While foot structure and chiropractic have been interlinked for decades, the typical chiropractic approach has been to recommend custom orthotics in an attempt to correct imbalances in the feet and ankles, thereby correcting imbalances in the hips and pelvis leading to a more stabilized spine that will correct and heal.
I have never liked the idea of orthotics. Orthotics are crutches, merely masking symptoms and compensating weaknesses instead of actually fixing a problem.
I have had the fortune of owning and operating two very distinct practices in my career as a chiropractor.
My first practice, in Sarasota, FL, consisted of wealthy people, snow birds, Medicare recipients and vacationing Amish from Pennsylvania and the Ohio valley.
My current practice, in a rural community in the Ozark mountains of Missouri, is filled mostly with country people, farmers, ranchers, the oldest order of Amish (i.e. most conservative) in the country, and a few town-folk from the nearest urban center, who prefer my brand of care and are willing to make the trip.
Chiropractic Maturity
I practice primarily two chiropractic procedures, same as I did in my Florida practice.
One procedure is an upper cervical specialty focusing on the top 2 vertebrae of the spine, the atlas and axis, otherwise known as C1 and C2.
In Florida, I found at least 99% of patients had atlas subluxations (misalignments causing nerve impulse disruption).
Some of this, in retrospect, I freely admit was due to professional bias or confirmation bias. When you’re a hammer, everything looks like a nail.
However, my desire has been to be completely honest with myself and with my patients, so I developed a discipline of “prove to me your atlas is out, beyond a shadow of a doubt”. I personally would rather miss a subluxation than address something that didn’t need to be corrected.
The longer I practiced, the more common it became to see patients who did not exhibit clear atlas subluxation indicators. I once pointed out this observation to a mentor, and he promptly “found” a slight variation I “… just wasn’t skilled enough…” to see.
Of course I and that mentor have never completely seen eye to eye, but when you are just learning a discipline, it can be very difficult not to abandon critical thinking and just buy into dogma, especially when you have such high regard for the one who is teaching you.
As I matured, I became comfortable with the realization of not everyone needing an upper cervical correction. Some people are lucky and healthy that way, and that’s fine because I also use a procedure which allows me to evaluate the rest of the joints of the body and make corrections as needed.
However, practicing in the Ozarks, I have experienced a striking difference with my Florida practice. Instead of adjusting the atlas vertebrae of 99% of my patients, I only have to adjust around 4%.
Quite a discrepancy!
For the longest time, I couldn’t tell what was different.
Again, some of it was because of my own maturity, recognizing confirmation bias and not being led astray by dogma, but bias doesn’t fully explain such a dramatic difference in the number of misaligned atlas vertebrae.
For a Healthy Body, You Need Healthy Feet
While researching barefoot running and its effects on the structure of the human frame, I learned of a chiropractor in Chapel Hill, NC known as the Sock Doc. Dr. Steve Gangemi makes an excellent case for the connection between the health of the feet and the health of the entire body.
I realized the difference.
People in my current practice were country people and were much more likely to go barefoot than the city folk who made up the bulk of my previous practice.
Amish, english, blue collar, white collar, it didn’t matter. People who live in the country are much more likely to live barefoot lifestyles than people who don’t live in the country.
The patients who didn’t go barefoot were much more likely to have an atlas subluxation and were much more likely to not hold corrections overall than patients who tended to go barefoot.
I didn’t know how to use this new information in my practice, though. I wasn’t comfortable telling my patients to be barefoot hippies in order to be healthy.
While researching minimalist footwear, I discovered the work of Dr. Ray McClanahan.
Dr. McClanahan is a sports podiatrist in Portland, Oregon who determined most people don’t have a foot care problem so much as a foot wear problem. Instead of approaching foot care from a standpoint of the human foot is fundamentally flawed, he began to look at the way modern foot wear deforms the human foot.
Based on the work of his mentor, podiatrist William Rossi, he changed his practice from a traditional orthotics-and-surgery podiatry practice to a natural and holistic foot care practice focusing on patient education and the correction of the toes.
Correct the Toes and You Correct the Feet
The toes were the key to the proper function of the foot. The toes were the missing link I had never properly considered because, unless one is suffering from bunions or hammer toes, the toes never bother most people.
However, it is the position of the toes which determines the architecture, function and health of the entire foot.
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Modern footwear, over time, deforms the feet, reduces blood circulation, alters the biomechanics of the entire kinetic chain of the body and leads to structural problems causing people’s biomechanics to break down.
Most modern footwear companies do not design shoes with correct anatomical function of the foot in mind, but design shoes according to what is fashionable.
Most shoes have a tapered toe box, a heel lift of varying degrees (called heel drop in the shoe industry) and a slight lift at the tip of the toe called toe-spring. This is a form based on the cowboy boot designed as a tool for riding in the saddle with a tapered toe box to make it easier to place your foot in the stirrup and a heel to make it easier to lock your foot in the stirrup. Toe-spring was incorporated to prevent tripping which sometimes occurs when wearing shoes with rigid soles.
A great design for horseback riding but terrible for the health of your foot and a completely un-functional design for the majority of modern humanity since we don’t ride horseback very often.
If you look at a baby’s foot and at cultures that don’t typically wear modern shoes, you will notice the toes are the widest part of their foot.
Top: The foot of a person who doesn’t wear shoes. Bottom: Baby’s footprint. Notice how the toes are the widest part on both examples.
The widest part of most modern shoes, however, is the ball; tapering the toe, pinching the toes together and slowly, over time, deforming the feet.
The average shoe is widest at the ball of the foot. Over time, this deforms the foot into a crippling configuration.
To address this problem, Dr. McClanahan invented a product called Correct Toes, developed to position the toes in an anatomically correct posture, and be worn throughout the day. Correct Toes facilitates proper neurological communication between proprioceptors of the feet and the brain, rehabilitating the muscles and tendons of the feet.
Over time, with regular use of Correct Toes and proper, anatomically correct footwear, the feet correct. Foot problems resolve, arches strengthen, ankle, knee and hip problems diminish and chiropractic subluxation corrections hold.
I found this new information so pertinent to my practice, and patient’s ability to hold chiropractic adjustments, I needed to learn more about how Dr. McClanahan evaluated feet and his natural approach to foot disfunction.
I made arrangements to shadow his practice.
The third week of March, 2016 I flew to Portland and hung out with Dr. McClanahan and his staff at Northwest Foot and Ankle.
They were very gracious, answered my questions about foot structure and proper foot wear recommendations.
I learned a ton and implemented much of what I learned immediately.
Correcting Foot Problems and Holding Subluxation Corrections
My patients are reaping the benefits. One lady told me, correcting her feet has been worth every penny, as she finally feels she is holding corrections, particularly in her hips, much longer than just a few days at a time.
Dr. McClanahan’s approach to natural foot care is a more sustainable and holistic solution for correcting problems in the feet, and subsequent imbalances in the ankle, knee, hip and spine than are the use of orthotics. It is also a truly corrective approach, and not just a crutch, masking or compensating a problem.
One of chiropractic’s founding principles is, the power that made the body, heals the body. It is a philosophical contradiction to then say the human foot is fundamentally flawed and the only solution is orthotics or inserts, and failing that, surgery. As Dr. Patrick Gentempo is fond of saying, quoting Ayn Rand:
Contradiction leads to destruction, and the amount of destruction is level to the amount of the contradiction.
If you are a chiropractor and want your patient’s subluxations and structural misalignments to correct and stabilize more easily and with more consistency, look to their feet, but don’t reach for the orthotic-casting foam.
Check out the work of Dr. Steve Gangemi and Dr. Ray McClanahan.
