McKeithan Pain Treatment Center
Winston-Salem, North Carolina
(336) 761-0501

Effective Alternative Therapies


Surprise!  Plantar Fasciitis Isn't Prevented by Arch Supports, Springs or Cushions --
--Nor Is Back Pain

So you run or play tennis, or golf, or racquetball, and you suffer from plantar fasciitis, shin splints, knee pain, hip problems or even lower back pain.  Please, just for now, lay aside all you've been taught (that is, told,  over and over, by every type of advertising medium there is, about feet and shoes -- especially athletic shoes.  Consider your feet -- both their design and function -- in the light of what follows, then assess your  foot gear for your body's long-term sustainability.

Your foot, as it has evolved over millennia, is a masterpiece of engineering design.  Fascia (connects and communicates), muscles (power), tendons (morph from muscle/fascia into attachment tissue), ligaments (hold bones together), bones (serve as fulcra, like the bars under see-saws, over which muscles move, multiplying and directing their power), nerves (electricity that powers the muscles), blood (nourishes each of thousands of cells) and lymph (lubricates and cleans soft tissue) -- they're all in there, in the foot.  They're all directed by the Will in conjunction with the fascial network to take you where you want to go.

Built into that foot is an arch, one which is supported by many muscles, a couple of the more important ones being the peroneus and tibialis, which attach on the inside (medial) and outside (lateral) of the foot.  Now, in a nod to accuracy, there are more than one of each of these and there are 100+ muscles in the foot, but this isn't an anatomy lesson, there'll be no test.  It just helps to follow this explanation if you have a couple of names to peg it to and these fill the bill.  The salient point here is that the arch is a marvelous device that stores and multiplies energy.

How's that work?  Well,  when you step down, the arch collapses, which pulls downward (toward earth) on the tibialis and peroneus -- very much like extending a coiled spring.  As your body shifts forward, which is the function of a whole bunch of muscles in the leg, pelvis, and yes, lumbar spine and core, the foot moves onto its toes, the weight shifts to your other foot, the peroneus and tibialis contract, re-arching the foot and the cycle begins again.  Forward momentum facilitates the process. Energy from the retraction of the arch is essentially stored by the peroneus and tibialis, adding to the metabolic energy produced by body processes.  This is why, when you watch a runner that actually lands on the balls of his or her feet, instead of on the heel, you can actually see the runner gaining energy from the foot strike, as though the earth were pushing back.  There's a resilience present that's not possible with the heel strike.  It's a glorious thing to watch.

Use It or Lose It

It's possible to defeat that amazing design, though.  Just add arch supports, so you train the arch-powering muscles not to operate, or to operate far less effectively.   Let yourself be persuaded that a long stride, with a heel strike as the only possible landing, is superior, faster, better.  Then buy shoes to support that heel strike, run, walk, play or stand in them awhile, and voilą, muscles atrophy, arches flatten, muscles of the knees over-extend and remain painfully that way, pelvis tilts, which pinches lumbar vertebrae and nerves, back pain emerges.  Trips to doctor, podiatrist, trainer, chiropractor.  "Oh, your arch has collapsed.  You need arch supports!"  Yeah, well, maybe.  But it doesn't really look that way, does it?

Turns out I'm not the only person that feels this way.   In his book , "Born to Run" (Alfred A. Knopf, NY,2010), Christopher McDougall shares his experiences in the long search for pain-freedom through various medical practitioners' offices and into the Copper Canyons of Mexico, a wild, desolate wilderness hiding the greatest runners of all time, the Tarahumara Indians -- a people who run barefoot or with tire-tread sandals, races of 50 or more miles.

This non-fiction book is passionate, shocking, heart-breaking and warmingly, thrillingly joyful -- well worth the read by anyone who is both interested in good health and loves a great story.  Here's a sample shocker, a quote from Dr. Daniel Lieberman, professor of biological anthropology at Harvard University:

A lot of foot and knee injuries that are currently plaguing us are actually caused by people running with shoes that actually make our feet weak, cause us to over-pronate, give us knee problems.  Until 1972, when the modern athletic shoe was invented by Nike, people ran in very thin-soled shoes, had strong feet, and had much lower incidence of knee injuries. (p. 168, italics mine).

For a second example, and there are many, he quotes from a study by Dr. Craig Richards, a University of New Castle (Australia) researcher, reported in the British Journal of Sports Medicine, stating that " ..there  are "no evidence-based studies that demonstrate that running shoes make anyone less prone to injury." (p.171, italics mine). That's the kind of shoes that most of the population -- every man, woman and child in the United States, and probably you -- wears, day in and day out, unless their work or school code requires otherwise.  If you want study this more thoroughly, you can start with Richards' abstract at (copy the link into your browser).

There's lots more of this quality of information, including a fascinating examination of the health and endurance of the Tarahumara, a people who are joyful and alive because they run, and they live their lives largely without the impediment of shoes.

In the end, the conclusion is inescapable, and I endorse it.  Never mind the gel pads, anti-pronation devices, shock-absorbing heels, etc. etc.  It's all hype.  To eliminate a primary cause of pain and fatigue  in your body, no matter whether they're Nike, Asic, New Balance, Reebok or some other brand, LOSE YOUR RUNNING SHOES.  Of course, you will want to start slowly -- not a good idea to demand strength and resilience from long-neglected muscles.  Start slowly.  Walk in your bare feet. Learn the arch and foot strengthening exercises that are necessary to strengthen your legs and feet, then practice them.

If you're already experiencing foot, ankle, knee or back pain and the information in this article rings a bell with you,  give us a call.  We can open a door for you to step through to pain-free running and walking.  Here's to happy feet!


Kent McKeithan
McKeithan Pain Treatment Center
Winston-Salem, NC

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