I have a confession to make. I was born with extremely high arches and an obscene love of boots in all their variations. Although my feet don’t quite meet the standards for Pes Cavus (who’s literal translation is “hollow foot”), the footprint I leave behind, were I to stand on a piece of paper with a wet foot, is pretty close. The ball of my foot and my heel can be plainly seen, but there is only a thin line in the print from the outer side of my foot (lateral aspect) connecting the two. The opposite foot structure from mine is a completely flat foot.
I could tell you how to properly trim almost any animal’s hooves, the importance of properly fitting shoes on a horse, how to treat thrush, how to prevent and treat hutch burn in rabbits, and even how to treat bumblefoot in chickens. But until a few years ago, when I was diagnosed with severe, chronic plantar fasciitis, I didn’t know a thing about my own feet, nor did I appreciate the importance of their care. Whether you’re farming or concerned about winter wilderness survival taking care of your feet should be one of your top priorities.
Foot Injuries vs Foot Conditions/Diseases
A foot injury is pretty self-explanatory. Something acute has happened- you’ve stepped on a sharp object, developed a wickedly painful blister, or broken a bone. Foot conditions, on the other hand, are usually things you’re born with that may or may not have any effect for some time. The problem is, it’s a cumulative effect, so addressing the underlying condition and caring for it properly before an issue arises, is much more affective than trying to resolve it after the fact.
As the saying goes, an ounce of prevention is worth a pound of cure, and this is certainly the case in foot problems. There’s a myriad of conditions and diseases than can affect the foot, but for this discussion, I’m going to focus on the ones most often encountered by “blue collar feet”: plantar fasciitis, sesamoid injuries, and their treatments.
Plantar Fasciitis and Heel Pain
As it progresses and is left untreated, the heel also becomes very painful after exertion. If you ignore these early warning signs, as I did, the pain can spread across the bottom of your foot from your heel to the ball of your foot, is constant, and is so painful that bearing any weight on your feet becomes impossible. It can affect one or both feet.
What is Plantar Fasciitis?
Plantar fasciitis is literally the inflammation and irritation of the plantar fascia, the strong band of tissue that supports the arch of your foot. To picture where this strong band of tissue is, imagine your bare foot print. The band looks something like a tree with the bottom of the trunk starting at the back of your heel print (called “the insertion point”), the trunk of the tree running up your arch, and the branches spreading out across the ball of your foot to each toe. Unlike other connective tissues in your body, the plantar fascia doesn’t stretch. Instead, it’s designed to absorb the high strains and stresses we place on our feet, but if too much stress is placed on it, it tears the tissue which causes stiffness and inflammation. Dr. Julia Overstreet, a podiatrist, high-risk foot and lower extremity specialist, has a very good video on the subject here.
Mild plantar fasciitis can be treated much like any other sprain or strain: over the counter (OTC) non-steroidal anti-inflammatory drugs (NSAIDS), an ice pack, and rest. Many doctors recommend stretching the affected area by doing a calf stretch and plantar fascia stretch.
- Calf stretch – Lean forward against a wall with one knee straight and the heel on the ground. Place the other leg in front, with the knee bent. To stretch the calf muscles and the heel cord, push your hips toward the wall in a controlled fashion. Hold the position for 10 seconds and relax. Repeat this exercise 20 times for each foot. A strong pull in the calf should be felt during the stretch.
- Plantar fascia stretch – This stretch is performed in the seated position. Cross your affected foot over the knee of your other leg. Grasp the toes of your painful foot and slowly pull them toward you in a controlled fashion. If it is difficult to reach your foot, wrap a towel around your big toe to help pull your toes toward you. Place your other hand along the plantar fascia. The fascia should feel like a tight band along the bottom of your foot when stretched. Hold the stretch for 10 seconds. Repeat it 20 times for each foot. This exercise is best done in the morning before standing or walking. (Source)
However, I completely agree with Dr. Overstreet that these exercises have little to no affect. The fascia doesn’t stretch, so you’re really just stretching the tissues surrounding them. This might work for very mild cases of plantar fasciitis, but it doesn’t work once you’ve allowed it to go beyond that.
Plantar fasciitis is a mechanical issue and as such should be treated with devices that help support the mechanics of your foot. That means finding an arch support that will fit your arch and keep it from being stressed. Low dye taping is an economical short-term treatment that can get you back on your feet long enough to get out of an emergency situation or to offer relief until you can see a podiatrist. Dr. David Hughes, podiatrist with The San Antonio Orthopaedic Group, has an excellent video on how to properly tape a foot in the low dye method for plantar fasciitis relief here.
A more permanent solution is to get a pair of OTC orthotics. Many think that the massaging gel foot inserts that you find at the pharmacy will help, but they won’t. Instead, go to a sports shoe store or a podiatrists office (you don’t need an appointment- many of them carry high-quality orthotics that they sell over the counter) and get your feet fitted for orthotics. Why get fitted? Because everyone’s feet are different, each arch is different, and the point is to get an orthotic that closely matches the arch of your foot to give it maximum support. You’re looking for something like this.
Examine Your Footwear
Now is a good time to examine your footwear, too. Shoes, like tires on your car, have a mileage life. Shoes will usually last about 300 miles. It doesn’t matter how pretty they still look on the outside- after 300 miles, the inner structure starts breaking down and will no longer support your feet. For maximum support, choose lace-up shoes. Slip-on shoes won’t hug your feet well enough to keep the arch support snug against your arch. There’s a reason the military provides all their soldiers with lace-up boots! This video gives you a good overview on how to evaluate the quality of the construction of a shoe or boot.
I love the convenience of my slip-on muck boots, but they had to go. My beautiful cowboy boots are now reserved for nights out on the town. Flip-flops and stilettos? Fuggedaboutit! You’ll probably need to remove the insole that came with your shoes. Most of them now have their own support and it will interfere with the custom fit of your new orthotic. Trying to put the orthotic in while the old insole is still in place will also make your shoes too small. If you find that your lace-up boots are too tight even after removing the old insole and replacing it with the new orthotic, you can try lacing them differently for a more comfortable fit. A video on alternative lacing methods can be found here.
This is another common injury of “blue collar feet” that take a pounding. Most joint bones connect to each other, but some do not, like your knee cap. The sesamoid bone in your foot is like the knee cap of your big toe. It’s in the underside of your foot where the big toe connects to your foot. Bruising of the sesamoid in your foot is more common (I’m looking at you, stiletto pumps!), but sesamoiditis (inflammation of the tendons surrounding the sesamoids) happens over time with repeated stress. Ironically, it was the quality boots and the custom-fit orthotics that made me more susceptible to sesamoiditis (through no fault of either device).
I took advantage of the increased support and felt indestructible. I was jumping off of things and sitting in bent-knees, toes-flexed-backwards position for long lengths of time. By the end of the day, it felt like a fire had been lit at the base of my big toe and stretching it backwards, even a little, was very painful.
If I had fractured the sesamoid, the pain would have been immediate. Fortunately, the treatment for sesamoiditis and fracture is the same- first, stop doing whatever it is that made it hurt. Next, use NSAIDS, rest, and ice the area to bring the inflammation down. Taping the big toe so that it remains slightly bent down or wearing a soft J-shaped pad to cushion it can sometimes offer relief (but really, you should just stay off of it). If the symptoms persist, you may need to wear a short leg fracture brace for four to six weeks to let the fracture heal.
Whether you’re thinking about preps for your bug-out or your feet are putting in a hard day’s work, having the proper support for them and quality footwear is a must. Shoes wear out after about 300 miles and foot problems can stop you in your tracks. Knowing what to look for in the construction of quality footwear and how to take care of the unique structure of your feet will insure you remain mobile in emergency situations or can keep you earning a living. As Leonardo da Vinci said, “The human foot is a masterpiece of engineering and a work of art”. Stay tuned!