Early Recollections Part 4

Part three left off with a recount of my bout with plantar fasciitis. I was in the grips of a stubborn case of heel pain that didn’t seem to respond to any of the treatments I was throwing at it. I had completely given up running and resorted to walking 30-60 minutes everyday for exercise which had the effect of making me feel a lot older than I was. Every morning I was greeting with a stabbing pain in the bottom of my foot and I was getting really frustrated that it was so persistent and even more so that I didn’t know what was causing it. 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 the flexibility to wear different types of shoes on a daily basis, instead of my running sneakers everyday. Some people may really enjoy getting to wear scrubs or workout gear to work, but I looked forward to having some more leeway in how I dressed.

I started regularly wearing shoes that I owned but previously used only every couple of weeks. While at the mall I stopped into a Clark’s store to see if they had anything comfortable that I might be able to use for work. I owned a pair of Clark’s desert boot 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. All I knew at the time was that they seemed a lot lighter than any shoe I had ever wore. I recently looked up what the Unstructured line is all about and apparently it has to do not only with their light weight but also the enhanced flexibility of the shoe. Their website also mentions climate control technology and a bit about intake and exhaust vents which seems over the top, but whatever the technology involved I fell in love with how the shoe felt.

About two months after buying those shoes, one day I woke up 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 and it may have simply resolved spontaneously as the condition is know to do. I have a strong suspicion though that it was the change in footwear from stability running shoes to a wider variety of footwear, including the flexible Clark’s that jump started the healing process.

I gave some thought to why this might be and I remembered in the past never really paying attention to what type of shoe I wore. It was only the recommendation of the running shoe store that caused me to think I needed stability shoes. Knowing what I know now, the recommendation to put orthotics into a shoe already designed to control pronation borders on ridiculous. The plantar fasciitis was in my left foot, the one with less pronation, so I’m guessing that the rigid stability of the shoe and orthotic combination was too much, and prevented my arch from doing what it is designed to do. Wearing different types of shoes on a daily basis probably allowed my foot to move more and relieved pressure from different parts of the sole to allow the plantar fascia to heal. The flexibility of the new shoes may have also allowed the muscles in the arch to strengthen which could have also played a role in the recovery.

So feeling whole again, I began running in whatever shoes felt the most comfortable to me–usually Nike’s that would fall into the neutral category, meaning they don’t have built in arch support. About a year later I went to another running store in town to try out their shoe selector system out of curiosity. After foot print typing and video analysis of my gait I got a similar recommendation of stability shoes, except this time with custom made inserts-inserts that they 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. I told him that I wasn’t sure anymore. He started to show me some of the shoes he liked and seemed friendly enough so I pulled out my paper of shoe recommendations that I got early and asked him what he thought about it.

It turns out that this young gentleman was kinesiology major at one of the local universities, with some interesting theories on the design and effects of running shoes. He told me in plain English to disregard whatever was on the paper and instead shared with me some exercises that he thought would be helpful for people who over pronate. I’m sure his employer would not be too thrilled with this candor but I wished every sales person could be as up front and honest as this kid.

I left the store without buying anything, but a seed had been planted in my head that maybe it would be possible to help or even eliminate flat feet and over pronation with simple exercises. 

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 and running in them a few times I knew I would never wear a bulky, stiff running shoe again–despite having flat feet, not matter what running shoe experts had to say about it.

After doing further research I discovered that there is little science behind the thinking that people who have flat feet need to be in 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 their might be a way to reverse flat feet. The medical community seems to accept that there is no way to correct flat feet without surgery or arch supports despite there being no research to support that thinking. Just as the design of running shoes is being questioned, I think it is also appropriate to investigate the causes of flat feet and over pronation and start discovering what can be done about it. 

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 over pronation with little attention paid to the benefits of exercise.

At one point having flat feet was considered an impediment, so much so that it woud keep a person out of the military. This is no longer the case as it’s been proven that flat footed people can walk, run, and march just as much as those with normal arches. What has yet to be determined is the long term effect flat feet have on the body as a whole. It makes since to me that if the alignment of joints is altered from what is optimal than it may cause those joints to wear down faster similar to the way car tires wear down when your car is out of alignment.  

What really motivated me to start this project and create this website was my attendance at to a four-day seminar on musculoskeletal problems for work. 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 lively lab partner was very happy to point out: flat feet, pronation, unstable ankles, loose knee joints, knee caps that grind, inflexibility, weak hip muscles, excessive lordosis etc.  As a physical therapist I help other people address biomechanical problems like these everyday 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 correcting these issues starting with flat feet.