In 30 Days, You Too Can Type and Play the Piano with Your Toes!

Got your attention? Ok, I made that up, but you can improve the dexterity of your feet. The intrinsic muscular anatomy of your feet is very similar to that of your hands with the exceptions that none of the digits are opposable and there is not  the ability to “cup” your foot as you can cup your palm. In theory, then, your feet should be able to move much like your hands. You need only look at a homunculus, which is a representation of a human, but whose parts or dimensions are mapped to areas of the brain devoted to those parts, to see the vast potential of your feet. In a homunculus, parts of the body that require the highest levels of dexterity have larger representations in the brain, more circuitry, and more neurons per muscle group. As you can see, the feet require a significant amount of brain power, which tells me that there is a lot of wasted potential for dexterity.

Homunculus

Homunculus

You toes, casted inside your shoes for hours, days, weeks, months, years, generations, are weak. They feel tight. You may not have attempted to move them independently of your foot or independently of each other for a very long time. I know a simple (but not necessarily easy) test and exercise you can do to evaluate and strengthen the motor nerves and toe extensor muscles of your feet. This can be done standing, sitting on the floor, or sitting in a chair. Simply lift your big toes (called extension) without lifting your other toes.This gives you an indication of the health of the neural pathway that exists between your brain and your feet. If you are unable to lift your toes, your foot is not properly innervated, circulation to that area is poor, and you are accumulating cellular waste that is not being removed by your lymph system because your circulation is poor. You are negatively impacting your gait since your big toes plays a huge role in gait biomechanics. If you are not toeing off properly in gait, all of your major joints will suffer.

If this is easy, then attempt to keep the big toe lifted, while you lift your second toe to join it. Still easy? Add the third toe, and so on. Try to put them down in reverse order, pinky toe first. Here is a list of variations of the toe extensions in order from easiest to more difficult – for me, anyway. You may find the ordering different for your puddins. Try them first one foot at a time. Once you master them, try both feet together.

Playing the Scales with Your Toes

Toe Lifts

Toe Lifts

  1. Lift big toe, put it down, repeat 10 times. Repeat any of the following variations multiple times.
  2. Lift big toe, keep it raised, lift second toe; lower second toe, lower big toe
  3. Lift big toe, add second toe, add third toe, etc. until you can add each toe; put them down in reverse order, ending with big toe
  4. Repeat #3, but put the toes down in the same order as you raised them, starting with big toe lowering first
  5. Start with the pinky toe and work in reverse, putting them down in reverse – big toe lowers first
  6. Start with the pinky toe, but then lower your toes, lowering your pinky toe first
  7. Once you are able to “play the scales” with your feet, it’s on to typing

Typing with Your Toes

This is very difficult for most people and may take years of moving your bare feet over natural terrain in good alignment and supplemented with loads of corrective foot exercises like those found on this blog. But when you’re ready:

8. Lift your second toe, and only your second toe; place it back down, Lift your third toe, solo, place it back down. Lift each of your toes independently of the others. Practice this every day and in 30 years, you will be able to type with your toes!

 Anatomy Bit. What muscles lift aka extend the toes?

Extrinsic Foot Muscles (has one attachment point on the foot and the other on the lower leg)
Extrinsic Extensors

Extrinsic Extensors

The above image is the dorsal (aka top) of the foot

  • Extensor Hallucis Longus – extends big toe; colored in blue
  • Extensor Digitorum Longus – extends the other toes; colored in yellow
Intrinsic Foot Muscles (both attachment points reside on the foot)
Intrinsic Extensors

Intrinsic Extensors

Above image is the dorsal or top of the foot with a section of extensor digitorum longus in yellow cut away to reveal the intrinsic muscles beneath (orange).

  • Extensor Hallucis Brevis – extends big toe; colored in green
  • Extensor Digitorum Brevis – extends the other toes; colored in orange

Book Alert

The Homunculous comes courtesy of my favorite anatomist/physician/yogi, Ray Long, whom I had the privilege of taking a workshop with in Vancouver, BC last September. It comes from his very excellent and would-be-dog-eared-if-it-wasn’t-of-such-high-quality spiral bound anatomy book Scientific Keys Vol. II: The Key Poses of Hatha Yoga by Ray Long (2008) Spiral-bound. This book comes in a non-spiral bound edition for less money, but I really like the option of having it lie open while I practice asana.

The muscle images come from The Anatomy Coloring Book (4th Edition). This book gives you a multi-dimensional way to learn bones, muscles & ligaments. And coloring is fun!

Yoga and other movement teachers, Ray Long’s book is my go-to book to understand and explain what is happening in my students’ body during postures – what muscles are contracting and how; what muscles are stretching and how; which muscles are helping; and most interestingly, how a student can manipulate her musculature to increase her range of motion during a particular posture. This book absolutely transformed my Virabhadrasana 1 (Warrior 1).

Namaste, Michele

The Best Free Foot Massage

I do my writing and studying at a DIY standing work station. I do it to avoid sitting and the attendant health risks, when done too much. And because if i sit for work, I turn into a big C (uh, that means I place my trunk into the shape of a C) and stay there for hours without moving. When I stand at my work station, I find that I naturally I squirm about more. I capitalize on and enhance this natural tendency to move by giving myself little activities to do. Today, while writing I:

  • stretched my calves on the half round (exercise to be described in a future post)
  • stretched the top of my feet (see future post)
  • Pelvic listed (see future post)
  • Hung out in Vrksasana aka the yoga pose called “tree”
  • Constantly checked my alignment – straightened the lateral edges of my feet, backed my hips up to vertically stack my major joints, dropped my ribs down, released my kneecaps by releasing my gripping quad muscles, aligned my pelvis so that my ASISs (pelvic bones aka hip pointers) and my pubic bone are in the same frontal plane, ramped my head back to get my ears over my shoulders and my eyes level with the horizon
  • Stood on various sizes of balls

If you’ve ever attended a FootLove Yoga workshop or maybe even one of my classes, you have have rolled a lacrosse ball on the bottom of your foot to loosen up the fascial tissues and provide a strong sensory nerve experience. Since beginning to stand at my computer station a few months ago, I have begun to crave these ball sessions, but using softer balls like tennis and racquet balls, and allowing my foot to rest quietly on the ball. As I’ve said before, your feet evolved primarily for walking on varied terrain with hills, bumps, divets, sharp rocks, smooth stones, roots, holes, sand, dirt, grasses, leaves, brambles, water, slick, sloggy, hard, soft – deforming their 33 joints (each!) in a nearly infinite number of positions while naked. The contours of the earth helped to keep our feet supple. While I’m at my standing desk, I use balls of various sizes, textures, and yielding properties to drape my feet over, one foot at a time. After several minutes, I may start to very slowly move my foot over the ball, but often I stay still and try to be present to the innervation or waking up of these areas. Exploring various shapes with your soles stretches your muscles and joints in ways that you likely won’t experience unless you are walking on the natural earth with your feet bare.

standingstation

staticball3

staticball2

If your feet have been immobile for a long time, start slow, with soft balls & shapes, for small amounts of time.

Namaste, Michele

What’s New in Foot & Ankle Science?

It’s 3:28 a.m. and I am standing at my computer station stretching the top of my foot (will post this exercise soon) and browsing abstracts from the Journal of the Podiatric Medical Association. Yup. That’s what I do on a Friday night. Technically, it’s Saturday morning because I have been to bed, but was rooted out by my dog, Jolie, who makes the occasional appearance in FootLove Yoga videos and pics.

I thought it might be interesting to share with you some peer-reviewed research conclusions from the main trade group of podiatrists (foot docs) in the US. Bear in mind, that you are receiving my cherry-picked extractions from abstracts that can only be understood and evaluated in the context of their full articles and require knowledge of how to evaluate research methods. That is the buyer beware. My intention is only to bring your attention to what is being studied and learned. [In brackets you’ll find my snarky 2 cents].

Bits from the Journal of the Podiatric Medical Association 2013 & 2014

Podiatric Medical Abnormalities in a Random Population Sample 40 Years or Older in Spain
There was a high prevalence of podiatric medical abnormalities, which increased with age and female sex. The most common diseases were claw toes (69.7%), hallux valgus [bunions] (38%), and hallux extensus [big toe permanently lifted up] (15.8%), which increased with age and female sex. [Each of these are likely load-induced conditions; and all are impacted by shoe choice]

Forefoot Midsole Stiffness Affects Forefoot and Rearfoot Kinematics During the Stance Phase of Gait
This study looked at the difference between shoes with stiff arches and those less stiff arches and how they affected gait kinematics (how you walk). They concluded that a less rigid mid-sole was associated with greater range of motion and foot stability. [Another argument for wearing thin & flexible soled shoes]

Effects of High-Heeled Shoes and Asymmetrical Load Carrying on Lower-Extremity Kinematics During Walking in Young Women This study demonstrated that when high-heeled shoe wearing and asymmetrical load carrying are combined, changes at the ankle, knee, and hip joints are much greater than with high-heeled shoe wearing or load carrying alone. [Your purse, making your positive heeled shoes even more harmful]

Recognizing the Prevalence of Changing Adult Foot Size
Ill-fitting shoes may precipitate up to half of all diabetes-related amputations and are often cited as a leading cause of diabetic foot ulcers (DFU), with those patients being 5 to 10 times more likely to present wearing improperly fitting shoes. The current study, performed in a male veteran population, is the first such effort to examine the prevalence and extent of change in foot length affecting individuals following skeletal maturity. Nearly half of all participants in our study experienced a ≥1 shoe size change in foot length during adulthood. We suggest that these often unrecognized changes may explain the broad use of improperly sized shoe wear, and its associated sequelae such as DFU and amputation. [Your feet are getting bigger, so should your shoes].

“Good for Older Ladies, Not Me” How Elderly Women Choose Their Shoes
The main themes identified about footwear selection were aesthetics and comfort. Aesthetics was by far the main factor influencing footwear choice. Wearing safe footwear was not identified as a consideration when purchasing footwear. [Golden Darwin Awards]

Effects of Nonslip Socks on the Gait Patterns of Older People When Walking on a Slippery Surface
Participants walked more slowly and took shorter steps when wearing standard socks. Participants rated nonslip socks to feel less slippery than barefoot and standard socks. Compared with wearing standard socks, wearing nonslip socks improves gait performance and may be beneficial in reducing the risk of slipping in older people.

Effectiveness of Foot and Ankle Exercise Programs on Reducing the Risk of Falling in Older Adults
Evidence suggests that FA exercise can improve certain fall risk–related motor outcomes and reduce falls. [Check out my foot exercises in the category…”Foot Exercises” on this blog]

Effect of Shoe Flexibility on Plantar Loading in Children Learning to Walk
When evaluating early walkers during gait, peak pressure was significantly different across shoe conditions for all of the masked regions. The stiffest shoe had the lowest peak pressures and the most flexible shoe had the highest.It is likely that increased shoe flexibility promoted greater plantar loading. Plantar pressures while wearing the most flexible shoe are similar to those while barefoot. This mechanical feedback may enhance proprioception, which is a desirable attribute for children learning to walk. [Get your toddlers out of shoes people!!]

Alterations in the Plantar Pressure Patterns of Overweight and Obese Schoolchildren Due to Backpack Carriage
Among other adverse consequences, childhood obesity is known to influence foot structure and functionality.Overweight and obese children generally had larger contact areas and higher peak plantar pressures compared with their normal-weight peers. In overweight and normal-weight participants, the backpack induced a similar generalized increase in contact area and pressures. However, the largest changes were observed in the forefoot, suggesting that load action tends to modify the physiologic pressure patterns. Backpack carriage raises the already elevated peak plantar pressures in overweight children during upright stance and modifies the physiologic pressure patterns. [Lose the weight. Lose the backpack. Humans were genetically adapted (evolved to) carry things with our hands and arms. Feelings of tightness and lack of range of motion in your shoulders & upper back is directly a result of no longer using your upper body by carrying things (or climbing, hanging by your arms, digging, throwing spears, erecting shelters, i digress). Wearing a backpack causes alignment issues that can lead to shearing of your vertebral discs and mal-aligned shoulders. How about putting your kid’s books and things into cloth bags with handles (you could even use $2 reusable grocery bags) and let them carry their stuff. Busy hands and arms are well behaved bodies and brains??]

Anthropometric Foot Changes During Pregnancy
The foot of the pregnant woman tends to flatten during gestational weeks 12 to 34, taking a more pronated posture, and the anthropometric changes in late pregnancy result in increases in foot length and forefoot width, changes that seem to be moderate. [Bigger feet require bigger shoes. Shoes that are too small lead to load-induced injuries and conditions of the feet]

Foot Overuse Diseases in Rock Climbing
Overuse foot diseases related to rock climbing are particularly frequent and debilitating. Eighty-six percent of the climbers were affected by a pathologic condition. Nail disease was found in 65.3% of patients, followed by recurrent ankle sprains (27.8%), retrocalcaneal bursitis (19.4%), Achilles tendinitis (12.5%), metatarsalgia [pain and inflammation in the long bones of the forefoot] (12.5%), and plantar fasciitis (5.6%). Male sex, the use of high-type shoes, the high degree of climbing difficulty, and the competitive level were often related to the onset of foot diseases. Climbing shoes are usually smaller than common footwear. This “shoe-size reduction” averaged 2.3 sizes, forcing the foot into a supinated [rolling to the outer edge] and cavus [high arched] posture that favors lateral instability. The posterior edge of the shoe aperture produces increased pressure on the heel, with retrocalcaneal bursitis. [ why don’t you just climb barefoot? asks the former climber who crammed her puddins into shoes 2 sizes too small for 15 years]

The Occurrence of Ipsilateral or Contralateral Foot Disorders and Hand Dominance
Left-handed people were less likely to have foot pain or any foot disorders ipsilateral [same side of the body] but were more likely to have hallux valgus [bunions] on the left foot. Among right-handed people, the following statistically significant increased odds of having an ipsilateral [same side] versus contralateral [opposite side] foot disorder were seen: 30% for Morton’s neuroma, 18% for hammer toes, 21% for lesser toe deformity, and a twofold increased odds of any foot disorder [If you are right-handed, and most of us are, you are more likey to have these conditions on your right foot]; there was a 17% decreased odds for Tailor’s bunion and an 11% decreased odds for pes cavus. [This begs the question of foot disorders in ambidextrous people]

I hope you enjoyed this literature review!

Namaste, Michele

 

 

 

 

Load-Induced Conditions of Your Feet

A theme running through many of my posts on feet this month is alignment. What exactly is alignment? How does it differ from posture? Again, I lean on the words and ideas of another, my teacher biomechanist Katy Bowman, to elaborate on the concept of alignment and to relate it to my understanding of foot health. Posture is the positioning of your body parts in relationship to each other and to the ground. When you are standing still and you straighten your feet or back up your hips, you are creating a posture. When you are performing vrksasana (tree pose) in yoga that is a posture. Alignment, which encompasses posture, is a creation of forces by your body position (posture) while still or moving that loads your tissues. Posture is the positioning. Alignment is the loading forces on your body. Alignment is not just where your hips are (posture) but where all parts of your body are and how fast and hard and how often and in what direction they are moving; and your shape and what you are carrying and where; and the surfaces you are on or under; and the terrain and temperature; and the gear you are using and structures you are interacting with. Alignment is the interactions of all the variables in a particular system right now and whether the forces created by this system that load the tissues of your body are inflicting damage on any one part of the system. An aligned and well body does not damage itself.

Plantar fasciitis, bunions, hallux limitus and rigidus, bone spurs, metatarsalgia, Morton’s neuroma, and Achilles tendonitis could all be considered load-induced diseases of the foot. How are loads created to the tissues of our feet? Through our alignment.

Here are some major components of your walking alignment system that impact your feet :

  • body positioning
  • injuries
  • stride and pace
  • intensity of your foot strike
  • range of motion in your hips
  • innervation of your intrinsic foot musculature
  • gait pattern
  • weight
  • your backpack, purse, or other carried items and how you are carrying them
  • the terrain –  wood, tile, carpet, asphalt, concrete, dirt, grass, flat, lumpy, uphill, downhill, slick, hard, soft, holey
  • the shoes you are wearing. the shoes you are wearing. the shoes you are wearing. the shoes you are wearing.

Change one variable in an ecosystem and the impact ripples across that ecosystem, impacting all relationships to some degree. In the case of your feet, their current state is a reflection of their ecological history. Change one of the variables in the list above and you may not see a change. Change many, most, or all of them, and you will change your feet. You can still change your feet.

Namaste, Michele

Foot Cramp Fetish or How I Learned to Love the Marble Bridge and Relieve My Plantar Fasciitis

If you like foot cramps, then this is the exercise for you! Seriously, if FootLove Yoga has inspired you to move your feet more and in a variety of new ways, you may have discovered that some exercises cause your feet and lower legs to cramp. This is not surprising as cramps can be the result of:

  • muscle fatigue – the intrinsic muscles of your feet are weak
  • limited range of motion – your muscles are not at their optimal lengths and your joints are not accustomed to exploring new ranges of motion
  • poor circulation – muscles that don’t move don’t get much blood into the smallest blood vessels
  • increase in activity – your muscles are not prepared for the loads you are now asking of them

Good news is that if you continue to exercise your feet, spend more time barefoot, and make better shoe choices (thin, flat flexible sole with a wide toe box) your feet will get stronger and more flexible and the cramping will diminish and disappear for good.

I first learned of an exercise I call Marble Bridge from an article by Robin Rothenberg in the trade magazine Yoga Therapy Today. Robin learned of it from her colleague John Childers. I lean on their language to describe how and why it works.

Marble Bridge

    1. Lie on your back with your knees bent and your feet standing on the floor, pelvic width apart
    2. Place a yoga block or stack of books under your sacrum (this is the lowest part of your spine. Make sure the block is not under your lumbar curve.)
    3. Hold a marble or large bead with the toes of your right foot, curling your toes around it as you would if you were making a fist with your hand. If you don’t have a marble, you can pretend to hold one, but it doesn’t work as well.
    4. Extend your right knee, keeping your knees even with each other. This is equivalent to eka pada salamba setu bandha sarvangasana or one legged supported bridge pose in yoga
    5. Cramp Point your foot (plantar flex); hold for 5 seconds
    6. Cramp Flex your foot (dorsiflex); hold for 5 seconds
    7. Alternate cramping pointing and cramping flexing your foot for as long as you can stand it…
    8. If you cramp, release the marble, rest and begin again. You may need to lesson the amount of time in each foot position
    9. You can make this posture easier by removing the block
    10. You can make this exercise more challenging by doing a full, unsupported bridge

marblebridge4

What is happening?

The action of grasping the marble strongly contracts the flexor muscles on the bottom of your foot; while the action of pointing your foot strongly causes a contraction through the Achilles tendon all the way up into your calf; at the same time you are deeply actively stretching the extensors on the top of your foot and front of your lower leg. This is a perfect storm of eccentric contraction that strengthens your muscles, increases the range of motion in your feet, and improves circulation and waste removal to your lower legs & feet, especially the heels that receive little blood flow and are ground zero for plantar fasciitis.

Both Rothenberg & Childers use this exercise to treat clients with plantar fasciitis. Rothenberg explains that the plantar fascia is often “locked long” or, put another way, chronically tensed in extension. The fix for tissues in this state is to strengthen them, since chronic tension makes them weak, and simultaneously use strong contractions to counter the state of chronic extension. She combines undulating stretching with strong contractions. She cured her life long plantar fasciitis this way.

You can watch a video of this exercise on FootLove Yoga Facebook page.

Namaste, Michele

Stop Distributing Your Weight Evenly Throughout Your Feet in Yoga!

I intended to post something on feet every day in January, but alas, embedded in all the knowledge I picked up at the gait workshop that I attended in Seattle (Walking the Lines: Anatomy Trains, Myofascial Efficiency & A Model of Gait), was something that feels like the flu.

I’m using my down time to read about the anatomy of feet and yoga, and was inspired to comment on a common yoga cue that I’d like to see go away.

“Spread your weight evenly from front to back”
“Distribute your weight across the four (or three) corners of your feet”
“Feel your weight in all parts of your foot”
“Your weight should be even across your big toe mound, baby toe mound, and heel”

You will hear some variation on this cue for Tadasana (mountain pose) in many yoga classes. Unfortunately, its not good instruction. If you follow this improper cue, then you will have an unnatural, strong forward lean of your body. The architecture of the foot is elegant and intricately complex on an a deep anatomy level, but quite simple on a gross level as pertains to weight bearing. Your heel bone (calcaneus) is the largest bone of your foot and is structurally located precisely below where the weight of your body is translated to the ground. Your lower leg bones and those of your feet make up your ankle joint, which is located above your strong, weight-accepting heel bone, not above the smaller bones (tarsals) and more slender bones (metatarsals) of your mid and forefoot, respectively. These smaller bones are meant to assist in transfer of weight during gait, propulsion of your body forward, and in supporting your arches but NOT to hold the mass of your weight. I go over this in more detail in my post on backing up your hips.

Even the cue to have “the majority” of your weight in your heels is not specific enough. The majority could be 60% and that is not enough weight in the heels. ALL of your weight should be borne by your heels. So if all of your weight is back in your heels, what is the rest of your foot doing? Wouldn’t it be lifted up off the ground? No.This is where your strong yoga foot comes into play. You can apply pressure to the ball of your foot by pressing it into the ground, without shifting your weight or hips forward.

Try it.

  1. Stand in Tadasana with your the front of your ankles the width of your ASIS bones (pelvic bones, “hip pointers)
  2. Line up the outer edges of your feet so that your outer ankle bones and the middle of your baby toes are in a straight line
  3. Sway your weight forward and back a few times, but then stop when your weight is fully back over your heels
  4. Press the balls of your feet into the floor
  5. Relax your toes
  6. Make sure to back your hips up until a side view in a mirror would show your hip joint directly over your knee joint directly over your ankle joint with all three joints stacked directly over your strong, meant-for-this-purpose calacanei.

Having a partner press their hands down firmly on the tops of yours shoulders should give you a sense of whether or not your weight is all the way in your heels. If it were spread evenly throughout your feet, you could buckle under the weight of your partner’s hands. If your weight is back, you can easily stand strongly under this downward pressure because you are using the vertical structure of your bones to resist downward force.

This is how you do Tadasana – not because it is part of any particular yoga lineage, but because it is optimal for the health of your feet. What’s the big deal if you are only doing Tadasana a few minutes per yoga class? Because what you do on the mat  often translates to what you do off of the mat – both the helpful and the harmful. This is how you do standing in line at the grocery. This is how you do standing around with a group of friends. This is how you do standing.

Namaste, Michele

Simulating the Toe Off Event in Walking to Stretch Your Plantar Fascia

You learned in my first post on Plantar Fasciitis that stretching the plantar aponeurosis aka fascia is associated with better outcomes than other conservative, conventional treatments including anti-inflammatory medications, corticosteroid injections, and both custom and over the counter orthotics. In addition to stretching the tissues statically, you can functionally stretch the plantar fascia by simulating the tensioning of the plantar fascia that occurs during the propulsion phase of gait (walking). Three variations of the static stretch are provided in order of intensity, followed by a link to a video of the dynamic, functional stretch.

Plantar Fascia Stretch – Static

Plantar fascia stretch

Plantar fascia stretch

Plantar fascia stretch from my behind

Plantar fascia stretch from my behind

Level 1

  1. Stand up on your knees with the dorsal (top) sides of your feet and toes touching the floor.
  2. Extend the toes of your right foot forward, so that the bottoms of your toes are touching the floor
  3. Hold for 1 minute and repeat on left foot
Kneeling plantar fascia stretch

Kneeling plantar fascia stretch

Level 2

  1. Be on your hands and knees with the dorsal (top) sides of your feet and toes touching the floor.
  2. Extend the toes of your right foot forward, so that the bottoms of your toes are touching the floor
  3. Pressing your hips back towards your heels will increase the stretch
  4. Hold for 1 minute and repeat on left foot
Semi hands & knees plantar fascia stretch

Semi hands & knees plantar fascia stretch

Level 3

  1. Begin in either Level 1 or Level 2 starting position
  2. Extend the toes of your right foot forward, so that the bottoms of your toes are touching the floor
  3. Sit back on your heels (vajrasana) with your spine upright and neutral
  4. Hold for 1 minute and repeat on the left side

007

Plantar Fascia Stretch – Dynamic

  1. Be on your hands and knees with the dorsal (top) sides of your feet and toes touching the floor
  2. Bring your right foot forward until the sole is on the ground and your butt is on your left heel
  3. Rock forward from heel to toe on your right foot
  4. See the video of this on FootLove Yoga Facebook Page

Note in the photo above that I did not get my pinky toe extended forward. I should have reached around to coax that lil puddin into extension.

In any of the variations, try to reach back to your foot and massage the fascial tissue in a crosswise direction, providing an additional myofascial release of these sticky tissues.

Namaste, Michele