Archive for December, 2010

Flat Feet versus Fallen Arches

December 8, 2010

A couple of weeks ago, over at America’s Podiatrist, Dr. Nirenberg asked, “Can Barefoot Running & Walking Fix Flat Feet?” He references a study, The Influence of Footwear on the Prevalence of Flat Foot: A Survey of 2300 Children, by Udaya Bhaskara Rao and Benjamin Joseph (The Journal of Bone and Joint Surgery, Vol. 74-B, No. 4, July 1992, p. 525. The study was conducted on children in India.

Below is the criteria they used for grading an arch as high, normal, or flat:

Definitions of arch types

What they found was that while 2.8% of the children who went barefoot all the time had “flat” feet, 8.6% of those who wore footwear had “flat” feet. They also found that the more shoe-like the footwear, the more of the children had “flat” feet.

There was a related study done a few years later, “The Influence of Footwear on the Prevalence of Flat Foot: A Survey of 1846 Skeletally Mature Adults“, by V. Sachithanandam and Benjamin Joseph (The Journal of Bone and Joint Surgery, Vol. 77-B, No. 2, March 1995, p. 254. In this one, they compared the prevalence of flat feet based on the reported age at which the adult started wearing shoes. They found a 1.75% rate of flat feet in those who didn’t start wearing shoes until over the age of 16, and about 3.25% for those who started wearing shoes earlier.

It sure looks like wearing shoes contributes to a lower arch.

But what does that have to do with flat feet? Many folks confuse a flat foot (that is, a foot with a low arch) with fallen arches. In fact, Dr. Nirenberg says as much as he starts his blog entry:

Flat feet is a condition where the arch of the feet undergo collapse and flatten: That is why it is often also referred to as fallen arches. Individuals with flat feet can suffer from a variety of foot ailments, pain, and fatigue, which can also extend to the legs and back.

I do not think this correctly describes the situation. To understand what is going on, we have to go way back to a much earlier study, “Conclusions Drawn from a Comparative Study of the Feet of Barefooted and Shoe-wearing Peoples, by Phil. Hoffman, M.D., St. Louis. (The American Journal of Orthopedic Surgery (1905)). Dr. Hoffman had a chance to examine barefoot natives at the Louisiana Purchase Exposition in 1904. He checked their arches and found a fair proportion of them did have low arches. However, and this is important, he did not see any pathologies associated with those “flat” feet. As he put it

If these statistics are a fair index for all feet, the conclusion is justified that weakness of the longitudinal arch rarely results in its depression, and that flat foot as a pathological entity hardly exists.

The height of the arch appeared to bear no relationship to the gait. In shoe-wearers, the affection commonly called flat foot is often associated with more than ordinary eversion of the foot on standing and walking. This eversion is due not to the low arch, but to the associated weakness or stiffness of the joints of the foot and weakness of the muscles controlling them.

In other words, among the barefooted, having a low arch, or “flat” feet, has nothing to do with whether you have a “fallen” or “weak” arch. A weak or fallen arch, a result of wearing shoes and thereby failing to keep those muscles and tendons and ligaments strong (also pointed out by Dr. Nirenberg), is a different condition than merely having a flat foot (or naturally low arch).

So, can walking and running barefoot fix a flat foot? No. But can it fix a fallen arch? Almost assuredly. Will it raise the arch? Maybe.

Obviously, as any physical therapist can tell you, using a previously inactive body part will strengthen it. It will not only strengthen that part, but all the other parts associated with it. Muscles, bones, ligaments, tendons will all respond to the greater use. I can see how it would be possible that toning all those parts could raise the arch as they are all strengthened. Obviously, there is some anecdotal evidence that this is so, but I’ve not seen studies that demonstrate it.

However, as the Hoffman study shows, who cares? It doesn’t matter! It’s not the height of the arch that matters, it is the underlying physiological structure, and you get that from going barefoot whether your arch rises or not.

In my own case, I have no idea if my arches are really raised since I started going barefoot. They do look raised, though. However, much of that just could be the appearance caused by the much thicker pads on my feet now. Since the pads get thicker on the non-arch parts of the foot, that can give the appearance of a higher arch.

One more point: There are reports of over-use injuries in those who just start going barefoot. These are the sorts of people who try to run long distance before all the muscles and bones and stuff have had a chance to properly strengthen (this can take around 6 weeks, and probably it is not fully there until 6 months). Since I also play tennis, I can relate this to tennis. If you never played tennis before and suddenly picked up the sport and starting playing hours on end, hitting as hard as you can, you have a very good chance of picking up tennis elbow. The parts of your arm need strengthening first, and it has to be worked up to (it also helps to work on technique!). Same with any sort of extended or extreme barefooting.

Reebok being sued for false claims

December 7, 2010

A couple of weeks ago Reebok was sued for making false claims about their EasyTone “fitness” shoes. The lawsuit asks the court to make it a class action lawsuit. According to a story in the Quincy, MA, Patriot Ledger:

A lawsuit filed Tuesday on behalf of Massachusetts consumer Sandra Altieri claims Reebok made false claims about the efficacy of its toning shoes in delivering more of a workout to leg and butt muscles than a typical shoe.

Supposedly, the way they work is to create an instability when walking, causing the muscles to work harder. Reebok claims 28% harder.

Toning shoes are presented as a way to improve muscular definition by using an unstable sole design. Companies such as Reebok that sell toning shoes say this instability causes leg and butt muscles to work more vigorously than they would if the wearer was using a typical sneaker.

(Whole article here.)

The problem is, a study by the American Council on Fitness found no such benefit.

From a barefooters point of view, the whole idea is insane. Why would you want to create an instability when you walk? One of the real joys and benefits of walking barefooted is the great feedback and proprioception that it gives you. When I’m working in the kitchen, some of the joy of barefooting is the feeling of dancing from counter to counter. I rise up on the ball of my foot and pivot. I shift weight from one side of my (bare) foot to the other. It gives such a feeling of control, of awareness. The same applies when I play tennis, or do a number of other activities. And along the way, this is strengthening my foot. It’s making my foot do its normal function!

Compare that to the false sense generated by the EasyTone. Bah!

Flying Barefoot

December 3, 2010

Since Daniel Howell was escorted off his plane yesterday for being barefoot, I thought I’d go over the situation for that.

Daniel was flying to NYC to appear on The Today Show to talk about The Barefoot Book. He had actually boarded the plane, and after he had his seat belt on, he was approached and asked if he had any shoes with him. He didn’t, so they tossed him.

Is that legal? Yes, it is. Your airline ticket is basically a contract with a private company, and the terms of that contract are detailed in that airlines “Contract of Carriage.” You can easily use Google to find the contract for any airline you are interested in flying. But it is probably not worth it. Practically every airline has a barefoot rule.

Daniel was flying US Airways, and you can see their Contract of Carriage can be found here (click on the PDF). The relevant section, for any airline, is under the heading “Refusal to Transport”, and for US Airways it says:

US Airways may refuse to transport, or remove from any flight, any passenger for the following reasons: Any passenger who may pose a threat to the comfort and/or safety of other passengers or employees including (but not limited to) passengers who: Are over the age of five (5) and barefoot, or otherwise inappropriately clothed, unless required for medical reasons;

Notice that they say that they may refuse to transport, not that they will, which really makes it a crap shoot depending on the employee who sees you. Also notice that they say the rule is for “comfort and/or safety.” That’s not a crap shoot; that’s just crap. Of course it is more comfortable to be barefoot, and medical experts actually suggest removing your shoes when flying to help keep the blood flowing. Now, maybe they don’t care about your comfort, but thing that the other customers might not be comfortable seeing bare feet. Crap there, too: they don’t ban flip-flops, which show the same amount of foot. And if were really about safety, then there would not be the exception for children under 5 years old, unless the airline wants to go on record saying that they don’t care about the safety of young children. (Think about that!)

It’s all just more mindless following the herd.

The origin of the rule predates the airline deregulation in 1978. Back then, flying was regulated by the Civil Aeronautics Board, and they dictated the Contract of Carriage. That Contract had the barefoot rule (but without the exception for children). After deregulation, most airlines just kept the original Contract, though over the years, many have slowly modified them. (You can see remnants of the CAB rules in that Refusal to Transport is still often called Rule 35.)

Some airlines (a very few) removed the barefoot restriction, Aloha Airlines being one of them. Unfortunately, Aloha ceased operating in 2008. Non-US airlines base their Contracts of Carriage (actually called “General Conditions of Carriage”) on a different model, and generally do NOT have a barefoot clause.

As I said, different airlines have modified the rules, so there are slightly differently worded versions.

Hawaiian Airlines:

Persons who do not meet HA standards for dress and attire: . . . For safety reasons, footwear must be worn unless the passenger is unable to do so due to a disability or physical condition that prevents them from wearing footwear.

Delta Airlines:

Delta may refuse to transport any passenger, and may remove any passenger from its aircraft at any time, for any of the following reasons: Delta may refuse to transport any passenger, or may remove any passenger from its aircraft, when refusal to transport or removal of the passenger is reasonably necessary in Delta’s sole discretion for the passenger’s comfort or safety, for the comfort or safety of other passengers or Delta employees, or for the prevention of damage to the property of Delta or its passengers or employees. By way of example, and without limitation, Delta may refuse to transport or may remove passengers from its aircraft in any of the following situations: When the passenger is barefoot.

AirTran:

AirTran may refuse to transport or may remove from any flight any passenger for one or several reasons, including but not limited to the following: If a passenger’s conduct is disorderly, abusive or violent, or the passenger: Is barefoot, or is clothed in a manner that would cause discomfort or offense to other passengers.

Grand Canyon Airplane Tours:

In addition to persons who may be refused transportation on Carrier under Section 6 above, refusal to transport or removal of the following Passengers may be necessary for the comfort and safety of the affected Passenger or other Passengers: Persons over two years of age who are barefoot;

So, how do you fly barefoot? Society for Barefoot Living members have developed a few strategies. Often you can just board barefoot, since the employees are really pretty busy. Don’t look down at your feet, but keep looking directly into the eyes of the employee, particularly when handing over your ticket, and when passing by the flight attendant as you enter the plane. Once you are seated, you are probably fine if they didn’t see you come in, because, as I noted earlier, many people do take off their shoes once they are seated.

However, carry a pair of flip-flops, or something else you can put on for just a moment if challenged. Put them on, pass the person challenging you, and then just take them off again. Yeah, it’s a hassle (I personally hate to have to carry footwear just in case, and rarely do so), but at least then you don’t miss your flight.

One time, on Southwest Airlines, an otherwise very friendly airline, I’d boarded and flown barefoot without being challenged. (They have the “comfort and safety” excuse with an exception for those under 5.) However, on getting off the plane, I was noticed by a flight attendant who went ballistic, telling me I couldn’t be like that. OK, I’m leaving. I think part of his frustration was that there wasn’t a darn thing he could do about me. Hah!

“The Barefoot Book” on The Today Show

December 2, 2010

Here’s a heads up. Daniel Howell, author of The Barefoot Book is scheduled to be a guest on The Kathie Lee and Hoda segment of The Today Show. He will be appearing tomorrow, Friday, December 3 at 10:00am (EST, and whatever that translates to in other time zones).

Time to set up those VCRs and DVRs.

One thing about these various interviews: the news media consider bare feet just odd enough, and interesting enough, that appearing on one show will often generate a request to appear on another show (and they do have to fill those time slots). When I have occasionally been on the news, it seems that one appearance can lead to another appearance.

I’ve never hit the big time like Daniel has, though.

[Update: Word is that Daniel boarded his flight to NYC to appear on the show, but was then escorted off the plane because he did not have shoes. I don’t know anything more at this point. Check in later for further updates.]

[Further update: Daniel’s appearance was entertaining, informative, and charming!]

[Update X 3: From the comments, here’s a link to the video of the segment.]

Athlete’s Foot

December 1, 2010

Those concerned about bare feet always seem to mention athlete’s foot. Here is part of a Question and Answer from Dermatology Insights, Volume 3, Number 1, page 30 (2002). It was published by American Academy of Dermatology. I’ve emphasized some of the text:

Q: Why does athlete’s foot develop?

A: Athlete’s foot is a term used to describe a fungus infection of the feet. The correct term for athlete’s foot is tinea pedis. The fungi that cause athlete’s foot grow in moist, damp places. Sweaty feet, not drying feet well after swimming or bathing, tight shoes and socks, and a warm climate all contribute to the development of athlete’s foot. It’s commonly believed that athlete’s foot is highly contagious — that you can easily catch it from walking barefoot in the locker room. This is not true. Experiments to infect healthy skin with athlete’s foot have failed and often one family member may have it without infecting others living in the same house. It’s not clear why some people develop athlete’s foot and others don’t.

. . .

Q: How can you prevent athlete’s foot?

A: Wash your feet daily, and always dry your feet thoroughly, especially in between your toes. Avoid tight footwear, especially in the summer. Sandals are the best warm weather footwear. You should also use an anti-fungal powder on your feet and in your shoes during the summer. Alternate shoes so that they have a chance to dry out at least 24 hours before re-wearing them. Cotton socks (or socks made of a material that takes moisture away from the skin) are best and you should change them if they become damp. Whenever possible, go barefoot at home. Athlete’s foot does not occur among people who traditionally go barefoot. It’s moisture, sweating and lack of proper ventilation of the feet that present the perfect setting for the fungus of athlete’s foot to grow.

I might add that going barefoot all the time, not just at home, is even better.

Also, this is the source of the quote about athlete’s foot on the web page of The Society for Barefoot Living.


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