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The answers to Pain are often in the FEET.

By August 31, 2018 5 Comments


As a licensed massage therapist (and NCBTMB Board-Certified), you can imagine how many feet I’ve seen since training that started in 1998.  From infants, to people in their late 90’s.   Pregnancy and Post-pregancy feet.  Plantar Fasciitis feet.  Runners’  and other athletes’ feet.    Dancers’ feet are in another realm altogether , especially if they worked professionally.  (On a related tangent, I’ve also seen professional acrobat feet — torn tendons and walking in with an ice bag attached to the injury, yet this person was scheduled to be on stage in a few hours — why why why?)  I’ve also seen plenty of toes:  Toes that were crossing over one another, hammer toes, broken toes, and bunions.

You might be surprised to know that I pay special attention to feet also in my exercise practice which is based in  Pilates and Osteopathic Sciences .   How are you using your feet?  What information do I see just by looking at them?  A lot, actually.


You might be further suprised that a lot of your aches and pains can be traced to the feet — that back problem for example could have an origin other than your back, or at least some coexisting issues.   And you’ll see what I mean when it comes to high heels .


While some health professionals use orthotics and inserts to address those imbalances and aches/pains, there’s a lot of dissension in the health care community, as to whether they help or perhaps do harm, by blocking functional movement.     I recall  my Physiotherapist and Teacher, Anne Dawson , remarking in 2008 that there were a lot of differing opinions  in her field.  Other healthcare professionals have voiced concerns that   “Many orthotics are poorly made and for the wrong reasons.”

Running is a hot-topic regarding orthotics and footwear in general.  Author Christopher McDougall’s book Born to Run discussed whether barefoot running was better than wearing shoes and provided some thought-provoking content.  He questioned why there were more problems with feet if our running shoes and all those inserts were so good.

I’m not telling you whether or not to get orthotics.  I’m just saying to get as much information as possible before making that decision, and it really helps to go to a qualified health professional.   At age 13 I got specially fitted by a Sports Medicine Doctor (just for running) and wore the athletic shoes that were recommended.   I also had great high school coaches.  I did feel that all of this helped me be able to run for another two decades.  Eventually I put running aside as a regular sport and gravitated towards Yoga and Pilates.  And so glad for the journey.  But now I’m itching to get back into running.  And what I see with running shoes so far has me scratching my head.  So much has changed in 18 years.


Once I started learning Osteopathic Sciences through Eric Franklin , I became convinced that certain specific practices, such as adding a “lift” in one shoe to address uneven legs from Scoliosis  did not solve the problem, and created more dysfunction.  That also led me to realize that some of the modified-Pilates approaches to Scoliosis that I’ve seen and experienced were similarly questionable — such as changing the equipment to add a “lift” to one foot.  You don’t actually even out the legs by doing that.  And you can end up causing even more dysfunction.


Sure, it’s pretty plain to see that feet provide balance and locomotion .  But there’s so much more to say.    Healthy functioning feet will provide “spring-loaded”  cushioning from the forces of gravity  .  Healthy feet will be able to disburse those forces of gravity, and create elastic rebound .    So, we can stand, walk, jump, run, engage in our favorite sports with less chance of injury, and the likelihood of enjoying it much longer.  With better-trained feet, your overall posture improves, too. 

Taking care of your feet is anti-aging, preventive healthcare.

Less then ideal feet will compel the rest of the body to compensate.  We take on a lot of extra force into all of our joints.  All of them.  If you want a physical demonstration in person, I often show people this by doing a proper jump/landing and an improper one.  Even though I’m doing the jumping, you can feel the force through the floor and into your own body.

Have you noticed how people tend to walk when they need to be in walkers?  Often shuffling the feet.  Better trained feet can help with that.

Have you noticed too, that when people get older, they start getting concerned about falling down a lot.  Better trained feet can help with that, as well.

Did you realize that your knee problem, back problem, hip problem will also be reflected in your feet?  As you guessed, better trained feet can help with that, too.

What do healthy feet need?

1).  Strong, flexible arches (yes I said arches because there is more than one arch in the foot.  Come see me to learn more about this).

2).  Good stability in the ankles.

3)  These arches and ankles require strong and flexible muscles, particularly in the foot and lower leg.


Our feet sure take on a lot of abuse.  Especially with women, and I’ve certainly been guilty…

We often put our feet in ill-fitting shoes.  Sometimes this is by choice ( ugh, those cute, cute, high heels — look what they do our posture and our bodies in gravity ).  No, I’m not done showing you things that can happen from chronic high heels — we also increase the chances of knee and low back problems .   My teacher Eric Franklin famously said in 2011 during class, that high heels place 2,000 pounds of pressure on the knee joint.

Sometimes, people had to make do growing up, and the shoes didn’t fit.  It happens, and there’s no blaming here.  Anyway this is the most extreme case I’ve experienced:  I once agreed to see a walk-in client who talked to a different teacher, and she arranged the schedule.  I was only informed that the client walked with a cane and wanted to do Pilates.  When this person slowly shuffled in I asked for the shoes to be removed.  That’s when I noticed the foot inside of the sock — it looked like a big ball.  So I asked if I could take a closer look.  Ohhhhh goodness… the big toe was literally wrapped up and across the top of the foot.   And some of the smaller toes were wrapped under the foot.  It almost looked like foot-binding.   I asked if perhaps the feet were in really small shoes as a child during the War in their home country, and the answer was yes.

It was such a complicated case.   This person could not even stand up in bare feet without the cane.  Because the client had already prepaid and insisted on some kind of service instead of getting a refund, I studied all the ways that the body was moving while on the professional Pilates equipment with very light springs, and with very light tension bands; and also used my massage therapy background to palpate muscles, joints, and especially the feet.   And with that, I compiled some personal notes and recommended going to a qualified Physician to get a proper Diagnosis, and to also receive some guidance on whether Physical Therapy was possible.  (It’s a bit of a process to get a prescription for Physical Therapy and for Insurance to cover it, but I worked alongside a number of terrific PTs, so I was hoping to provide referrals to them).

There is often still a way to improve those feet.

One thing that really made me jump for joy (literally and figuratively) has been Graston Technique®, and I am a Provider.  I sought out the training after six sessions resolved my own case of Plantar Fasciitis which thankfully only bothered me for a few short weeks in 2015.

And as well, I spend a lot of time with Pilates and Franklin Method® clients working on the feet.  All those muscles in the foot and lower leg are vastly under-appreciated.

Would you like more information on how to improve your feet — and by doing so, improving your entire body?  Let’s connect.

Malama Pono,

Lahela Hekekia

PMA and STOTT PILATES® Certified Pilates Teacher

Franklin Method® Level 3 Certified Movement Educator

LMT (MAT#6286) and Board Certified (NCBTMB#307766-00)

Graston Technique® Provider

Lahela Hekekia

Author Lahela Hekekia

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