What I’m Learning About Foot Health

I explained in my post, Desperately Seeking Healthy Feet, how I’ve come to be researching foot health and holistic cures for my plantar fasciitis complaints. You can get off the edge of your seat now, because I’m ready to tell you what I’m learning!

I’ve been poring over Katy Bowman’s site, Aligned and Well, trying to figure out how her philosophy of “movement is medicine” can help improve my overall state of health and wellness — and particularly my feet. I like her scientific approach, and a lot of her theories on the body’s alignment and our sedentary lifestyle causing chronic pain as we age make sense, but I’m not sure I’m ready or willing to implement everything she is suggesting. It’s a lot to take in! I mean, girlfriend has a furniture-free house, for crying out loud. (Really, watch the video, then come back and read the rest of this post with a grain of salt.)

Still I can’t help but think that she’s onto something. Not that I plan to go furniture-free anytime soon, but I would like to incorporate more movement and better body positioning into my life. Ultimately I want to be as healthy as I can be as naturally as possible, as long as I can do it in such a way that it doesn’t take over my life!

I don’t ask much, do I?

For now I’m focusing primarily on the foot portion of her site and her book that I read over the weekend, Every Woman’s Guide to Foot Pain Relief: The New Science of Healthy Feet.

Every Woman's Guide to Foot Pain Relief: The New Science of Healthy Feet

Foot Health: The Basic Premise

Did you know that 25% of your bones and muscles are located in your feet? I don’t know about you, but that kind of blows me away. Suffice it to say, our feet have the potential to be MUCH MORE flexible and useful than we have allowed them to be.

Most modern foot problems are due to disuse and then overloading that underused tissue.

Katy likens wearing shoes day in and day out to living with mittens on our hands. Fortunately our feet can be retrained, but it takes some time and effort — not what you wanted to hear, now was it?

Retraining our Gait

There are two structural issues we need to be aware of — foot alignment and pelvic positioning.

Most of us stand and walk with our heels together and toes pointing outward. Take a look when you’re standing naturally. Do your feet point out? Most people’s do, but they should be aligned parallel to one another. You can practice standing on a wood or tile floor and lining up the OUTsides of your feet with straight lines in the floor.

The other issue is with our pelvic positioning. Evidently, having your pelvis stacked correctly is an essential part of foot health (and overall skeletal health as well). Because of wearing positive heeled shoes most of our lives, we tend to stand so that our pelvis is tilted forward, over our knees, when it should be set back over our heels. You can stand in front of a mirror and use a yardstick to help determine proper posture. I’ve been thinking about this recently when standing, and trying to set my hips back over my heels rather than over my toes.

Take a look when you get a chance and see if you don’t feel more balanced when you stand with your feet properly aligned and your pelvis stacked over your heels. (NOTE: You cannot do this in heeled shoes.)

And that provides the perfect segue, does it not!?

Shoes: To Wear or Not To Wear . . . and WHAT To Wear?

One of the themes throughout the book is the problem with heeled shoes. This is not surprising; I’m sure most of us realize that high heels throw off the body’s alignment, causing a host of knee, hip and back complaints among women who wear them regularly. High heels also squeeze your toes in an unnatural way so that they tend to develop corns, hammertoes and bunions.

Katy actually likens the high heels of today to the cigarettes of the ’70s.


Image courtesy of hinnamsaisuy at FreeDigitalPhotos.net

It’s a dramatic statement, but her analogy is compelling. Research shows that high heels can cause bone density issues, nerve damage and arthritis — all of which are becoming more and more common in our aging society, and these health issues are costing our country a lot of money. Cigarettes used to be viewed as sexy and cool; now we know that they compromise our quality of life and kill us slowly. High heels may be doing the same thing.

Go figure. It’s not all about what we eat after all! (Not that that isn’t important as well, but it all goes hand in hand.)

Fortunately for me, I don’t wear high heels all that much, but I do wear shoes. I’ve been warned not to wear flimsy ballet flats and flip-flops that cause me to grip with my toes to keep them on. Do we all need to resort to those ugly Vibrams to simulate barefoot walking? Say it ain’t so!!!

Our feet were not designed to wear shoes, but our feet were also not designed to walk on the concrete and asphalt that covers almost every outdoor surface of our modern society, so shoes are pretty much unavoidable for most of us. The question is, what kind of shoes should we be wearing to accommodate our shoe-wearing landscape?

Katy shares 4 criteria for shoes that won’t inhibit your natural mechanics from working properly.

4 Criteria for Proper Shoes

1. The sole should be flexible enough to allow for natural movement of the foot.

2. The upper should be constructed in such a way that you don’t have to grip with your toes to keep your shoes on. In other words, bye-bye, flip-flops!

3. The toe box should allow your toes to spread comfortably.

4. The heel (or lack thereof) should allow you to maintain vertical alignment.

Of course, I am hoping she will go a step further and recommend brand names that fit the criteria, but she doesn’t do that until the very end of the book in the Appendix where she has a list of resources. The most shoe-like option she recommends in that section are KALSO Earth Shoes (negative heeled shoes.) But there are a lot of brands making therapeutic shoes these days, with plantar fasciitis becoming such a common problem, so I am going to also try some other brands to see what I think. Still, I am liking these Kalso Earth Insignia for a possible ballet flat option come fall!

 Kalso Earth Insignia

Restorative Exercises

Finally, because of our sedentary lifestyles and positive heel wearing habits, the muscles in our legs are tight and shorter than they should be. We can fix this with exercises and by re-evaluating our body positioning and daily habits.

Katy describes a series of Restorative Exercises that are supposed to strengthen our feet and lengthen our leg muscles. I’ve been trying to fit those in a few times a day, in addition to the calf stretching and strengthening exercises I was already doing.

I like how she differentiates between exercise and movement. She encourages the reader to fit in the exercises throughout the day, to consider how we are standing when we’re in line at the grocery store and to pay attention to our foot alignment when we’re walking the dog. It doesn’t have to be a huge undertaking. PHEW!

What About the Barefoot Movement?

As I read this book, I kept wanting to ask Katy what she thinks of the modern barefoot movement and how it works into her theories. There’s an FAQ section at the end of the book that covered many of my unanswered questions.


When addressing the barefoot movement, she hit the nail on the head with this:

We Westerners have a habit of picking a “natural” habit and jamming it into our unnatural lives.


She definitely thinks barefoot is the ideal, but not for everyone all the time. She advises the reader who wants to go natural to transition slowly from being a shoe-wearer to a minimalist and gives a list of guidelines to get there. One of the guidelines is to be a walker and even that should be done on natural surfaces.

Frankly, I have no desire to be a minimalist if it means giving up running and cute shoes. What I like about Katy and this book is that she is not telling everyone to go be a minimalist. She also gives advice for those of us who want to be healthier without dramatically changing our lifestyle.

For the rest of us, she advises replacing the shoes we wear most often with ones that fit the criteria listed above. And when we do feel the need to wear heels or shoes that are otherwise not good for our feet, to increase our exercises to compensate.

Advice for Plantar Fasciitis

I was thrilled when she addressed plantar fasciitis in the FAQ section. I’ve been advised by many to try orthotics, but my chiropractor has avoided putting me in them, hoping that I can heal naturally. His view is, once you start to rely on them, you’re stuck with them forever, and he wants to me to avoid that if possible. That advice jives with what I read here.

Katy addresses orthotics in her typical sensible fashion. Orthotics provide support for damaged feet, but they will not help strengthen the feet. The goal for orthotics wearers is to practice the strengthening exercises with the goal of eventually not needing the orthotics anymore. So for now, I’ll steer clear and hope that the exercises I’m doing will prevent me from needing them.

I’ve also been told to wear wedges to be more comfortable, and I found that is definitely true because I’m not putting pressure on my sore heel.

fabulous wedge sandals

Katy explains that wedges are often advised for plantar fasciitis because they help alleviate discomfort by not allowing the heel to touch the ground, thus not aggravating the condition. But that doesn’t solve the problem, and if they’re not being stretched, eventually those muscles and tendons will get tighter and the problem will get worse. Her advice is to transition to flat or negative heeled shoes while practicing the restorative exercises regularly.

Ultimately, her answer to curing plantar fasciitis is to simply being diligent with the restorative exercises, pay attention to alignment, and gradually get used to wearing shoes without a heel.

In my last post, I said that I was still conflicted about whether or not to wear shoes around the house. Given all this, I’ve come to the conclusion that I need shoes to protect my feet while they heal, but they should be shoes that fit the 4 criteria listed above so that I have full range of motion of the feet and ankles and I’m not aggravating my condition. My hope is that if I am diligent with the restorative exercises, I will enjoy being barefoot again eventually, and hopefully will be able to walk pain free.

What I Plan to Do Next

I have no plans to put all my high heels in the Goodwill bin and wear Vibrams every day, but I am thankful that I don’t have a job where I feel the need to wear high heels on a daily basis. I can still wear them on special occasions, but I will be more selective about the times I do wear them. Meanwhile, I’m committed to wearing everyday shoes that protect my feet as I work on strengthening them.

I’m willing to concede that as long as I insist on running, I may never be pain-free.

running on the beach

I also may not be able to hang around the house barefoot as much as I’d like. For now, I’m willing to make that sacrifice to continue doing something that I enjoy. But I’m also open to integrating other forms of exercise and activity that are more conducive to longevity and good health. Basically, I will listen to my body and see where that takes me.

I plan to try to fit the restorative exercises into my day as often as possible in attempts to strengthen my feet and restore mobility. Because I have always valued going barefoot as much as possible and haven’t worn high heels that much, I don’t have corns and callouses, and I have a lot of mobility in my feet and toes. Despite my plantar fasciitis, I think my feet are actually healthier than most modern feet and I have a really good chance of healing them — or at least making them stronger.

I do have a family history of bunions and I had surgery on mine when I was 21. I’ve noticed one foot looking a bit suspicious in recent years and I was worried that a new one might be developing. I’m hopeful that if I follow this protocol, I can avoid that.

The other thing I plan to do is take better care of my kids’ feet.

We just bought sneakers for my husband and son on Saturday, which is when they discovered my latest bandwagon. Fortunately boys and men are easy. They generally value comfort over style, and both of my guys like sneakers. They both got the Nike Flex, which I don’t think is quite as flat as the Free, but they liked the look and feel of the Flex better, and it’s lightweight and flexible with plenty of room in the toe box so I’m trying to let go of my crazy and admit that sometimes a good choice is just fine, even if it’s not the best choice.

As far as my girls are concerned, this should probably be a post in and of itself, but I’ll tack it on here because I am delusional and actually believe that people read to the end of my lengthy posts. HA! So if you’re still here, and if you have kids, read this.

PSA to Parents

Katy says:

It is frightening to see positive-heeled shoes on small children. Here’s why: the body establishes the level of maximum bone mineral density by age twenty. The upright, weight-bearing motions that develop bone happen abundantly in kids. Putting a heel under their feet during this critical phase of bone development penalizes them for the rest of their lives. You can never develop bone past the quantities set during this development phase. Do your kids a favor — forsake the trendy mini-fashions for their long-term skeletal longevity.

kids in heels

Given that information, I’m not going to buy heels for my girls anymore. They will HATE ME. They love shoes with a heel. But while their feet are developing, I feel like this is a battle worth fighting.

I am quelling the urge to go through their closets and toss everything and go shopping for a new shoe wardrobe right now. It’s summertime so they have a lot of flip-flops and sandals, which aren’t ideal, but I’m biding my time and waiting for back-to-school shopping to put my footwear criteria into effect.

So there you have it — everything you ever wanted to know about foot health and then some!

Actually there is SO MUCH MORE to it and I left out much of the science and mechanics behind the issues. I will let you read the book for yourself if you want the deets.

Join The Conversation

12 Responses

  1. That video!! “We don’t have a pool. We do have a rooster.” Does that rather sum up a modern trend in family life? haha 🙂

    I gulped at your last section about your girls. My almost-14-yo had a pair of heels (just for Sunday) and when she out-grew them, she wanted a new pair. I haven’t bought them yet, mostly b/c I never found a pair while we were out together that I wanted to spring for. Now I’m wondering if I should have a good heart-to-heart with her and tell her what you posted here.

    And that’s another way heels are like cigarettes — they are adored by teens and indulged in by older teens. The high school girls I taught a few years ago — oh my! They were into those 4″ heels. Sigh. I wonder this: do men have better all-around foot health than women? I would guess so, given the effect of the Heel.

    Great post. I’m going to work on correcting my foot alignment and pelvic positioning, although I gave up heels decades ago and always allow wiggle room for my toes. Still room to improve!

    1. It’s hard to know how extreme to get on this stuff. I mean, 4 inch heels, yikes!! But I think every once in a while, it’s probably fine. I am more concerned about my ballet flats and flip flops, maybe because that’s what I wear more, and I think they are bad too in their own way, although she didn’t really mention them. For me, it’s more about my toes being squished. I have very squarish feet.

      My girls are 10 and 7 so it’s really ridiculous for them to be in heels. The problem with my 10-y/o is that she wears them every chance she can get. At least the 7 y/o only wore them on Sunday, and they had good ankle straps and room for her toes. So they don’t seem so bad. For fall, though, heels are out. B/c they would be pumps, and those are so hard to walk in. Can NOT be good for developing little feet.

      I think men do have overall better foot health (and why her book was geared to women) but they sometimes have heeled shoes too and she addresses that. And those sneakers that are all jacked up – they’re supposedly not great either.

  2. I love heels, so like you I think it would be tough to give them up entirely. Although I don’t wear them that often. And we’ll need to wait a few more years for the ‘right’ shoes to go more mainstream and get cuter and less crunchy (and cheaper); although I looked at Nordstrom’s entire selection and some of them are kinda cute. And I don’t sweep nearly often enough to go barefoot in the house. I wear crocs in the winter and flip flops in the summer.

    But I spend an enormous amount of time surfing and working from the couch. And sometimes I can definitely feel it. I need to either clean-up my office and/or create a better working location downstairs.

    We don’t really have a need for dressy shoes for my 10-year-old daughter so we don’t buy them. Fortunately, she’s never asked for heels and I hope my love of them doesn’t rub off on her. I actually need to run out today and get her a pair of dressy shoes and I hope that heels aren’t my only options.

    1. I went into the Walking Store the other day just to see what they have, and I agree, they are getting cuter and less “crunchy” – I will definitely be updating my shoe wardrobe this fall with some more sensible shoes. 🙂

  3. I love my bed too much to go furniture free.

    We’re going to Disney in November. I know that you did a post a few years ago about footwear for Disney. Would your opinons have changed now? (Maybe an updated Fashion Friday post?). I desparately need help with that – I wear heels or ballet flats to work and flip flops on the weekends in the summer or Uggs on the weekends in the winter…

    1. I actually still like the advice I gave in that post, although to be honest, I wouldn’t be quite so averse to gym sneakers anymore. It is just important that the outfit works with them, which I find hard, without resorting to athletic wear — and I’m not sure that’s such a bad idea either. Activewear is so cute these days. I think it’s just a matter of putting some thought into it, whatever you wear. I will never understand why people go to Disney and throw all concern for personal appearance out the window.

      A fashion sneaker or Privos are great, and I’ve discovered some new brands that I’m definitely going to suggest when I update that post. It is one of my top 10 most popular posts so I just keep updating it rather than writing a new one. 🙂

  4. I bought the book after your first post about it and I’m about half-way through. It is very interesting. Those very shoes are currently in my shopping cart at zappos. I went straight to my favorite shoe source after reading her blog the other day…which, BTW, I spent way too long doing! It’s very easy to get lost on there!

    I get tired of trying to jam natural things into our unnatural lifestyle. I find that I’m constantly fighting the battle of how to reconcile what I’m reading and learning with our current suburban way of life. I just have to be satisfied with incorporating as much as I can without letting the “all or nothing perfectionist” me get in the way. I have to believe that even making little changes here and there will improve our lives because ultimately it doesn’t really improve our life if it takes away peace, right? I love the beauty of furniture and cute shoes too much to completely give them up right now, but I see the value and I’ll make small changes in order to get closer. Thanks for the very valuable links and information and for sharing what you’re doing. I found that, while it took a long time, my PF went away after much stretching and wearing of good shoes. Dansko’s were very helpful.

  5. I am finding your foot health/shoe posts interesting and helpful. I was a pretty intense athlete my entire youth and had no injuries, but now I have issues. I gravitate towards wanting to strengthen my feet and not use a crutch (orthotics that the podiatrist gave me to relieve my pinched nerve in my foot), but it is tough. I have given up distance running in favor of bootcamp and that has helped a ton, but I still have to be vigilant. I’m going to look into those shoes you referenced!

    1. I think after this half marathon (if I make it thru – 8 miles this morning – ugh!) I will reduce my miles and work on strength training more intensely. I really want more muscle tone, and I think it’s less damaging to the body over time. I am starting to think I’m not cut out for distance running. I would still love to train for 5K and increase my speed, though. 🙂

  6. Great post – very informative and much needed because I think foot health is an ignored aspect of healthy living and taking care of yourself.

  7. Hi Jo-Lynne! I have been reading your site for awhile and was saddened to hear you have plantar fasciitis. I think the book you mention has some valid points and I hope you get better soon. I have struggled with this injury for years and had surgery on both feet at Paoli back in November. I am better but not over this injury. I wanted to comment and reiterate that stretching is a huge part of getting better and to not discount tightness you may have in your calves/Achilles… It’s all related! If you’re not getting relief, orthotics help those of us with this injury in a major way. Don’t feel like you’re doing something wrong if you need them; sometimes our bodies don’t heal like we’d prefer.

    For comfort footwear, I see you’re also a fan of Orthaheel.. Love! Taos also has some cute wedges, and I have found other brands like Clarks to sometimes have things that pass my fashion muster. In cooler months, I have a pair of Tory Burch boots with a substantial almost motorcycle-like sole that accommodate my orthodic without making me look like I shipped in my Granny’s closet.

    Best of luck to you!!!

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