A Simplified Foot-Related Scientific Overview

 

Foot-Related Problems - Who Has Them and Why?

66% of North Americans' feet hurt on a regular basis (according to a survey conducted by the American College of Foot and Ankle Surgeons)

Less that 3% of habitually barefoot populations develop debilitating foot problems.

Footwear is the leading cause of foot-related problems (seen in the feet, legs, hips, and back)

Why Do People Who Regularly Wear Shoes Have More Foot-Related Problems?

Almost every type of footwear interferes with healthy natural foot function in some way. This is particularly true of shoes that restrict the raising of the toes and arches, provide extra "support and cushioning,” or incorporate excessive motion-control features. Over time, the feet, the legs, hips, and back maladapt as they physically and functionally conform to these restrictive and less stimulating footwear environments. This maladaptation is a leading cause of most foot-related problems.

How Does Footwear Cause the Feet to Maladapt?

To answer this question, we first need to understand the dynamics of optimal healthy foot function.

Healthy Foot Function

The daily activities and the environments they are used in determine the neuromuscular functional capability of the body.

For example, if you challenge your body through regular exercise, it adapts by becoming stronger and more capable; if you don't regularly exercise it, it will adapt by becoming weaker and less capable.

Your feet are no different. They require appropriate stimulation and regular exercise for optimal strength and flexibility just like every other part of the body's musculoskeletal system. Whenever you walk or run barefoot on varied terrain, your feet naturally receive the varied sensory stimulus and exercise they need to stay healthy and strong.

Neuromuscular and Skeletal Function

Whenever we move, the body’s neuromuscular and skeletal systems are involved.

Neuromuscular Function

The neuromuscular system is responsible for muscle activations that control the movement of the body. It is composed of integrated neuro network that relays sensory information via neural pathways to the brain and to activate the muscles.

The "coordination" of this spatial movement is called Proprioception, which is the body’s ability to "sense" the relative position of neighboring parts of the body and the degree of effort being employed in movement. Proprioceptive movements can be either conscious or unconscious (reflexive). Conscious proprioceptive movements become unconscious with sufficient regular repetition or training, therefore, proprioceptive abilities are adaptive: their functional capabilities are determined by regular use and environment. Examples of this can be seen when learning to write, walk, swing a club, catch a ball, or drive a car. Initially, the conscious focus is on the activity in order to gain control of particular movements. Eventually, these movements become unconscious and reflexive through repetition.

Proprioception also plays a key role in keeping our bodies safe via innate (unconscious) and consciously trained Protective Reflexes. When you instantly pull your hand away from something sharp or very hot, that’s protective reflex in action. And when an experienced driver in the passenger seat of a car reacts to danger by stepping down on a brake pedal that isn’t there, that’s a consciously trained protective reflex in action. By repeatedly practicing a new response of sufficient intensity and duration, you can modify a reflexive proprioceptive movement or reaction to an alternative adaptation.

Skeletal Function and Environmental Influences

For the purposes of this explanation, we will view Skeletal functional capabilities as those related to the collective ability of the mechanical alignment of the neighboring bones, interrelated cartilage and fascia to manage forces. Optimal alignment is observed when the bones are aligned to most efficiently manage the forces created relative to an activity, which corresponds to balanced muscle use with the least degree of damaging stresses. Conversely, less than optimal bone alignment corresponds proportionally with force management inefficiencies, imbalanced muscle use, and damaging stresses.

As described above, proprioception plays a key role in skeletal functional capabilities. However, environment is also a significant influencing factor. When the musculoskeletal structure's function is not restricted or impeded and usage is optimized through healthy exercise, the neuromuscular and skeletal systems will be positively challenged and adapt accordingly. But when the musculoskeletal structure's function is restricted and usage is impaired, the neuromuscular and skeletal systems will correspondingly maladapt.

For example, casting the hand and wrist of an avid writer for as little as two weeks will cause the loss of "coordination" and functional capability in the extremity. In this situation, the environment of the cast has inhibited functional activity long enough to cause the Proprioceptive and Reflex Responses to diminish or cease altogether. This is a maladaptation because it is the system’s accommodation of its own functional impairment.

Maladaptation can only be reversed by consciously retraining the Proprioceptive movements through repetition until the body re-adapts, restoring the reflexive optimal function. The phrase, “use it or lose it,” is an apt reference for musculoskeletal functional capabilities.

Restrictive environments cause maladaptation in the Neuromuscular systems and in the skeletal structures as well. The centuries-long practice of "foot-binding" in the Chinese culture is an extreme example. On a lesser scale, though no less significant, this dysfunctional environment persists today in the form of modern footwear with pointed toes, high heels, and rigid soles that cause similar maladaptations that developed into structural deformity.

Structural (mal)adaptions due to environmental influencesEffects of Chinese Foot BindingEffects of Conventional Footwear

Proprioceptive Activations in the Feet and Legs

Stresses and forces generated during all types of activity trigger Proprioceptive Protective Reflex activations that are responsible for bone alignment and muscular stabilization throughout the feet, legs, hips and back. An "unrestrictive environment," which is ideal for healthy function, promotes a balance of strength and flexibility that effectively reduces the stress and strain throughout the body.

Most importantly, Proprioceptive and Reflex mechanisms and their related functions throughout the feet, legs, hips, and back are synergistically intertwined, meaning what affects one area has a corresponding effect on the other areas. When the functional mechanics positively adapts or maladapts through repetition and becomes reflexive, all areas are equally affected.

Optimal Foot and Leg Mechanics - What It Should Look Like

What has to happen for optimal neuromuscular and skeletal function throughout the feet, legs, hips, and back while walking, running, or weight-bearing?

As we walk or run, the neuro pathways instantaneously pick up, process, and transmit sensory information such as touch, force, pain, spatial orientation), and activate the required muscles relative to the activity. Based on the force generated (intensity), at any given time, this sensory information is used by the Proprioceptive system to coordinate the feet, legs, hips, and back safely and efficiently. During each step sequence, the Proprioceptive systems respond to sensory information from the current step (ground contact) by triggering a Protective Reflex in the foot, leg and hip that are still off the ground before ground contact. This pro-actively aligns the feet, legs, and hip to:

  • protect them from damaging stresses when the foot contacts the ground,,
  • safely and efficiently manage the forces at contact through propulsion, and
  • optimize performance.

Proprioceptive Protective Reflex activations are involved during the three phases of each step:

  1. Anticipation/Preparation Phase - the foot, leg, and hip optimally align to most efficiently manage the forces anticipated during the next two phases.
  2. Ground Contact Adaptation Phase - the foot adapts to the terrain and provides the stable platform required to maintain optimal alignment throughout leg and hip.
  3. Propulsion Phase - the foot maintains a stable platform and optimal alignment throughout leg and hip, for the most efficient use of muscle energy during propulsion.

From a mechanical perspective, the same Proprioceptive Protective Reflex muscle activations are required through all three Phases. These muscle activations raise the arches and toes in concert, (commonly known as the Windlass Effect), and effectively cinch the bones of the feet into a strong, resilient, and adaptive dome-like structure that resists collapse.Reflex Activated Anticipation/Preparation PhaseRelaxed StateReflex Activated Ground Contact PhaseReflex Activated Propulsion Phase

How high the arches and toes rise upward corresponds directly to the immediate activity-related forces generated. The greater the immediate force, the higher the toes and arches rise. These moment-to-moment reflex activations ensure optimal performance with the least risk of injury.

Footwear and (Mal)adapted Foot Function

Almost all conventional footwear interferes with healthy natural foot function to some degree. This is particularly true of shoes that restrict how high the toes and arches can rise upward, provide extra "support and cushioning,” or incorporate excessive motion-control features. Unfortunately, this creates a never-ending cycle where the feet, ankles, knees, and hips progressively weaken and become more dependent on the added support and cushioning. Over time, the neuromuscular and skeletal function throughout the feet, legs, hips, and back maladapts as the feet conform to these restrictive and less stimulating footwear environments. This maladaptation is a leading cause of most foot-related problems.

It is no surprise that optimal foot health is so frequently misunderstood. All our lives we have been taught that our feet must be supported and cushioned to be problem free, however these myths are largely unsupported by scientific evidence. Many footwear companies attempt to prevent or mitigate the symptoms of foot-related problems by promoting designs with various supportive features that are meant to control movement (support), provide comfort (cushioning), and improve performance. Unfortunately, these features create a never-ending cycle where the foot becomes progressively weaker and more dependent on the added support and cushioning.

Conventional Preventative/Treatment Methodologies

Conventional insoles and shoe inserts (orthotics)

Conventional insoles and shoe inserts (orthotics) work in much the same manner as footwear with supportive and cushioning features. Additional support, support, cushioning, motion-control, and bracing contributes to structural weakening and dysfunction (maladaptation).

Did you know that long term support and cushioning are not recommended in any other area of musculoskeletal medicine to rehabilitate or improve function? Despite this, the most commonly recommended preventative and treatment option for foot problems is supporting and bracing the feet.

The good news is that the human body is extremely resilient and adaptable. As with any other part of the body, maladapted foot function can be rehabilitated by reducing or eliminating these features along with conventional rehabilitative therapies to address any historical pathology.

Rehabilitative Therapies

According to the American Department of Health, exercise that promotes muscle strengthening and joint mobility is fundamental to optimal musculoskeletal health and is the number one recommended treatment for arthritic muscle and joint pain.

Exercise regimes are commonly employed to rehabilitate and improve maladapted musculoskeletal function. Proper Technique is fundamental to the effectiveness of rehabilitative exercise programs. “Technique” training is proprioceptive training. This conditioning concept is the foundation of most modern sport training and conditioning that promotes little to no degenerative stress, reduced risk of injury, and enhanced performance capabilities. Poor Technique leads to less than optimal musculoskeletal function, encourages maladaptation, increases degenerative stress and risk of injury, and hampers performance capabilities.

In addition to exercise regimes, there are a variety of effective methods for increasing mobility (addressing scar tissue/fibrosis), strength and muscle function. Some of these are ultrasound, deep tissue massage, Active Release Technique, and Graston Technique.

Optimal Foot Dynamics and Footwear Characteristics

We spend most of our time in shoes. To get meaningful and long lasting benefit from any form of therapeutic activity, footwear should provide a Healthy Technique environment and enough sensory stimulus to trigger Protective Reflex activations relative to terrain and activity levels. Footwear must not restrict the optimal alignment (the raising of the toes and arches) and its soles and upper materials should also be as soft and pliable as possible so that foot and shoe move together, eliminating friction and pressure spots.

The stiffer and more restrictive the footwear, the greater the Poor Technique environment.

BioPodsTM  - The Rehabilitative Alternative

BioPods Insoles and Footwear Are Not An Instant Fix But Work Gradually, Much Like An Exercise Program

BioPods insoles and footwear are designed to encourage healthy protective reflex function and work in harmony with the natural dynamic movement of the feet rather than attempt to artificially support, cushion, control, or restrict. When using BioPods insoles and footwear your shoes should be loosely laced to allow room for adequate foot flexion.

BioPods insoles and footwear provide a safe “spring-like” variable stimulus under the center of your arches that continually engages and optimizes your body’s Protective Reflexes in the feet, legs, hips and back when walking, running, or other weight-bearing movement.

Regular variable stimulus challenges the body's natural proprioceptive and protective reflex mechanisms and causes them to adapt towards healthier function. Even though the stimulus is at the sole of the foot, it affects proprioceptive and reflex function in the feet, legs, hips, and back.

Soft Tissue Adaptation Phase

When using bioPods insoles and footwear for the first time, the body's neuromuscular systems will undergo a Soft Tissue Adaptation Phase as the feet, legs, hips, and back respond to the BioPods’ stimulus. As with any neuromuscular muscle training, the Soft Tissue Adaptation Phase takes approximately 6-8 weeks for most individuals but can take longer for those sufferers noted below. During this period, it is normal to experience transitory twinges or tightness in various areas at different times. It is during this period that latent historical scar tissue or fibrosis may become noticeable in the form of soreness. Seek advice from medical professionals who specialize in soft tissue mobilization, as noted below, if soreness persists.

Please Note:

BioPods insoles and footwear do not treat already damaged tissue, such as scar tissue or fibrosis that has been caused by trauma or maladaptation related degenerative stresses from poor foot mechanics and function. Damaged tissues can be treated by a medical professional with complementary conventional mobilization therapies such as ultrasound, deep tissue massage, A.R.T. (Active Release Technique), or Graston Technique, as appropriate.

RECOMMENDATION for sufferers of chronic myofascial pain, fibromyalgia, plantar fibrosis, or multiple trigger points:

It may take longer to adapt to the BioPods' stimulus. It is possible that enough inelastic scar tissue or fibrosis has developed to cause transient pain or “sticking points” that will reveal themselves during the Soft Tissue Adjustment Phase. In these instances, a medical professional can apply a regime of complementary soft tissue mobilization therapies such as ultrasound, deep tissue massage, A.R.T. (Active Release Technique), Graston Technique, etc., to break down the scar tissue or fibrosis and restore elasticity to the soft tissues for full mobility.

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