Oh! Those aching feet!

Why they hurt and what you can do about it.

By Serena Elhard, D.C

Feet are the “foundations” of our bodies that contribute to our stability as well as the alignment of the rest of our body. Each foot is a miracle of complexity, consisting of twenty-six bones and thirty-one joints. These bones and joints must work in synch to propel us against gravity. Feet constantly move and change based on conditions “under-foot,” whether it is in or out of footwear.

When a person has problems with the foot bones or joints, the forces acting on them from activities such as walking, running, climbing, or skiing can interfere with the function and comfort of the rest of the body. An improperly functioning foot creates instability and misalignment of the skeleton. This in turn can lead to inordinate wear and tear on other joints and may create muscle imbalances and nerve irritation. Eventually, enough irritation and inflammation can occur to cause pain. The pain stage can happen immediately or may take weeks, months, or even years to develop. Consequently, correcting problems before they become serious is the best way to avoid pain and injury.

Our foot has two actions it must complete correctly: pronation and supination. When the foot pronates, the arch collapses slightly and the foot becomes more flexible. This allows it to accommodate irregularities in the ground and absorb impact. Pronation causes a chain of events all the way up the spine. The leg rotates in. This causes the knee and thigh to rotate in, which in turn flexes the spine forward.

Supination, on the other hand, reforms the arch and makes the foot a rigid lever to help propel the body forward. This happens when the toes push off.

Most people over-pronate. Their arches stay collapsed too long, especially when trying to push off. Consequently, the feet must work harder to propel the body forward.

For many years, the solution to this problem was some sort of corrective insole for the shoe. Generally, there are three types of “arch supports” available: inserts, footbeds, and orthotics. But not all “arch supports” are created equal.

Inserts offer a generic fit based on shoe size. They provide some minimal support. Inexpensive and convenient to obtain from retail stores, they can be worn with static (skiing) or dynamic (snowshoeing) foot positions. Some inserts can be slightly custom fit: basic foot measurements can be taken and a plastic lined insert made. While inserts do not change the way the foot functions and hence cannot prevent problems, they do provide a little support that may relieve some discomfort. Fit and quality are comparable to the fit of clothes from a large discount chain store. For some who have mild dysfunction of the foot, the inserts may help. However, for others the inserts can cause problems due to the generic fit. The materials of inserts usually allow for a life of 2­6 months.

Footbeds create a level surface for feet and keep the bones in one neutral position, supporting neither pronation nor supination. This is done usually by “bringing the ground up to the foot” with increased height at the heel via a rubber post. Generally footbeds are custom designed to an individual’s foot. Methods for doing this vary. These appliances work incredibly well as long as the foot remains in a static posture such as in skiing or snowboarding. Footbeds can be more expensive than inserts, but they tend to last longer.

Most health professionals would call orthotics a true “arch support.” Always custom-made, they act like a footbed in keeping the foot neutral, but they additionally improve the mechanics of the feet by altering the shape and function of the arch through its various positions. They are superior to an insert in this regard.  They also work better than a footbed and are usable in other dynamic activities, such as Nordic skiing, snowshoeing, and hiking. Orthotics are often used in everyday shoes to prevent problems and symptoms. While they are the most expensive form of support, if fitted correctly they are invaluable to improving performance and preventing injury. In addition, they last longer due to better quality of materials; as a bonus they may be covered by insurance.

There are many different types of custom orthotics and methods used to make them. Be sure to ask questions and consult with a professional who is knowledgeable in helping you make the right choice in supporting your foundation.

Serena Elhard is a chiropractor/kinesiologist/nutritionist in Lakewood. She is a member of CMC and her activities include running, hiking, biking, skiing, and triathlons. She can be reached at (303) 238-0545. P