Kicks for Kids

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When it comes to footwear for our children, are we making “shoddy” choices?

“What shoes are best for my child?” As natural foot care specialists, this is a question we often hear in our office. It’s a question posed by concerned parents who, themselves, are afflicted with foot ailments such as bunions, hammertoes, fungal toenails, and plantar fasciosis. Kids, as you well know, spend a lot of time on their feet, walking, running, and playing. In fact, an active child takes about 20,000 steps per day! Parents often wonder about the best way to protect and support their children’s feet and prevent future musculoskeletal problems.

For adult foot problems, it’s usually possible to treat existing ailments without surgeries, medication, and injections, though, unfortunately, this approach is not often practiced in mainstream medicine. A more natural treatment approach to common foot problems involves understanding and respecting the inherent integrity of the foot and the physiology of weight-bearing movement. Your foot is naturally and brilliantly designed for optimal standing and locomotion if it is allowed to function the way nature intended. Conventional footwear actually hinders your natural foot structure and function, and, over time, this can cause many problems in your feet and the rest of your body’s structures. But why is this so?

Notice the shape of a young child’s foot. Which part of the foot is the widest? The ends of the toes, of course! Universally! Now look at an adult’s foot. In almost everyone, the widest part of the foot is at the ball. Why is there such a difference in foot shape between young children and adults? Is it just a normal process of growth and development? The answer is no. Observe the shape of most adult footwear. Notice that the widest part of the shoe is at the ball, and notice how the toe box tapers toward your foot’s midline. The similarity of adult foot shape and shoe shape is not a coincidence. Almost everyone in the western world spends a majority of their waking hours in shoes. This starts even before children are able to walk. Years and years of weight-bearing activity (running, walking, hiking, standing, etc.) in conventional footwear causes the shape of your feet to change. Your feet deform to fit your shoes. This transformation has hugely negative implications for adults.

If you look at certain non-western cultures, especially groups in Africa, South America, or India, where people spend much of their lives barefoot or wearing only sandals, you will see that adults maintain the same foot shape as in childhood; that is, a foot that is widest at the ends of the toes. You should also note that these same cultures have almost undetectable instances of bunions, hammertoes, and other common lower extremity ailments. This correlation is too important to ignore.

Some of you may be wondering: What does the medical literature say about all this?

Interestingly, there is much written on the subject, though, unfortunately, it’s largely overlooked by mainstream practitioners. For one thing, there is no scientific evidence that shoes are good for children. One study found that a staggering 80 percent of preschool-aged children had foot and toe deformities that were not seen in unshod (barefoot) children. It is said that by the time shoe-wearing children are teenagers, only about 33 percent will have normal feet. The good news is that these shoe-induced foot deformities and problems can be prevented.

As a parent, you are in a wonderful position to help your children’s feet and bodies develop optimally. It’s simply a matter of allowing your children’s feet to function the way nature intended. This means selecting footwear that does not, in any way, alter your child’s foot. Your child’s footwear should not elevate his or her heel or scrunch his or her toes together. It should not spring the toes upward either. Kids’ shoes should be lightweight and flexible, and they should not have built-in “arch support.” Your foot’s main arch (the medical longitudinal arch) is an inherently strong and stable structure if your heel and forefoot are level and your toes are properly spread. Footwear features such as arch support and pronation control actually hinder the natural development of the foot, leading to lower extremity pain and other problems in later years.

Our advice to parents who pose the question “What footwear should I select for my child?” is this: Seek footwear that is completely flat, widest at the ends of your child’s toes (not just at the ball), flexible, and lightweight. Shoes that fulfill these criteria are surprisingly difficult to find for all but the very youngest members of our society. But your persistence in seeking these shoes will pay dividends in the appropriate and healthy development of your child’s feet.

Here’s wishing children and parents alike long-term foot health and abundant, pain-free movement!

In the video below, Dr. Ray McClanahan shares his tips for choosing the healthiest possible shoes for your children. He explains what features to look for and what features to avoid to aid your child’s natural foot development.

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Hallux Limitus and Hallux Rigidus

FA12.HalluxLimitusHaluxRigidus.11.27.11
Photo courtesy: http://www.ourhealthnetwork.com

Hallux is the medical term for your big toe. Your big toe is one of the most important parts of your body, as it provides propulsive force during gait. Your big toe should possesses between 50 and 90 degrees of extension—also known as dorsiflexion—if it is healthy and injury-free, and you should be able to move your big toe through a full and pain-free flexion range of motion, too. A dysfunctional big toe will cause other parts of your body, especially the joints and tissues of your lower extremity, to compensate when you walk or run, which places increased strain on these structures and may, over time, cause pain and fatigue.

Condition Description

Hallux limitus is the term podiatrists and other healthcare professionals use to describe loss of motion in your big toe joint. The metatarsophalangeal, or MTP, joint of your big toe is the structure affected by this health problem. Your first MTP joint is the location where your big toe connects to your first metatarsal bone—a long, thin bone that spans your mid-foot and forefoot.

Hallux rigidus is considered by many podiatrists to be the end stage of hallux limitus, or a state in which your ability to create motion in your big toe is lost or severely restricted. Hallux rigidus may lead to long-term damage of your first MTP joint, and it usually involves erosion of your joint cartilage and the development of osteoarthritis, or degenerative joint disease. Hallux rigidus is a condition characterized by near-ankylosis, or a state in which your big toe becomes stiff and immobile due to the partial fusion of your involved bones.

Causes and Symptoms

Hallux limitus and rigidus are often considered idiopathic, or caused by unknown factors, but certain known factors may contribute to this health problem, too. Possible causes of hallux limitus and rigidus include:

  • Trauma
  • Faulty foot biomechanics
  • Genetics
  • Rheumatoid arthritis, gout, or other inflammatory diseases
  • Overuse

One of the most significant factors contributing to this health problem, however, may be the prolonged use of inappropriate footwear, especially footwear that constricts your toes.

You may experience the following signs and symptoms if you have hallux limitus or rigidus:

  • Pain and stiffness when moving your big toe
  • Pain in your affected area when walking, running, or squatting
  • Pain and stiffness brought on by cold, damp weather
  • Swelling and inflammation in or near your first MTP joint
  • Limping
  • Pain in your other lower extremity joints as well as your low back

Treatment

Non-surgical treatment options exist for this health problem and may help reduce your symptoms. Possible conservative care treatment options for your hallux limitus and rigidus include:

  • Correct Toes: This toe-spacing appliance helps realign your big toe with your first metatarsal.
  • Shoe therapy: Minimalist shoes with wide a toe box allow your toes to splay properly.
  • Physical therapy (PT): Ultrasound or other PT modalities may help relieve your symptoms.
  • Daily stretches, such as the toe extensor stretch and ‘bunion’ stretch.
  • Topical pain relievers: Natural pain relievers may help reduce swelling, pain, and inflammation.

The extent to which non-surgical treatment (e.g., using Correct Toes and wearing wide-toe-box shoes) can alleviate hallux limitus and hallux rigidus depends on your ability to manually move your big toe in two directions: away from your second toe (abduction) and upward (dorsiflexion). If these movements are significantly restricted, conservative approaches may not help with your condition. However, if some movement remains, the above-mentioned strategies can be useful. Please check out our testimonials page for examples of individuals who have experienced relief from the common conditions of hallux limitus/rigidus.

-Dr. Ray McClanahan, DPM, NW Foot and Ankle/ Correct Toes

Earthing

Dr. Ray McClanahan interviews barefoot enthusiast Michael Sander on the theory of Earthing and its potential health benefits.

51EarthArticle originally appeared in Walk About Magazine

Wearing minimal shoes for walking and walking barefoot have been topics of discussion in Walk About magazine for many years now. Repeatedly we have discussed such potential benefits as increased strength of the muscles of the feet, thickening of the protective layers of the foot skin, and increased body awareness by better feeling of the ground (proprioception).

Many walkers are aware of these directly observable physical changes that can occur in human feet. What are not so clearly observable and measurable are the newly emerging reasons why we should be removing our shoes and standing and walking in direct contact with the earth. It is called Earthing.

Briefly described, the theory suggests that our bodies develop built-up electrical charges that change our internal chemistry toward a more inflamed state of existence. This is thought to occur because American walkers live their lives largely separated from the natural electrical charge of the earth. We ride in cars, wear shoes, live in houses and high-rise apartments, and sleep on mattresses. We rarely touch the actual ground. If we reconnect with the ground, we recalibrate our systems to what our natural electrical state should be, and dissipate built-up electrical charges. This equates to better health.

Since the introduction of Earthing a few issues back, I read the book, Earthing: The Most Important Health Discovery Ever, and have interviewed doctors and researchers who are familiar with the science behind Earthing. I have talked to people who live barefoot and walk directly on the earth, as well as others who reap the benefits of Earthing by connecting themselves to products that are connected to a grounding rod buried into the ground outside of their homes. A common example of this type of Earthing is accomplished by using grounding sheets that are placed on top of mattresses to be slept on.

Many people who have experienced Earthing report a variety of positive health benefits such as better sleep, quicker recovery from exercise, and greater flexibility and mobility. The book was great, but I needed to talk to real people who had real experience with Earthing.

The most interesting person I met in my research on Earthing is the author of Barefoot Running, Michael Sandler. The reason why I found him so beneficial to my research and understanding of Earthing, was because he was the only individual that I met who had extensive knowledge and experience with both types of Earthing, natural Earthing, by living barefoot, and, simulated Earthing, by using grounding devices. He has had a professional cycling career in Europe. Here is a conversation I had with him.

Do you believe in the theory of Earthing?
Yes, as our bodies are electrical, the earth is electrical, and everything that touches the earth or is disconnected from the earth is affected by the charge of the earth. To me it’s like asking if I believed in the theory of electricity. Just because you don’t see it, doesn’t mean it doesn’t affect us on a minute-by-minute basis.

Has your habitual practice of living barefoot confirmed any of the ideas supporting Earthing?
Yes, I can see large differences in the way I feel ([reduced] inflammation in the joints, healing, stress reduction, and greater creativity) by the time I spend in direct contact with the ground.

Have you perceived a difference in the effects of natural Earthing (barefoot living), compared to your experience of using grounding recovery sheets in your professional cycling (simulated Earthing)? Surprisingly, yes. While I believe there’s benefit to using grounding recovery sheets (I’ve seen inflammation decrease, and I personally sit on one when I’m working at the computer and when sleeping at night), there appears to be a much greater difference, and a very different sensation, by sitting or walking directly on the earth. For instance, the creativity, calmness, and feeling of joy that I get when directly connected to the earth appears to be far greater than [what I get from] a grounding sheet.

Are the potential positive health benefits from Earthing as significant as has been reported, or is the effectiveness of this approach being exaggerated and hyped?
I think there’s both hype and a thread of truth in everything we hear and read. After all, we all have our own personal biases. However, with that said, I think the effects of grounding are huge and deserve significant further examination. Personally, after a near-death accident, I could not heal and could not run again until I began going barefoot. In a sense, getting connected to the earth saved my life and returned me to health. And I’m not alone with [my] story. The anti-inflammation benefits cannot be overstated. And we live at a time when inflammatory diseases are the Number One cause of death. I believe it’s because at no time in our history have we been this disconnected from the earth. Plugging back in and getting that “Vitamin G,” for ground, as I call it, is the most important thing in the world, it’s like a starting point or foundation. If you want a strong building, build it into the earth. If you want a strong tree, you need great roots growing into the ground. And if you want a healthy human being, then we need to be connected to the ground beneath our feet.

What are the most important features to understand for walkers to begin their own Earthing experiment?
Vitamin G, or getting grounded, is cumulative. Even spending a few minutes every day helps, and the more time you do it, the better. There’s no such thing as spending too much time connected to the earth. Imagine telling a squirrel it may get sick if it doesn’t get up and off of the ground or put on shoes. So the more we do it, the better. However, going fully barefoot is something the musculoskeletal system of our body needs to adapt or adjust to. So in the beginning, baby-step your way into barefoot walking, with 100 yards your first day, none the second, then add 100 yards every other day. You can still connect with the earth in-between, for instance, sit outside on a light cloth at daybreak (particularly with your bare feet touching the ground), or lay down and let your head rest directly on the earth; or at lunchtime too, spend a few minutes fully barefoot or sitting on the earth, this is one of the greatest ways to recharge, de-stress, and reinvigorate yourself.

Ray McClanahan, DPM, is a podiatrist and owner of Northwest Foot and Ankle Clinic. He’s passionate about preventive foot care. To contact McClanahan call 503-243-2699 or visit www.nwfootankle.com.

About Michael Sandler
A former professional athlete, Sandler of www.RunBare.com is the best-selling co-author of Barefoot Running. Along with co-author Jessica Lee, they travel the world and hold retreats, helping others reconnect with the Earth, quiet their minds, and heal through

Are Correct Toes customizable?

Yes! Here are a few examples:

1. Correct Toes are designed to allow you to progressively increase the space between your toes. This is accomplished by using shims (small pieces of EAV material) in the spaces between the 1st & 2nd toes and the 4th & 5th. You can use 1, 2, or 3 shims in each, depending on your personal needs. As always, any changes should be implemented slowly and progressively, so that your body has ample time to adjust.

2. It is possible to decrease the space between your fourth and fifth toes. This may be useful if: the 5th toe (“pinky” toe) is pushed out too far (this occasionally happens for some types of feet), or to use Correct Toes in shoes that are almost, but not quite, wide enough. To accomplish this, start by cutting ½ of the small interspace along the vertical plane. This will diminish the space between the last 2 toes. If necessary, the whole 4th interspace can be removed. Correct Toes will still work quite well.

3.  Need a bit more space for your toes? Simply use a hole-punch on the first and/or fourth interspace. This increases the stretchiness of Correct Toes.

-Dr. Ray McCalanhan, DPM, Northwest Foot & Ankle/Correct Toes

For more videos from Dr. McClanahan and Correct Toes check out our Youtube channel.

Thank You, Body Care Professionals!

ImageNorthwest Foot & Ankle and Correct Toes wishes to thank and commend the massage therapists, body workers, structural specialists, reflexologists, and pedicurists who incorporate Correct Toes and natural foot health concepts into their practices. These folks do great work for the feet and entire body, and we appreciate their efforts. To find a practitioner near you who understands the natural foot health concepts we discuss in our newsletters and on our website, please check out our Healthcare Providers and CT Retailers pages.

Body care professionals: What’s your favorite self-massage or foot care technique? Leave a comment for us below. We’d love your expert feedback!