Everything is Broken, But You Don’t Have to Be (Part 1)
Someone close to me, a very bright PhD who knows all the associated risks, recently admitted that they smoked cigarettes in college. This was a shock because they don’t smoke now and at the time they were a Division I athlete competing at a very high level. It didn’t seem like cigarettes would fit their lifestyle. When I asked why, they said that it was the only way they could get a break during work; they worked at a very busy restaurant to help pay for college. It was baffling that their manager permitted employees to leave work to turn their lungs black, but a mental health or food break was not permitted. This got me thinking, why is it generally acceptable to make exceptions for things that harm us? In other words, why is everything broken? Today we’ll begin a mini-series that will span a few months, exploring what’s broken and how we can fix it.
In the months to come, this mini-series will cover topics like how our jobs affect our health, why fitness is limited to the gym and a few other cultural norms that might do more harm than good.
Today’s topic is going to be about foot health and shoes. So, to begin, why do we abuse our feet? We wear terrible shoes because they’re convenient (flip-flops) or look good (high heels) without stopping to think of the long-term consequences. To make matters worse, it is common for sneakers, which are generally viewed as good for your feet, to have narrow toe boxes (the front of the shoe). If a shoe comes to a point, your toes will not be able to abduct (spread apart) and prepare to absorb the forces associated with daily movement. To convince you that this is a big deal, the forefoot commonly absorbs forces as high as 8x your body weight. If the foot cannot properly prepare for that force, trouble is not too far behind. Just ask anyone who suffers from bunions how uncomfortable it can be to absorb force with the forefoot. To make matters worse, this isn’t the only problem with sneakers. Most sneakers have so much padding that you can’t feel the ground. When you can’t feel the ground, your feet become desensitized and changes in gait or excessive heel striking may occur.
So, how do we fix these problems? Start by looking for shoes with a wide toe box and go barefoot as often as possible. When determining the width of the shoe, try taking out the sole. If the width of the sole is narrower than your foot, or you must crunch your toes together to make it fit, it isn’t wide enough for you. This is usually where people push back. They want their shoes to look cute or trendy and worry that a shoe that lets them both feel the ground and spread the toes might not help them look good. This argument is essentially the fear of not fitting in. It’s human nature to want to fit in and be accepted as one of the group. I understand that wearing shoes that look a little different might get some snickers, sneers and unwanted comments. However, when it comes to health, going along with the crowd can be a recipe for disaster. Most people, statistically speaking, are unhealthy. Remember heart disease is the number one killer in this country.
If you truly believe that you can’t wear shoes that are good for your feet, perhaps your job has a strict dress code, try wearing toe spacers. Even 10 minutes a day of wearing toe spacers is a good place to start.
With only 5 senses to navigate the world around us, we should take advantage of all of them. Neglecting the high concentration of sensory neurons within our feet limits our sense of touch. You probably wouldn’t deliberately dampen your sense of vision or hearing, so why would you mute your sense of touch?
Disclaimer: if you experience pain walking around barefoot and or have been diagnosed with a foot issue, these suggestions may not work for you, please consult your pediatrist if you think this pertains to you. Some doctors will prescribe orthotics to be inserted into your shoes, if wearing these takes your pain away, it will probably be a good idea to wear them, at least in the short term.
Anyway, if you’ve been spending most of your life walking around in thick and cushioned sneakers, please don’t immediately abandon them. Like any other change, it’s best when it is applied gradually. If your sneakers currently provide an “8 mm offset” which typically results in a greater heel strike, starting with a “4 mm offset” might be a better first step than going directly to a neutral or barefoot style shoe. The goal would be to eventually progress to a neutral shoe but take it slow.
If you come across an article or video about how our “ancestors walked around without shoes” and are thinking about giving up on wearing shoes altogether, just know that this may lead to more issues than solutions. Our ancestors didn’t walk on the same surfaces that we do now, and our protected feet have become desensitized. However, there may be some benefits to restoring movement to your feet that our ancestors probably had. Toe yoga, or the ability to lift & move one individual toe at a time, can be a beneficial practice. Especially when we consider the relationship between the big toe and the glutes. It’s harder to activate your glutes if you can’t push your big toe into the ground. If this sounds silly, recent studies have shown that poor toe strength is highly correlated with an increase incidence in falls. To further stress the importance of this, for those over 70 years old, a fall that results in a broken hip can decrease life expectancy to less than one year. Let me say that again, less than one year! Strong toes may result in a better health-span and a longer lifespan.
If you’re interested in learning more about this, we suggest you check out Episode #296 of The Drive Podcast with Dr. Peter Attia.