Special section: Feet
How your feet work — and three steps for keeping them healthy
Standing and walking on two legs has many advantages over
depending on four, six, or even eight, but it does mean we ask a
lot of our poor two feet. They need to provide a steady base for
the rest of the body to perch upon. They serve as shock absorbers
as we walk, smoothing out the impact of landing with a force that
exceeds our body weight. Run, and there’s even more force and a
need for cushioning. They act as levers that propel us forward —
and occasionally in other directions.
An engineering feat
Tall orders for two low-level body parts? Most of the time, our
feet are up to the job because of some rather amazing anatomy and
Each of them has 26 bones, one less than in our hands. The
phalanges form the bendable (and breakable) toes. The calcaneus
(pronounced kal-KAY-nee-us) makes up the heel. In between are the
slender metatarsals and the blocky tarsal bones, which could be
the work of a master mason the way they’re ingeniously put
together into an arch.
Over 100 different ligaments are needed to lash together this
elaborate bonework and its 30-odd joints. The scores of muscles
and tendons that orchestrate the foot’s movement are divided into
two groups, extrinsic and intrinsic. The extrinsic muscles and
tendons start in the lower leg and wrap around the ankle in
various ways before attaching to some part of the foot. They form
a kind of sock, constructed out of crisscrossing straps of muscle
and tendon tissue, which joins the leg to the foot and enables
the foot to move in several directions. The intrinsic muscles
start and end in the foot. Most of them are arranged in several
layers across the sole of the foot so they help form its
graceful, lengthwise arch.
All of this intricate architecture comes into play every time we
take a step. In a normal, healthy gait, the heel hits the ground
first. The calcaneus and a layer of fatty tissue underneath it
absorb some of the impact. As the foot rolls forward on its
outside edge, the intrinsic muscles of the sole of the foot give
way a little and a band of tissue along the bottom of the foot,
called the plantar fascia, stretches out. Then the weight moves
to the ball of the foot and over the joints formed by the
metatarsals and the first, or proximal, phalanges. Finally, we
get leverage by pushing off on our big toes, while the Achilles’
tendon lifts our hee
Lucky for us, this happens without our having to think about it
So what could go wrong? Plenty. Some people are born with
irregularities like clubfoot (talipes equinovarus) or very high
arches (pes cavus). In many cases, those problems can be
corrected with surgery, particularly in young children.
There’s another, larger group of us who have relatively minor
defects. Age, weight, and time spent on our feet turn them into
something more serious.
For example, 20% of adults have flexible flat feet — their arches
flatten out when they put weight on them but keep their shape
when they don’t. Usually, flexible flat feet are more of a
curiosity than anything else, but the age-weight-use triad can
turn them into troublemakers for muscles and other tissues in the
feet. The fix is sometimes easy: comfortable shoes with a good
arch — the beginning of wisdom for much that ails the feet — or
perhaps a pair of orthotics, replacement insoles that go inside
the shoe to support the arch and provide some extra padding.
Another example is overpronation — the tendency to walk or run
along the inside part of the foot. Many people overpronate, and
neither they nor their feet are any worse off for it. But other
overpronators wind up hobbled by sore knees and ankles, fallen
arches, and inflamed, overtaxed foot tissues. The opposite
problem, oversupination, or walking on the outside edge of the
foot, is less common but can run a similar course.
Then there are the foot problems we bring upon ourselves by the
shoe choices we make. Hammertoes and bunions are often a
consequence of continually jamming five toes into narrow shoes.
High heels are murder on the metatarsals and no kinder to the
Even when we buy sensible shoes — a category that includes
athletic shoes and casual dress shoes like Rockports — we make
mistakes that our feet wind up paying for. We buy shoes that are
too small, not realizing that as we age, our feet tend to grow by
half a size or more because the ligaments and tendons stretch
out. Even if the shoes are the right size, we often wear them too
long, so the sole that helps with shock absorption is worn away
and the heel counter that holds the back of the foot in place is
swayed to one side.
So here’s step one to having healthier feet: buy
shoes that fit well with low heels and plenty of room for your
toes — and replace them regularly. An obvious point? Maybe. But
it’s often not acted upon.
Step two: stay trim, and if you haven’t, work on
losing some weight. Your feet won’t be the only body part to
And step three: take your feet for a walk. The
heel-to-toe motion strengthens and stretches your feet. See step
one if your shoes are old and worn.
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