Cold Feet

Cold Feet

Circulation is an important issue, especially as it pertains to your extremities. Blood flow to the points in your body farthest away from your heart, including your feet and toes, can become compromised for a variety of reasons, including a cold environment. With wintry temperatures and conditions settling in, we thought it would be a good time to discuss the topic of cold feet; specifically, what are the best ways to prevent cold feet and toes in winter climates. We’ll take a look at several key strategies that can help your feet and toes stay toasty warm in the cold conditions you may encounter outside.

Optimizing Foot & Toe Circulation
One of the best ways to prevent cold feet and toes is to optimize or enhance foot circulation (i.e., blood flow). And one of the best ways to accomplish this particular goal is to use Correct Toes. Correct Toes, as explained in greater detail in our article entitled Correct Toes & Circulation: Visualized, enables optimal foot and toe circulation by spreading the toes. This allows more blood to enter and exit the foot, reaching foot and toe tissues—including the very ends of the toes—that may otherwise experience less-than-optimal circulation. And where there is healthy blood flow, there is warmth.

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Other Helpful Strategies
In addition to wearing Correct Toes, other strategies to prevent cold feet and toes include wearing wide toe box boots that are thermal insulated, wearing wool toe socks (companies such as Injinji and Toesox offer wool varieties), wearing battery-powered socks, or using a product such as Toe Warmers by Grabber.

Dr. Ray’s Protocol
Correct Toes inventor Dr. Ray McClanahan periodically spends time in the Montana winter wilderness, and he has had good success in preventing cold feet by doing the following: wearing wide, thermal insulated boots, thick wool socks (from Toesox), Correct Toes, battery-powered socks over the Correct Toes/toe socks combo, and Toe Warmers. Dr. Ray states that this combination of footgear keeps his feet and toes pleasantly comfortable, even in single-digit temperatures.

IMPORTANT NOTE: If you are using an uninsulated winter boot or shoe, we recommend NOT wearing your Correct Toes in freezing cold temperatures. The device itself can get quite cold, and it’s proximity to the toes can cause discomfort. Correct Toes are designed to be used either inside a thermal insulated boot in combination with warm wool socks and/or in reasonably warm temperatures.

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West Point, NY. September 2015.

Sports medicine specialists from around the world convened at West Point Military Academy to discuss best practices and what is new in the field of sports medicine.

While some things stayed the same, such as attempting to help our athletes recover without surgery, other things changed substantially when compared to our previous approach to athletic injuries.

A significant example of one such recent change is that we will no longer suggest that pronation is a primary cause of athletic injuries. Rather, pronation is a normal physiological movement that varies from athlete to athlete and should not be treated as a dysfunctional movement. Further, the idea that athletic shoes favorably alter pronation, and thus reduce injury, has been abandoned. This is a huge paradigm shift in the world of sports medicine, and fortunately this shift is supported by the available medical literature that was reviewed.

Another powerful step forward (this pun is intended) is the realization that teaching an athlete how to run better can alter their body mechanics in such a way as to reduce certain types of injuries. Heel striking as the favored method of running has been replaced with the need to get the athlete’s foot under their body, by teaching and focusing on a midfoot strike. Again, thankfully, the medical literature supports this as an injury reducer.

Dr. Mark Cucuzzella gave a great talk on how we all need to play, and that movement is medicine for all of us, for our entire lives.  Unfortunately, he had to condense what he ordinarily teaches in a 2-day course into a 30-minute talk. Nevertheless, his wisdom was appreciated.

Golden Harper, designer of Altra footwear, was present and tirelessly taught many sports medicine doctors the merits of natural foot positioning, and the importance of allowing the athlete’s feet to function as nature intended with the least amount of interference coming from the footwear.

Jonathon Beverly, editor of Running Times and Runner’s World magazines, was there to capture it all.

Many relationships were formed, and a renewed passion for helping our athletes was deeply palpable.

Perhaps the highlight, of many high points for me personally, was the invitation to speak to the group next year regarding the natural foot health program we offer at NWFA/Correct Toes. Could it get any better? Yes! Next year’s meeting will be held in Portland, Oregon, and I have been asked to help organize and lead the meeting.

If you are a sport medicine provider, we hope to see you in Portland next year.

Until then, have fun, be well, and don’t forget to play each day, no matter your age!

– Dr. Ray McClanahan, DPM
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In Top Photo: Dr. Ana, Dr. Ray McClanahan, Dr. Mark Cucuzzella

In Bottom Photo: Golden Harper (Altra Running Shoes), Dr. Ray McClanahan, Dr. Mark Cucuzzella

Award-Winning Study: Correct Toes’ Influence on Balance

Adam Kelly, a researcher currently about to begin work on his PhD in Exercise Physiology at the University of Miami, recently completed the first-ever study of Correct Toes and its effects on balance, specifically dynamic balance—the ability to maintain stability of the center of mass with movement.

Kelly became familiar with the Correct Toes product during his undergraduate education and knew that he would like to potentially study the device once he got to graduate school. His interest in the device along with his knowledge of the prevalence of foot deformities in our society (due to poor footwear choice, design, and fit) provided the motivation for this study and helped Kelly earn his master’s degree.

Read a synopsis of Kelly’s findings, below, or watch the video for a complete presentation of the effects of Correct Toes and minimalist footwear on dynamic balance.

Award-Winning Correct Toes Study

Correct Toes & Balance Study Synopsis:

Study Title: The Influence of a Foot-Toe Orthosis and Minimalist Shoe on Dynamic Balance and Hallux Valgus Angle

Lead Researcher: Adam Kelly, MS, ATC

Study Synopsis: This study sought to examine and compare the effects of a foot-toe orthosis (Correct Toes) and minimalist shoe (Lems Primal 2) on dynamic balance and the angle of the big toe, or hallux valgus angle. Balance alone is defined as the ability to maintain center of mass stability over a support base, whereas dynamic balance is the ability to maintain center of mass stability with movement—a more accurate and relevant measurement for everyday life. The researchers hypothesized that participants receiving the intervention (i.e., Correct Toes with Lems Primal 2 shoes or just Lems Primal 2 shoes alone) would experience improvements in dynamic balance and a reduction in hallux valgus angle. The researchers randomly assigned 65 young, healthy volunteers (aged 21 to 29 years) to one of three distinct groups (the two groups mentioned above and a control group) and then took immediate measurements and follow-up measurements after 4 weeks. What researchers found was that there were significant differences in dynamic balance scores in the follow-up measurements of the Correct Toes/Lems shoes group and the control group and the Lems shoes only group and control group. The effect on dynamic balance was “strong” in the Correct Toes/Lems shoes group and “moderate” in the Lems shoes only group. Researchers found that there were no significant differences in hallux valgus angle between the any of the groups after 4 weeks, though this is likely due to key limitations of the study (e.g., short study duration, young and healthy participants, etc.). This study was the first to show that a toe-spacing device such as Correct Toes and/or a minimalist shoe such as the Lems Primal 2 may cause an increase in dynamic balance (in 4 weeks of wear) in a young, healthy adult population.

Correct Toes & Circulation: Visualized

Infrared Image #1

Have you ever wondered if Correct Toes can improve foot and toe circulation? Well, wonder no more. We were recently sent the above image (along with many others) by a Correct Toes user, Sergio, in Spain, who used his infrared (IR) camera to capture some very illuminating images. Sergio (@metatarsalia, on Twitter) is a certified building energy auditor.

The above image is a fantastic visual representation of the effect Correct Toes has on foot and toe blood flow. The darker areas represent areas of lower blood flow, while the lighter areas are regions experiencing greater circulation.

Here is a short description from Sergio about his IR images of Correct Toes and the feet:

This picture was taken two days after I bought my Correct Toes. I felt so good, resting better since the first day. On the second day, I decided to see what was happening on my feet wearing Correct Toes, so I put on Correct Toes on right foot and not on left foot. I did normal life, and after 1 hour of wearing [the spacers] I took my IR camera to see what nobody can see: the heat. And then I show, clearly, that right foot, the one with Correct Toes, was warmer than left foot. Blood can go to the end of my toes to warm them.

Sergio notes that IR images offer a much more detailed picture of what’s actually happening in the real world, whether it’s inside a building or the inside the human body. He says:

Visual images are what people see and think that everything is normal, under control, but when I turn on my IR camera they see that not everything is right. People can feel their cold toes, but when they see the IR picture, they make the decision to do something. It is like energy saving—many people don´t act until I show them how energy flows out of the building.

Here is another image that demonstrates the incredible effect that Correct Toes has on foot and toe circulation:
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This image also shows temperature variations (both within the foot, and between the feet). Both midfeet are approximately the same temperature, 33.2-33.4 degrees Celsius (92°F), and both big toes are colder. Note the temperature differences between the right and left big toes and feet:
The big toe on the right (Correct Toes side) is 3 degrees Celsius (5°F) warmer than the big toe on the left. Also, the temperature differential between the midfoot and big toe is 3 degrees Celsius less on the right (Correct Toes side) than the left (i.e., the right big toe retains more heat due to greater blood flow)!
Below are a few more of Sergio’s infrared images: The first photo depicts both feet without toe spacers. In the second, Correct Toes are on his right foot (left on screen) but not his left. The difference in temperature (blood flow) is evident in all the toes.
IR_3906 IR_3910
Thank you, to Sergio, for providing these valuable images and data. Pictures really are worth a thousand words.

Natural Strides Keeps Georgia’s Runners Feeling Peachy

Natural StridesNatural Strides is a progressive running store in Woodstock, Georgia, devoted to healthy and natural running. We recently interviewed Owner and Founder, Greg Scott. Here’s our discussion:

CT: Please tell us a bit about yourself and your store.

GS: I am a 38 year-old father of 2 and my life revolves around 3 main things: my wife Erin (who is an elite runner), my kids Troy and Belle (elementary aged and active), and our store (Running and Natural Movement Specialty). As such, my life is made up of all things running, movement, and health. Natural Strides opened 3 years ago in September 2011 as the first Natural Running Store in the Southeastern United States. That year I quit my job as a Special Education Teacher, which I loved, for something that I knew I would love much more. As a runner who had rewired my gait patterns and was transitioning into minimalist and natural footwear, I found that there were no Atlanta-area running stores who could cater to my needs. Online shopping was time-consuming and frustrating, leading to many ill-fitting shoes and returns. I knew there was a need for a brick & mortar location that could not just give footwear options to natural runners, but actually cater to them specifically, while providing traditional runners with education and another viewpoint to consider. So I took the plunge and it has been awesome.

Our focus as a store is to provide humans of all shapes, sizes, and goals with footwear and education on natural foot health. Ironically, as the owner of a shoe store I make it a point to encourage customers NOT to wear shoes whenever possible. When they need protection or style, we have options that provide that while still allowing for natural foot function. I am very proud to say that we do not and will not put customers in footwear that does not match their inherent foot shape: traditional, pointed-toe shoes have no place here and we are spreading the word about just how much damage can be done to the body by pointed and heel-lifted footwear. All of our shoes are level to the ground, wide in the toe box, light, and flexible. We offer a non-traditional gait analysis, which we do not use to fit people in shoes (that always seemed backward to me), but more to provide insight and our opinion on how they might move more efficiently. Both Erin and I are certified ChiRunning Instructors, and I am also a Certified Personal Trainer with ACSM. Erin is a part of the Altra Endurance Elite team, and is currently in training for the JFK 50 mile this fall. She manages our finances and her accomplishments as a natural and minimalist runner are a huge asset to our store. We also have excellent employees who walk the walk by running and living in natural, minimalist footwear.

CT: What are the most common foot complaints you hear from your customers?

GS: Plantar Fasciitis/Plantar Fasciosis is by far the number one complaint, and I estimate that 30 to 40 percent of people who come into our store for the first time are suffering from it. It is reaching epidemic proportions. With Dr. Ray’s help we have spread the word to thousands that this condition is preventable and treatable by natural means. Many of our customers, young and old alike, suffer from bunions and hammertoes as well. It is fun to work with these people by exposing them to some strengthening exercises and educating them on the natural shape of their foot as it should be. Correct Toes are the perfect complement to that process. We also have had many customers come in with neuromas, and have had several of them return to proudly say that their neuroma has completely disappeared and that they are pain free as a result of their foot-shaped shoes (imagine that), toe socks, and Correct Toes.

CT: What are customer’s initial reaction when they see or experience Correct Toes?

GS: Every customer that is fit for shoes here will see and experience Correct Toes, so we have seen every reaction possible. Most people are at first confused as to what it is, being that it is not something they are accustomed to seeing in running or shoe stores. But with a quick explanation, most get it and are intrigued. Once they wear the product and try on shoes with it on their foot, I would say that 75% of folks are pleased to have learned what their foot should look like and love the feeling of realignment. There are a few (usually women with a fashion mindset) who are not into it and not willing to give it a try at all, but we are happy to at least have “planted the seed” in their mind about natural foot health.  We have had people say “No way will I wear that,” and then decide later that they will buy a pair. Most often the reaction is very positive.

CT: What results have you seen in your customers by using a natural foot health approach?

GS: This is what makes our job very satisfying. In our 3 years doing this we have seen so many people come back and report life-changing benefits. It is really cool. Most often people are thrilled that their PF went away or are happy that their neuroma pain is gone, but we also have had a large number of folks see and feel the full body effects of setting their foundation right. Knee pain, hip pain, back pain, postural difficulties—all work their way out of their life when their feet become strong and aligned.

CT: Please feel free to share a customer or personal testimonial about recovery from a foot problem, using Correct Toes.

GS: Here are a couple of testimonials from our customers:

“Want healthy feet? Go talk to these guys; they know their stuff. My wife and I bought 4 pair of Lems minimalist shoes and Correct Toes. After 1 week I had no more plantar pain and started regaining feeling in my toes. This was a problem I have had for some time. My wife also noticed she had no more hip pain and could move her big toe. I am now a believer in the flat zero drop shoe with a big toe box. There isn’t any other shoe I would wear after being in these. I haven’t ran in 10 years but now feel like starting after walking in these shoes. Looking forward to new dress designs in this style in the future.”

“Greg, I recently bought a pair of Lems and a set of toe orthotics (Correct Toes) from your store in Woodstock. I also bought a pair of shoes for my 3 year-old grandson at the same time. He loves them! I just wanted you to know my “hammertoe” condition has improved significantly and my shoes feel wonderful, as do my feet and legs!! I am a very satisfied customer and have already been showing my shoes to all my friends here in Orlando. I am trying to steer them your way […] I will be up at the end of the year to purchase at least one more pair for me and I am bringing my wife to get fitted too!”

Thank you, Greg and Natural Strides, for your commitment to healthy running and optimal foot health!

Introducing #AskCorrectToes

#AskCorrectToes is a brand new educational program that we are pleased to introduce. You can now ask Dr. Ray questions about Correct Toes and natural foot health topics on Facebook or Twitter using the tag #AskCorrectToes. Each month we will select the top questions and Dr. Ray will answer them on video. Answers will be featured on our blog and in our regular monthly newsletter.

Here is the first #AskCorrectToes video answer to a question about orthotics and Correct Toes:

Correct Toes Play an Important Role in Physical Therapy

TAI LogoTherapeutic Associates Inc (TAI) is physical therapist-owned and operated partnership of unique clinics that aim to be an integral part of an individual’s journey toward positive health and wellness. TAI phsycial therapy clinics are located throughout Oregon, Washington, California, and Idaho. Many TAI practitioners have incorporated Correct Toes into their practices, and we were curious about their, and their patients’, experiences. We recently interviewed Belen Vala-Haynes, PT, DPT, OCS of Northeast Portland PT and Julie Dresch, MS, PT, OCS of Ballard PT. What follows is our discussion:

CT: Please tell us a bit about yourself and your PT clinic.

BVH: I work at a manual therapy focused clinic – meaning that we do hands-on work in combination with a very specialized home exercise program aimed at improving musculoskeletal problems. When we see our patients, we aim to give them a hands-on approach as needed with soft tissue work and mobilizations or stretches that the patient can’t do or that are aimed to progress their body area impairments and carried over with their home exercise program.

BVH: I myself am a physical therapist (PT), and I have my board certification in orthopedics (OCS), and I have been through some specialized training through Kaiser’s residency program in manual therapy. My personal philosophy is: talk to patients, listen what they want to get out of PT and try to give that to them. I think it is really important to explain what I can do and what their role is in their own improvement. I let them know that they need to take responsibility for their injury in order to get better, because they aren’t going to be in PT forever.

JD: Julie Dresch MS, PT, OCS. My clinic is in the Ballard neighborhood of Seattle. We are a busy outpatient practice with 3 full-time physical therapists, and we specialize in general orthopedics. We have an active group of employees from our front office to professional staff who pride themselves on creating great experience for our customers.

CT: What are the most common foot complaints you hear from your patients?

BVH: The most common foot complaints I treat are plantar fasciitis, post tibial dysfunction and generalized foot complaints from equinus posture in the foot (tight calf syndrome).

JD: We see a great deal of foot and ankle patients at TAI Ballard PT. The injuries are quite varied including plantar fasciitis, a variety of tendon pathologies, great toe arthritis, ankle sprains, and post-operative management.

CT: What are patients’ initial reactions when they see or experience Correct Toes?

BVH: Most of the time they really love them. I have them try them on to see what they do for their foot alignment. Then I make them walk around in them and usually that is where they are sold. The only problem I encounter is the price point – it’s sometimes a hard sell, but usually if they really want to get better, they buy them.

[CT: To address any concern about the Correct Toes price-point, please visit our Correct Toes Advantages page.]

JD: On observation, they look a little silly (thank my 3 year old, for me describing everything as silly!). With a good explanation on neutral foot positions and the effect returning to a nice wide forefoot can have on mechanics, pain relief, and muscle recruitment, they are usually willing to try. I almost always have foot/ankle patients try on our clinic pair (we keep all sizes on hand in our gym for trials), then have them perform balance and gait activities with and without so they can feel immediate changes..

CT: What results have you seen in your patients using a natural foot health approach?

BVH: I have had good results in the patients that work really hard at home to strengthen their feet. The ones that want me to do all the work, never feel satisfied. They may see some quick improvement with wearing the Correct Toes, but if they don’t do anything else they tend to plateau and get frustrated. They have to do the work.

JD: We live in a very educated world, and I think people are doing more proactively to find out about conservative and natural treatments. I have had nothing but praise for our approach to trying to find solutions that our own bodies can be trained to manage.

CT: Will you share your favorite foot rehabilitation tip or exercise?

BVH: I like tibialis anterior strengthening without toe extensor use – so you curl your toes, keep them curled and them tap your foot. I also give a lot of calcaneal eversion self mobilizations and a “Foot Rainbow” – which is a pronation/supination active foot exercise.

JD: Strengthen your hips along with your feet! Never ignore the top of the chain, because we are only as strong as what the foot is attached to.

CT: Please feel free to share a patient or personal testimonial about recovery from a foot problem, using Correct Toes and natural foot care.

BVH: I wear the Correct Toes everyday, and it has done wonders for my bunionette on my right foot!

Thanks, Belen and Julie, for sharing your experience and for all your work in helping alleviate foot pain in the Pacific Northwest!

Meet Running Wild

Running Wild
Running Wild
is a fantastic shoe store in Pensacola, FL that carries Correct Toes. We recently reached out to our friends at Running Wild to see how their customers are responding to Correct Toes. What follows is our Q&A with Running Wild:

CT: What are some of the most common foot complaints you hear from customers?

RW: Plantar Fasciitis is definitely #1. But most often customers just complain of heel and/or arch pain rather than identifying their condition as PF. Others tend to be: pain in their big toe area from a bunion or burning/pain in one of several of their metatarsals.

CT: What are customers’ reactions to Correct Toes once they see a visual demonstration of how it works?

RW: We have yet to have someone not buy them once we put them on a customers feet. It’s amazing when they try on the Correct Toes they say: “Wow I’ve never had anything on feet feel this good.”

CT: What are some of the most common questions you receive about Correct Toes from your customers?

RW: Usually before a customer tries them on, they ask about comfort, but as soon as they try them on they ask if they can buy them.

CT: What are the advantages of offering a product to your customers that addresses so many foot and toe ailments?

RW: Well the advantage is that the Correct Toes are seemingly so simple and non-invasive. The response that we’ve had is overwhelming. We started carrying them just a few weeks ago and we’re ready to place our third re-order.

CT: Can you share with us your personal experience with Correct Toes and how this device has helped you or people you know?

RW: As soon as we received our first order I snagged a pair and have not taken them off. OK, maybe a few times. They have definitely made my feet feel more stable and running more comfortable. I wanted a pair for my 11 year old daughter because she has a slight bunion on one foot, but we sold out of her size the second day after we received our order. I finally got her size in and once I put the Correct Toes on her feet, she had instant relief. She’d previously complained of her toes cramping and arch pain, but not any longer.

Thanks, Running Wild, for sharing your experience and for helping Pensacola’s runners to… run wild!

Men's Health ImageDr. Ray McClanahan was recently interviewed for an online Men’s Health article. He and the rest of the Correct Toes team are grateful for the opportunity to pass on natural foot health knowledge to Men’s Health readers.

Unfortunately, the final version of the article did not accurately depict the interview with Dr. Ray or NWFA/Correct Toes’ message. We are dedicated to providing the best possible information on foot health, and so in this post we’d like to correct some errors in the article and provide clarification.

Please find below the original article and Dr. Ray’s follow-up comments. We hope this response will eliminate any confusion and provide you with the most helpful information. Dr. Ray’s principle goal, after all, is optimal foot health for all people.

Common Foot Pains for Men — 5 Ways to Keep Your Feet Happy

Don’t let foot pain stop your life. Stop your dogs from barking with these quick tips

By Brian Dalek, March 15, 2014

Your feet allow you to do amazing things: run a marathon, jump for the rim, carry you anywhere and everywhere. So it’s a shame that you don’t pay more attention to the 26 bones and 100-plus muscles, ligaments, and tendons in each one. Nearly 75 percent of people report at least one foot ailment a year—and that’s whether you’re an athlete or not, reports research from the American Podiatric Medical Association.

To get to the bottom of guys’ most common foot problems, we turned to Ray McClanahan, D.P.M., a podiatrist based in Portland, Oregon. He breaks down the 5 top foot ailments, and the best ways to relieve the pain. 

Pain: bottom of your heel 

This sharp, shooting pain is typically plantar fasciitis. It comes from inflammation of a band of connective tissue—called the fascia—that extends along the bottom of your heel to the ball of your foot. Studies show that more than 40 percent of people who see podiatrists deal with heel pain like plantar, says McClanahan. 

Dr. Ray: “Fascia” should say “plantar fascia,” and “plantar” should say “plantar fasciosis.”

A chronic case of fasciitis could turn into plantar fasciosis—where the tissues aren’t inflamed but actually degenerate due to repeated stress. You’ll feel the pain most after waking up or prolonged sitting.

Dr. Ray: The following statement from above is inaccurate: “A chronic case of fasciitis could turn into fasciosis.” For more information on this topic, please see our detailed description of plantar fasciosis and our video discussion.

It is true, however, that heel pain typically results from degeneration, and not inflammation.

Causes: Runners and athletes often get plantar fasciitis because of excessive training, especially if they pronate—a rolling in of the foot and ankle with each stride. But your shoes may also be a cause. Footwear with a tapered toe box forces your big toe in an extended position. This causes the muscle that controls your big toe—the hallucis—to pull your foot unnaturally, which restricts blood flow to the bottom of your foot, says McClanahan. Over time, this can lead to plantar fasciosis.

Dr. Ray: There are a several problems with the first sentence above. First, “fasciitis” is an inaccurate term. The “-itis” implies inflammation, which typically is not present in this condition. “Fasciosis” is the correct term. Second, pronation is not a cause of plantar fasciosis. Inappropriate footwear (i.e., footwear with heel elevation, toe spring, and toe box taper) is the main culprit. And third, excessive training is not, in and of itself, a principle cause of plantar fasciosis, but weight-bearing in footwear that holds your feet and toes in a deformed position is.

“The hallucis” should say “the abductor hallucis.” This is the muscle that moves the big toe away from the rest of the toes.

Pain relievers: Give yourself a massage by rolling a golf ball or frozen water bottle under your foot. This relieves the inflammation. You can also insert a metatarsal pad into your shoe, shortening the plantar fascia ligament and re-distributing pressure away from the troubled area. If your shoe has a tapered toe box, switch it for one that allows your feet to splay naturally, like the Altras.

Dr. Ray: Regarding the sentence: “This relieves the inflammation,” again, plantar fasciosis is not a condition of inflammation. The massage techniques described do indeed relieve pain, and they most likely do so by mobilizing the accumulated dead tissue in the plantar fascia, so that it can be removed by the bloodstream.

Pain: big toe

Blame the redness, soreness, and swelling on a bunion, a bony bump that forms at the base of your big toe. You’ll often notice a “bump” on the outside edge of the foot because of swelling. 

Causes: Heredity can play a factor. Chances are if your father has bunions, you’ll inherit his odd foot shape and get them, too. Wearing shoes with tight toe boxes can exacerbate the problem.

Dr. Ray: It’s a common (and understandable) misconception that bunions are inherited. However, I do not believe heredity plays a direct role in bunion formation. The main cause of bunions is footwear that forces your big toe toward your second toe. Unfortunately, this applies to any shoe that has a tapering toe box. Everyone has a unique foot shape and connective tissue integrity, and certain foot shapes are more likely to be negatively impacted by tapering toe boxes than others. But the biggest problem remains the footwear, not the foot shape. For more information, please see our detailed Bunion Information article and our video discussion.

Walking, running, or exercising with poorly-fitting shoes applies pressure to the joint. 

Pain relievers: Acute pain can be handled with ice and anti-inflammatories. If it’s a progressive problem, wear shoes with a wide toe box and try a toe-spacer device like Correct Toes that helps to re-align your toes. 

Dr. Ray: I do not generally recommend either ice or anti-inflammatories for this condition. Wide toe box shoes in combination with Correct Toes is indeed helpful for many longstanding and progressive foot and toe problems.

You can also try a bunion stretch. Here’s how to do it: With one hand, pull your big toe away from your other toes. With your other hand, apply a deep tissue massage with your thumb on the tissues between your first and second metatarsals.

Dr. Ray: Please check out our video demonstration of this stretch.

Pain: between your toes or on the ball of your foot

If you have a stinging sensation on the bottom of your foot, as if you’re stepping on a pebble, you may have a neuroma—an enlarged growth of nerves. This is essentially a pinched nerve in your foot, and usually occurs between the third and fourth metatarsal. This spot represents the confluence of two plantar nerves joining together, and with a larger volume it’s more likely to be pinched/squeezed.

The cause: Neuromas occur from ill-fitting shoes, repeated stress, or trauma to the feet.

Pain relievers: Go with a well-cushioned shoe that has a lower heel and level platform. A metatarsal pad can help relieve pressure on the nerve, as well. “If that doesn’t work, you can ask your doctor about cortisone,” says McClanahan. This destroys the scar tissue around the affected nerve.

A simple toe extensor stretch may help, too. Do this: While seated in a chair, keep one foot flat on the floor and bring the other foot underneath the chair. Your heel should be off the floor. Now curl your toes toward the ball of your foot, and push the top side of your toes into the floor. Hold this for 20 to 30 seconds. You should feel a stretch of the extensor muscles on top of the foot. (Click here to watch McClanahan demonstrate the toe extensor stretch.)
 
Pain: ankle top

When walking or running, the quick pinch you feel just below where your shoelaces are tied could be your peroneal nerve—a nerve that runs down your leg and through your foot.

The cause: You may aggravate your peroneal if you tie your shoelaces wrong or your shoe’s tongue hits your ankle.

Pain reliever: Release the pressure from the nerve. “Skip the last two or three shoelace eyelets or cut off the top inch of the tongue,” says McClanahan. If this doesn’t help or it’s more than a fleeting shock of pain, see a podiatrist.

Pain: Achilles

This shooting pain above the heel and below the calf muscle is commonly tendonitis. Over time, your ankle feels less flexible.

The cause: Overuse can cause inflammation and swelling of the Achilles tendon, a strong tendon that connects your calf muscles to your heels. If you’re new to more minimal shoes, research shows that transitioning too quickly to a lower profile shoe can put strain on calf muscles. In turn, this puts a larger burden on the Achilles with each step.

Pain relievers: First and foremost, you need to rest. Ice your Achilles for 15 to 20 minutes throughout the day, and take anti-inflammatory medication like Ibuprofen. You can also use a heel lift—a shoe insert that helps absorb shock—to take pressure off your Achilles. 

Dr. Ray: This treatment information for Achilles tendinitis is inaccurate. Our Achilles Tendinitis article contains our best recommendations for addressing this condition.

If you want to prevent this pain from starting in the first place, increase Achilles and calf flexibility, says McClanahan. That includes a slow transition into minimal shoes if you’re a runner, and stretching the Achilles.

Do this: Stand on the balls of your feet on a stair or a curb. Keeping your legs straight and the balls of your feet on the stair, release your heels toward the floor. Pause for 10 deep breaths. To increase the intensity of the stretch, keep one foot flat and lower the other heel. Then switch legs.  Do this a couple times a week or more if you’re noticing tightness.

Dr. Ray: Please visit our website – NWFootAnkle.com – for extensive information on foot problems and natural foot health!