The Xero Blog

It is estimated that around 10% of the population suffers from heel pain caused by plantar fasciitis. Interestingly, though the condition is quite common, we don’t know as much as you might expect about what causes it and how to treat it. I often hear from runners who have switched to barefoot-style running that they have experienced freedom from the plantar fasciitis that used to bother them. In this article, I’d like to share a bit about some research that points to a reason why this may be happening. If you suffer from plantar fasciitis, you may find this opens up some new directions to explore as you seek optimal foot health. I’ll start off with some important background about what plantar fasciitis is, what seems to cause it, and how it’s often misdiagnosed. Then we’ll look at some research that points to an interesting new approach to helping people find relief. What is plantar fasciitis? On the bottom of your foot, there is a thick band of tissue, called the plantar fascia, that connects the front of the foot with the heel bone. The plantar fascia helps to support the arch of the foot and absorbs shock when our feet hit the ground. The plantar fascia can become inflamed and cause stabbing pain in the heel. Typically, symptoms are at their worst upon waking in the morning and improve once you get up and move around. What causes plantar fasciitis? Many people believe that plantar fasciitis is caused by repetitive stress. Stresses to the plantar fascia can cause small tears and these, in turn, can lead to inflammation and heel pain. What causes this kind of stress? In the literature, certain risk factors are associated with a greater likelihood that a person will experience plantar fasciitis, like doing lots of running, having a higher weight, or being in an occupation that keeps you on your feet all day. This seems to make sense. If plantar fasciitis results from repetitive stresses to your plantar fascia, those factors sound like ways of ramping up the demands placed upon your feet. But what if it’s not repetitive activities, or weight, that’s the real cause of the problem? For example, what if running form is the issue? Some ways of running place a lot more stress on your feet than others. So, the standard description of the cause of plantar fasciitis encourages us to think in terms of a simplistic picture: that repetitive stress is the input and plantar fasciitis is the output. And yet you’re about to discover that there is an important mediating factor that has a lot to do with the stresses we’ll actually experience, whatever our activity level, and how those will impact our feet. Is it really plantar fasciitis? But first, plantar fasciitis can be easily misdiagnosed. Sometimes the symptoms of PF can be caused by overly-tight calf muscles which pull on the plantar fascia. Here’s how to check: try using a foam roller and/or deeply massage on your calf muscles and see if the symptoms improve. If they do, you know that you should pay attention to releasing that calf tension. What is the best treatment for plantar fasciitis? This is where things get interesting. There is a common protocol for treating plantar fasciitis. It involves rest (to give your feet a break from whatever is thought to cause the repetitive stress damage in the first place), stretching, and the use of ice and NSAIDs (think ibuprofen) for pain. The essence here is to treat the foot pain associated with plantar fasciitis by giving the feet a rest. Recently, some researchers are proposing a different tack. Patrick McKeon and colleagues, for example, suggest that perhaps what the foot needs most isn’t rest but exercise. This isn’t to say an acute inflammation of the plantar fascia might not need time for recovery, but they argue that the core strength of the foot is the key factor that determines how likely we are to experience injuries like plantar fasciitis in the first place. In other words, greater foot strength is the key to greater foot health, both when it comes to plantar fasciitis as well as with other repetitive stress injuries, including those typically associated with running. A clinical trial backs this hypothesis up. It found that strength training exercises for the foot and ankle resulted in better outcomes than stretching alone for those suffering from plantar fasciitis. Barefoot shoes and plantar fasciitis So what does this research have to do with barefoot shoes? Barefoot shoes (sometimes also called minimalist shoes) are designed to let your feet move as naturally as possible, as they would when walking barefoot. Barefoot shoes have zero heel-to-toe drop (also called “zero drop”), meaning the heel and forefront are level and the sole of the shoe is completely flat. In comparison, typical running shoes come with things like arch supports, thick padding, and elevated heels. Wearing “supportive” shoes keeps your feet from moving the way they ordinarily would. And guess what? Immobilizing your feet, which happens with arch support and stiff shoes, can make your feet weaker. Research by Katrina Protopapas showed that adding arch support in the shoes of healthy people reduced their foot muscle size and strength by as much as 17% in just 12 weeks. Conversely, when your feet are allowed to move, they can get stronger. Research by Dr. Sarah Ridge and others have shown that walking in minimalist shoes indeed strengthens the foot as much as doing a foot exercise program (And, by the way, she says Xero Shoes should give you the same benefits as the shoes used in her study.) So we can put these two ideas together: one group of researchers says strengthening the core foot muscles will help avoid injuries like plantar fasciitis. Another says walking barefoot (or in minimalist shoes) is effective in strengthening the muscles of the foot. What’s the conclusion? It looks like the evidence suggests barefoot shoes (or walking in bare feet) could be helpful for avoiding plantar fasciitis pain. Here I want to point you to just one more piece of research. It reports on a case where barefoot running was successfully used to treat plantar fasciitis in a female athlete. I know; it’s just one case. There is more research needed to confirm barefoot running (or walking) as a way to prevent or treat plantar fasciitis. But the evidence so far is encouraging. If you have ever developed plantar fasciitis, it is certainly worth looking into. If you’d like to try out wearing shoes that are designed to let your feet and toes move naturally, find your pair of Xero Shoes right here. The content of this post does not constitute and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a physician or other qualified medical professional with any questions or concerns you may have about your health or a medical condition. Common questions you may be wondering about going barefoot I’ve been talking with people about going barefoot for a long time. I know there are a couple of common questions that come up. Just in case, I’m giving some brief answers here (and a pointer to where you can find more information). Are barefoot shoes really the same as going barefoot? Obviously, they aren’t exactly the same. When you wear shoes, you have a layer between you and the ground. You do lose something here; we all know that irreplaceable feeling when we kick off our shoes and feel our bare feet on the green grass. But there are downsides to bare feet. They don’t offer you much protection on rough or sharp surfaces and they don’t do much for you in the cold. Barefoot shoes are designed to get you as close to the barefoot experience while still providing protection to the foot. If you want barefoot running shoes (or any kind of barefoot shoes), just keep in mind what you should be looking for. Dr. Irene Davis defines barefoot, or minimalist shoes with these characteristics: They’ll have a wide toe box to give your toes plenty of room to move, splay, and breathe. They are zero drop, meaning they won’t have an elevated heel which can negatively impact posture. Barefoot shoes do not have unneeded cushioning. (Research from Dr. Christine Pollard shows, much to her surprise, that cushioning does not actually reduce impact forces.) Barefoot shoes won’t have unnecessary arch support. (Research from Katrina Protopapas shows that adding arch support to the shoes of healthy athletes reduced foot strength and muscle mass by as much as 17% in just 12 weeks.) They will have a thin sole that allows both flexibility and ground feel. The end result is that your feet will be moving as you walk and run, using and therefore can strengthen the muscles of your feet. If I’m interested in starting to walk barefoot or in barefoot-style shoes, how should I get started? The short answer is that you begin slowly and listen to your body. If you’re willing to listen, the feedback you’ll get from your feet will teach you how to walk in a natural, pain-free way. Think of it like going to the gym after a long break – you don’t do 8 hours of bench presses. You do one set, see how you feel the next day, and as your body tells you it can handle the load you add reps, or weight, or, eventually, sets. Use that same attitude and strategy when switching to minimalist shoes. If you want to maximize your chances of beginning well, you’ll want to have a look at our post on how to walk barefoot.

This article was updated on April 10, 2023 I’ve always been a fan of shoes as a fashion statement. However, when looking cool or sexy becomes the priority over feeling good, we have a problem. It is no secret nowadays that the health of our body directly affects how we think and feel. The last 10 years of my life have been dedicated to helping others feel good in their body and mind. When it comes to feeling good, I always start with the feet. Why Are Foot Strengthening Exercises Important? Many of us know how to stretch and strengthen our abs, chest, shoulders, thighs, and buttocks. But what about the feet and ankles? Feet are the foundation of our posture, but they are often ignored at the gym. You can improve your overall well-being by practicing a few main joint movements of the ankles and toes. Further down I will go over a few daily exercises to improve your health from the ground up. Your Feet Affect Everything When I teach yoga – especially my hip-focused workshops, I spend 20% of the time on the feet and ankles. The health of your feet directly affects all of the muscles and joints above, including the hips, knees, and lower back. “Supportive” Shoes Are Only A Quick Fix I always find it comical that modern medicine provides these solutions for your foot problems: Shove a sole into your shoe to lift your arches for you Find shoes that articulate your ankles for you while you walk Don’t get me wrong, there is a time and place for these quick solutions. However, they are not a long-term solution that will make your feet stronger. Here is an analogy of what short-term solutions do to your body. Pretend that your body is a lazy employee at work, and your doctor is the manager. The manager can either: Teach us how to be productive and inspire us to take action Simply do the work for us and teach us nothing Firing the employee is not an option – you only have one body, after all! The best option, of course, is the one that is better for us in the long term. However, most of us don’t actually take the time to support our overall well-being. If you’re reading this, you probably aren’t a “lazy” human being. You are looking for solutions and answers, and you are willing to do the work. This is why you have chosen to wear barefoot shoes from Xero Shoes, isn’t it? You want to take care of your long-term foot health! So, let’s get into building strength. How Can I Make My Foot Muscles Stronger? In order to get stronger feet, let’s take a look at the four main actions of the ankle. Dorsiflexion Dorsiflexion is what we commonly refer to as flexing the feet. Stand on two feet and bend your knees, lean forward till your knees move forward. You’ll see the skin at the front of your ankle wrinkles, this action is called dorsiflexion of the ankle joint.   Plantarflexion Plantarflexion is the exact opposite of dorsiflexion, and it is commonly known as pointing your foot as a ballet dancer would.   Inversion Sit down with your legs out in front and turn the soles of your feet toward each other like you are making “prayer” feet. This is called inversion or inverting your ankle. Note, you may sit up on blankets or a couple of pillows if your hamstrings are on the tighter side.   Eversion This is the opposite of inversion and is usually the most challenging. Stand up again, press the big toes down, and pull the outside edges of your feet up. You will see wrinkles form in the outer ankle, and you will feel the muscles along your outer shin engage.   What Feet Strengthening Exercises Work? The following foot strength exercises will help to strengthen your muscles so you can perform the actions above: https://youtu.be/lPb3ZY13oY8?feature=shared 1. Seated Plantar flexion Sit down with your legs in front. Plantar flex and relax your ankles repeatedly with straight knees. You are trying to activate your calf muscles. Keep your feet everted by squeezing the inner ankles together. If you need to, you can use a yoga strap to help with the range of motion. Try without the strap as well to build up your foot strength. 2. Seated Dorsiflexion This action is the opposite of the first exercise. Sit down with your legs in front and pull the tops of your feet back. Release and repeat three times or more until you feel the heat building in the top of the shins. These muscles are your tibialis anterior muscles. 3. Calf Raises Stand upright with your feet flat on the floor. Plantar Flex your ankles until your heels lift. Try not to let your ankles roll outward during these. The target muscles here are called the gastrocnemius and soleus muscles. To keep the ankles from rolling forward, you’ll be using the muscles of the outer shins. 4. Inversion and Eversion Practice the inversion and eversion techniques described above. These exercises are the ABCs for your feet and ankles. Do them daily before getting out of bed to wake up all the muscles in your foot and ankle. Bonus: The Toes Take your foot exercises up a notch by spreading your toes. Also known as abduction, and you can do this either with a toe spreader or using your fingers to separate the toes. With time and repetition, you will be able to use your muscles to spread your toes. Until next time, Matt Giordano, aka @TheYogiMatt The information in this post does not take the place of medical advice. Only your doctor can provide advice, diagnosis, and treatment. Talk to your doctor or physical therapist if you have questions about your health.

Dr Emily Splichal - Xero Shoes Partner Our feet carry us through life, supporting our weight and keeping us on the move. They carry us through our day to day, but we often don’t appreciate them until they start to ache or become injured. Research suggests that up to 87% of people will experience foot pain at some point in their lives. This number is so high not only due to the amount of repetitive stress our feet encounter on a daily basis. From overly supportive shoes to a gradual weakening of the foot with age, we need to be proactive in our foot health to prevent this high risk of foot injury. As a functional podiatrist, I strongly believe in the power of daily foot recovery, foot strengthening exercises and smart footwear choices to offset daily repetitive foot stress and to make a lasting impact on foot health and movement longevity. In this blog, we will explore an example of a daily routine to help you take steps towards improved foot health. Morning As you wake up each morning, this is the perfect time to also wake up your feet and align your foot posture, allowing you to better react and respond to each step throughout the day.First, start each day by releasing your feet for just a couple minutes with the Naboso Neuro Ball. This innovative product is unlike any foot release tool in that it is not only a ball but it also splits open to make two domes. In addition, both domes are covered with a patented texture which uniquely stimulates the nerves in the bottom of the feet. To begin, follow this simple 5 point foot release where you stand on specific points on the bottom of your foot for 30 seconds - allowing for pin point acupressure stimulation along the muscles of the feet. After releasing the feet, I like to go directly into an exercise called forward lean. This is a foot posture activation exercise that takes less than 30 seconds to do. Start by standing with the feet shoulder width apart and find the foot tripod under the 1st metatarsal head, 5th metatarsal head and heel. Lift the toes, spread that out as wide as you can, then place them back down onto the floor. Slightly lift the arch of the foot by rotating externally in the hips. Now that your base is stable, stand tall with your arms by your side. Imagine you are stiff as a board. Staying stiff as a board, slightly lean the body forward until you feel the toes push down into the ground. Return to the starting position and relax the feet. Repeat 5 times to sufficiently wake up the foot muscles for your day. During the Day In an ideal world, work would do itself and we would be able to just live our lives as our feet take care of themselves. While this isn’t fully possible, there are tools that make it almost that easy! Stay connected to your feet with no effort at all by wearing minimal footwear and sensory-stimulating insoles or socks. Evidence suggests that our foot muscles respond to sensory stimulation, so by reducing cushion in our shoes it could help strengthen our feet and support our body alignment. A combination of Xero Shoes plus the Naboso Activation insoles creates an environment of maximum sensory stimulation and therefore could help support overall foot health. Evening At the end of a long day, we all just want to kick our feet up and relax. However, just taking pressure off of our feet may not be enough to fully recover the 26 muscles in the bottom of our feet. A great way to passively restore your foot shape and stretch your toes is toe spacers. Toe spacers such as Splay by Naboso, gently realign the toes to their natural position, improving foot function and minimizing arch pain. Whether you want to wear toe spacers while relaxing on the couch or walking around your home, toe spacers are fast becoming one of the fastest-growing foot recovery trends as featured in a recent Wall Street Journal article. To learn more, you can watch a recent lecture I gave about the science of toe spacers. Conclusion There are many options available to help boost your foot recovery and offset foot pain. Remember, the more consistent you can be in your daily foot habits the better the results you will see! By starting with these tools and exercises, you’ll be fast on your way to the results you want. About the Author/Bio: Dr Emily Splichal, Functional Podiatrist and Human Movement Specialist, is the Founder of EBFA Global, Author of Barefoot Strong and CEO/Founder of Naboso Technology. With over 23 years in the fitness industry, Dr Splichal has dedicated her medical career towards studying postural alignment and human movement as it relates to barefoot science, foot to core integration and sensory integration.