By accident, I recently came across the 2 founders of The Foot Collective on a podcast, talking about (you guessed it) feet!
They seemed like very sensible people, like myself, trying to get as much information out there about foot health in a non-technical way, so I found them on Instagram and Facebook and listened to their podcast episode about Plantar Fasciitis.
It is not often that your own understanding can be challenged, but this podcast episode has definitely turned on some light bulbs for me when it comes to treating my Plantar Fasciitis problems.
I transcribed and have listed the main takeaways for me from this podcast, to help you understand that these sorts of foot problems are 100% treatable – provided you go with the best advice.
“Plantar Fasciitis is an umbrella term used for pain on the underside of the foot [..] you could probably just call it shoe-itis and and that would almost describe the problem better for a lot of people.“The Foot Collective
This follows the way I think about PF or foot problems. They are usually caused by people wearing bad or inappropriate shoes.
From my perspective, wearing properly supportive shoes did help reduce the pain I was feeling, but the podcast goes on to talk about how modern shoes can be the cause of foot problems, not the cure.
“On topic of shoes another thing that we talked about is when you combine an elevated heel and a toe spring.
So toe spring is when you put on a shoe and most shoes, when you put flat on a flat surface and you look from a side profile, the toes are elevated above the ground and the reason that’s there is because most shoes are so rigid, they don’t actually allow your big toe or your toes to extend.
And because they don’t allow that articulation point they have to create kind of this rockered ramp at the front of the shoe to allow you to roll off the shoe, or else it’s very hard to walk.
And what that does, the elevated heel toe spring at the front is putting your toes into extension.
You’re literally winding up tension in the fascia at all times because of that position and then you’re not doing that normal propulsion mechanism, you’re not propelling yourself forward.
And that shows you you’re farming it off to the shoe. Exactly you’re farming that off so you’re not having to.“The Foot Collective
The design of most modern shoes gives you an elevated heel, which means the distribution of your weight is tipped forwards. Because this is not a natural position, the front part of the shoe is raised up, which allows your feet to move in a more natural way when you walk and run.
However, this is not a natural position for the foot. The design of the shoe is actually causing more tension and stress to the arch of your foot, which can lead to more damage.
The members of The Foot Collective promote the going barefoot as much as you can or wearing minimalist shoes that have no raised heel at all. Allowing yourself to be barefoot will help build the muscles of your feet, making them stronger and more able to support themselves.
It might not be easy to change to being barefoot or wearing very flat shoes. Take your time and gradually increase the time you are not wearing shoes.
This advice goes against what I had been told and read that wearing shoes with arch supports as much as possible is best for you is you have Plantar Fasciitis.
This follows nicely into their views on using orthotic insoles to help treat Plantar Fasciitis. Again, something I tried when I was first diagnosed by a Podiatrist (and something I paid a lot of money for too).
“So what we’re finding is that orthotics are essentially, a lot of studies are showing that all they do is to kind of differentially load the foot, so they kind of offload it in a way because they’re just putting pressure in different areas.
This study basically said that, hey, if you’re gonna use orthotics, don’t use them past three months and it and they said that the effectiveness starts to wear off after three months and then there’s no no difference thereafter.
It can offer temporary relief but not recommended after three months as the sole way to get this better and also there’s no difference between store-bought and custom orthotics in this study“The Foot Collective
So whilst wearing orthotics, custom made or bought from the store, can make a difference in reducing the symptoms of Plantar Fasciitis and foot pain, they are not recommended for use after 3 months as their effectiveness decreases.
Also, this does not mean that this is not working after 3 months because they are wearing away, your foot is just no longer seeing the benefit of being supported in that way any more.
Usually, a podiatrist should ask you to wear orthotics as part of a treatment plan that may also include stretching or another sort of treatment. They are not the cure to your painful feet – only a temporary way to relieve pain whilst you address the root cause.
What causes Plantar Fasciitis?
The main factors that can cause Plantar Fasciitis was also discussed in the podcast, some of which I knew already, but they focussed on sitting too much as a possible cause too. Also something I am guilty of (as I sit here typing this!).
The main factors that contribute to Plantar Fasciitis are:
- Overpronation or inability to control pronation
- Ankle dorsiflexion limitation
- Reduced toe flexor strength
The Foot Collective team talk a lot about the stresses and strains your feet are put under on a daily basis. Being overweight increases the load on your hips, legs, ankles and feet – so it’s no wonder that increased weight can lead to foot problems.
“If each foot is designed or adapted to bear a certain threshold of weight and you’re double that weight on each foot you’re probably gonna have overloading problems eventually.“The Foot Collective
Obesity is a growing epidemic, both here in the UK and also across many developed countries. Addressing overall health problems like these can benefit every part of you.
If you are overweight and suffering from foot pain, take steps to address this issue as soon as possible.
The Foot Collective describes overpronation as “anatomically flat feet” due to weak intrinsic muscles of the foot.
If your feet are weak enough to not be able to support yourself correctly, this can lead to pain or additional stress to the plantar fascia.
If your foot has reduced movement at the ankle, where it cannot move back towards you, much, this is classed as reduced ankle dorsiflexion. A normal range is classed as from 0 to 16.5 degrees.
“Dorsiflexion showed up in a ton of studies, both associated with just tightness in the ankle.“The Foot Collective
Problems such as these can be caused by many different factors and wearing footwear that tilts your feet forwards, like high-heels, putting the foot in the opposite position to dorsiflexion. Over time, this may impact the ability for your foot to bed upwards and cause damage to your fascia tissue.
Reduced toe flexor strength
When you walk, you are not putting your feet flat on the floor and lifting them upwards to move forwards (like you are wearing flippers). There are some muscles in the foot called toe flexors which propel you forward, allowing you to push off with your foot.
If these muscles are weak or restricted from doing their job, this can cause additional load or stress to be placed on other parts of your feet. Namely, your plantar fascia.
Modern footwear, including running shoes, can stop your toes from performing this function effectively. If you look at a pair of running shoes, they often have a higher heel at the back so that your foot is sloping downwards.
The front of the shoe is then raised up slightly to give you that sense that you are able to bend your toes to push yourself forward. This is not a natural position to have your feet in and is another reason why The Foot Collective recommends transitioning to minimal footwear as soon as possible.
“When a shoe ends in a point and crushes the toes together, especially that big toe, the action that the big toe flexor would normally do to help propel you and push off forward, that muscle action, now turns in to a muscle action of pulling.
You are crooked not pushing off through the big toe. So it’s almost like part of me thinks that some of that propulsion might even be inhibited because activating that big toe flexor actually just pulls that big toe more crooked and doesn’t actually create a good rigid lever to push off on.“The Foot Collective
It’s all in the hips
But, my hips are quite far from my feet, so why should they have any impact?
“Let’s start at the hip. So if you spend most of your day sitting in a chair with your hip in a flexed neutral rotation position you’re going to lose the ability to optimally organize that joint to generate torque. Torque at the hip is what generates the right position downstream of both your knee and your foot.
To organize the foot into a nice arch position you must have a functional hip.
If you don’t have a functional hip, good luck getting the foot in the right position to even allow a contraction of the intrinsics (muscles) to hold it there.“The Foot Collective
The Foot Collective see the hips as the foundation of having good feet. If your hips are tight, have some restricted movement or are not aligned properly, this will have an effect on the position of your feet.
Without a stable platform, extra stress and strain will be placed on your lower legs and feet, causing problems.
“If you take the analogy of a bricklayer creating a bridge, that’s an arch made of stone, the bones are the bricks, the muscles are the mortar holding them together and the hips are the stonemasons.
So if the stonemasons that are in charge of placing the stones into an arch, into a nice stable rigid structure that bears load evenly, if the Masons aren’t there to organize the stones into an arch you cannot create an arch.
If your hips do not have either the software the muscle activation patterns or even the mobility to organize the bones of your foot into the arches, the mortar is useless, the muscles are useless.“The Foot Collective
So whilst you might think that plantar fasciitis is caused by something in your feet going wrong, it could be that the foundational blocks of your body are also incorrect.
I am guilty of sitting too much and I agree that tight hips can lead to leg stiffness, which can lead to foot pain. I try to remember to stand up and walk around as often as I can and do some stretching exercises to relieve any tension.
Taking a holistic view of Plantar Fasciitis
So as you have read, there is more to foot or heel pain than just that your plantar fascia is not working properly. There are many other factors that need to be considered and taken into account when addressing this problem.
But this is another issue in itself.
As I said earlier, most podiatrists will diagnose plantar fasciitis, tell you to use orthotics or have invasive injections and send you on your way. But this is just putting a sticking-plaster over the issue, not solving the root cause of the problem.
This happened to me when I visited my podiatrist. They were keen to sell me something rather than look at any underlying issues or causes of my plantar fasciitis. I feel that they were obviously just out to make some money.
If you are not considering your overall health, leg, hip and muscle strength as well as addressing the immediate pain in your feet, it is likely you may never get full relief.
The guys at The Foot Collective are very knowledgeable, are fans of toe spreaders and are a great source of information and tips. Make sure you check them out at their website, Facebook and Instagram pages.