Patient Resources

Understanding is everything

Like any problem, a physical condition needs to be properly understood in order to be improved.

 

With the wealth of information available online it can be easy to feel confused and overwhelmed about what’s right for you. Here you’ll find not only relevant information regarding Podiatry but also common misconceptions and myths that I’ll set straight. Anything here that you’d like to discuss or find out more about, please don’t hesitate to get in touch.

Misconceptions

"A bunion is a hereditary thing..."

There is no bunion gene in the human genome. The hereditary predisposition comes from hypermobility (loose ligaments) not holding the metatarsal in place. In turn this lets the arches collapse, the bodyweight shift spends a longer period of time on the ball of the foot unable to take all those pressures. A good foot support at an early stage helps to prevent bunions by holding the arch to offload the forefoot.

 

It’s worth considering orthotics to offload the weight on the ball of the foot, also avoiding soft pads underneath too. That is, unless your Podiatrist recommends it to you to reduce the discomfort of a fat pad atrophy for example.

“Orthotics make your feet lazy...”

Do glasses make your eyes lazy? No. Orthotics are a conservative, removable, and adaptable solution to reduce or treat body pains. Having orthotics is like having a walking stick  or wearing glasses, you will only feel the benefits when you use them. They will work as soon and as long as you wear them. Holding your foot and its three arches (medial, lateral and transversal) from underneath, rather than overloading some extrinsic muscles (the muscles inserted on the leg on one end and on the foot at the other end).

 

A precise moulding of the foot allows it to relax, square and feel grounded. The right choice of materials (resins rather than hard plastic) allow the foot to press onto the orthotics instead of having the orthotic digging into the foot.

 

Every step you make wearing your orthotics provides you with an even distribution of the body weight on the sole. This absorbs the shocks without dissipation. It asks each pair of muscles to work together and aims to keep the joints above (ankle, knees, pelvis) aligned in order to provide you with a better posture.

Really, orthotics make your feet stronger and your body work better. You can be barefoot at home every night and wear light shoes when you go on a beach holiday. But to commute, work, shop or go out with your orthotics, it’s quite simple – they work as soon as you wear them.

 

“We can create an arch by exercising our foot muscles...”

The bones tell the muscles not only how to work, but how much to work. Not the other way around. Bone alignment and rotations will define the muscle work by moving their insertions in 3 dimensions. It is essential to work on the structure, the skeleton, with your Osteopath, Chiropractor and Podiatrist before relieving or reinforcing any muscles individually or as a chain with your Physiotherapist, Massage Therapist or Personal Trainer. Working only on your muscles will provide you with temporary results as, again, muscles are subject to fatigue, wear, tear, and pain.

"Shoes are better when light and with a soft sole..."

Not true. The weight in a pair of shoes is the support. Light shoes provide less support and let the feet roll in or out and can misalign many joints above. This causes joints to impinge and unbalances the way the muscles work. Impingement and excessive muscles work are the main sources of discomfort and body pain.

"We shouldn't wear shoes..."

Even if you were providing your child a shoe free education, your child might still have to live in a city covered by hard pavement and where the social norm is to wear shoes to work. Whether the shoes protect your feet or simply dress them nicely, they are just as much a source of problems as much as they are a remedy. Those living barefoot are not immune to physiological issues. Humanity’s biggest power is its ability to adapt to circumstances by evolving. Accept your shoes and make the most of them to protect your feet, prevent musculoskeletal disorders and many body pains.

“Sportwear manufacturers took the footwear development too far; We were born to run..."

This statement often comes to me from patients who have read “Born to Run”, a fantastic book from the experience and opinion of Christopher McDougall. The best thing that book did was to bring conversation about the footwear and how technical they have become to the table.

In my opinion, some parts of the book take the message a bit too far and has quickly introduced permanent change in the life and training of runners – keeping us Podiatrists busy.

 

Other readers remained more moderate; trialling minimalist shoes on short sessions and forming their own opinion. While a third type of readers stood against the message from day one (but seemed to enjoy reading about it). Still popular today, “Born to run” created a community that I still see in the clinic regularly. This section of fan club members took this book as an invitation to fight against the traditional footwear and their “drop”, resisting evolution (city ground and sportswear R&D work) despite an absence of scientific evidence admitted by the author himself.

 

I do recommend reading this book as its subject is interesting and that message simply had to be written down and shared. But once again, it’s not about the knowledge you get from a book, but it’s how it helps you grow. I believe that a book could be written on every single runner, but it would be better for you to try to understand your own problem. You cannot apply a ‘one size fits all’ solution to everyone's problem. We are all unique, from our body build to our environment. And as far as running shoes are concerned, to me, running and barefoot running are two different sports, like tennis and badminton, so you must adapt your training accordingly.

 

“Running on the forefoot help avoiding knee pain...”

The foot is beautifully designed in order to stock some natural energy from a heel strike, transfer it through the aponevrose and restore it while pulling down the big toe during the propulsion phase. This is how you make a good use of the Kinetic energy (movement) to make the most of each impact on the ground.

 

Remember that when a foot collapses, or over-pronates, you dissipate this precious kinetic energy and end up using your muscles among your calves to pull back this foot until the next strike. You are now using mechanical energy (muscles).

 

When running on your forefoot, your ankle, knee, and hip are flexed and will either remain aligned by a well-balanced muscle work or be misaligned and make running dangerous. Running on the forefoot means running with your muscles, using mainly mechanical energy. It’s important to remember,  however, that muscles are subject to fatigue, wear, tear, and pain.

 

Running with your muscles in short efforts, whilst being in good shape and generally pain free is going to keep the knee on track, the kneecap aligned with the second toe minus some natural pronation to absorb the shock and will be safe for a certain time.

 

But as soon as your plantar fascia, Achilles tendon, calves, knee (cartilage, ligament, or tendon) are in pain, DO NOT run on your forefoot and apply up to 3 times your body weight on those fragile structures. In short, you can do it if you listen to your body and consider pain as your best friend bringing you the right message.