Any podiatrist, or other foot specialist here wanna chime in on barefoot shoes?

[MW]

Bit late to this. But have a read through some of Katy Bowman stuff on body alignment and walking. https://www.nutritiousmovement.com/blog/ is maybe a start. I know she updated her website and it now focuses on pushing courses, hence her old blog is more information.  Some of her podcasts can be useful if you like her style.

Essentially its not just a feet issue. Lots of people walk with feet pointing out to the sides, which has long term consequences.  Same with hip issues – as the leg can end up rotated inwards – which also impacts down at the feet.

Commiserations on the podiatrist. They seem to just want to prescribe inserts and custom shoes. Though in fairness to them, some issues do need inserts and shoes, but for most, making foot changes via exercises takes months before improvements are clear. And the vast majority of their clients aren’t compliant to maintain the required exercises for such a length of time.

Also see also Kit Laughlin. This video gives some information about feet also:   https://www.youtube.com/watch?v=XfAJa0yNliM   He talks about it taking two or three years to fix some problems.

My foot issues have taken a long time to sort out. It has been a bit of trial and error. And also finding the right information, or how it applies to my case.  I wouldn’t say I’m done yet, as while I can walk as much as I like in barefoot shoes, I can see that I’ve still alignment and strength/stretch issues to resolve. Still starting from unable to walk because of pain in shoes, I’m happy with my progress. I walk barefoot about the house always and when I can outdoors, but my local area is harsh and I don’t want to risk glass/thorns/cuts that would need recovery time; hence barefoot shoes.

I only started looking at my feet when I had pain. Feet where just something on the end that hit the ground. I ignored them till I couldn’t. I can tick the roll call of all the ‘bad for your feet’ list from the above posts and more: too tight shoes, squashed toes, foot alignment, hip tightness, weak gluts and abs, anterior pelvic tilt, nerd neck, etc).  Initially, I changed my footwear, but eventually tried a couple of podiatrists. All wanted inserts and custom shoes. I tried the inserts for a while because of “a missing fat pad”, but didn’t like them. Eventually, improvement came by cutting my mileage to only essentials to rest and recover from the pain.  There was a regime of strength and stretch from the toes all the way up: toes, feet, ankles, calves, gluts, abs, lower back, neck.  Then I used cushioning footwear for a while to get mobile and to reduce the risk of re-injury.  Then transitioned back to barefoot shoes.  It wasn’t all linear recovery. There were crests and troughs, and I perhaps pushed things too much at times, and ended up back in rest mode. So don’t be disheartened if improvements are quick.

Best wishes for your progress.

 

Edit: “Gait” was the word I forgot. How you walk. It matters.

[Rusty Beaver]

Thanks to you all for sharing your insights, experiences, and encouragement. I’ve had more injuries in my life than I care to admit. Nothing has had me this worried though!

As much as I dreaded doing it, I made another appointment with a different podiatrist. I go in on Wednesday. Also, I have some silicone toe spacers arriving in my mailbox tomorrow (ordered because I found that spreading my toes with cotton seemed to help. Cotton wouldn’t stay in place though) and a pair of shoes coming Wednesday…a type I never would have dreamed I’d be wearing – Altra Olympus 3.0’s. The height of those things are ridiculous compared to what I’m used to! At this point though, I don’t care…if they help.

Additionally, I have upped my stretching routine considerably, trying to cover every muscle in my body. I found Kit Laughlin’s videos and philosophy to be  inspiring. Thanks for the suggestion, MW! I have yet to look much in to Katy Bowman’s stuff.

I’m also putting more time in building my core strength, as well as self-massage on my feet and calves. Deeper inhalation and longer exhalation along with more water too. With that, my diet is about as clean as I can get. Being I’m sitting more than any time in my life, I’m riding my bike more, attempting to compensate. With flat pedals, pedaling doesn’t seem to bother my feet too badly.

I’d be interested in Harry Looong Walkers yoga he mentioned. A specific link would be great!

Re gait: It has been noted that I walk with my toes out. From what I understand, it may be caused by my foot structure, or more specifically, an extra long second toe.

 

[BCap]

Your body is unique.  Your problems are unique.  You don’t need someone else’s solution, or the ‘average’ solution — you need your solution.  Find someone (PT, podiatrist, wacko hippie, whoever) who is willing to systematically work through different possible remedies giving each enough time to actually have an effect.  It is worth trying to avoid someone with a strong preconceived notion of what your problem is, unless they can support it with data that isn’t as full of holes as a stop sign in Texas.  In the absence of clear science (hard to come by for ‘pain’ related things), anecdote can help guide the list of potential solutions.  Hopefully that will let you find something that works for you.

In the meantime, if biking isn’t so bad, then maybe a bike-packing tour is on your radar?  If there is anything that I’ve started to learn after hurting my back is that you gotta work with what you got and enjoy life as you can.

EDIT:
I should add my anecdote to the mix.  I’ve always had achy feet since as young as I can remember despite spending plenty of time running around barefoot outside.  When I was around 20 y.o. I worked for a summer as a sailing instructor and I was excited to spend 3 months straight in the sand and barefoot.  I fully expected my feet to get ‘strong’ and ‘healthy’.  They didn’t.  They just got worse.  Fast forward 10 years.  For the PCT I was worred about my feet holding up and I opted to try some orthotics — green superfeet.  Against my expectations they’ve made my feet feel quite a bit better in the long term.  I doubt Roger would be helped by orthotics, but for me they turned out to make a world of difference.  Different feet, different solutions.

[Rusty Beaver]

Thanks. Good thoughts, Bcap. Finding that right person though seems to always be THE challenge… particularly in the field of allopathic medicine, where the patient is little more than a number in a long line of sufferers watching TV in the waiting room, anxious to get their turn with the “doctor” who has an allotted time of 8-10 minutes per patient…the Doc then forgetting said number’s name the moment they greet the next patient the nurse has herded into the room.

Sorry for the cynicism. I have become utterly disillusioned with the current medical system we have…

Good thoughts too on working with what we have. That’s actually how I got back in to backpacking. When having shoulder, wrist, and elbow problems from whitewater kayaking, I thought to myself “Though I may not be able to paddle right now, I can still walk!”. This past summer, since I couldn’t walk, I paddled more when the water was good then did some self-supported multi-day backcountry trips on my dual-sport motorcycle. Though not as gratifying to me as backpacking, because of my cycle and feet crisis, I was able to see some areas I was curious about that I wouldn’t have taken the time to visit otherwise.

Thanks again to all the posts, everyone. Appreciated. Keep’em coming!

[Rusty Beaver]

Well, I saw another podiatrist. That makes four foot “pros” now with no diagnosis from one, and three completely different diagnosis from the other three. From everything I’ve been reading though, I believe this last guy has it right…at least partially: Morton’s Neuroma.  When I asked about the other pain issues I was having with my feet, he advised that we focus on one spot at a time. I believe it’s all connected so would like to focus on it as a whole. He didn’t look at my gait, my ankle, calves, hips or anything other than my feet….and wanted to inject my one foot with cortisone on the spot. I declined so he sent me with some uncomfortable gel insoles and told me to come back in 6wks if not better. Alas, the search for the “right” person to help me continues……

I got my Altra Olympus 3.0s. They weren’t as cushy as expected. Maybe they’ll require some wear time. Have only wore them inside for 5 minutes. Not sure I’m going to keep theme.

I also got my silicone toe spacers. $5 from eBay. They are so uncomfortably tight that I’ve stopped wearing them. Will try some more modifications before I bite the bullet and buy the better looking and far more pricey Correct Toe spacers. $65

Have watched Youtube videos and read about feet till I’m blue in the face. Amazes me the wide spectrum of opinions from those with the same credentials. One Dr says the only time we should be barefoot is while showering… then goes on to suggest having Crocs bedside to slip on in the night to use the restroom. I’m no “pro” but this all seems to defy logic in my mind…

After doing the exercises one foot “pro” (a PT) gave me 3 weeks ago, my feet are every bit as bad now as they were 6 months ago, if not worse.

From being able to backpack in bare feet to not being able to stand barefoot on carpet. Frustrated…

[Roger Caffin]

Morton’s Neuroma
Happens, from wearing narrow shoes. It’s a common problem, but not terminal and not inhibiting. Just feels funny. No cure that I know of.

He didn’t look at my gait, my ankle, calves, hips or anything other than my feet
Incompetent and useless. Dangerous guy.

wanted to inject my one foot with cortisone on the spot
Dangerous stuff and can be addictive. But you probably knew that already.

One Dr says the only time we should be barefoot is while showering
Seriously ignorant and incompetent. I wonder what he would say about that half of the world that does not own any shoes? Sue and I are barefoot in the house all the time.

silicone toe spacers. $5 from eBay.
They will sell ANYTHING on eBay. But I can’t imagine that the more expensive ones will be any better. Why should they?

They weren’t as cushy as expected.
Too cushy and you lose proprioception, which can be dangerous. To my mind, the only Q is whether they are wide enough. Most niche brands are not.

Sympathy.
Cheers

[Geoff Caplan]

I emphatically second what Roger is saying – to look at your feet in isolation from your whole-body gait is just incompetent and is unlikely to be effective. And how will insoles or pain-killing injections get to the underlying cause?

You really need to find someone with a more holistic approach, like these folks. Quite a few of them are in the US. I find this guy Gary Ward quite impressive – I have his book and use his ideas. You’d better do your own due diligence, but it’s very likely that his trainees would be more effective than the people you’ve seen so far:

https://www.findingcentre.co.uk/search/

Maybe other people could chime in with contacts to decent practitioners?

[S Long]

My family have all been barefoot people for most of our lives. I routinely will hike 5-10 miles a day barefoot on backpacking trips because I like how it feels. A few years ago, my mom had a big block of wood fall on her foot and started having a lot of pain in one foot similar to what you describe. She went to a few doctors that couldn’t figure out what was going on. Finally they did some imaging and found a big neuroma between her big toe and the one next to it. They tried cortisone once. It didn’t help very much. She had a terrible time finding any shoes that weren’t excruciatingly painful. Finally they performed surgery and removed a huge neuroma. Her toes are more splayed where they removed it and she has a decent little scar there, but she has been able to start wearing her usual shoes and going barefoot again without the pain. Surgery is always a last resort option, and absolutely not one I would recommend without extensive (good) professional consultation (which, it seems, you have sadly not yet found). However, it worked for her, so I wanted to put it out there as a possible option. PS-she and I both have mild Morton’s Toe.

[Rusty Beaver]

“Morton’s Neuroma
Happens, from wearing narrow shoes. It’s a common problem, but not terminal and not inhibiting. Just feels funny. No cure that I know of.”

From my experience, it’s quite inhibiting. If it were not, I wouldn’t be sitting here typing this now. ;-)

“silicone toe spacers. $5 from eBay.
They will sell ANYTHING on eBay. But I can’t imagine that the more expensive ones will be any better. Why should they?”

Some seemingly well respected foot pros sell and/or recommend them. The idea is that they spread the toe bones, giving the Neuromas some space…relieving pressure on them. Willing to try anything, once I had heard of spacing the toes (most peoples toes are scrunched tightly together from wearing conventional shoes all their lives), I stuck cotton balls between my toes. A definite help…but the cotton shifts easily. The cheapo ebay spacers I got stay on but are far too tight. The $65 Correct Toes look to be much looser… and they come in different sizes.

“They weren’t as cushy as expected.
Too cushy and you lose proprioception, which can be dangerous. To my mind, the only Q is whether they are wide enough. Most niche brands are not.”

At this point, I just want to be able to get off my butt and onto my feet without so much pain and discomfort. Even if I could walk 1 mile right now…. that would be like a dream! As far as width, Altra’s are good there…particularly in the toe box.

Thanks for your post.

[Rusty Beaver]

“I emphatically second what Roger is saying – to look at your feet in isolation from your whole-body gait is just incompetent and is unlikely to be effective. And how will insoles or pain-killing injections get to the underlying cause?”

Thank you for your post. Your thoughts match mine exactly. The one redeeming quality this last foot guy had was that he wasn’t overly arrogant and he actually spent ~40 minutes with me. Not even close to being enough time but… it beats the standard of ~10 minutes.

I am looking in to those trained by Gary Ward.

S Long – Thanks for your post too. I’ve read some horror stories with these type of surgeries. It’s nice to hear of some success. I see that you’re from the Wasatch area. I’m in Southern Idaho and would travel down to Salt Lake if there was a guru there whom would be willing to spend some time with me. So, if you have any recommendations….

[Katherine .]

picking up on the RLS sub-thread. I have a mild, manageable case. I have a handful of triggers (caffeine, SSRIs, low iron) in the mix. Every now and then it starts to keep me up at night. What I do is flip around in bed so my foot presses against the wall or headboard. That active, sustained stretch/pressure usually does the trick for me. No idea how long I stay in that position after nodding off.

[Roger Caffin]

Some seemingly well respected foot pros sell and/or recommend them.
And an international shoe company like Nike promoted arch support, pronation control and gel soles. All of these are now recognised as being very bad things for your feet. Olympic-level coaches won’t touch any of them. So much for ‘well respected’.

Story: Many years ago Nike donated a whole lot of their gimmicked shoes to the American track&field team. When they arrived at a training session to get some great PR photos, they found all the shoes in their boxes and the athletes training barefooted. So much for that idea.

Now, the problem with ‘toe separators’ is that they try to force your toes into a distorted configuration. The inevitable result of doing so is that sooner or later the tendons and cartilage in your feet start to protest at the unnatural strain being put on them. Small wonder. IF you try them, start with very small gaps.

At the risk of displaying considerable bias, can I suggest you at least try wearing some fairly loose (well, not tight anyhow) flip-flops for a few weeks? NOT the shaped ones, just the very cheap FLAT ones. You get some cushioning, protection from sticks and stones underfoot, and you can always claim you are wearing them for medical reasons (which may even be the truth).

Above all, do NOT expect a fast miracle cure. Go very gently and let your feet recover naturally.

Cheers

[Roger Caffin]

Hi Kat

RLS can actually be triggered by certain chemicals. Dark chocolate is one known trigger (honest!). There are many others. Afaik, avoidance is the best cure. Recovery make take several years.

Try searching on ‘restless leg syndrome chocolate’ for details. Be warned that not all medical web sites agree with each other.

Cheers

[Geoff Caplan]

Here’s another interesting group of holistic practitioners. They’re not so focused on the foot as Gary Ward, but they have a very good reputation in the field of sports injury. They are much better established, so you’re more likely to find a practitioner nearby:

https://www.functionalmovement.com/members

The thing about both those groups is that people who have paid for that kind of certification are likely to be strongly committed to whole-body approaches and have a variety of relevant trainings and skills.

[Rusty Beaver]

Thanks, Geoff. Surprisingly, the nearest AIM practitioner is little if any further than the nearest Functional Movement person. But, it would still be a solid 8 hour drive for me…one way. I wouldn’t hesitate though at this point… assuming I can find one I felt comfortable with who would accept me.

Thanks to the other posters for their replies as well.

 

[Geoff Caplan]

Rusty

Yeah – buyer beware. I’ve looked at a few of their bios and they seem to vary widely in experience. Some look great, some not so much…

[Rusty Beaver]

Thanks. My thoughts, too, Geoff. I believe in alternatives but there’s a lot of snake oil to be waded through some times. Getting the right person though can be gold!

 

[Ethan A.]

Rusty I saw this thread a while back and meant to comment and got caught up. Hope you’re feeling better. Please note I haven’t read all of it yet but plan to, as I have some experience returning to full activity from injury that I think might be helpful. For now I wanted to suggest one thing that could only help, not just your feet but your whole body, and that costs very little $ and time and feels great. I did it before in PT, but really learned to appreciate it from a friend who made the US Olympic running team and got me doing it daily.

I highly recommend you pick up a hard foam roller (softer foams do not work as well) 36 in. x 6 in. – they usually run $18-20 – and use it every single morning after waking, before bed and before and after exercise. It only takes several minutes to roll to significantly stretch key muscles and connective tissues. It also helps drive out lactic acid. Rolling helps prevent tight muscles from pulling other muscles and bones out of good alignment. You’ll accomplish much more with stretching + using a roller than stretching alone.

First facing up – butt and hamstrings up to the back of the knee, then calves, then your upper back from top of your mid-back (but not lower back). Second, facing down, roll the front of your legs from hips to above knees. Finally, for extra credit, you can roll your IT band on the side of your legs between hip and knee. On trail you can roll with a nalgene bottle.

If tight muscles or connective tissues are causing issues for you as they do for many people (often unknown to them), rolling will help a lot. It helps the Ms. and me avoid injury and pain and feels great.

[Rusty Beaver]

Thanks, Ethan. Appreciate that. I have seen some improvement since my last post. Tons of stretching and core strengthening….and wearing the Altra Olympus shoes. That said, I’m sure open to adding in more things that may help. Do you have a link to a video that shows the techniques you speak of?

[Rusty Beaver]

Thought I’d add an update. Mid spring, I began wondering if there was a connection between my back and feet. I had tweaked my back a couple months before I noticed something going on with my feet. Not bad enough to see a back guy, other than a three chiropractors who did nothing. I believe one actually made things worse. But I digress.

I see a neurologist for restless leg syndrome and while speaking with him during a routine visit about this, he suggested I get an MRI on my back. I did and nothing was glaring, as if I’m one small fall from being in a wheelchair. However, I have a series of smaller issues in my back, one being a bulging disc where a nerve that goes to my foot is located. The Dr couldn’t say with any certainty if that was the trouble spot but left little doubt that my foot issue is actually nerve related.

Since posting last March, I have developed tingling and numbness on top of the pain. I can’t go barefoot but for a few feet on our carpet at a time and still stand on a foam mat while showering. The tall Altra Olypus’s are the only shoes with zero drop I can tolerate. The most I can walk, on a good day, without a fair amount of discomfort, is 2 miles.

To say I am bummed is an understatement! Riding my MTB is doable though and I did more of that this yr…as well as whitewater kayaking, and some backcountry moto touring. I long to get back to backpacking though… but I don’t know when that will be. Right now, though I’d like to think I see light at the end of the tunnel, I can’t honestly say I can.

Never take your feet for granted.

[AK Granola]

I have zero medical expertise, but I have the absolute best physical therapist in the world. She has helped so many people with so many problems. The first thing she does is watch you walk, and again, and again. She sees things doctors tend not to see. I’ve been to her for two ailments and she cured both (with my cooperation of course, faithfully doing the exercises she gave me). All the serious athletes go to her.

You’ve tried so many things, was one a good PT? Yoga is the other practice that saves my old, arthritic body so that I can hike another day.

I hope you find something. Keep trying!

!

[Rusty Beaver]

Thanks, Karen. I have seen 4 different PTs. Three are personal friends who watched me walk. They didn’t see anything… though that isn’t to say they didn’t miss something.

I do stretch and am continually active and in great health otherwise. Yoga though would be a great thing to add to my routine though, I’m sure

 

[Roger Caffin]

Karen is lucky.

There is a huge difference between a podiatrist accustomed to treating ‘ordinary’ (street-bound) civilians and one experienced in treating serious athletes. Keen walkers going on multi-day trips ARE serious athletes. (The same applies to general practitioners of course.)

From my very limited experience, I have to note that back pains & hip pains often do come from either the knee or the foot. You try to compensate for problems down there, but that throws a lot of stress up higher.

Cheers

[Sam Farrington]

Rusty,
Some things I noted in your posts:

“I have after all, had a lot of tendon/muscle/fascia injuries in the last ~25 yrs.” And also that the bone in one big toe is short, and may be causing pain in the neighboring toe joint(s). So am wondering if there has been some permanent injury that needs to be treated, even with surgery (but only if that is necessary.)

That you have a bulging disc where a nerve is located. Sciatica is not necessarily what you have, but if it is, it can radiate right down the legs to the feet, and can be readily treated with physical therapy and LIMITED corticosteroids with one or two subdural injections.  Ask about ‘Williams’ exercises.

That you were prescribed analgesics, but were not keen on them. OK, but pain can destroy you. What works for me is LIMITED use of Nabumetone, a remarkable drug that has limited effect on the GI tract, but not the possible cardiac side effects of drugs in the Celebrex family, or COX-2 inhibitors.

With respect to the Morton’s neuroma, this Mayo Clinic link may be helpful:
https://www.mayoclinic.org/diseases-conditions/mortons-neuroma/symptoms-causes/syc-20351935

With the above in mind, note that the USA has probably the worst healthcare among developed nations. American health care – not much health, and they don’t care. So it is no surprise that you have seen numerous doctors who did not help. This has happened to me many times, more frequently as I get older, have more serious issues, and I hate to say it, can be written off as not worth treating due to age. A veterinarian friend refers to this as the “Hurry up and die” syndrome. It may be hard to believe, but your health is often not what doctors have most in mind. It has a lot to do with the ‘greed is good’ outlook, which unfortunately is getting worse, not better. And in fairness to the doctors, dealing with hopeless agony and death on a regular basis is not exactly a recipe for empathy.

So what I look for is a specialist who I can relate to, and who wants to “follow” me as a patient. In other words, he/she makes further appointments for me to come back after recommended actions are taken and schedules follow ups after that. Most don’t. The ones who do almost always turn out to be much better and much more helpful. One or two appointments and have a nice life? – forget them. Hopefully you have health insurance to pay for the wasted trips.

A nurse friend I admire came down severely ill some years ago. She just dropped everything, made the arrangements, and went to the most respected clinic in her part of the country. She was successfully treated, and teaches dancing classes.

Above all, don’t give up. You may not run or backpack, or even hike or cycle again; but life can still be very rewarding if you keep on keeping on. And with persistence, many painful conditions improve over time. The most valuable experiences come from relationships with other people; or in a pinch, get a dog as Harry Truman quipped. I’ve done that, and God bless them, they transform my life.

[Daryl and Daryl]

“I’ve *always* been able to fully heal my feet by (a) diversifying the footwear I wear”

Me too.  I don’t get a clear understanding of what the problem was.  One day I just realize that it doesn’t hurt anymore.

[Author]

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