Feet & Shoes

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JOHN PETROZZI:   Hi and welcome to Living is Easy with John and Josh.  I’m John Petrozzi.

JOSH HARPER: And I’m Josh Harper.

JOHN PETROZZI: This show is about you. It’s about health and wellness and everything in between. You will learn how to improve your health. You will listen in on inspirational interviews and it may even change the way you live your life. But by no means are we a substitute for your medical advice. So listen up and get healthier.

JOSHUA HARPER:   What’s on the show today John?

JOHN PETROZZI: Well Josh, today we’re talking about feet and shoes. We’ve heard a lot in the past about wearing backpacks and how that’s bad for your spine; of course it is. Well today, I’d like to talk about, how shoes can be bad for your feet and also for your spine.

JOSHUA HARPER:   Before we get into shoes, tell us a bit about the foot, John.

JOHN PETROZZI: Well the foot’s got about 26 bones in it. So, it’s a lot of bones, so a lot can go wrong. It has about 52 joints. If you look down at your foot, can you see these toes wiggling at the end of it? It comes up towards the ankle joint, which is a whole bunch of joints, blocked in together, which needs to support your weight everyday – every single time you walk. A lot can go wrong, but a lot can go right, too.

JOSHUA HARPER:   What holds the foot together, John?

JOHN PETROZZI: Well, these small little ligaments will hold the foot together. You know it’s like sticky tape. Ligaments hold bones together just like sticky tape does; around each joint in the foot, but actually all throughout the body. You’ve got a capsule which is a strong ligament parachute around the joint. What that does is it protects the joint, and it contains liquid, which is called “synovial fluid” and that produces a nice smooth even surface so that the joints don’t get stuck. They can just move evenly and smoothly.

JOSH HAPRER: Can a running shoe make the ligaments bad as well?

JOHN PETROZZI: Yeah, exactly. That’s actually the whole crux of today’s topic really. It’s how bad-fitting shoes can make your feet go bad. Because the joints in the spine and also in the feet have to move all the time to stay hydrated and to stay healthy; if a joint gets stuck, over time, what starts to happen is you’ll start to get some degenerative changes and cracking of the joints. Have you seen pictures of Ayers Rock?

JOSHUA HARPER: Yeah, cracked.

JOHN PETROZZI: Cracked and hard, and red, and patched. That’s exactly what can happen to the joints in the foot.

JOSHUA HARPER:   Is that the ligaments or the bones?

JOHN PETROZZI: That’s the bone surface. So if you can imagine two plates rubbing together, that’s how a joint works. It’s basically two plates rubbing together. But if you got a bad-fitting pair of shoes, what can happen is those joints will become more compressed and over time, the ligaments around the joint become stiff, sometimes frozen, and then you will get some cracking of the joint surface because it’s not moving like it should.

JOSHUA HARPER:   A shoe worn incorrectly can just do this to your foot?

JOHN PETROZZI:   It can, yeah. For instance, pair of a good running shoes, what that tends to do is it will support the foot generally in a nice and neutral and healthy position. So what I mean by a good shoe is you need a shoe that supports the heel, so the heel doesn’t rock and roll around too much. Because often, what happens is when you’re wearing a pair of shoes that you don’t lace up for instance, what can happen is the foot will roll from side to side, inwards and outwards, inwards and outwards. What will happen over time is you’ll get some locking of the upper part of the ankle and the mid-part of the foot will start to over work. What the body tries to do to stop that muscle and ligament from over working, is it tries to freeze up the ligaments around the joint to stop them from overworking.

JOSHUA HARPER:   So why don’t we talk about different types of shoes like high heels for instance.

JOHN PETROZZI:   High heels? Oh, the bane of my existence. I’ve got so many patients at the practice that continue wear high heels day in and day out. They love them. They look great, but they are not very good for your feet. We should only wear—not we, because we don’t wear high heels—but high heels should only be worn for about 4 to 6 hours a day. I think a lot of ladies in the offices use them for a lot longer than that.

JOSHUA HARPER:   Can we get support to put inside the high heel?

JOHN PETROZZI:   You can. You can get an orthotic device, which is an arch support, modelled to your own foot that can be inserted into a high heel.  What that does is it helps to support the arch of the foot, so the foot doesn’t go flat. Because that’s the real problem with shoes; if you don’t have a shoe that’s got a nice arch support or support inside the shoe, the foot will tend to become flat and it can also roll inwards. So if you got a foot that actually rolls inwards, your foot is pronating.

JOSHUA HARPER:   What does pronating means?

JOHN PETROZZI:   Pronation means (you can test that on your own feet), what it means is when you stand, your whole foot rolls inwards towards your big toe. So, it will give you an appearance that you don’t have an arch anymore, your foot’s gone flat.

JOSHUA HARPER:   So that’s flat-footed?

JOHN PETROZZI:   Yeah. The appearance is flat-footedness. I think pronation of a foot is really a common and pretty chronic condition that a lot of the population has. I think a lot of it comes down to the way that people wear their shoes and the way they select their shoes.

JOSHUA HARPER:   Can we test if we have bad feet?

JOHN PETROZZI:   You can, yeah. Definitely I suppose, the easiest way to test that is just to stand comfortably in front of a mirror that’s down to your feet. Look at your big toe – if your big toe is turning in, you’ve probably got an arch that’s probably flat as well, so the arch is also rolling in. If you go a little bit further up your limb to your knee, you might notice your knees turned in and it might also be knocking inwards as well. So it might be an angulation inwards.

A lot of those knee problems can also originate from a foot problem. A domino effect will happen as well if you got a bad working foot and ankle, then they won’t work, which means the hip and lower back won’t work as well. We’ll go into that later on.

JOSHUA HARPER:   Okay, why don’t we talk about different types of shoes now?


JOSHUA HARPER:   What about runners?

JOHN PETROZZI:   Yeah, runners. You can get some excellent runners, but you can also get some pretty poor runners as well. When you’re selecting a running shoe, you need to look at a shoe that’s got some rock on the bottom of it. Which means, you want the bottom of the foot or the bottom of the shoe to have a small bend in it, so the toes kind of curl upwards and the heel is sort of resting up off the floor very, very slowly. When you look at the back of the shoe, you want a nice stiff support at the back part of the heel. What that does is it helps to support the ankle, and it also prevents the foot from rolling inwards and outwards as well.

JOSHUA HARPER:   Also the pressure when you’re falling on the ground, the impact.

JOHN PETROZZI:   Exactly, yeah. So it depends on what the actual material that the sole is made up of. If it’s a sole that’s very, very thin, it means that every single time you walk, most of the impact of the ground, of your foot hitting the ground, will shot it right up through your foot and into your ankle. So you want a nice sort of spongy, but still firm and very, very strong material on the bottom part of the shoe.

Air sockets in shoes, you can get gel sockets and pockets. Just try them out. Unfortunately, shoes that can be expensive, so it can be an expensive mistake, but the ones that I tend to go for are the really popular running shoes, like the ASICS. They work really, really well, because they’ve got a really good strong cross support right at the back part of the heel.

When we come back from the break, we’ll talk about how to lace up your shoes and the importance of doing that. So stay tuned.


JOSHUA HARPER:   John, you noticed when we’re coming into the studio that my shoe laces were quite loose, and you said that this was a bad thing? Well, what happens?

JOHN PETROZZI:   I did notice that, Josh. It was the first thing that I noticed. Shoes need to be tied up. If they’re not tied up, what tends to happen if it’s loose, the shoe or the foot will rock around very, very loosely inside the shoe. So that’s kind of like—well, you know what it’s like—the foot’s going to roll around and it will create damage to the shoe and the foot. You’ve got lots of bones in the foot, and they don’t like to roll inwards. But if you got a shoe that doesn’t have its shoe laces tied up, what will happen is the foot will roll inwards, and then overtime, you’ll get fatigue, tightness, and also freezing up of joints in the foot and ligaments. That can lead—chronically over time—to problems like a syndrome called “plantar fasciitis,” which is just inflammation of the tendon on the bottom of the foot. It can be pretty quite painful. You can also get some degenerative changes or arthritic changes to the joints if that pressure is consistent on the foot.

There’s a nasty thing that can happen as well to the nerves on the bottom of the foot. They can start to bunch up, and they can start to grow haywire, kind of like an ingrown hair. It’s called a “neuroma.” What that is, is basically the nerves just growing ballistically, but unfortunately, over time it becomes really, really painful. The good thing is that all these things are preventable. You can prevent them by wearing good shoes and looking after your feet.

JOSHUA HARPER:   What would you consider as tight shoe laces?

JOHN PETROZZI:   You mean over-tight?

JOSHUA HARPER:   Over tight or too loose.

JOHN PETROZZI:   Too loose just means that you can grab the bottom of your shoe and move it from side to side, and if there’s a lot of movement, then it’s way too loose. So you know these shoes are tightly done up and adequately done up when the shoe doesn’t rock around, so your foot’s quite firmly jammed in the shoe, but it’s still comfortable without blocking blood circulation.

JOSHUA HARPER:   Can it be too tight?

JOHN PETROZZI:   It can be too tight, yeah. I actually had this problem with myself when I was playing soccer and when I was working overseas with the soccer team. What I found is the guards would pull your shoelaces too tight. What would happen is they would start to get some pressure sores around the top part of the foot and also they start to get some rubbing and wearing of the bottom part of the foot, so they get a lot of blisters.

JOSHUA HARPER:   Blisters.

JOHN PETROZZI:   Yeah. But also they might get some tendon rubbing, too. And that can be really, really painful. I had to do a lot of work on their feet to try and free them up. But also, you need to be very, very careful of the shoe that you wear, too. Do you wear flip flops?

JOSHUA HARPER:   I do, only when I go to the beach though.

JOHN PETROZZI:   Yeah, that’s okay.

JOSHUA HARPER:   Are they all right for your feet?

JOHN PETROZZI:   Yeah, just don’t wear them too much. If you’re wearing a flip flop or a thong or some sort of open shoe a lot during the day, then your foot is not getting supported, which means your foot’s going to rock and roll all day long. I think with those sorts of shoes, wear them part of the day, but not the whole day. I get a lot of guys and patients coming in and they actually walk to work from like here into the city, which is great – really, really good for fitness.

But what can happen sometimes is they’re actually walking with their high heels, so they walk through like out of the end of the bridge and into the city, but they wear their high heels the whole way. By the time they get to the city, the foot’s had way too much pressure and tension put across the joints and ligaments that it becomes fatigued. As a consequence, the foot becomes irritated, the leg becomes irritated, and so is their spine.

But also, because of that consistent pressure on joints and muscles in the foot, mentally, they’ll become fatigued as well, which means they weren’t concentrating as well during the day and the level of inflammation may increase as well.

JOSHUA HARPER:   Can your shoes die? Can they get old and-?

JOHN PETROZZI:   Yeah, definitely. Yup! Actually, everybody should have look at their shoes every couple of months. All you need to do is pick up the shoe, look underneath it, and look for any particular heavy wear marks. The place where you will get wear marks is at bottom outside of the shoe, because that’s the area of your foot that heels strikes first, but make sure it’s not excessive. So if you look at the back section and you see quite an acute angle, and there’s a lot of rubber that’s been worn off, then it’s time to throw the shoes away and get a new pair.

JOSHUA HARPER:   So is that the area you need the most support for – the back outside corner?

JOHN PETROZZI:   It is, yeah exactly. So when you’re selecting a shoe, most shoes do have extra material and padding and high-density foam on the outside portion as well. So, look at your shoe and just make sure it’s not worn out. The other portion to look at is right in the middle part of the forefoot, just underneath your toes, really. If that section there is worn out, you need to look at your shoe and apparently replace it as well.

JOSHUA HARPER:   Do you need a different type of footwear depending on your environment?

JOHN PETROZZI:   Yeah, definitely. If you’re working in an office, most of the time you’re working on nice soft carpet. What that means is you don’t need a shoe that’s got a lot of support or rigidity or softness. So, if you’re walking on hard surfaces, you need a shoe that’s got a bit of support and softness through the foot or the bottom part of the foot. But you need also a shoe that’s going to be comfortable during the day, because it doesn’t get a lot of movement unfortunately.

But really for people who work in the office, they need to build and exercise into their day, so they’re actually getting out of the office. What I’ll suggest if you do work in an office, have a nice office comfortable shoes, but also bring your pair of sports shoes as well, so you can actually get out of the office at lunch time and go for a walk for half an hour or 40 minutes. Your body’s going to love it.

JOSHUA HARPER:   What about when you’re sitting there at the computer? Could you roll your feet around? Do you recommend that?

JOHN PETROZZI:   I do, yeah. Probably even better still, take your shoes off and even do some exercises with the feet. Later on in the program, we’ll talk about some exercises that you can do. But I suggest just keeping your shoes off and down and walk around barefoot.

JOSHUA HARPER:   What about different types of places like cafes with the hard floors? What would you recommend there?

JOHN PETROZZI:   Someone who works in an environment that’s got hard floors, they need a shoe that’s going to support them. Oftentimes, you’ll get some nice supportive shoes. Oftentimes, closed shoes, either with or without laces, but you need a really nice soft rubber sole on the shoes so that the impact isn’t too great on your foot. Otherwise, you’ll start to get pressure sores on your foot and pain.

JOSHUA HARPER:   What about those rubber mats you can use in kitchens and cafes?

JOHN PETROZZI:   Actually, I only just saw those come in—I must have been observing enough—I only saw them sort of come in about 10 or 15 years ago that they started to use those. They are a great idea.

JOSHUA HARPER:   You mean the rubber flooring?

JOHN PETROZZI:   The rubber flooring, yeah. If you are in an environment that requires you to stand up in the same place, like a bartender barista, a cashier, anyone who’s standing in the same place, have a look around and ask for a mat to be placed in that area so that it’s absorbing the load, instead of your foot absorbing the load.


JOHN PETROZZI: Today, we’re talking about feet and trying to keep them happy. We’re going to talk a bit about orthotics.

JOSHUA HARPER:   What’s an orthotic?

JOHN PETROZZI:  An orthotic is sort of like an arch support plastic device that you put into your shoe.

JOSHUA HARPER:   Those inner rubber soles?

JOHN PETROZZI:  Yeah, that’s right. Some of them are made of rubber; some of them are made of hard plastic or fibreglass. The reason you go and get an orthotic—and you can get an orthotic from podiatrists, physios, chiropractors; they’re the main people who would dish out orthotics—what an orthotic device does is basically provide an arch support for the foot. It helps to stop the foot from rolling inwards. That can work really, really well for a lot of feet really. I wore orthotics, and I have done for over a long time. But the thing is, if I wore orthotics and didn’t get my foot work done—because I’ve got a couple of little issues in the foot—then really the feet problem would get worse over time and the orthotic will just hide and mask the symptoms really.

JOSHUA HARPER:   What type of person needs an orthotic?

JOHN PETROZZI:  People that need orthotics are people whose feet roll in excessively. Again, you know you’ve got pronation or excessive foot rolling in when you stand and your foot turns inwards towards your toe, because that, over time, can start to produce a bunion at the front of your foot. What a bunion is—you may have seen it before on people’s feet—is a large lump or burn that starts to form at the base of the big toe. They can be really, really painful as well. If you got a foot that rolls in, over time, that’s a symptom that can happen.

JOSHUA HARPER:   What about pre-made ones? Or would you recommend the ones you get fitted for?

JOHN PETROZZI:   I think they’re both good. It just depends on the extent of the problem and the result you want to try and achieve. The pre-formed ones, you can buy from sort of pharmacies and sports stores. What they tend to do is, an average sort of arch, they input strain into your shoe to give you an added amount of support. But the thing is, if you got a good shoe, most shoes have got that build in to it already. That’s what you need to look for in a good shoe.

JOSHUA HARPER:   Do most shoes have the arch already inside it?

JOHN PETROZZI:   Most do, yeah. But what you’ll find is, unfortunately, with steel-cut boots that people use on work sites, often those would be a flat foot or a flat in-sole. There’s no arch support in there at all.

JOSHUA HARPER:   These people would have problems with their feet?

JOHN PETROZZI:   Unfortunately yeah, because steel-cut boots have got a flat foot. There’s no arch support. The actual sole of the shoe is super hard, because they don’t want nails to be puncturing through it. There’s a hard bit right at front, so that a brick, if a brick falls on there, it doesn’t damage their toes. Also, often there are no laces on them; they’re just a slip-on shoe. You’ve got a lot of working against you. You’ve got a shoe that’s unsupportive to the heel, so the foot can rock and roll on the inside. You’ve got a shoe that doesn’t provide any support for the arch, so your foot collapses in. You’ve got a shoe that doesn’t have any sort of shock absorption underneath the foot, so all the force of your stepping on a hard surface goes right through your foot. Finally there are no laces as well, so you can’t actually determine how much tension you put through the shoe.

It doesn’t have a lot going for the old workman shoe, but you can get some really good ones. They can be quite expensive, but they’re really, really good, I’ve seen them. They’ve got laces, they’ve got heel support, they’ve got arch support on the inside and still they’re very light. They’ve got a nice hard toe to protect the toes.

JOSHUA HARPER:   Back to what we were talking about before, would you go and see your chiropractor or podiatrist to get your foot measured out to see if you’re that bad?

JOHN PETROZZI:   Yeah, definitely. You can get lots of assessments done. What the practitioners would generally do is they’ll make an assessment of the foot to see what the mechanics are like and they’ll determine it by doing some tests and some measurements and sometimes a foot scan of where the pressure gets put into the foot as well. Ideally, when you put your foot down, you want the heel to strike first. Then the outside of the foot starts to roll along the ground and then eventually your toe pushes off the ground to propel you. That’s a nice sort of pressure arch that starts at the bottom, outside and into the front.

Often, what will happen if your foot rolls in a lot—if it’s excessive pronation—is the force will just go straight to the bottom of the foot flat. So over time, the ligaments and muscles start to fatigue, because they’re not meant to take that much weight all the time.

JOSHUA HARPER:   This causes problems up to your spine as well?

JOHN PETROZZI:   Exactly, it’s a domino effect. If the ankle doesn’t work, neither does the knee, or the hip or the lower back. But it doesn’t just stop there either, because if the lower back’s not working, it spreads up through the spine and end up in towards the neck and shoulder region.

If you think you’ve got some shoe or foot issues, go and get them seen too. For heaven’s sake, if you got some bad fitting shoes, bite the bullet, throw them out and buy a new pair.

JOSHUA HARPER:   Can you give us any exercises and stretches to improve the health of our feet, John?

JOHN PETROZZI:   Yeah, definitely, Josh. Firstly you should walk around barefoot as often as you can, and preferably on either carpet or grass, or even sand.

JOSHUA HARPER:   And why is that?

JOHN PETROZZI:   What that does is it helps to improve the proprioception, which is position sense of your foot. And it improves the elasticity of ligaments and it strengthens the muscles. That’s really important to walk around barefoot.

Other exercises you can do when you are in the office, you got the computer, or whatever: throw your shoes off, kick them off and just gently do some stretches with your toes. So, pushing the bottom of your toes into the floor, so your foot is being stretched open. What that does is it elongates the muscles and ligaments in the foot and helps to relax them as well.

Other things you can do is if you’re bored at night time and you want to strengthen your feet is just put some marbles or some pens, or something on the floor, and just start to grab them with your big toe and under your feet. Just transfer them around the room or around the floor. What that does is it helps to strengthen the base of the foot, which means if you got a strong foot, you have strong propulsion along with walk and also whenever you’re running. So it will make you run faster.

JOSHUA HARPER:   Anything else?

JOHN PETROZZI:   Yup! It’s important to keep the calf muscle stretched out, which is the back part of your leg. That’s the muscle that gets very, very tight with people who wear high heels. The best way to stretch that is to have a stand up, place your hands against the wall, stretch your legs up backwards behind you and push the weight through one leg, or actually down through one heel.

JOSHUA HARPER:   And keep your heel on the ground.

JOHN PETROZZI:   Keep your heel on the ground, yup. What that does is it stretches that calf muscle. Another stretch to do is standing on the step, put your heel or your toes on the step and drop the heel way off the step. Again, that stretches the calf muscle and also the Achilles tendon, which is the tendon that connects your calf muscle to your heel.

Other muscles to keep nice and supple are your hamstrings, which is the back part of the leg. The way to stretch your hamstring is to place your heel up onto a chair, keep your back straight and lean forward. You’ll feel a stretching pull sensation down the back part of your leg.

Another really important one to stretch is the quadriceps, which is the front part of your thigh. The way you do that is just to stand up—you can support yourself on the wall with one hand—grab, for instance, your right foot, grab that with your right hand and pull your leg backwards. You will feel a stretching sensation through the front part of the thigh. So that’s a couple of exercises to do.

JOSHUA HARPER:   What do these do?

JOHN PETROZZI:   What they do is to help to keep the elastic muscular structures of the leg supple and flexible, because as you know, your muscles become stiff, and over time, they become weak and less strong as well. So it’s important that your muscular system, particularly down to your lower limbs and feet, stays nice and supple, so that it keeps you healthy, and keep your joints healthy as well.

JOSHUA HARPER:   That’s all we have time for today. What’s the overall message you want our listeners to take home?

JOHN PETROZZI:   Well, I suppose, the number one message is select good shoes. Make sure that when you go to the shoe shop, ask a person there in the shop to help you select the best shoe that’s right for your foot. The second thing is limit the amount of time that you wear high heels to about 4 or 6 hours. Don’t use them too much. The third thing is exercise and stretch your feet as regularly as you can, throughout the day at the office or when you are at home. And the fourth thing is for heaven’s sake, tighten your shoe laces, because your feet will love you for it.

Well, what a great show. Thanks for joining us and you’re bound to have happy feet after that.

Thanks for joining us. You’ve been listening to Living is Easy with John and Josh. I’m John Petrozzi.

JOSH HARPER: And I’m Josh Harper.

JOHN PETROZZI: Until next time, stay well and stay happy.

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