LER: Foot Health – June 2016
From the editor:
Small muscles, huge potential
In recent years there’s been a lot of study and discussion—some of it quite contentious—of the relative merits of running barefoot, in minimalist shoes, or with various foot-strike patterns. But it seems to me that these debates are distracting foot specialists from a more important aspect of this research: the clinical implications of intrinsic foot muscle weakness.
As detailed in this issue of LER: Foot Health (see “Importance of intrinsic muscles for foot health,” page 15), one study suggests that runners who have difficulty transitioning from conventional running shoes to minimalist shoes are more likely to have undersized intrinsic muscles than those who make the transition more easily. Regardless of how one interprets this finding relative to the advisability of minimalist running, it clearly adds to a growing body of literature suggesting that weak intrinsic foot muscles are associated with a number of foot-health issues—including plantar fasciitis, diabetic neuropathy, and obesity-related foot pain.
Another recent running study found that habitually shod runners who gradually transition to minimalist shoes over a six-month period can significantly increase intrinsic foot muscle size. This suggests that a switch to barefoot or minimalist footwear can be an effective intervention to address intrinsic weakness. But that’s only true for patients in whom minimalist running is both feasible and safe. It’s probably not a realistic option for most patients with diabetic neuropathy, for example.
Foot strengthening exercises, on the other hand, offer an intervention that can be done by just about anyone. The effect of these exercises on intrinsic foot muscle size or strength has yet to be fully documented in the literature, but the findings so far are promising.
Running style preferences may always be up for debate. But, given the apparent prevalence of intrinsic foot weakness, it’s clear that intrinsic strengthening really should be considered as part of treatment for almost any foot issue.
By Jordana Bieze Foster
Gait compensation may play role – The location of foot pain doesn’t always correspond with elevated plantar pressures and abnormal forces, which suggests the availability of region-specific compensatory gait mechanisms may play a role, according to recent research using Framingham Foot Study data.
By Emily Delzell
Few businesses can claim a heritage quite as long as the Bail family’s five-generation relationship with the shoe industry. But more than just a long history of selling shoes, the Bail family’s story is one of resilience.
By Nancy Shohet West
Crary Shoes has a motto: “The last is always first.” With a decades-long commitment to quality, the business provides custom shoes for clients with a spectrum of foot concerns, ranging from diabetes to unusually shaped or sized feet.
By Samantha Rosenblum | Photos by Monty Wolfe
A growing body of research suggests the strength of small muscles in the foot can have big implications for a range of foot-health issues—including running-related injuries, diabetic neuropathy, obesity, flatfoot, and plantar fasciitis—and that interventions for strengthening the intrinsics may help.
By Barbara Boughton
Silver fibers and other examples of nanotechnology are increasingly turning up in shoes, socks, and orthotic topcovers in an effort to control odors, reduce the risk of infection, and improve foot health by making these devices moisture wicking, breathable, antifungal, and/or antibacterial.
By Shalmali Pal
Help your patients step out in style
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