The Answer is a Strong Foot
Dr. Nick wrote a beautiful letter yesterday for Podiatry Today, confirming what we’ve been sharing in our book Barefoot Running, and in our new movie. In short, his conclusion is that the old method of treatment, supporting the foot through orthotics and heavily supportive shoes, doesn’t work very well, or people wouldn’t be coming into his office.
Instead, he recommends strengthening the foot, through foot exercises, a gradual introduction to going barefoot (including barefoot running) and a change to a mid or forefoot strike.
He cites Dr. Irene Grogan, who has done significant studies on this, and even goes on to suggest how surgery may not be the answer. In short, if you don’t address the mechanism of the problem (typically tendonitis, also known as plantar fasciitis) then you haven’t solved the problem. The mechanism, a weak foot. The answer? A strong foot. He recommends getting out of a shoe that doesn’t allow the toes to grab at the ground, and allowing the foot to be a foot again.
Here is a bit of his plan. The full-article can be found here:
How do I treat these patients with acute plantar fasciitis? I instruct them to rest the foot until the pain becomes tolerable. Then they can begin exercises for strengthening the muscle and realigning the muscle fibers. They can accomplish this by decreasing activity, wearing a cushioned running shoe temporarily and possibly an over-the-counter orthotic if necessary. The key is stressing the word temporary. Obviously, non-steroidal anti-inflammatories (NSAIDs), icing and stretching play a vital role in healing. However, the key is educating patients on what caused the condition and getting them to strengthen their feet.
If the situation is chronic in nature (greater than six months) and patients have failed other treatment with orthotics and motion control shoes, my approach differs. I will make the suggestion to begin going barefoot 20 minutes a day and gradually progressing each week. Of course, patients respond by saying all of the other physicians have advised not going barefoot. My response is to question if wearing shoes and orthotics worked for them. A more regimented program of physical therapy also helps.
Strengthening the feet and incorporating barefoot time is the answer. This needs to be done gradually, but have faith, your foot was designed to give you all the support you need, and if you start in slowly, will wake up, grow strong, and help you walk and run again, pain free.