar fascia three times a day. Wear a splint (available online) or a special Strassburg sock (www.thesock.com) at night to stretch out the bottom of the foot, which will lessen the pain of those gimpy first steps in the morning. Schwartz also suggests doing stretch no. 7 above before you get out of bed.
Problem: Morton’s neuroma: A benign growth or inflammation at the base of the third and fourth toes where the nerve splits, causing pain, a burning sensation, or tingling or numbness between the toes and in the ball of the foot
Reason: Ill-fitting shoes (especially high heels or those with tapered toe boxes) cause the bone to rub against the nerve or place excessive pressure on the ball of the foot.
RX: Have a podiatrist place a thick, triangular metatarsal pad in the shoe to help spread the toes apart; massage the sole of your foot by rolling it over a golf or tennis ball; apply ice to the inflammation.
Problem: Bunion: A dislocation of the big toe, causing it to drift closer to the second toe.
Reason: Hereditary structural problems (flat feet or low arches), excessive pronation; shoes that are so tight or short that they squeeze your toes.
RX: Wear shoes with a wide toe box that won’t rub on the big toe; make sure you have half an inch of space between the end of your longest toe and the tip of the shoe; use a bunion cushion (sold in drug stores) to protect the protrusion. Schwartz suggests doing exercises with spacers (www.yogatoes.com) placed between your toes to help straighten the big toe and strengthen the muscles weakened by the bunion.
Problem: Hammertoe: This occurs when one of the small toes bends at the joint nearest the nail and points down, like the business end of a hammer—and stays that way.
Reason: Tight shoes; hereditary structural problems that can worsen over time as foot muscles weaken; muscle weakness in the calves and shins; arthritis; instability in the foot as it pushes off during walking or running.
RX: Wear shoes with high toe boxes so there’s no pressure on the hammertoes and exercise the muscles on the bottom of your feet and backs of your legs (see no. 6 above).
Jennifer Lang is a freelance writer and certified yoga instructor in White Plains, New York.