Two Feet Under

The foot rules the shoe business. Shoes are made for feet. NO feet, no shoe business.

You’d think that with this so obvious, shoe people would be knowledgeable about feet. Yet, unfortunately, most shoe people are foot illiterate. And both the customer and the store pay a penality for that lack of foot knowledge.

So let’s get started on our foot lesson.

The foot has 26 bones. Yes? No. Most people say 26, but it’s actually 28. There are two tiny bones called sesamoids located under the big toe joint that usually don’t get counted with the rest. The sesamoid protect the large tendon passing between them to move the big toe.

Those 28 bones make up one of the most remarkable anatomical structures in nature. The seven big chunky bones in the rearfoot (called tarsal bones) are tightly compacted together because the rearfoot bears most of the body weight. The heel bone is the biggest bone of the foot. The midfoot consists of five long, thin metatarsal bones with air space between. This is the spring section of the foot that allows the foot to yield a bit on weight bearing and absorb shock.

There are 14 small toe bones – three tiny ones for each lesser toe and two larger ones for the big toe. Plus, of course, the two sesamoid bones. The toes are vital for grasping and giving the foot leverage and balance in walking.

Put that foot skeleton together and we have a masterwork of anatomical engineering. Each section has its own special bone design for its own special function.

This is an important discovery. It means that the foot doesn’t behave as a one-piece unit like a hoof, but rather with each of the three sections having a separate function distinct from the others.

These bones are joined by 37 joints. The joints are held together by 107 semi-elastic, criss-crossing ligaments that serve like hinges. When you stand or walk, the ligaments yield a bit, allowing the joints to open and absorb the weight and shock impact.

Fanning out over the sole, heel to ball, is a broad span of ligament-like tissue called the plantar fascia. Without it, the foot would collapse on standing or walking. It helps hold the foot together as a unit. It also serves as a cushion to protect the sole of the foot.

The foot has 19 muscles and tendons, 18 of which are attached to the toes – an indication of how important nature regards the toes in foot function. There are another 13 muscles and tendons that come down from the leg and attach to the foot.

If the toes are cramped by narrow or pointed-toe shoes, the tendons are diminished or shut off. That contributes to the weakening of the whole foot.

All those 32 muscles and tendons together give the foot all of its movements and strength – the ability to stand, walk, run, jump, dance, etc.

The single most powerful tendon is the achilles tendon, attaching the heel bone to the calf muscles. It is capable of lifting almost a ton of weight. If slashed, it would be crippling for life. If injured or overstrained, all foot activity is diminished.

The foot has four arches – two long ones on either border of the foot, the metatarsal arch under the ball, and the invisible transverse arch under and across the tarsal rearfoot. Only two are true arches: the transverse and the inner, long arch. They remain arched on weight bearing. The other two flatten on weight bearing and hence, aren’t true arches.

There is no normal height to the long main arch. It can be high, medium, low or flat and still be normal. A very high arch with a bump instep (called pes cavus) can be more vulnerable than a flat arch because it has more distance to fall.

The foot has a complex system of blood vessels and nerves, which give the foot its life – its sense of touch, its ability to maintain temperature, to give nutrition to foot tissues, and ignite the movement of the muscles and tendons.

The foot has two pulses, one on top of the foot and one in front of the achilles tendon. You can feel the pulses with your fingertip just like the pulse on your wrist.

The sole of the foot is covered with about 1,700 sensory nerve endings. These give the sense of touching the ground when standing or walking – the sensory response. They are all vital to the sensory contact with the physical world.

Shoe soles smother much of this sensory response. The difference is enormous. Shoe wearing people are denied much of this sensory exhilaration.

Each foot has about 1,500 tiny sweat ducts, tiny tubes leading out to the surface of the skin. They are the foot’s ventilation or air conditioning system. They give off and maintain foot temperature – which is why feet sweat more on humid days, or in unbreathable shoes.

Each day, an average pair of feet gives off a half-pint of foot moisture, almost two quarts a week. That’s why shoe breathability is so important.

The human foot is the most complex and remarkable in all nature. There is no other foot like it. It is the only foot with arches, a straight-ahead big toe, and a heel bone that touches the ground.

It’s tragic that it’s taken for granted. It shouldn’t be. On an average day, a 150-pound person will put almost 2,000 tons of cumulative weight on the feet. Over a lifetime, that’s more than 27 million tons.

If a foot is kept strong and healthy, it will fulfill these tasks and burdens. But most people are not good to their feet. Feet are constantly neglected and abused causing heavy penalties to be paid in both dollars and foot distress, most of it chronic and debilitating.

For example, Americans are spending $12 billion a year treating foot ills, plus another $14 billion for over the counter products. But somehow they forget to look at their shoes as the culprit to their foot woes. This is a total of 26 billion and increasing.

An estimated 80 percent of foot troubles and their heavy costs are shoe caused or shoe related.

As estimated by studies of millions of people around the world who never wear shoes, the foot ills is about 2 percent compared to 70 percent among shoe wearing societies. Foot strength of shoe wearing people averages 40 to 50 below that on shoe-less people.

Foot defects and weakening begin at age three and progressively increases. Starting at age six, it is impossible to find five straight toes on shoe wearing children.

Keep in mind that 18 of the foot’s 19 muscles and tendons are attached to the toes. When those are weakened, the whole foot weakens

Clearly foot health and shoes are closely linked. This is why a thorough understanding and appreciation of the foot is so important. Respect the foot/shoe relationship and the incidence of foot disorders is improved.

In fact, no shoe person, designer, manufacture, retail salesperson, fitter, etc. –can do justice to his or her occupation without a reasonable degree of foot knowledge.

By William Rossi, D.P.M.
(author and editor of two footwear publications and marketing counselor to the footwear industry)