Feet. They are critical for fall prevention yet often overlooked.

A recent article in the New York Times entitled, “Bracing for the Falls of an Aging Nation“ pointed out or increasing problems in America with falls and injuries related to falls–even deaths from falling. While the root causes of falls are multifactorial, there are some definite PREVENTION tips that are worth mentioning especially with feet and ankles.  The article did a nice job discussing some visual upgrades to help people see walking surfaces better like marking stairs, colored toilet seats, etc. but very little was mentioned about the fitness side of fall prevention whether it be from feet, joint mobility, or vestibular training of the inner ears which are critical to maintaining balance. Dr. Christian Thompson of University of San Francisco has been teaching fall prevention classes for seniors with great success for many years with multiple factors addressed as above including gait assessment and improvement. Fall prevention…it can be done. For now, here are a few tips to get you started at home.

Here are a few Foot Fitness tips for fall prevention:

• Wake up the nerves in your feet.  Feet are like computers on the ground gathering information. When you wear stiff shoes with thick soles, the sensory information is very blunted decreasing the information the brain needs to prevent a fall.
• Wear flexible shoes. Unless you have a true orthopedic clinical issue, flexible shoes allow the smaller nerves in feet to start working more efficiently. Since all shoes get in the way of the smaller nerves in feet, consider the next point.
• Walk barefoot. Many of the small nerves in feet are in skin of feet. The best way to activate these small nerves is to put the skin of you feet right on the ground. If you are afraid to “walk” barefoot as an elderly person, you can start waking up nerves in your feet while sitting with a great foot therapy called The FootLog. While the FootLog is a tool I often reference for Plantar Fasciitis, it’s also a great overall foot health tool for stimulating nerves in feet.
• Get limber. Walking barefoot without stiff shoes or even walking with more flexible shoes is a way to start allowing the joints in your feet to start moving–or “limber up” as they mobilize through ranges of motion.

Here are a few Ankle Tips for fall prevention:

• Get limber again–in multiple planes of motion with rotation. “Stiff” ankles are a fall waiting to happen. Ankles are mobility joints meaning they need to be able to move in order to make up for uneven ground below. If you step in a hole with a stiff ankle–the body above has to move off center increasing your chances for falling if you cannot correct the imbalance efficiently. Ankles should flex both ways meaning pointing toes down and pulling toes back up towards shins. Ankles should tilt left and right, and also very important–ankles should be able to roll in large circles. You can do all of these movements while sitting in a chair. Do them enough–your ankles will likely get more mobile and thus be able to make up for uneven ground more efficiently. One of the best ways to prevent falls with elderly populations? Improve ankle mobility.

In closing, I used to teach an exercise class at a community college. My students were up to 92 years old. Most of the class was retired. NONE of my elderly students used a cane or walker to come to class daily. In five years, I never had one of them fall. We worked on balance and fall prevention DAILY. Think about it.

Interestingly, as pointed out by Podiatrist and shoe history expert Dr. William Rossi decades ago, “All footwear fashion stems from only seven basic shoe styles: the pump, boot, oxford, sandal, clog, mule and moccasin.”  In fact, there has not been a new shoe type invented in about 400 years!

For a fascinating and fun look back at the true history of the only seven shoe styles ever made, read the article “All Shoe Fashions From 7 Basic Styles“ by William A. Rossi, DPM.  This article was originally published in “The Selling Floor” in September of 1998 and is part of the William Rossi Archive Collection at Stonehill College.  Dr. Rossi was one of America’s top podiatrists and shoe experts for decades who truly understood the function of feet and how they interact with shoe dynamics.

Also called “shoe inserts,” these alter the natural function of feet.  They add height through the heel which throws off your falling line meaning you will have to compensate from the ground up to keep standing upright.  The stiffness of the device removes elasticity of feet too.  While there “can be” clinical reasons for orthopedic orthotics made by a podiatrist, the notion that you as a consumer can just buy inserts off the shelf and slap them in your shoes to “fix your feet” successfully is highly unlikely.  These foot beds or shoe inserts just treat the end symptoms—not the root causes.  To get a “step ahead,” you need to find out why your foot has collapsed or hurts in the first place! *For more foot facts and shoe info, see my Products Section.

The idea of “Foot Fitness” is nothing new. The historic photo and foot exercises directions are from the 1943 US Department of War Field Manual 35-20 PT for female WACs. Fit and healthy feet are important no matter what your mission or place in life. March on–with healthy feet!

Here’s an interesting Foot Fact–the very first shoe to use a heel or platform was the ancient Greek “Cothornos” (also kothornos).  It came from Greek theatre and was said to have been introduced by the Greek dramatist Aeschylus around 450 B.C.E. to help distinguish actors by height. Remember, this was before fancy microphones and PA systems, so actors used many methods to add drama between characters and plot. The higher the platform Cothornos, the more distinguished the actor, and thus the tradition likely began where height via shoes was viewed as a status symbol. The ancient Cothornos platforms were as high as six inches.

Interestingly, at one point in history, only upper class people were allowed to wear large heeled shoes and platform shoes while the peasants were relegated to low (lowly) shoes. The added height allowed upper class people to “look down their noses” at the lower class people. A “well-heeled woman” also came out of status and height as women with high heels were only upper class socialites at one point in history in some cultures.

*(Source: William Rossi, D.P.M.)

A major plantar fasciitis point I have learned by experiment was to drive without my shoes on. For some reason, when I drive with shoes (and even foot-friendly shoes), my foot really barks and can sometimes send me a sharp pain to let me know it’s irritated. If I remove my shoes, then my accelerator right foot (the one that has bothered me with plantar fasciitis) feels completely different. I have always felt that the excessive driving I do was a significant factor in developing my plantar fasciitis, and since I must drive a lot for my job at times, at least one of the causes still remains. I’ve passed this tip on to others, and they have also reported that their plantar fasciitis is much better if they remove their shoes while driving. Try it. Your foot might like it! For more info, check out my Products Section.

After studying the history of shoe design, it’s very simple. The only reason we have heel lifts is to make people taller. When studying physics of feet, you learn that ANY abnormal heel lift throws off our fall line thus creating all kinds of compensations up and down the kinetic chain. Add some coil springs big enough for a Volkswagon to the mix, and it spells trouble…it actually spells something else I’d like to say, but I’m doing my best to keep this site family friendly. To think we can outsmart nature with spring loaded shoes is pretty funny…not really, but you get the point hopefully. If not, you’re feet will. For more information, see my Products Section.

An interesting point few discuss, but to understand gait, you must understand what shoes have done to gait. There are precious few “natural” shoes available. The only true natural shoe design is going to be something like a moccasin! Interestingly, at one point in history, shoes were not “right or left” sides but one shoe could fit both feet. There was no “shoe last design” that forced feet into shape—and thus the authentic moccasin allows the foot to function naturally without getting in the way. The end result is that the only true “natural” gait patterns are going to be found in shoeless populations. We might view a person as having a “normal” gait in Western culture, but in reality, normal is NOT natural because our feet have been deformed by the shoes we wear which results in altered gait patterns. This is a very important point that is rarely ever mentioned in current foot and shoe discussions. For more information, see my Products Section.

I saw a “fitness” woman today with some horrific shoes on. Very stylish of course which reminded me of how fashion drives the shoe business instead of function. Her shoes reminded me of the shoes above from some of my shoe history research. Throughout history, a smaller and shorter foot was viewed as more attractive. There were some folks over the generations that elongated the appearance of feet on purpose–like the shoe above. While the shoes today were not long, they were very “pointy.” Her shoes came into a very sharp point directly in “what appeared to be” the center of her foot. I have worked with lots of feet for years. I have yet to see just ONE FOOT that is pointed in the middle! Why on earth would we wear shoes that have no resemblance to the actual shape of our feet? To make them look smaller. The price women (and men) pay for fashion is disfigurement, pain, injury, and even surgery. I have yet to meet one woman that had foot surgery where the actual surgery was successful. Every single case produced another foot problem from trying to fix the first foot problem. What causes the initial problems? Usually the shoes themselves strangling the feet into submission. Sexy women are great, but pick and choose your foot battles ladies because the more you wear pointy shoes, the worse your feet will feel, and if you wear them enough–you’ll actually change the bone structure of your feet as you disfigure them. Enjoy the fashion. I’ll take fitness feet any day. *See my Products Section for more information.

Most shoes have a compressive “binding” effect on the foot much like a corset around a Victorian lady’s waist.  Shoes should not force the foot to conform to a certain shape, but rather, the shoe should stay out of the way of the foot!  A foot during gait should “expand” as weight is applied spreading at the toes and balls of foot.  Shoes tend to bind this expansion thus decreasing the stabilizing potential of the foot from the ground up.  The more you bind the foot—the worse you will move and walk—it’s that simple.  Tall columns need good base of support for stability and integrity.  Narrowed feet “bound” with shoes will never facilitate optimal base of support.

Disfigured feet from binding

Why do we bind feet with shoes?  Sex and attraction—to make the feet appear smaller or more attractive.  To improve both health and safety from the ground up–remove the foot constraints and allow the feet to expand naturally. *See my Products Section  for more information