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Barefoot Running and Walking: Part III – Flat Feet Maybe A-Okay #gait #physical therapy #feldenkrais
It’s true; it is well supported in medical and scientific literature that, in and of themselves, flat feet do not require some kind of treatment. Yet it I suspect it is also true that if you find an adult with flat feet, you will also find an adult that has been given an extra supportive shoe or an orthotic for those flat feet.
A recent New York Times article about orthotics and flat feet recounted the experience of Jason Stillman, a man with flat feet that virtually every medical doctor he has ever seen has tried to treat. Starting in puberty, Stillman was given orthotics to wear all the time. (1)
According to the Mayo Clinic, an individual has flat feet when the arches on the insides of the feet are flattened, allowing the entire soles to touch the floor when standing up. (2) In searching for definitions, this seems to be a fairly common one.
If you have read the first two installments in this series, you probably know by now that I am fairly enamored with Dr. Hoffman’s study of hundreds of pairs of feet in which he compared shoe wearers to life-long barefooters. (3) In 1905, Dr. Hoffman called into question some of same issues that have been all over the news for the past few years.
In his findings, Hoffman concluded that while low arches (a decreased longitudinal arch) is less common than a medium arch (follow link to see the bones of the foot and a medium arch), it has no bearing on the common diagnosis of “flat foot”. Stillman, the man who started wearing orthotics in puberty might agree since he has now weaned himself almost entirely from orthotics and uses them only when running.
“Observations on the longitudinal arch of the foot led to the conclusion, contrary to common opinion and teaching, that its height and shape are of little or no value in estimating the usefulness of the foot, and that there is no one type as the normal, but that normal feet present high, medium and low arches. While it is true that the moderately high arch is in preponderance, the very low arch, when present, seems to be no indication of weakness, and in many instances where it was found in the primitive Filipino or African, it was associated with a foot that was strong and flexible.”
He goes on to say that the so called flat foot diagnosis is not dependent on a low arch but “whether there was a transition from an original higher condition with concomitant change in the relationship of the tarsal bones and strain of ligaments and muscles.” He felt such a transition was rare.
“It is not uncommon to find the same symptoms associated with arches of good height and I have found them associated with an extraordinarily high arch. It is equally as common to find low arches in symptomless feet.”
Arched, flat and flexible - What?!
As you can see in the illustration based on Dr. Hoffman's research, an adult Bagobo, who had never worn shoes, did have flat feet.
Dr. Benno Nigg, a professor of biomechanics and co-director of the Human Performance Lab at the University of Calgary in Alberta, has always wondered what the big deal about flat feet is. He views foot arches as an evolutionary remnant for gripping trees. However, study of the hominin foot from the Plio-Pleistocence period suggests that even then there was a great deal of variation in arch development. "Lucy" in particular had flat feet. (4) Research just published last month by Carol Ward and colleagues confirms that Lucy and her kin had a stiff mid-foot that allowed for extensive walking but was not as good as the flexible mid-foot apes use for branch grabbing. (5)
Today's human foot is an interesting combination of stiffness and flexibility. The stiffness gives us a lever for pushing against the ground, the flexibility provides the shock absorption.
Propulsion and Shock Abortion
Developments in artificial limbs has highlighted the importance of ligaments and tendons as springs for motion against gravity. Springs have the interesting quality of storing energy and delivering explosive power. Prosthetic limb researcher Hugh Herr has done some leading-edge exploration along these lines using his own body as the laboratory. Herr lost his legs below the knee at age 17. Since then he has systematically worked to bring himself back to normal function. At MIT, he has honed in on the important role of tendons and their spring-like fibers. "The body uses springs to reduce the work the muscles have to do. The human leg is filled with them, and there is this elaborate energetic flow. Energy is constantly being shuffled from tendon to tendon to tendon." (2)
Herr has been using motors to feed energy into springs so that the spring can release pent-up energy at once, allowing the prosthetic foot to propel off the ground like a normal human foot. Herr is himself now running up to four miles a day using his own technology.
Of course, all these spring-like tendons work together. They are continually sending information up the spinal cord to the brain, and the brain is sending instructions back down. All along the chain, an intricate coordinated response is being formulated moment to moment.
How does this relate to flat feet? As Dr. Nigg in 2011 indicates, and as Dr. Hoffman wrote in 1905, flat feet are not necessarily a problem.
An Integral Human Gait™ View
From our Integral Human Gait™ theory perspective, the "flat foot" is a bit misleading. A low arch does not inhibit the springs on the tendons of the lower extremity from working efficiently. I have seen a number of clients with high arches whose tendons have lost their spring.
From a somatic perspective, the image we have of our body matters. If you would like to improve your walk, try thinking of your feet and lower legs as containing springs. Simply shifting your idea can make a huge difference. For the therapist or somatic educator working with a person who has lost the spring in the longitudinal arch of the foot, try playing with dynamic alignment (not static) and engage the client in press/release motions along the entire chain, or at least the chain of the foot to the gluteal muscles. Include in your thoughts and plans for improvement not only the muscles and tendons but the bony arch of the foot through the tibia, fibula, and even how the head of the femur seats itself in the hip socket, noting its response to pressure or availability of response to a downward force.
Supporting a flat foot with a hard arch support is likely to have the effect of further solidifying the image that the arch is rigid and instead of flexible and responsive.
There is a classic Feldenkrais® Awareness Through Movement® lesson that can be used to awaken the flexible arch of the foot. We have made an abbreviated version available MP3 audio available at no charge: Mapping The Arch of the Foot. It is one of the key exercises we use in our Gait for Wild Human Potential workshop. Take a listen. You will likely be surprised at by the lesson.
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Cynthia Allen is a Feldenkrais® Practitioner and Bones for Life® Teacher/Trainer. She is co-creator of the Integral Human Gait™ Theory and teacher of Gait for Wild Human Potential workshops.
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References
(1) Kolata, G. (2011, January 18). Close Look at Orthotics Raises a Welter of Doubts, The New York Times, p. D5.
(2) Mayo Clinic Staff (2010). Flatfeet. Retrieved from http://www.mayoclinic.com/health/flatfeet/DS00449 accessed 2/06/11
(3) Hoffman, P. (1905). Conclusions drawn from a comparative study of the feet of barefooted and shoe-wearing peoples, The Journal of Bone and Joint Surgery, 2 (3), 105-136.
(4) DeSilva, J. M., & Throckmorton, Z. J. (2010). Lucy's Flat Feet: The Relationship between the Ankle and Rearfoot Arching in Early Hominins, PLoS ONE 5 (12). Retrieved from http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0014432
(5) University of Missouri-Columbia (2011, February 10). Foot bone suggests Lucy’s kin had arched foot, for walking. ScienceDaily. Retrieved February 20, 2011, from http://www.sciencedaily.com /releases/2011/02/110210141213.htm
(6) Piore, A. (2010, November) The Bionic Man, Discover,31(9), 52-57
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Christopher McDougall: Are we born to run? #barefoot #running #gait #PT #feldenkrais
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Barefoot Walking and Running Part II: Graphic Evidence
One would think a foot is a foot. But not so. If you had never worn shoes in your life, your own foot might be unrecognizable to you because it certainly wouldn’t look like the foot you use today.
In 1905 an orthopedist wrote an article entitled "Conclusions Drawn From a Comparative Study of the Feet of Barefooted and Shoe-Wearing People”. Using photos from his paper as a reference, we are providing two sketches. The sketch A shows the foot of a man who had been wearing the classic dress shoe of his time. When comparing the shape of his shoe to the shape of his foot, we can see that the shoe itself became a kind of mold. (Hoffman)
Ready for a visually breathtaking comparison to someone who had never worn shoes and lived close to the earth? Sketch B illustrates the foot a Bagobo tribesman who had never worn shoes.
The first response of a westernized shoe wearer might be "Ugh--how primitive." But that would be the point. Feet were designed to be in connection with the earth. Nowhere else in the human body will you find 26 bones, 33 joints and myriads of muscles, tendons and ligaments designed to marvelously adapt to a changing terrain under a load.
In Part I: The Incredible Human Foot of this series, we delved into the evolution of the human need (perceived or otherwise) for footwear. This article continues a bit further along these lines. The difference between a more “original model” foot that is shaped by its direct contact with the earth and a foot that bears the wear and tear of a mold causes us to consider when and how we shoe our ourselves and our children.
If you read Part I, you already know my position is not either/or but both. Yet, I am inclined to believe that most of us (myself included) wear shoes far more of the day than is helpful for a healthy skeletal system and perhaps even mental state.
How much of the day do you wear shoes or go barefoot? What are your thoughts on children and shoes? If you are a runner, have you been exploring the barefoot running possibilities? We enjoy hearing your thoughts.
Part III? Coming in a few days.
By the way, the 1905 article is well worth reading. It takes a while to load but follow the reference below if more interests you. It also contains more graphic evidence through pictures.
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Cynthia Allen is a Feldenkrais Practitioner and Bones for Life Teacher/Trainer. She is co-creator of the Integral Human Gait Theory and teacher of Gait for Wild Human Potential workshops.
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References
Hoffman, P. (1905). Conclusions drawn from a comparative study of the feet of barefooted and shoe-wearing peoples, The Journal of Bone and Joint Surgery, 2 (3), 105-136.
Sternbergh, A. (2008, April 21) You walk wrong. Retrieved 01/15/10 from http://nymag.com/health/features/46213/.
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Barefoot Walking and Running: Part I - The Incredible Human Foot
During the last couple years, barefoot running has become a hot topic. If you are following social media, you may be seeing tweet after tweet on the topic. In view of my interest in reconnecting individuals to a life-supporting gait or walk, I’ve decided to join the discussion with an attempt to shine an integral light on the subject.
The discussion really revolves around the fact that shoes didn't come with the original make and model. Obviously, many things in this world are not part of the original human structure. Walking sticks, gloves, bras, and jock straps, like shoes, were invented to support and/or protect the human being. And like most things, there is a time and place for them.
As a somatic educator, I’ve had an interest in the topic for a while now, and especially since the day when I asked a new client with balance problems to remove her shoes for a private Feldenkrais® session. The 80-something-year-old woman began to sob as she told me could not stand without shoes. Her balance—what little of it she had left—would be gone.
I was struck by both the statement and by the palpable fear
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Hard to beat the Barefoot Professor Feet 101; Archs supports detrimental?
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