Screen shot 2013-10-05 at 5.23.33 PMby Jim Hixson.

If you have plantar fasciitis and have been told by a doctor to wear a stability shoe, orthotics, and never go barefoot, do yourself a favor and immediately switch to another doctor, preferably one who has read about how the foot functions, and not just knows all the names of the bones, tendons, muscles, and ligaments.

I speak from experience, since I was given this advice by a well-meaning podiatrist when I had plantar fasciitis over a decade ago. After he finished telling me of the dire consequences which would affect my feet if they were not externally stabilized, I asked him how long I would have to follow his program. His answer was simple: for ever!

I wisely didn’t follow his instructions, but I did do a little research about feet and the maladies which affect them, and then I did some more fact-finding, and I never really stopped my quest because what I discovered was fascinating: barefoot populations do not have the foot problems that afflict people who wear supportive shoes. In fact, the characteristics of traditional shoes are often the most harmful, but which sound the most positive and comforting: supportive, stable, and cushioned.  These features areactually the ones that are the worst for the strength and health of your feet.

So much of what I was reading was different from what I had been taught that I had to suspend my previous beliefs about shoes. So, although I knew that weak feet were obviously more prone to dysfunction, I initially found it difficult that high-quality shoes could be the major cause of this weakness. If I had been more systematic in my thinking I would have realized that injuries associated with running had not decreased, despite all the the technological advances advertised by the major shoe companies.

One of the most common foot problems, both for runners and the general population, is plantar fasciitis a (de)condition that seems to have reached almost epidemic proportions, since it eventually affects one out of ten U.S. residents. Among certain populations, including runners, those who stand for long periods of time, the overweight, and sedentary, the rates are much higher.

Eventually I found the evidence overwhelming and was willing to enter a finding for the prosecution: traditional shoes are the major source of maladies affecting the foot and a significant contributing cause of other structural problems further up the chain of movement. I was now able to ask one major question and give a simple and accurate answer. But before we get there, let’s go into some detail about the exact nature of plantar facsiitis.

The plantar fascia is a broad band of connective tissue stretching from the front of the bottom of the calcaneus (heel) to the phalanges (toes).  Its purpose is to transmit stress through the foot by acting as a truss to help support the weight of the body when standing and to stabilize the foot and improve its function as a lever as part of the windlass mechanism while walking, running, and jumping.

Plantar fasciitis (PF) is an inflammation of the plantar fascia caused by excessive stress.  The major symptom is pain of varying intensities near the origin of the tissue, right where it attaches to the calcaneus. The dysfunction or excessive stress is caused by the foot being forced to operate in an unnatural way and without the full muscular capacity that is often caused by the construction of traditional (rigid, heeled) shoes, both running and casual.  A shoe with a difference between the height of the heel and forefoot immediately places the foot in a weaker mechanical position by shortening the effective length of the plantar fascia and the Achilles tendon which, in turn, forces both to become overworked.  Depending upon the frequency, duration, and intensity of the exercise, the plantar fascia can become inflamed.

Q. What can you do to maintain or retain healthy feet and avoid plantar fasciitis?

A. Be barefoot or wear minimal shoes for as many activities as possible.

Just like minimal running shoes minimal casual shoes should fit the anatomy and function of your feet. With no restriction of its natural range of motion, the foot is able to maintain its strength, balance, flexibility, and responsiveness. The truth is, theoretically we should always be barefoot, but in today’s world that is not always possible of feasible. Fortunately, by wearing minimal shoes, almost all of the advantages of being barefoot are preserved.

a1c32448a85b93c62ac6b6f94c566909Several companies (Vibram FiveFingers, Merrell, Altra, Skora, Xero Shoes) make excellent minimal running and athletic shoes, but there are relatively few companies that make true zero-drop minimal casual shoes. In addition to Merrell, two footwear brands excel: The first is Vivo Barefoot. This company, which is part of a larger U.K.-based corporation, Terra Plana, makes approximately ten models of minimal casual shoes, half for men and half for women. Some have laces and others are slip-on models, but all are lightweight, flexible, and very comfortable. The other is a fairly new U.S.-based company called Lems, and their zero-drop casual shoes have ample-sized area for your entire foot.

Each step you take with a minimal shoe, no matter what the activity, allows you to strengthen your feet and reinforce proper patterns of movement

This essay originally appeared here: