The Foot: Evolutionary Disaster or Persecuted Masterpiece?

In the world of anatomy and human movement the foot is an evolutionary marvel. Two and a half million years in the making, this combination of 26 bones, 33 joints and over 100 muscles, tendons and ligaments is astonishingly complex yet beautifully functional.

The process of evolution in general didn’t get much wrong. Modern medicine is a busy and profitable industry on many levels not because our bodies are evolutionary disasters but more because our man-made world has grossly diminished our ability to function as healthy, fit, strong human beings. If I was to attribute our diminished health as a population to one main factor, it is sitting. Sitting is killing us! Many experts and non-experts alike have written great articles on this topic, and will continue to do so as I cannot see things changing for the better on this front.

Before I delve too far off the topic of this article I will bring your thoughts back to those marvellous structures at the end of your legs. The intricate combination of bones, muscles, tendons, ligaments, etc. that comprise our feet carry the average human for between 5,000 and 10,000 steps each and every day. That is a phenomenal achievement, especially since it does not take into account hopping, skipping, jumping, running, etc.

Now, why would anyone take something as amazing as our feet and destroy them by putting them in a coffin for most of our lives? This coffin I speak of is part literal and part metaphorical. We call them shoes. Shoes destroy the remarkable natural function of our feet.

There is no other human body part that we immobilise more. For anyone that has suffered any injury or ailment that resulted in immobilisation of a joint, be it via a plaster cast for a fractured wrist or an arm sling for a shoulder dislocation, you will know how weak that entire limb became due to the lack of movement for that period of time. Yet we are happy to immobilise feet with shoes from an unforgiving young age.

Now, before the shoe loving sector of our community have time to write their first damning paragraph in response to this article, we human beings in our modern world one hundred percent need shoes! Our man-made world of concrete, tiles and asphalt is far harder than the natural terrain of grass, dirt, sand and even drought stricken plains that our feet evolved on.

This still shouldn’t mean putting our feet in a brace most of our life and wondering why they contribute to so many problems. Our feet are not an evolutionary disaster that need to be locked in a cell for fear of causing global atrocities. And no, putting your children’s feet into shoes from the time they can walk will not help them avoid the foot, ankle, knee, hip and back pain you have suffered supposedly through dysfunctional feet (I would recommend directing your blame at sitting and shoes themselves).

Ever noticed how an infant who has just started walking will revert back to crawling when you put shoes on them? Or how their footsteps become really heavy as they clump and thump around in those evil contraptions you put them in?

There is only one reason why I spend each and every day treating ailments and pathology related to our feet, and that is weak foot muscles. And the reason for weak foot muscles? You guessed it, shoes!

What if we strengthened our foot muscles?

That would be fantastic. However, our world of concrete dictates that too many hours of our lives will be in shoes, weakening our feet. The sure fire way to strengthen your foot muscles is to move to a deserted island and walk around without shoes on natural terrain, 24/7.

There are numerous foot strengthening exercises that recommend you to scrunch up towels and pick up marbles with your toes; but do you really think these non weight-bearing exercises will do anything when you put body weight on your feet for 10,000 steps each day? How about five times your body weight in force when you run? Sorry, but save getting toe jam on your towels and marbles as these exercises are more likely to solve world peace than give you sufficient foot strength to survive life.

So then we do need these big, clumpy coffins we call shoes?

There are many issues I have with ninety-nine percent of the shoes worn today, but here are two of the biggest villains. The first is the raised heel. Most running and walking shoes are raised 12-14mm at the heel compared to the toes – that’s right, our running shoes are actually high heels in disguise! This raised heel chronically shortens the achilles tendon and calf muscles, which in turn causes excessive pronation. (Pronation is the natural rolling in of the foot to absorb shock when our foot contacts the ground when walking. Too much pronation causes undue strain on our feet, ankles, knees, hips, lower back and most of the musculature involved with these areas.)

The second biggest criminal in this big, clumpy shoe racket is the posterior and lateral flaring around the heel of the jogger. These huge lumps of rubber can nearly double the width of your actual heel (especially as a toddler); which, again, increases pronation.

It still amazes me that shoe companies promote and advertise anti-pronation/support/control footwear that indirectly and directly increase pronation. Also, it is not only the amount of pronation that they increase but also the speed at which it occurs. And it is rapid pronation when the foot contacts the ground that causes more dysfunction, stress and injury than anything else I see in patients.

So what is the answer?

Unfortunately, there is no simple answer. Too many of us are 30 to 50kg overweight and therefore need a reasonable lump of rubber just to get moving.

Then there is the topic of heel striking vs. forefoot striking when running. More than 95% of adult runners heel strike; yet no infants or toddlers do. Toddlers do not start heel striking until they become slaves to big, clumpy shoes around school age. Whilst this is a topic for another day, try jumping up and down on your heels. Now try it with a forefoot landing. Pretty simple to see which area of the foot we should land on when running. But changing from clumpy heel striking to efficient forefoot striking presents its own perils of injury. For this reason I have developed a project called The Running Lab (www.therunninglab.com.au) to teach people how to run efficiently.

Again, back to the topic at hand. What if we could prevent most of what we adults have suffered by not allowing young children to ruin their naturally good foot function? What if we encouraged them to run around bare-feet, strengthening their foot muscles? And when they do need to wear shoes for hygiene or safety reasons, why don’t we put them in the lightest, simplest pair of shoes with just enough good quality rubber (bulk does not equal quality), no heel raise and no unnecessary flaring (i.e. the shoe should barely be broader than their actual foot shape at the heel)? And no, thongs don’t equal simple – the mechanical changes at play when wearing thongs is as destructive as the foot coffins this article is about.

I am on a mission to give my children a fighting chance in respect to being healthy, fit, strong human beings. Along with less time sitting I am determined to keep them out of shoes that will alter their gait, joint mechanics, muscle strength, tendon and muscle length, etc. In order to do this, footwear companies need to see a huge decrease in sales on their big, clumpy, evil shoes; and schools need to accept that their current uniform policies need to change.

I appreciate that what I have written in this article does not apply to everyone. What I hope to achieve with this article is for parents, schools and shoe companies to consider the ramifications of placing big, clumpy shoes on otherwise healthy little human beings.

Tim Bransdon

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