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To Arch Support or Not to Arch Support

8/27/2018

In recent years, I've begun teaching more and more about foot health and the problems of most shoes we wear. One of the most common topics of concern is arch support. Whether it's flat feet, high arches, plantar fasciitis, or some other foot malady, "good arch support" seems to be the answer. But what if it's not?

Don't get me wrong, arch supports may be absolutely necessary in your world right now, but they most likely aren't necessary for the long term.

[Note from The Management: I am NOT advocating throwing away your supportive shoes and custom orthotics. Read on for my complete thoughts on the matter.]

If you break your foot, you will likely have it put in a cast. The cast is there to keep your foot immobilized while the bones heal. When your foot has healed and the cast is removed, your foot will be weak, the muscles atrophied, the joints stiff. Do you therefore put your foot back in a cast because it's weak and stiff? Of course not. You start physical therapy and work to restore mobility and strength to your foot.

Plantar fasciitis, collapsed arches, high arches and the like are certainly not a broken foot, but they can cause considerable pain and they most certainly are accompanied by weak muscles and tight joints. (Just a reminder, there are 33 joints in each foot. THIRTY-THREE! And they need to function fro your feet to be healthy.) Your orthopedist may well recommend "good," stiff, supportive shoes while you are in acute pain. You may be given arch supports to put in your current shoes. Either way, you are putting your foot in a cast. Arch support may not look like the cast you have for a broken foot, but it does the same thing. It splints your foot so the joints and muscles can't move fully while the inflammation goes down and the pain lessens. But once the pain has receded, do you really need to use them for the rest of your life? That is the common answer most orthopedists give: wear these forever; never go barefoot again; never buy shoes without good, solid arch support.

Why?

Why do we readily work to regain strength and mobility after wearing a plaster cast or boot, but we don't even consider physical therapy after wearing orthotics or stiff shoes?

(I don't have an answer to that question. I'd love to discuss it with some orthopedists some time.)

Having worked with numerous students and clients over the years, I have watched as feet become stronger doing simple restorative work on a daily basis. I do NOT tell those students to get rid of their arch supports (supportive shoes or orthotics). What happens instead is that over many months of foot restorative work, my students start to notice that the stiff shoes, the external support starts to interfere with the function of the feet. They start to wear the orthotics less or rediscover shoes with less support.

This does not happen quickly.

Let me repeat that: THIS DOES NOT HAPPEN QUICKLY.

I used to wear Converse a lot in my 20s. In my 30s, I started buying "good supportive shoes" and wearing them more often. I gradually found I couldn't wear the Converse anymore without my feet hurting. I thought this was a natural part of aging, needing better support in my shoes. But it was actually the stiff, supportive shoes that were causing the problem. As my feet no longer had to work to support themselves, they stopped being able to.

Two years ago, shortly before I turned 50, I started doing truly restorative work for my feet, their joints, muscles, arches. After about six months, I was back in Converse and could walk several miles in them with no problem. Six months of daily work on feet that weren't in any kind of daily pain, though I did have the occasional bout of plantar fasciitis. Six months for feet that are not in shoes when I teach or when I'm at home. Six months from a pretty strong starting point. Six. Months.

If your starting point is always wearing shoes, always wearing orthotics, already in pain, think well beyond six months. You are looking at a year or more, at a MINIMUM. Wear the orthotics. Wear the shoes you have. But if you really want healthier feet, you need to work to make them stronger and more mobile. You need to do the work BEFORE you change the external support, and for as long as you intend to have healthy feet.

I did a whole series of videos about a year ago called Sit Less Move More Foot Week. (I've linked to the first video in the series. There are four in total.) They are a good resource for general restorative work you can do for your feet. They are also a good source of info about shoes and some of the problems with what we think of as good shoes. If you're truly serious about your foot health (which directly leads to overall health), I'd love to meet with you, in person or online, to help you create a practice for your particular foot issues.

So ... do you need arch supports? If you're using them currently, yes, stick with them. But consider that with better function of your feet, you might not need them forever. Start where you are. Begin to move your feet more as you are able. And in time, those feet will move more for you.

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Guest blogging

3/13/2014

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A few weeks back, I responded to a blog about "three exercises to do for back pain relief." There was no information about what kind of back pain would be helped by these exercises. As I read it, it was also clear that some back pain might even be aggravated by this work. So I commented saying as much.

Next thing I knew, I'd been invited to be a guest blogger. My piece was published today by Dr. Stefano Sinicropi, MD, and you can link to it here.

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Pleasing the Teacher (or, It hurts, but I'm okay)

2/11/2014

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Students in yoga classes generally want to succeed. They want to try and do what is being taught. And culturally, we accept that in a group setting, we should do what the group does. But sometimes, trying to do what the group does is not in the best interest of the student or the teacher. Recently, I have discovered folks were holding poses that caused them great discomfort. This is a safety issue that frequently stems from trying to be a good student.

If you are that "good student," if you really want to please the teacher, here are a few thoughts. (Caveat: My Eischens Yoga classes often appeal to those with injury or limitations. I also encourage an informal environment in my classes. Some of the opinions presented here might not be pleasing to a teacher of another kind of class.)

Ways to Please the Teacher Before Class

Tell the instructor about injuries (old and new) that are relevant to your range of motion, level of pain. Yes, the instructor should check in with you, but sometimes that doesn't happen for a variety of reasons.
Do not keep your injury information to yourself because you "can take care of yourself." When I see someone doing something different than what I've said, I will check in to make sure everything is all right. Sometimes that is the first time I learn they've had knee surgery, or chronic neck pain. Guess what? Knowing about that might help me offer a better modification. Or I might be able to use that information to observe where old habits are pulling you into a rotation or collapse that might re-injure the area. Not every yoga instructor can do that, but some of us are really good at it. By "taking care of yourself" and not sharing valuable information, you could miss out on moving into a new, more healthful practice.
Find out how the instructor wants to handle questions. Some instructors are trying to create a mind-space that is meditative. Stopping for questions as they arise might be disruptive in that class. My classes are about creating body, energy, and breath awareness. I don't mind a question stemming from new awareness of movement patterns or discomfort as it occurs. Keeping a yoga journal of observations and questions can be another way to address this. Again, find out in advance, whether stopping to make a note is acceptable during class, or if there is time after class to jot down thoughts while they're still fresh. Instructors will have differing opinions about this.

Ways to Please the Teacher During Class

Know the difference between working hard and feeling discomfort. When you wake up new muscles, they might get sore or tired. But when muscles are pulling so tight that you feel they might tear, when a joint has uncomfortable pressure, those are signs you may be headed for trouble.
Get out of a pose if it hurts. Any sign of pain should be listened to: that twinge in the knee when you bend it; feeling anxious, agitated, depressed or angry when you are in a certain pose; not being able to breathe fully; and most certainly anything that makes you say, "Ouch!"
Get out of a modification if it hurts. (This was already covered in the last item because a modification IS a pose, but I'm saying it anyway.) I hear tales of Child's Pose being offered as the go-to pose when you need to come out of the pose the class is doing. I have also met many an individual who cannot breathe comfortably in Child's Pose, or feel pain in their knees, hips, or ankles when folded up that way. Personally, I had an SI injury some years ago. Child's Pose was about the worst place I could go because it stretched already over-stretched ligaments. I couldn't walk after 30 seconds of that pose.
When you have to get out of a pose, find a pose that you CAN be in. if you don't know what else to do, stand in Tadasana, or sit with the wall supporting your back, or lie down. And breathe. And when the instructor comes over, let them help you figure out how to handle whatever just occurred. It isn't an imposition. Really. It's our job.

Ways to Please the Teacher After Class

Let the instructor know if anything feels worse OR better after class. This is how those of us who work with injury learn how to help others. Knowing what helps one student with a frozen shoulder gives me more options for the next person with that issue. Knowing what causes increased tension and/or pain teaches me even more.

So the next time, you are in class and you think you shouldn't be in a particular pose, stop doing it. Ask questions. Get help. Find other better ways to work. If a teacher doesn't respect you respecting your limits, find one who does. The annoyed teacher will probably be happy to not have you in class; the teacher who knows how to work with your issues will be glad to have you; and you will happily find your way to better health and self-care.

Your yoga is supposed to be YOUR yoga. So always, always remember, do as the teacher says ... except when you don't.

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