The Foot Mechanic

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Foot Workshop Saturday June 16, 2012

Your feet accomplish a lot for you every day.  What do you do for your feet?  Do you give them a few exercises or stretches every day to keep them healthy?  Do you know how to keep your Achilles tendons happy, or how to help slow or stop that bunion or hammertoe or plantar fasciitis from developing further?  This workshop will empower you to be the authority on your own feet.

This 3-hour Franklin Method workshop will cover:

• The biomechanics of your feet, particularly the transverse tarsal arch, the longitudinal arch, calcaneal eversion/inversion, subtalar sliding, the gears of the foot and more.

• What movements are likely to cause problems for your feet and knees

• Barefoot & shod running 

• Strength building exercises using therabands, small inflated balls and gravity

• How you can maintain your newly flexible & happy feet

 

LOCATION:  CHAMISAL TENNIS CLUB

185 Robley Road  Corral de Tierra, CA 93908

 

DATE:  SATURDAY JUNE 16, 2012 

11:30am to 2:30pm

COST:  $120 if payment is received by June 15, 2012 (after June 16 the cost is $150).

TO REGISTER:  Contact Donna Luder at 831-206-0725 or donna@donnaluder.com

Send payment via check or Paypal to donna@donnaluder.com

 

Gnarly toes

Have you ever seen gnarly toes dressed in a gorgeous strappy sandal?  "Poor thing" we think. Then "Thank God those aren't my feet".  On the other hand, and I'm sorry to be blunt, but perhaps you look down at your own feet and see Gnarly Toes. 

Here's the good news: you don't necessarily have to have gnarly toes. Ever. And if you do have them now, you don't necessarily have to have them forever. But you do have to do something about it other than hoping or wishing.  Are you ready to take it on?

This is the bottom of your foot. As you can see it is made up of many small bones, and each joint has potential for movement.

The bottom of the foot has lots of small muscles to pull on the bones of the foot. Here I've drawn in the line-of-pull of a group that operates on toes 2-5 (the flexor digitorum brevis group).  If this group is too tight, it will pull the knuckles of the toes toward the heel, creating Gnarly Toes. 

Instead of lying flat like this: 

The toes will be pulled into the classical "Gnarly Toe" shape. (You can correct your podiatrist when he calls it a claw toe. Tell him the correct term is "Gnarly".) I illlustrated this shape with just the little toe here, but you can see what I mean, right?

In life it looks like this:

So what to do about this? You need to lessen the tension on that flexor digitorum brevis group so it doesn't drag the tip of the toes down. In other words, you need to stretch out your feet. Generally speaking, muscles that are tight are also weak and unable to generate force dynamically or powerfully. Weak foot muscles make you a slow runner and will lead to calf strain because the calf muscles will try to do the job of the couch potato foot muscles. So there is a two-pronged approach necessary here: stretch and strengthen. Get a tennis ball and a theraband and join me on the video that I will post this afternoon.

 

 

Men in Heels

Here is a NYTimes article about some fashionable young men wearing tall-tall shoes to parties and clubs in the city.

The problem is that usually men have tighter feet than women, so the male foot stubbornly resists the demands of high shoes.  I'm sure we can all agree that tall shoes are very demanding biomechanically.  If your feet can't negotiate with your tall shoes, a few things are likely to happen:  you fall down or you give up and take them off.  This is not acceptable!  Your shoes are way too cute for that!  You've got to develop flexibility in your feet and thank God I can show you how to do that. 

Of course, men wearing "women's" shoes is not new.  I've always adored the Trocks, the ballet company of men who dance in pointe shoes and in drag. You're welcome.

 

A new way of thinking about your feet

We tend to think of our feet in only one dimension:  the-looking-down-at-your-foot-from-above-dimension.  (You thought there were only 3 dimensions, didn't you?) This plane is the most familiar:  the top-view plane:

There's the profile plane:

And then there's the head-on view (also called the transverse plane):

Anyway, the five metatarsals (if you don't know what or where metatarsals are, read this post) move in this transverse, or head-on, plane when you step on your foot.  And they don't all move the same direction.

Look carefully and critically at the foot and you will notice it can be divided into two distinct sections:  what Eric Franklin calls an "ankle-foot" and a "heel-foot". 

Top view:

   

  Bottom view:

 

The first 3 metatarsals (rays 1-3) are related to the talus and we can call this the ankle-foot; while rays 4 & 5 relate to the heel (calcaneus) and voila!  It's the heel foot.  

Here's the profile view:

...and the head-on view:

The heel-foot and the ankle-foot function somewhat separately although they are (obviously) very reliant on each other for stability. The metatarsals don't move forward/back or swing like pendulums... they rotate along the long axis.  Now because: 

-- the 1st-3rd rays move with the midfoot (cuneiforms and navicular) and the talus in one group

--and because the 4th-5th rays move with the cuboid and heel-bone (calcaneus) in another group, we have a cogwheel effect of the ray.

 This motion occurs each time you step on your foot.  The weight comes down, the gears turn, and the sole of the foot spreads out like a puddle of pancake batter.  Pick your foot up, and the opposite happens.  The gears turn the other direction and the foot domes like a suction cup under suction.

Put a pebble on the floor and try to pick it up with the middle of your foot -- not your toes, the MIDDLE of your foot.  (Yeh, go ahead and massage out that cramp you just got.  I'll wait.)  This is your foot doming.  This happens every time you lift your heel in walking, or push strongly out of the starter's blocks in a race, or jump up in the air.

If you're a dancer, visualize standing on the line between rays 3 and 4 -- this is your perspective.  Rays 1-3 and 4-5 turn en dehors as you releve, and en dedans as you plie.  Imagine that you are lifted up into releve because your foot domes first.  Ahhh.  Isn't that magic?  The power doesn't come solely from your glutes, hamstrings or calf muscles (this is SO important for those who have achilles tendonitis!!!!) -- it can also come from the muscles that live entirely between the tips of your toes and your ankle.

I'll post a video of the embodiment of this movement next time.

Do Certain Types of Sneakers Prevent Injuries? - NYTimes.com

Scientific rumblings about whether running shoes deliver on their promises have been growing louder in recent years. In 2008, an influential review article in The British Journal of Sports Medicine concluded that sports-medicine specialists should stop recommending running shoes based on a person’s foot posture. No scientific evidence supported the practice, the authors pointed out, concluding that “the true effects” of today’s running shoes “on the health and performance of distance runners remain unknown.”

via well.blogs.nytimes.com

The problem with assessing your foot posture and then recommending a certain shoe type (cushiony/soft or supportive/rigid or middle-of-the-road) is that your static foot posture is not necessarily indicative of your foot rhythm in gait.  I tend to overpronate on my right foot and yet I have very high arches.  The shoe salesmen from this article would tell me I need a cushiony shoe because of my overpronation, and yet a rigid shoe for my high arches.  See?  Ridiculous. I'm proud of the researcher quoted at the end of the article because he recommends readers listen to their body and pick running shoes based on that.  Yay!  One point for our side!  Researchers don't usually recommend kinesthetic awareness because they like to measure things, and subjective thoughts are impossible to objectively measure.  

I'm barefoot most of the time because that's what Pilates instructors do, but when I do wear shoes I often pick my Vibram toe gloves.  I just wish they were flesh colored, because I'm 5'2" and wear a size 9 shoe.  I look like *$&%* Minnie Mouse.

 

Lisfranc fracture

 The above image is from Thieme's excellent Atlas of Anatomy.  Get it if you don't got it.

I met a new client this week who suffered a Lisfranc fracture in a head-on car wreck.  This is when the midfoot, where the long metatarsals meet the cuneiforms and cuboid, dislocates and/or fractures.  It appears that this fracture is missed probably 20% of the time. (see footnote)

The thing to watch out for with Pilates clients with this fracture is discomfort when the foot is on the Reformer's footbar, on the push-through bar or in the footstraps.  Basically, anytime the foot is positioned with the weight on the arch will be uncomfortable for this client. 

 If you're doing the feet in straps variations, it might be helpful to steal the Gyrotonic foot-loops (not Froot-Loops) because it transfers some of the load onto the ankle.

 

You can get these from Balanced Body here.
 

Reference: (Hardcastle PH, Reschauer R, Kutscha-Lissberg E, et al. Injuries to the tarsometatarsal joint. Incidence, classification and treatment. J Bone Joint Surg Br 1982;64:349-56.)

Your foot is like a suction cup

I'm sure you remember the foot is constructed of arches (from the toes to the heel is the longitudinal arch and from the big toe to the little toe is the transverse arch).  Your weight depresses these arches slightly with every step, just like pressing down on the toilet plunger compresses and deforms the suction cup end.

Instead of sticking you to the floor, however, like this guy...

this spreading or widening of your foot is an energy absorber.  (But wouldn't it be cool to go up the sides of buildings like SpiderMan or a tree frog with your sticky suction-cup feet?)  

When you land a jump, your feet spread out for a couple of very sensible reasons: to distribute your weight over a wider area, to stabilize your landing, to maximally disseminate the landing force.  Don't believe me?  Then try jumping in stilettos. Have you ever tried on new shoes that felt great as long as you were sitting, but absolutely killed when you stood up? That's your transverse arch spreading out like a suction cup.

 It would seem therefore, that pointe shoes do not make any sense.  

 

Take them out of the box and they are very rigid.  They are made of cardboard and glue and covered in satin; some have a carbon-fiber shank in the sole to provide support and longevity to the shoe.  When they are new they are very supportive to the foot, but most uncomfortable. Each dancer has her own personalized method for softening up her pointe shoes: hammering, scraping, closing in a door, warming and reshaping, etc.  

When pointe shoes are new and stiff it is very difficult for the transverse arch to widen and flatten out and you feel it as compression.  Pointe shoes are at their peak in mid-life (just like people).  This is when they have softened enough to allow the toe box to widen a bit for the natural rhythms of the foot and yet not so soft that they can't provide the necessary support for dancing on the tips of your toes.  

You know all this already, though, from your own experience.  Your gut tells you that these Jimmy Choos

 
 

 will probably be more uncomfortable than these Keens

and now you know the biomechanical reason why. 

Gait cycle & the big toe

Every step you take moves through a gait cycle.  Look at the activity of the right foot:  half of the time you are standing on it (stance phase) or swinging it forward and preparing for the next step (swing phase).  The stance phase is made up of  the following events:  heel strike, foot flat, heel off and finally toe off.  Here's an illustration of the gait cycle.

When the foot moves through toe-off (that's the second leg to the right of the shaded leg in the above illustration), normally the big toe is the last bit to leave the ground.  The very last scrap of propulsion your body is going to get is going to come from this moment.  Do you think the big toe can provide much oomph for the rest of the body?  After all, it's not very big....

The big toe is ingeniously designed.  Its tendons are long and thin so that the belly of the muscle is located much higher up, in the calf.  This image is from Thieme's General Anatomy textbook.  It's the mostest awesomest anatomy book ever.  Go visit them at the winkingskull.com or buy it at amazon.

 

This illustration shows the muscle flexor hallucis longus (a long name like that describes the muscle - that is it flexes a joint, it's attached to the big toe, and it's very long) as well as some others.  To find the flexor hallucis longus, look at the base of the big toe and follow that gray tendon upward, behind the inside ankle bone and toward the outside of the calf muscle.  Look at how big the belly of that muscle is!  It's extremely powerful (or at least has the potential to be).  The larger the cross-section of the muscle, the more force it can generate.  As in:

 
Sorry, I got distracted there for a moment.  'K, look at his shoulder, that is the muscle belly of his deltoid.

 

 That's a muscle with a lot of potential for power, and it attaches directly to the bones it affects.  There's no long thin tendon attaching it to a bone far away.  The big toe's ingenious design allows our feet to be bony and light, and yet still have access to power.  Like a long extension cord!  If our feet had to pack the muscle in right on top of the bones, our feet would look like big pillows stuffed with sausages.  Ick.  Nothing fun like this would ever happen again:

Watch sprinters bursting out of the blocks at the beginning of a race; of course that power is coming from the posterior hips and thighs, but don't dismiss the contribution of the big toe and its flexor hallucis longus.  For dancers, this muscle is essential for jumps and releves.

  

 

Dance sneakers

I have a few Pilates clients now and then who have arthritis in their feet and do not tolerate the Feet in Straps series on the Universal Reformer very well because Pilates is usually done barefoot.  These dance sneakers can help.  They are lightweight and do not block the foot and ankle from pointing and flexing.  They are also great for jazz class or Zumba class. Available at discountdance.com. (Gail, these are the shoes I spoke of the other day in class.)

 
 

"Good" balance involves your feet

Many anatomy texts attribute balance to the inner ear, identifying the vestibular system as the organ of balance and equilibrium.  But it's just one piece of the puzzle.  Humans also rely on visual cues and on sensory information such as the sensations picked up by the soles of your feet.

Stand up with your feet about fist-width apart and close your eyes for a moment.  Can you sense that your body is not completely still?  You are swaying slightly, typically forward and backward, constantly adjusting your center of gravity over your feet.  This oscillation is called postural sway and is the result of a feedback loop between your sensory system, your musculoskeletal system and gravity.  It's completely normal.   Now stand on one leg and close your eyes again.  Did this sway increase?  Could you keep your eyes closed for 10 seconds, balanced on one leg?

This gentle sway is present whenever you are in quiet standing, such as in line at the grocery.  If you have "good" balance, your postural sway is likely to be slight and hardly noticeable.  If you have "bad" balance, your postural sway is probably such a large oscillation you can hardly perform the closed-eyes balance without your eyes popping open and grabbing for a hand-rail.

Postural sway does not negatively impact quiet standing until one of the members of the loop is compromised in some way.  We can safely assume gravity isn't going to develop an issue, so chances are it's the sensory or the musculoskeletal system.  These two systems work together so closely to determine and maintain balance that they can be collectively termed the sensorimotor system.  One system detects what's going on and the other corrects any problems:  whoops I'm falling forward, I better get my weight back... whoops now I'm falling backward, I better get my weight forward.... you get the idea.  People who have bad balance basically have a slow reaction to the shifting.  By the time their sensory system has detected the shift of the center of gravity, and the motor system has organized a response, the person has already stumbled. Being drunk slows your motor system and that shows up as poor balance or slurred speaking (1:39 below - I love MST3K.)

Poor balance is as if your sensorimotor system was chronically drunk and this has a very negative impact on fitness.  Many older adults reduce their physical activity levels because of a fear of falling (Lee, Arthur & Avis, 2008), and this lack of activity of course slows their reaction time even more.  A negative spiral that will likely end with a fall, a hip fracture and a long stay in a nursing home.  Yikes.  

So what to do?  

--Challenge your balance with every workout.  If you don't work out, then add simple balance exercises to your day.   Hiyamizu, Fukumoto, Kataoka, and Yagi (2009) found adults between 61 and 71 improved their postural sway by simply standing for 10 seconds each day for 10 days on foam pads of differing density.  The subjects were asked to detect the firmness of the foam pads they stood on, thereby engaging the sensory system in an active way.  At the end of the trial, the researchers found significant improvements in postural sway.

--Take a ballet class at the local community college.  Don't worry, no one else is looking at you; they are all too busy looking at themselves.  Dance is fantastic balance training and it makes your tush look good.

--Take a tai chi class.  Good for your balance, good for calming the monkey mind.

--Facing a wall, stand on one leg.  Watch an imaginary spider crawl up the wall, so that you tip your head up.  Try to maintain your balance as you watch the "spider" go up and down a few times.  Repeat on the other leg.

A few simple tools to use are:

-the Airex mat 
-the BOSU  

One of my favorites is the baby BOSU, it is one of the very best gifts for a 6-year old ever.  My boy simply bounced on this thing for about 3 years.  Tons of fun, and versatile for adults too because it provides the unstable training surface, doesn't take up so much room, and is cheaper than the larger version.

Reference:  Lee, L., Arthur, A., & Avis, M. (2008). Using self-efficacy theory to develop interventions that help older people overcome psychological barriers to physical activity: a discussion paper.  International Journal of Nursing Studies, 45, 1690-1699.