Читать книгу Simple Steps to Foot Pain Relief - Katy Bowman - Страница 10
Оглавление“He shifted his weight from foot to foot, but it was equally uncomfortable on each.”
—DOUGLAS ADAMS
First, let me congratulate you. Picking up this book is the first step toward improving the health of your feet, knees, hips, pelvis, spine, and bones. Most of what you are about to read was gathered during different parts of the academic research I did for my master’s thesis. Using a force plate to see how shifts in hip position change the loads on the foot, measuring how flip-flops change your gait pattern, or observing how upper body curvature affects balance are everyday occurrences in a biomechanics lab. It is from these experiences that I designed the exercise protocol in this book, not only to make the foot healthy but also to optimize how the foot works with other tissues in the body. Through my corrective exercises and alignment suggestions—via books, DVDs, at our training center, or online—thousands have been successful in repairing their own feet by learning to change how they move. Some have shared their stories in this book to help motivate and inspire you and to illustrate that the solution really can be simple.
There are three likely reasons this book has called out to you:
1. You have feet.
2. You love the human body, preventive medicine, and anything to do with health.
3. As you are reading this, you have an aching, stabbing, soreness, swelling, stiffening, bunioning, smashing, cramping, and/or a limping sensation in your feet. You also have a closet of shoes, along with a vague notion that the two may be related. (Here’s a hint: you’re right.)
You have had your feet since birth. You’ve had them in your mouth, you’ve had them stepped on, and you have definitely had them squished into what seemed like a good style choice at the time. But chances are that you have no idea of the inner workings of your foot and ankles.
While you have about 200 bones in your entire body, 25 percent of them reside from the ankles down. The same goes for your muscles—a quarter of all the muscles and motor nerves in your body are dedicated to your feet. Despite all of these movable parts, I’ll bet you’ve never been told this part of your body needs movement to keep healthy.
A keen student of the natural sciences, Leonardo da Vinci referred to the foot as the most complex piece of machinery ever designed. Don’t let this statement mislead you, however, into thinking that understanding your anatomy is over your head. While the function of the foot is fantastically detailed, you will be amazed at how easy it is to navigate your way around a complicated area when you have a map. Wait, did you not get your map to the foot? Well, here it is.
Okay, you probably don’t need to know this much anatomy in order to successfully steer yourself to healthier feet. That being said, you probably need to know a little bit more than this:
When it comes down to it, most of us know more about our cars than our bodies. Knowing the basics of automobile maintenance and performance parameters can significantly reduce the wear and tear on your car; the same goes for your anatomical parts.
To make significant headway toward healthy feet, you don’t have to know the name of every single bone, muscle, tendon, and ligament that you can find in your feet, but you should know the general landscape and some basic terms.
In addition, a little information goes a long way when it comes to your ability to self-assess your ranges of motion, giving you an objective measure for your level of foot health. Knowing the correct anatomical terms will also help you to communicate with more self-empowerment, should you need to make a medical appointment. As a five-year-old, I’d have to point to a body location when the doctor asked, “Where does it hurt?” It’s kind of embarrassing when you have to do the same thing as a thirty-, forty-, or sixty-year-old. With the number of baby boomers on the rise, and the steadily declining state of health across the country, the time has come to take more responsibility for our own personal health. Of course, if you are reading this book, you have already assumed that responsibility. Good for you!
THE HISTORY OF FEET
Feet and humans go back a long way. In fact, they go back all the way, right to the beginning. They grew up together, and evolved together, for hundreds of thousands of years before any shoes showed up on the scene. In the modern world, shoes have served to protect our living tissue from the unnatural surfaces that generate excessive forces, both at the surface (skin), and below it (bone). The increase of human-made debris has also created safety issues while walking barefoot through natural environments. Stemming from pre-antibiotic days when foot puncture could be catastrophic even for even a healthy person, footwear gradually evolved from light surface protection to completely engineered full-body stabilizers like the hiking boot. Recently a whole new category of footwear—“healthy shoes”—has emerged, along with myriad enticing claims about how a particular shoe design can increase our health or fitness levels if we do nothing more than wear them.
Footwear has evolved to a level of almost complete protection of the tissue from the environment. What began as the protection of the foot has steadily become the encasing of the foot, usually in materials more rigid than the feet themselves. In other words, what da Vinci called “a masterpiece of engineering,” a machine whose refined design evolved over millennia, is now stuck in one of your shoes. When an engineer begins making repairs or modifications to any machine—whether made of metal or organic tissue—the engineer has to ask the question: What else might this change affect?
A biomechanist looking at the mechanics of the human body will ask a similar question: For all of the benefit that protective footwear may bring, what else might it affect?
Consider all of the bones and muscles that make up and control your hands and fingers, and how many wonderfully unique ways you can move them. The ability to type, play the piano, conduct surgeries on microscopic tissue, and even button your shirt are all a result of learning how to use the muscles in your hands, and keeping them limber through regular use. Now imagine that when you were two years old, someone placed stiff, tight, leather mittens over your hands, lumping all of the bones together, every day, from morning to night. Your body would adapt to the situation, learning how to use the muscles of the forearms and the joints of the wrist to a greater extent. You would learn to use the outside edge of your hand as one “finger” and train the digits to all work as a single body part. This way of using your hands would be completely normal to you, as that is the way it would always have been.
Now ponder this: the anatomy of your feet indicates the potential for them to be about as dexterous as your hands. However, the act of wearing modern footwear every day has created a mitten-hand situation in your feet—and you didn’t even know it. We have weak, underdeveloped muscles within the foot and have placed large loads on the muscles of the lower leg, on the joints in the foot, and on passive tissues (those that cannot adapt strength) like the fascial systems and ligaments of the foot.
The good news is, by learning a bit more about your foot-machines, you can restore a lot of lost function and start the repair process right away. As long as your feet contain living tissue, they can change, grow, and improve, no matter what they’ve been doing (or not doing) up to this point.
Anatomy Lesson One: Your toes are separate structures from your feet for a reason.
When we think of the feet, we typically think of everything from the ankle down. Lumping this whole area together in our minds has the end result of lumping all the tissues together in our using patterns (or is it vice versa?). Each toe, just like each finger, has its own set of pulleys that allows it to function independently. While you’d be hard-pressed to come up with a modern activity that requires us to use our toes individually, using all of our parts serves a larger purpose. Every muscle has its own nerve supply that, when activated, keeps that local area of the body well nourished. While writing with our toes is not required for daily living (thank goodness—my penmanship is bad enough as it is!), being able to generate these movements is required to keep these parts of your body vital.
Anatomy Lesson Two: Your toes should be able to move separately from your feet.
Many people, especially those with chronic foot issues, cannot lift their toes without lifting their foot. Go ahead and try this. Stand up (it’s okay, you can take the book with you), kick your shoes off, and see if you can lift just your toes without taking the entire foot with them. If you don’t get it right away, try backing your hips up so your weight is over your heels, and keep practicing. You’ll be surprised how quickly your toes may go from “zero” to “some movement” with a little practice.
Anatomy Lesson Three: Your toes should be able to move separately from each other.
Imagine all of the unique motions you can create with your fingers, lifting them one or two at a time, playing a piano, or even typing. We have the same potential in our feet as we do our hands, but we have casted these muscle groups via footwear, often for our entire lives, and so we have been left with stiff, weak, atrophied, and degenerating tissues in the feet. It’s no wonder our feet hurt! If you had fun with the last exercise, you’re going to love this one. Try lifting your toes individually, without bringing along the rest of the gang. I suggest starting with your big toe (see page 108 for an illustration of this motion).
Don’t worry if you can’t do it yet. You will learn eventually, with practice. In fact, many people who are without arms or hands train their feet to complete daily tasks—from diapering a baby, to writing, to playing the piano. We come with the necessary pulleys, levers, and electrical equipment needed for these movements—we’re simply out of practice using them.
Anatomy Lesson Four: The front half of your foot should move separately from the back half.
Now that I’ve told you your toes are separate structures, keep in mind that the foot is not just one giant, fixed bone, but is made up of 26 bones and 33 joints. The primary reason our body even has joints is to allow for fluid movement. Could you imagine how hard it would be to use your arms or legs if your elbows or knees were missing? Your movements would be extremely rigid and stiff. The same goes for your foot: the less you use the many small joints within your foot by moving it in unique and novel ways, the less fluid control you have over stabilizing your body’s weight—also known as balance.
Anatomy Lesson Five: There is no part in your foot that is shaped like an arch.
If you cut open the perfectly formed and healthiest foot, you would not be able to find an arch-like structure. Rather, the arch is a shape created by what the muscles and bones are doing. Wondering what happened to the arch of your foot? Think about arching your eyebrow. The work that goes in to lifting your eyebrow is similar to the muscular work that goes into drawing up the mid-foot. Only instead of using the muscles on your face, you’d need to use muscles in the foot, shin, and thigh. Said another way, if you want to restore the arch in your foot (or reduce an overly high arch in the foot), it’s most helpful to think of the arch of the foot as an action, and not a part.
If you feel your high or low arches are giving you problems, you’ll need to address both the strength and the flexibility of your feet. Whether your arches are completely missing, or high and stiff, the recommendation is the same: condition your feet with the Fit Feet exercises shown later in this book to develop strength and mobility in the right places for your body.
FOOT MUSCLES
Every muscle comes with its very own nerve supply. When you underuse muscles in the body, the communication between those nerves and muscles is less, resulting in a decrease in the health of both tissues. The inverse is also true: increasing the use of a muscle can improve the health of both that muscle and its nerve by increasing local circulation. Increased circulation means more oxygen-rich blood (tissue “food”) being delivered to an area and also a simultaneous removal of cellular waste products—waste that can otherwise accumulate and accelerate tissue breakdown.
The nerves that are responsible for moving the foot muscles originate from the lower parts of your spinal column. Traveling from your spine all the way to your feet, these nerves are some of the longest in your entire body.
The muscles of the feet can be placed into two groups: extrinsic and intrinsic. Extrinsic foot muscles are those with one end residing within the foot, and the other end residing somewhere outside of the foot. The muscles of your calves are examples of extrinsic foot muscles. Running between the feet and lower leg, these muscles move the foot around relative to the lower leg, but can’t move the foot relative to itself.
Intrinsic muscles are those muscles that are contained completely within the foot. These muscles are much smaller, and are responsible for tiny, controlled movements of the many bones in the toes and feet. An example of an intrinsic foot muscle would be the abductor digiti minimi, the muscle that moves the little toe out and away from the rest of the foot. Ever heard of it? I didn’t think so.
If we think back to the example of covering our hands with leather mittens, it would be the intrinsic muscles that would become underdeveloped due to lack of fine movements. It would be the extrinsic muscles working to compensate. In a chronically shod foot, the extrinsic muscles work more than they should and the intrinsic muscles work less than they should. Ideally, the work between the two should be more balanced, with the intrinsic muscles functioning in coordination with the extrinsic muscles to walk deftly over natural ground, optimizing the shape of the foot arch and improving the nerve-muscle relationships of the foot.
ALL ABOUT YOUR PIGGIES
• In anatomical science, the toes are numbered outward, from the big toe (Toe #1) to the pinky toe (Toe #5).
• The bones in the toes are called foot phalanges (fa-LAN-gees).
• There are three phalanges in each toe except for the big toe, which has only two. This gives the smaller toes the ability to curl better than Toe #1.
FAST PHALANGE FACTS
TOE #1: Hallux is the Latin word for the big toe. It was derived from the Greek verb meaning “to spring” or “to leap.” The big toe should be the last part of your body to leave the ground after your pelvis vaults into the next step, but often when the big toe joint is stiff, the entire foot must leave the ground faster and as a single unit—and can result in a shorter stride length.
TOE #2: The second toe, also called the index or long toe, can be the same length or sometimes longer than the big toe. This condition is typically referred to as a Morton’s toe. Oftentimes people will experience pain in this toe and be told that the longer toe is the problem. While a long second phalange will change the way the bones in the foot are loaded, damage to this area is caused not just by the toe itself, but also by a particular gait pattern coupled with the extra-long appendage. If you are dealing with pain and have a Morton’s toe, you can change the mechanics of how you move to decrease the pain. Fun fact: the “Largest Morton’s Toe” award goes to the Statue of Liberty.
TOE #3: Ask most Americans, and they’ll tell you that this little piggy, the “middle toe,” had roast beef. My Irish mother-in-law will say that this little piggy typically has bread and butter. How about we settle on a roast beef sandwich? Those with webbed toes (a not-that-uncommon condition called syndactyly) will usually experience the tightest bond between the second and third digit.
TOE #4: The fourth toe doesn’t have a special name. Maybe that’s why people wear toe rings, just to boost this toe’s self esteem. This toe does have a greater risk for brachymetatarsia (“brachy”—short; “metatarsals”—bones in the foot), a bone that stops growing at a young age. Many people with a shortened fourth toe may notice some of the surrounding toes moving underneath, leading to painful walking patterns and “rubbing injuries” like corns and calluses.
Even though I have all my toes, I have been walking on only four toes ever since I was little. My next-to-pinky toe stopped growing at a certain age in my childhood, and that shorter toe has made it hard to find shoes that fit. Shoes either had to have lots of space in the front because the short toe sticks up (the pinky toe has curled underneath that toe to support it), or go high enough that they don’t rub that toe and make it sore. Can you imagine cramming that toe into heels and walking without it hurting? Not a good idea, of course, but I have done it anyway, since high school! Your exercises and Earth-brand’s wide toe box has helped me so much be able to spread my toes now and the shoes don’t rub the top of my toe next to my pinky toe and make it sore. No more sore and aching feet! I am forever grateful!
—LANENE W.
TOE #5: This little guy got the cutest name of all: pinky. Typically the smallest of the toes, this little guy, unable to defend itself against fashionable footwear, is often greatly displaced when wearing your favorite pair of shoes and develops a corn as a response to the extra pressure or friction from the tight fit.
CORNEUM, CORNS, AND CALLUSES, OH MY!
There are lots of visual signs you can learn to read that give you insight into how you use your body. Corns and calluses are actually very clear visual signals that your body is experiencing excessive pressure or friction.
Have you ever wondered what a corn is, or how it got its name?
The top layer of your skin is made of dead cells and is called the Stratum corneum. Corneum is derived from the Latin word for “horned,” as this layer is the oldest and “hardest” of the five layers that make up the outer layer of your skin.
The normal physiological response to mechanical irritation (increased rubbing or squeezing) is to “beef up” the area, to protect irritated skin. This thickening process is called hyperkeratosis (“hyper”—excessive; “kerat”—from the word keratin, a family of structural proteins; “osis”—the process of).
A “corn” is the small, kernel-shaped result of hyperkeratosis, which is a result of how your foot is interacting with its environment (shoe or landscape). A callus is the same thing, only more flat and broad compared to a corn. Corns are most commonly found along the outside of the pinky toe, although they can form wherever skin is pushing into something foreign. Calluses are typically found on the sole of the foot, where pressure (i.e., where you carry your body weight over your foot) is the greatest.
An interesting note: calluses are actually areas of the skin that have better circulation than other areas. What makes a callus uncomfortable is the fact that it is only a small area of thicker skin. This small patch of “health” becomes like a rock in a shoe (or a pea under a mattress if you’re royalty).
If we walked barefoot over natural terrain throughout our life, we would prompt a gradual adaptation in foot skin thickness over that time, giving us a stronger surface to handle walking barefoot. Said another way, our feet are sensitive to walking over ground because they’ve adapted to footwear (i.e., the skin on the weight-bearing surface of the foot is too thin).
Key Points, Chapter 1
1. The anatomy of our feet indicate their potential to move in much more complex ways than we actually use them.
2. Allowing the muscles of the foot to go unused or underused allows muscles to atrophy.
3. Many foot problems are a result of disuse, combined with overloading the underused tissue.
4. The muscles in your feet are the same as the muscles in the rest of the body; they respond and adapt to regular use and specific exercise.
5. Retraining the muscles in the feet can increase the regeneration of the tissues that make up the foot, which can decrease disease and increase the overall health of your feet.
