Your Flat Feet are Exhausting

I’ve written about the purported benefits of engaging a strong yoga foot in past posts. It seems foot researchers are catching on to something yogis have been practicing for a long time. It’s called the “short-foot exercise,” but is essentially the equal of the strong yoga foot. Several recent small studies show promising benefits of the short-foot or strong yoga foot exercise for strengthening intrinsic foot architecture and improving postural stability aka balance. This is heartening as many health claims in yoga have arisen, unsubstantiated, out of various yoga lineages and proliferated through popular yoga publications and well-intentioned teachers. Proselytizing unsubstantiated health claims harms our profession.

Your feet are complex and serve many functions in stability and movement. Standing, balancing, and walking gait require the arches of your feet to deform on command as the need for stability, rigidity, flexibility, and elastic energy storage and release quickly changes depending on what you doing. Add other forms of movement you might do – run, jump, dance, hike, climb, etc. and its apparent that you need strong, flexible, mobile feet with keen ability to propriocept or sense the terrain under them. Your intrinsic foot muscles, which have all of their attachments within the foot, are considered stabilizers (as opposed to the extrinsic muscles that have attachment points both on the foot and on the lower leg and are your movers). One of the main jobs of the intrinsics is to support the four arches of your foot (medial, lateral, and two transverse) that one could envision as a half dome. It is this half dome that must deform properly in all types of movements – standing, balance, walking, running, dancing, etc.

Half dome of foot arches

Half dome of foot arches

*Image from McKeon article.

With each step you take, your intrinsic foot musculature acts to control deformation of this half dome of arches. When these muscles are not functioning properly because they are weak and uninnervated, your foundation is unstable and misaligned and thus abnormal compensatory movement occurs. I’ve written previously on how foot turnout and a forward pelvis can wreak havoc with your feet. Imagine what abnormal foot biomechanics in movement might do?? Several conditions immediately come to mind – plantar fasciitis, bunions, metatarsalgia, Morton’s neuroma, and pes planus or flat feet.  A weak medial arch (that’s the long arch on the inside of your foot) is one possible cause of flat feet, which, if you have them, negatively impact your other weight-bearing joints with friction and subsequent degeneration. Your flat feet have weak plantar muscles that fail to function optimally in their crucial roles as shock absorbers, in gait efficiency, and as postural stabilizers, making balance difficult. And, oftentimes, they just plain hurt. If your feet are flat, your medial arch is missing, which means your half dome cannot deform to provide necessary transitions from rigidity, flexibility, and energy storage and release that propel you forward when walking or running. When your arch doesn’t store and release elastic energy in gait, you are having to work exponentially harder to move forward. Your flat feet are exhausting.

The strong yoga foot or short-foot exercise is used to reinforce the arch of the foot by strengthening the plantar muscles – the four muscle layers on the bottom of your foot, predominantly your abductor hallucis, which is the most superficial and easiest to measure of the intrinsic muscles. By contracting the foot’s intrinsic muscles, the long medial arch is shortened and its angle increased. This lift of the arch lowers the mediolateral center of pressure (the pressure on the part of your flat foot that should be arched), and increases pressure of appropriate contact areas of the foot (forefoot and heel) on the floor stimulating cutaneous and muscle receptors, which help you to right yourself in the context of balance. Essentially, a strong arch is crucial to optimal gait and balance. Research shows that the short foot exercise reduces arch collapse, improves balance ability, increases big toe flexion strength,  and improves function in chronic ankle instability.

How to Perform the Short Foot Exercise

The short-foot exercise is performed by shortening the foot in a front to back direction – the first metatarsal head (aka the base of big toe; big toe mound; or ball of the foot in yoga speak) is drawn toward the heel without flexing or curling your toes. The forefoot and heel touch the floor, while the medial arch lifts.

Short foot exercise

Short foot exercise

*Image from McKeon article.

The short foot exercise can be performed either sitting or standing for improving strength, but should be practiced while standing if using this exercise to improve balance. When standing, it can be done bipedally, meaning both feet on the ground, but only one foot should be working; or unipedally – balancing on only one working foot. Placing the ankle into passive dorsiflexion by inclining the foot 30 degrees on a board or yoga wedge results in higher activation of abductor hallucis than that of the typical, neutral short foot position, possibly due to length-tension relationship in which optimal muscle length generates the greatest muscle force. The exercise is repeated 3 times for 5 seconds per rep, making one set. Sets of three reps are repeated 5 times, with two minutes of rest after every set. Alternatively, sets could be spread throughout the day.

A daily progressive program  might look like this:

  1. Week 1 – sitting,  5 sets of 3 reps with at least two min of rest between each set
  2. Week 2: – bipedal, 5 sets of 3 reps with at least two min of rest between each set
  3. Week 3: – unipedal, 5 sets of 3 reps with at least two min of rest between each set
  4. Week 4: – inclined foot, 5 sets of 3 reps with at least two min of rest between each set
  5. Maintenance – any combination of the above

For yoga practitioners, use the strong yoga foot in Tadasana and foot balancing postures. Remember, for whole body health:

  • shift your hips back when standing/balancing so that the center of your mass (your pelvis) is aligned over your knees and ankles, and heels and not over the fragile structures of your forefeet;
  • engage the lateral hip muscles on the balancing leg as this strength is crucial to optimal gait and missing in most people; and
  • lower your kneecaps by relaxing your quadriceps to minimize the amount of friction/degeneration in your knees.
The following studies informed this post and are available free, in full text on PubMed.

The foot core system: a new paradigm for understanding intrinsic foot muscle function. McKeon, PO et. al. Br J Sports Med. 49:290, March 21, 2014.

EMG Activity of the Abductor Hallucis Muscle during Foot Arch Exercises Using Different Weight Bearing Postures. Goo YM, Heo HJ, An DH. J Phys Ther Sci. 2014 Oct;26(10):1635-6.

The Effect of an Inclined Ankle on the Activation of the Abductor Hallucis Muscle during Short Foot Exercise.
Heo HJ, An DH. J Phys Ther Sci. 2014 Apr;26(4):619-20.

Immediate Effect of Short-foot Exercise on Dynamic Balance of Subjects with Excessively Pronated Feet.
Moon DC, Kim K, Lee SK. J Phys Ther Sci. 2014 Jan;26(1):117-9.

Namaste, Michele

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Sitting on the Floor…A Proposal

I start my yoga classes asking students to sit on the floor. I often ask “has anyone sat on the floor this week – aside from a yoga class?” I get a lot of “no’s.” Then I suggest opportunities for converting couch/chair sitting to floor sitting/squatting, such as when you are watching TV or reading or try performing activities at a low table like paying bills, computer time, eating meals, playing games, etc.

Sitting at a desk or on the couch/recliner/easy chair for long periods of time is associated with cardiovascular disease, diabetes, and many cancers, which means it increases your risk of death from one of these diseases. One study showed a 61% greater risk for those who sit 7+ hours per day watching TV over those who sit less than 30 min. When you sit on furniture, especially cushy furniture that molds itself to your body, thus casting it into the shape of said furniture, you end up nearly motionless for long periods of time. You use few skeletal muscles when you lounge back on the couch. Idle muscles burn less fat (you get fat), respond less effectively to insulin production (you get diabetes), and promote less blood flow. Poor circulation in legs results in unsightly swollen ankles and puts you at risk for varicose veins and, even worse, blood clots. Muscles that sit around on easy chairs don’t contribute to cellular waste removal and conduct less energy to boot. Slouching back on a comfy sofa puts you in a tail tucked position that can, over time, result in pelvic floor disorders.  When you sit on your tailbone, as a slouchy couch promotes, you risk herniated spinal discs, pressure on your sciatic nerve – which can lead to the painful condition of sciatica – and weak butt muscles. Sitting with your hips and knees flexed for long periods of time, in any type of chair, decreases range of motion in your hamstrings and limits hip mobility, which is a major cause of falls in older persons. While it may seem comfortable while you are doing it, when you get up from your recliner after a Netflix binge, you are sure to experience a stiff spine and sore low back, shoulders, and neck.

So what happens if instead of slumping onto the couch, you choose instead to sit on the floor? When you sit on the floor, with your back unsupported by anything other than your own musculature, you in fact strengthen that supporting musculature otherwise known as the postural muscles of your trunk aka your core. A daily practice of sitting on the floor with your back unsupported (this means you don’t sit against a wall or couch) strengthens the stabilizer muscles that protect your spine, as well as trims your waist in a natural, functional way. I would put my money on floor sitting over abdominal crunches as the optimal way to strengthen my core ANY DAY. When your postural muscles are firing at their optimal lengths, you become strong enough to align or stack your vertebra, bringing back the natural, compression reducing, curves of your spine. When you sit on the floor, you are more likely to be on your sitting bones rather than on your tailbone, which is better for your pelvic floor musculature and your low back. Hanging out in seated postures on the floor increases your tolerance to greater ranges of motion in your joints, which results in a sensual experience of more flexibility. You feel less stiff, less tight.

When you sit on the floor supporting your own spine, you squirm. You don’t sit still. You move about. Frequently changing positions articulates your joints into many different angles, causing a seemingly infinite variety of loads to the tissues of your spine, pelvis, hips, groin, and legs. Different loads stimulate different muscles which, through the process of mechanotransduction, pushes blood into the smallest of blood vessels, innervates the tissues, and removes waste products.

When you sit on the floor, you do something you almost never do on furniture – you stretch. Just sitting on the floor in a cross-legged position provides passive tensile and compressive loads to your connective tissues, increasing strength and suppleness. But active stretching is likely to happen as well. Once you’ve shifted your position a dozen times to get comfortable, you’ll usually give in and just begin actively stretching your muscles! This would not happen if you were in a chair. Just sayin.

Claudio Gil Araujo is a Brazilian researcher who studies people’s’ ability to get on and off the floor as a marker of longevity. Basically, those study subjects that had to use one or both hands, an arm, their knees, a lower leg, a hand/s on their leg/ as a brace, or momentum to stand up from a floor-seated position, had a greater mortality rate as compared to those who could bring themselves from a floor seat to standing and back to a floor seat using only the strength of their bodies. While internal force production, or being able to mobilize and lift your own body weight, may not predict how long YOU will live, it is certainly a marker of functional health and reflects your mobilities and strengths at the deeper level of your cells and blood vessels.

Lose points for:

Lose points for:

In the image above, you would lose points in your overall sit/stand test score for using a hand, knee, forearm, hand on knee, or side of leg to brace or leverage getting on/off floor.

Here is a video of Araujo’s sit/stand test, with English subtitles.

Sitting on the floor. Being able to get down onto the floor and back up again with grace and ease, like all things worth achieving, takes practice. It also takes remembering to do it, forming a habit. The next time you find yourself sitting in a chair, nudge yourself to take your task onto the floor, even if only for a minute, to begin a daily, lifelong habit and practice of sitting on the floor.

So here is my proposal.

“Do you FootLove Yoga Blog Reader promise to sit on the floor, unsupported, everyday, several times a day, for as long as you live?”

“Do you?”

“Do you?”

Namaste, Michele

You Are Not as Sensitive as Your Big Toe

There are few body parts more sensitive to surface pressure in the skin than your toes. The only areas with a higher density of receptors are your fingers and your face. Once again, I turn to Mel Robin’s book A Handbook for Yogasana Teachers. Mel references BKS Iyengar as a master of linking skin sensation to intelligence. Mel advises that when you are balancing in a posture like vrksasana (tree pose) to “trust your big toe, and keep the body’s primary intelligence in the toes, foot, and ankle of the balancing leg,” pg 916 – yes, there are over 1000 pages in this behemoth of yoga intelligence!

Let’s try it. Come into vrksasana – I posted a fuzzy, old picture of me below in case you don’t know tree pose. Your foot can be above or below your standing leg’s knee. Direct all of your attention to your toes, especially the big gal. Allow them to grip as much as needed. Toe gripping in balancing postures generates necessary countertorque for balancing and should not be discouraged.* Consider the big toe and the areas around it as being the brain of the posture. Be less concerned about what is happening in the other areas of your body, keep returning your attention to your toes, letting them guide the subtle swaying and nuanced corrections of your body. Play  around with letting your toes relax or lifting them to see how that changes your balance.

Since vrksasana, along with all standing balancing postures, is terrific for practicing that strong yoga foot I wrote about yesterday, try pressing the ball of your foot down, with or without gripping your toes, and lift your arch. Viva la feet!

Vrksasana

Vrksasana

*Toe gripping outside of single leg balancing, as in how you have to grip your toes to keep on a pair of flip flops or other shoes without a secure upper, is highly discouraged. Long term toe gripping in non-balancing yoga postures, while driving, or in trying to keep on flip flops, slides, clogs, etc. can contribute to muscle tension patterns that make you susceptible to hammertoes.

Namaste, Michele