Almost everyone I work with has had pain in their feet. It doesn’t seem to matter how young or how old they are. It doesn’t seem to matter if they have a job that is more sedentary or if they have a job that requires being on their feet all day. It is also interesting that it is almost never the primary complaint and it frequently comes up after the evaluation is over and we are well into treatment. Clients often report that it is an old issue that has never gone away. People just expect to have pain in their feet.
The traditional approach to foot pain is to add support. Inserts and shoes with highly developed technology to mold to, support and protect your feet and ankles are big 
business. What if the opposite were true? What if less was more when it comes to your feet?
There are 52 bones, 107 ligaments (the tissue that connects bone to bone), and 19 muscles. There are 33 joints in the foot making the number of possible positions of the foot amazingly high. (I asked my son to do the math and assume each joint can be at neutral, up or down. The answer is over five quadrillion possible combinations in just one foot!) If there are so many potential positions, why do we intentionally limit them with sturdy shoes? When we think about the rest of the body, we know that strong and flexible creates a healthy body. Why not the feet, too?
Keeping our feet bound up in shoes and supportive inserts keep our feet immobile making them weaker and less flexible. Think about your foot health and your footwear habits. Does this make sense? We have not even talked about high heels yet! Any heel, even low heels, can lead to foot and whole-body pain, but that is another discussion. Let’s stick to shoes in general.
When did you start wearing shoes? I treated a baby recently. He was nine months old and starting to pull himself up and cruise the furniture. After the treatment was over, his mom began to dress him. She pulled out an adorable little pair of shoes. When I saw they had thick solid soles, I asked her if it was ok if I made a comment on his shoes and she was very open. I explained to her about all the muscles and bones in the feet and that his feet were still developing. I also described how all the possible motions of the joints and muscles were providing his brain and body with feedback helping him learn balance. 
Allowing him to wear no shoes or socks is best. If you are afraid of him slipping or stepping on something use socks with grippers or shoes with flexible leather soles. Allowing his feet to become strong and flexible as a baby will help him with coordination and balance as he grows older. She put the shoes back in the bag and put two pairs of socks on him instead. She asked if she should have her older kids go without shoes sometimes too. The answer was yes. It is never too late to develop healthy feet.
I worked with a teen who was complaining to his mom that his feet hurt when he wore his new football shoes. They had tried several brands, and they all hurt his feet. The shoe issue came up in conversation and was not the reason I was seeing him. Mom said he hated to wear any shoes other than his high-top sneakers and always complained his feet would hurt in other shoes. He also told me he wears them all the time except sleep and showering and likes to lace them up super tight because that feels best. I gave them my “free your feet” talk and added more information about the fascia.
The fascia connects everything throughout the body. So, if the fascia in your feet is tight, it can pull into the entire body, sometimes in very unexpected places. The fascia is also a communication system. It helps you know where your body is in space so you can move smoothly and accurately. When one part of the fascia is pulled or stretched, the rest of the body knows this and reacts due to the interconnectedness of the system. This is called tensegrity.
So, if you are out walking and step on a rock with the left front part of your right foot your whole body can immediately adjust to keep you upright. This information is sent throughout your nervous system and your fascial system. If your fascia is tight and inflexible, communication may be limited. Weak and rigid feet can lead to poor balance, as well as tightness and pain in the feet and other parts of the body.
Ok, one more story. I decided to try reflexology. A reflexologist is a person who applies pressure to points in your feet with the intention of addressing issues throughout the body. They believe the foot is a map of the entire body and pain in your body will mirror throughout your feet.
My friend told me she had tried it and it was a very painful experience. I loved it. I felt no pain. I did experience some tenderness that mapped to places in my body that were tender. Interesting. Why was my experience pain-free and my friends was not? She loves shoes. I don’t. Well, I do love a cute shoe when I must wear them, but that is not the point. I am out of shoes every chance I get. I rarely wear shoes in the house. I regularly take walks in my backyard without shoes. I exercise without shoes. I take my grandson to the park, and we take our shoes off when climbing the equipment together. (Yes, the area gets a thorough scan to be sure there is no broken glass or sharp objects. Stepping on rocks and twigs is welcome.) When I hike, I wear flexible hiking sandals instead of sturdy hiking boots. Plantar fasciitis used to plague me. Now, when it rears its ugly head, I go for a barefoot walk instead of pulling out my old shoe inserts. Yes, it helps a lot.
So, what about adults and older adults? Don’t throw out your shoes just yet! Assess your shoes and how often you wear them. Do your feet ever get any no shoe time? If not or not much, move in that direction slowly. Your feet see a lot of action so you must go easy. If your feet don’t typically work for you outside a shoe, they will be sore if you do too much too soon, just as any other part of your body would be if you started a rigorous exercise program. Let me be clear! Shoes are a necessity of life and often a safety requirement. I’m not advocating for no shoes all the time. Safety is always number one. Give some serious thought to your footwear and try to balance safety with flexibility and strength as much as possible. 
If you have foot pain that will not resolve, you may want to get checked out to be sure there is not a medical problem. Then, you may want to try myofascial release and slowly begin working on the flexibility and strength in your feet, legs and hips. Myofascial release can give you a jump start on your flexibility and bring your feet into the best possible alignment as you begin your no shoe adventures. Opening the fascial system and aligning your tissues, allows all your systems (muscles, nerves, ligaments, etc.) to work even better. Alignment is critical!
You can start your home program by just not wearing shoes for short periods of time in your home. If this sounds unappealing, find slippers or shoes with flexible soles. If you have access to a yard, try walking barefoot in your yard and feeling the lumps and bumps under your feet. Notice how your feet move and where you feel the responses in the rest of your body. If your feet get sore, adjust your program but don’t give up. If you need help designing a plan for yourself or your family, contact me. You may consider choosing exercise opportunities where shoes are optional, such as yoga. Your feet were designed to be free and support you in all your daily activities. Give them the chance to support you and are likely to be pleasantly surprised.
Be patient. Your feet work hard for you. Treat them with care!
-Amy Mayer OTD, OTR/L, RYT 200
