Inflexible/Weak Feet causing your Low Back, Knee, and Pelvic Floor Pain??

Recently, I posted a TikTok showing that I was wearing minimalist footwear shoes and I had the caption, “Try to make sure that your feet are both strong and flexible.  If you don't, you have just lost the shock absorber for your body and that can give you issues like plantar fasciitis, ankle pain, knee pain, hip pain, or even pelvic floor dysfunction.” You can think of it as the wear and tear that happens in your body when you’ve lost the primary shock absorber.

Somebody then asked in that TikTok video what would be the best kind of shoes to wear or how do you get stronger, more flexible feet. I decided to make a blog to touch on these things so you can get an idea on how you can slowly implement different things to make your feet stronger and more flexible without jumping in from wearing restrictive footwear to a minimal pair of shoes.  If you do this too quickly, you could get injured or have pain. The musculature in your feet, just like muscles anywhere else, need to slowly build their tolerance to increased load.  

The Feet As A Shock Absorber

The concept surrounding the idea that the feet are the body’s shock absorber is that we have three arches in our feet. We have the medial, which is on the inside of the foot, the lateral, and the transverse, which is across the center. As we go through that motion of gait, walking, running, the arch should flatten out and then recoil as we come through. The muscles of the arch should be able to eccentrically load as they are flattening out, and then concentrically contract as we come through.

The Problem With Footwear

A lot of times, with a really supportive shoe or structured shoe, we lose that ability to have good movement through our arch. If you are a runner and you think about where you strike on your foot, you have to ask yourself if you are hitting mid foot or you are heel striking. If you were to run in minimalist footwear and you didn’t have that artificial buffer of a really padded shoe, you will not be a heel striker. It wouldn’t be comfortable and you will probably not be able to tolerate it. Ideally, we hit through our mid foot and have that shock absorption happen.

The other thing would be if you have a lot of built-up arch support in your shoes. If the arch is really high and it is artificially holding your arch up there, think of that as a brace. It’s doing the work for the muscles and any time we wear a brace somewhere else like in our ankle or our back, we’re going to get atrophy of the muscles. Wearing such footwear slowly deconditions our feet and we atrophy the muscles because we wear shoes all the time.

Some people do not like to go barefoot and they wear shoes even when they are at home or even when they have nowhere else to be. If they develop a problem like plantar fasciitis, they get into this hamster wheel of weakening their feet, developing plantar fasciitis, being in pain, etc. Because of this, they have to always wear their shoes and have trouble strengthening their feet appropriately. 

I am not saying do not wear shoes. What I am saying is to think of the activities that you do. For example, if you are exercising, do you do activities where you need to wear shoes or something that is stiff? I used to like rock climbing and the shoes that I had to wear to do that activity are really restrictive. I hated that, but that’s how they are made. When I was younger, I also did dance and I wore pointe shoes. Pointe shoes are not super ergonomic for your feet. If you do yoga, gymnastics, or activities where you are barefoot, you get a better neurologic input to the foot because it is feeling lots of different textures and moving through full ranges of motion.  Think of the activities that are part of your normal day, how often you are in your bare feet, and how often you wear footwear? I love wearing flip flops, but it depends on how they fit. Often, flip flops create toe gripping to keep them on and that is going to cause another set of problems.

What Are The Recommended Activities 

Remember that we have to work on toe extension and a nice and even movement in the foot. If you are wearing traditional and restrictive/padded footwear, I would start with getting a shoe that has a wide toe box instead of jumping right into using minimalist footwear.  The toe box is where your toes are at and the ball of the foot. Make sure that it is wide and doesn’t put even an ounce of pressure on the big toe to push it into the center.

When people think of things like bunions, they think huge, gnarly bumps. However, that is not true for all instances. I have a lot of patients who have the beginnings of a bunion and it’s probably simply from the footwear that they wear. 

After switching to a footwear that has a wide toe box, I will move on to mobilization. Here, you can use a tennis ball, a yoga tune-up ball, or any ball that you have lying in your house. You would simply roll the bottom of the foot to get some nice movement of the tissue at the bottom. That is where the plantar fascia is and you will be warming it up. You will then put your heel on the ground and the ball under the arch. Roll the ball side to side so that the big toe and the pinky side will be touching down. You will basically be rocking it back and forth. I did a video on Instagram regarding this exercise and you can check out how to do it here. This exercise is called Mid Foot Mobilization and it feels really good. A word of caution though, you might not be able to get the big toe all the way down as well as the pinky at the beginning. You will get better and you will get there eventually!

After this exercise, you can move on to working on extending the toes individually. This is especially useful for people who are flip flop wearers. You would put the tripod or the sole of your foot down and put the big toe up on the ball and let it stretch the big toe back in extension. You will then lightly press into the ball for an asymmetric contraction of your big toe flexion and relax. Do the press and relax motion a couple of times. You then start stretching it a little bit more by bringing the heel up. Here is how to do it as seen on my Instagram account.

The big toe is important because you have to be able to extend it to have proper gait. If you cannot extend your big toe, you will be causing problems in the ankle, knee, or hip. This is because it will change the twerk at the knee or the hip because of how we have to compensate. If you cannot extend the big toe, you have to externally rotate that shin to roll over the side.  You will do the same thing to the next three toes. As you use the ball on the next three toes, you will probably say to yourself that those are neglected areas in your body because they are going to feel stiff and restricted.  Last is the pinky. When you do the pinky toe, you might feel like nothing is happening. However, that does not matter because it is a brain connection. You are telling your brain to flex that pinky toe. Even if not a sliver of movement happens, you are still sending that brain connection to those muscles that actually flex the toe. Eventually, you will get more, but the brain connection part of it is just as important as what you can see moving.

After these exercises for the toe, I would have them do lumbrical release, which I first saw from Dr. Perry Nickelson. I do it to all my patients who have plantar fasciitis. It is weirdly painful if you have trigger points, but lumbricals are really tiny muscles that help with the structure of our foot. LUMBRICAL RELEASE 

You can always work your way up into doing muscle work into the calf. I typically look at the whole body even for something like plantar fasciitis. 

Strengthening Exercises

The next thing I recommend that you try would be strengthening exercises. The strengthening that I like to do, which is super common in the PT world, are short foot exercises and windshield wipers. If you think of the tripod of your foot, you have this nice triangular base. For my patients, whenever they do exercises, I ask them to think of rounding through those three points. I even had people tape pennies to each side so they can really sense where they should be distributing their weight.  If you are a little weaker in this area, it might feel like it will start to spasm. Remember to not let the toes grip and claw down, let them be nice and loose and light, and use that big base of the big toe to be the contact point with the floor.

After doing these exercises, you will try to load it. By loading it, it means you will add in a band. You can tie a simple theraband to something like the leg of a table. Move around the big toe and you are going to draw the foot internally rotate and that will also lift that arch to create that strength in the arch. You can also do the other direction.  When you are bringing the foot over, you might feel the big toe kind of leading the charge. This is also a great exercise for someone who has bunions because it is recruiting and encouraging that medial movement of the big toe naturally.

The other thing I also want to mention, which is kind of for both strength and mobility, is standing and lifting the toes up, spreading them wide, and placing them down wide. Bring them together then put it down. It is working on that toe splay whether you are seated or standing. You can then try to move just the big toe by itself up and down then work on the rest of the toes. Again, this is a brain connection kind of thing.  If you just cannot lift your toes by themselves, specifically the smaller toes, you can hold down the big toe and lift them. You get that brain connection through doing this and as you practice it, you will get better. The body and the brain are phenomenal at adapting and learning new things; we just have to have that consistency. We are not going to do it just once and expect to get it. We have to be consistent.

You can also try a few variations of calf raises. Try coming up onto the ball of the foot while raising the heels. I like to really niche down and make the movement more specific.   Sometimes, I will have people stand on a step but hold a tune up ball or tennis ball between their heels so that when they come up onto their releve or on their toes, they know that their heels are tracking together because they have to hold up altogether. I also like asking them to do calf raise rainbows. Here, you will come up with your heels completely together and then bring them down apart. Basically, any activity that will control the foot and ankle movement is something we can play around with. Remember that it’s best to do this one foot at a time because we are often a little asymmetric so when we do a calf raise we might have a dominant foot or dominant calf that we are going to rely on that side to do the lion share of the work.

Shoes You Can Wear

Once you’ve got your wide toe box shoe and you’ve done the myofascial release, the mobility, and the strengthening, that would be the best time to wear minimalist shoes. I would suggest wearing them only for a half an hour at a time. You can do this for the first week. By next week, you may be wearing it for half an hour in the morning and half an hour at night so that you slowly build that strength to be able to wear them all day.

It won’t take that long to achieve that and it could depend on different circumstances such as you having a history of foot issues. It would be a slow process, but that would be the safest way to do it.

There are many different minimalist footwear brands out there. I have Vivobarefoot shoes and they also make kids’ shoes and my kids wear those. I do have a pair of Earth Runners, which are a sandal minimalist footwear.

I used to love going to the gym pre pandemic.  I would obviously wear shoes whenever I would go there. Post pandemic, however, I work out at home now and I don’t ever wear shoes unless I am on the spin bike. Now, it would be really weird for me to squat and deadlift in shoes as with going barefoot, I feel like I can feel the ground better and feel my tripod on my foot better.

Maybe it will become a thing someday.

If you have any questions, you can drop it in the comment section or you send me a message through Facebook or Instagram. I’d be happy to do another podcast about your questions. Also, if you want me to talk about something specific, let me know!

You can also check my TikTok account as I use the platform to educate viewers about movement, chiropractic education, yoga, pregnancy, and more!