inchworm

We have long ago ditched any Victorian shyness around showing our ankles, thank goodness. In fact, they have become a fashionable part of the body to celebrate with short pants and an ornamental tattoo. But unfortunately for our ankles, the picture is often not so rosy as the years go by…

Healthy ankles can serve both fashion and function! Image from Pickpik.com

You might be surprised to learn that some of the fastest growing orthopedic surgeries are for ankle fusions, and partial and full ankle replacements. Though still less common than the 790,000 knee replacements and 544,000 hip replacements¹ done every year in the U.S., the number of total ankle replacement surgeries has grown to over 10,000² per year, and these are expected to overtake fusion surgeries.

Surgeries have pros and cons

When ankle damage is beyond the reach of physical therapy, ankle surgery is an option. Various procedures are used for treating post-traumatic, osteoarthritic, and inflammatory arthritic ankle conditions. While we recognize that continual improvement is being made in these surgeries, and welcome the mobility life-line they offer to many, ankle surgery can also leave patients with a relatively small range of motion in the joint, wound complications, and residual pain.

Maintaining quality of Life

Good ankle function is clearly important for enjoying life’s pleasures, such as dance, sports, and being in nature—but it is also about being pain-free, being able to keep a job, avoiding fall injuries, and maintaining independence. 

       
Being able to walk with ease and pain free ankles (left) makes life more doable and enjoyable. Image from Pexels(left img, right img)

What causes ankle pain and degeneration?

Ankles become problematic for a number of reasons. Some of our students trace their issues back to old injuries, such as broken bones or “rolling the ankle” and tearing ligaments. And it is true that less than optimal healing or poor rehab can have ongoing consequences, or issues that surface in later years. 

The muscle spindles within and the bands of ligamentous tissue that bind the ankle are especially rich in sensory organs called proprioceptors. These are important for sensing our balance and how we perceive the location and movement of our body parts. Thus, incomplete recovery from ankle injuries can leave us more prone to poor coordination and falls.  The long tendons running from the various lower leg muscles through the ankle to move the bones of the feet want to be strong, as do the connective tissues, giving our legs power and stability. 

The tendons of long muscles such as the tibialis anterior (shown in red) cross the ankle, inserting to work the toes and forefoot. The ankle is bound by strong ligaments. Wikimedia

People sometimes tell me that they have inherently weak ankles, like one of their parents. While our DNA clearly shapes our structural inheritance, a more likely cause for the actual manifestation of ankle problems is poor use of the joint due to problematic posture. A poor gait pattern is often learned from our parents, or role models, influencers, or well-intentioned but misguided coaches. 

Motion is lotion—plus strength and flexibility

From a Gokhale Method® perspective, the root cause of ankle problems in our society is varying combinations of poor posture and insufficient use. Even on flat terrain, walking as we were designed to involves a considerable range of motion—the back of the ankle and Achilles tendon gets stretched as the back heel stays toward the ground, and then the front of the ankle is opened wide as we push off using the toes.  

As we came to work ever more sedentary jobs, walking shorter distances along flatter surfaces in our offices and malls, our ankles do less and less. In centuries past our feet would work hard to grab the textured surfaces of rough earth or cobblestoned streets on which we walked barefoot, or in lighter-soled shoes. Going uphill and downhill makes even more demands on our ankle structure, as do naturally challenging surfaces such as tussock grasses and scree-covered hills. 

Traditional dance forms as diverse as the Indian Bharata Natyam, classical ballet, Irish dancing, and Samburu tribal dance from Kenya, all employ considerable ankle strength and flexibility. Image from Pixabay and Wikimedia

Let’s strengthen our ankles 

Consider your starting point. Don’t go straight into a new or strenuous activity if your ankles have been used to taking things easy! At best you could feel very sore, at worst you risk an injury—the very opposite of what you want. If you are recovering from injury or surgery, we advise you to check with your preferred health practitioner.

If we are lucky, we will gain healthy ankle strength and flexibility as we grow, and maintain it throughout life. But many of us in our society need help to do that. Image from Pexels

Rather than rotating your ankles, which is a commonly given exercise, we recommend you take a look at our free Inchworm and Toe Tap videos (below). Start each exercise gently with a minute’s work on each foot daily, and build up from there.

These are highly functional exercises that can immediately benefit your walking. Although you focus on moving your feet, you will feel your ankles and lower leg muscles working hard as well.

In time, these movements, and others we teach on our in-person Foundations course, one-day Pop-up course, online Elements course, and Gokhale Exercise program, will help to make your walking more balanced, smooth, and powerful. After all, walking well is nature’s way of maintaining your foot and ankle health, giving you the thousands of reps per day that your feet were designed for. 

For our Alumni, we are pleased to announce the return of our popular Advanced Glidewalking course, starting Monday, October 7, 12 p.m. (PST).  You can book your place here.

Best next action steps 

If you would like to improve your ankle function and comfort, get started by booking a consultation, online or in person, with one of our teachers. 

You can sign up below to join any one of our upcoming FREE Online Workshops…

References:

¹ “Joint Replacement Surgery.” n.d. Rheumatology.org. https://rheumatology.org/patients/joint-replacement-surgery#.

² Penner, Murray J., Gregory C. Berlet, Ricardo Calvo, Eric Molina, David Reynolds, Paul Stemniski, and W. Hodges Davis. 2020. “The Demographics of Total Ankle Replacement the USA: A Study of 21,222 Cases Undergoing Pre- Operative CT Scan-Based Planning.” Foot & Ankle Orthopaedics 5 (4): 2473011420S0038. https://doi.org/10.1177/2473011420s00381.

Welcome to the second blog post in our series on running. My name is Michelle Ball, and I am a Gokhale Method™ teacher in Tasmania. I am a life-long runner, and am passionate about sharing my experience with beginners and would-be beginners, as well as seasoned runners and everyone in between. If you missed Part 1, you can catch up here. 

Reactivate your feet

When it comes to advice about running, the feet often get overlooked as the subject immediately turns to shoes. While shoes are an important subject (spoiler alert! Part 3 is about shoes), I prefer to start with that miracle of bioengineering that actually does the work—your feet.

Our feet become very passive from walking on flat, featureless surfaces rather than natural, more undulating terrain. They are also constrained, misshapen and deconditioned by less-than-ideal footwear, which, sadly, includes many running shoes on the market.

Running on sand trains my feet to grab the ground and push it behind me.

Learning to engage and strengthen my feet has been a game changer, enabling me to recover from old running injuries and enjoy running into my sixth decade. I would therefore like to share some well chosen exercises you can do in addition to training on the job. These will both strengthen your feet and train them in better patterns of muscle recruitment. Your feet will soon engage more actively than they are likely used to doing. 

Some basic anatomical knowledge can help us get to know and appreciate our feet. This beautiful 1850s engraving (by Henry Vandyke Carter, Gray’s Anatomy) illustrates the primary arch that gives the foot its convexity. Wikimedia

Exercise 1: Inching your way to stronger feet

Inchworm is an excellent warm-up exercise, mobilizing the toe joints, mid foot, and heel bone, contracting and releasing the plantar muscles, and lifting the inner arches and also the transverse arch which spans the base of the toes. It mimics the grabbing action our feet naturally make when accustomed to walking on more varied surfaces.

This video shows how my plantar muscles contract and release to inch my foot forward. I alternately release my heel, and then my toes, from the ground.

Exercise 2: Kidney-bean shaping the feet.

One of my favorite Gokhale Method® concepts to help develop strong, functional feet, is “kidney-bean shaping.” Like inchworm, it strengthens the four layers of plantar muscle, helps raise the inner arches, and also preserves the transverse arch which spans the base of the toes. Restoring tone in these areas confers the springiness you are looking for and protects against common foot problems such as plantar fasciitis, Morton’s neuroma, and bunions. Infant’s feet have this more bean-like shape, and this is the shape preserved into adulthood among more traditional, nonindustrialized societies around the world.

Infants’ feet have a notably bean-like shape.

In nonindustrial societies a bean-shaped foot is maintained throughout life.

In addition, kidney-bean shaping the foot enables us to find a healthy outward angle for the feet and legs, and weight in our heels when standing. This multipurpose exercise is taught in all three formats for learning the Gokhale Method—our in-person Foundations course, our online Elements course, and our Pop-up course. Directions can also be found in Esther Gokhale’s number one best-selling book, 8 Steps to a Pain-Free Back, and her DVD (streamable), Back Pain: The Primal Posture™ Solution.

These photos show how, if you have a tendency toward flat feet (left), kidney-bean shaping can restore your arches, and counter any tendency to being pigeon-toed (right). It also guides your big toe home, reducing bunions. Modeled by Tegan Kahn, our Gokhale Method teacher in Australia.

Exercise 3: Bob before you jog

If you are not in the habit of jogging, or even if you do so already, it is good to ensure you jog with spring in your feet. This contributes to both push off and, most importantly for injury prevention, absorbs energy on impact. This is a natural, effective, and sophisticated mechanism that uses your muscles and foot structure rather than relying on heavily padded shoes to cushion your landing. It helps care for and protect all the weight-bearing joints in the body, as well as your feet. 

CAUTION: If you have back pain or reason to believe you may have spinal degeneration, we recommend you take one of our courses to learn appropriate techniques to protect your spine before doing this exercise.

Getting started with bobbing 

I recommend you start bobbing by shifting from one foot to the other with the heels scarcely leaving the ground. Initially just a few minutes may be plenty, and you can develop resilience for greater bounce and duration over a number of weeks. I like to suggest students play music and make it a dance. A few tracks each day will quickly build strength in your feet. 

Esther demonstrates bobbing on the feet. These clips are from her 1-2-3 Move program for Alumni. Each 15-minute Dance Party has bobbing covered!

Bobbing is a very adaptable exercise for all levels of foot strength—from slowly shifting your weight from one foot to the other, to your first split second of being airborne. As you get stronger you can intensify the work with more skipping and even hopping. 

Free Online Workshops

If you would like to find out more about how the Gokhale Method can help support you, whether you are currently sedentary or a seasoned runner, sign up to join one of Esther’s upcoming FREE Online Workshops.

Having some asymmetry in our bodies is natural and by no means a problem… for example, the majority of us are either strongly right- or left-handed, and if we play soccer we soon discover that we have a preferred foot, too! This study shows that pelvic obliquity (often caused by legs of a slightly different length) is present in equal measure in people both with and without Lower Back Pain, and doesn’t seem to be a contributing factor to the problem of back pain.

A famous example of someone who had a big leg length discrepancy was Bruce Lee. It didn't hold him back very much! To quote him, "I became a martial artist in spite of my limitations. My left leg is almost one inch shorter than the right.  That fact dictated the best stance for me – my right foot leading. Then I found because the right leg was longer, I had an advantage with certain types of kicks, since the uneven stomp gave me greater impetus.”

Bruce Lee, who had almost a 1" leg length discrepancy, managed to go far nonetheless.

It is a good bet that having a dominant side is not a significant problem for humans, or we would likely have evolved to be more ambidextrous!

Pete Sampras showing great form. Playing tennis is a very asymmetric activity, but amateurs and professionals alike don't suffer from it in any obvious way.

As long as our bones and joints stay well aligned and our postural muscles are strong, moderate amounts of muscular asymmetry doesn’t seem to be problematic. However, if our posture and movement patterns have been poor, we are much more likely to develop shears or twists in our bodies, and suffer injury or uneven wear in the joints. Joints or muscles that remain unused because of pain or weakness can degenerate or atrophy, hindering the development of a strong postural base.

Because of this, it is worth observing our everyday movements. If you favor one side to the extent that one side of you becomes strong and the other noticeably weaker, or one side is flexible and the other stiff or uncomfortable, applying the Gokhale Method can help redress the balance:

Stretchlying on a Different Side
If it is suitable for your back, give a little more attention to stretchlying on your less favored side, where it is likely that your back muscles are tighter and shorter.

Stretchlying on your less favored side can help even your body out. 
 

Fine-tune Your Hiphinge

Make sure that:

1. Your weight is evenly distributed between your feet

2. Each knee is bent the same amount

3. Each thigh is externally rotated to the same degree

4. Most importantly, check that your pelvis and torso remain central and that you are not listing to one side.

Be sure that as you bend, your knees point in the same direction as the feet, and that you don't list to one side.

Glidewalking
When practicing your glute squeezes for glidewalking, usually by raising a leg behind you, it can be helpful to complete more reps on your weaker side. Same with the inchworm exercises for gaining foot strength.

Try to even out unevenness in the strength of your feet by doing more reps on the weak side.
 

Steps and Stairs
Make sure you do not always climb up steps and stairs with the same leg first. Alternate which leg you start with, and focus on pushing off from behind with the foot.

Alternating which leg you begin climbing stairs with helps eliminate a possible cause of muscle imbalance.

You may also notice that a movement flows well in one direction, and feels awkward in the other direction (for example, opening a door with your non-dominant hand). Practice switching sides from time to time. Beginning with a blank slate will help you reexamine and improve your movement pattern. Being somewhat ambidexterous can improve your overall muscular strength and be helpful in sports and everyday life; it can also help chart new and helpufl neural pathways in your brain.

Do you have activities in your life that are very asymmetric? Have they caused you problems or have you navigated them just fine?

Join us in an upcoming Free Workshop (online or in person).  

Find a Foundations Course in your area to get the full training on the Gokhale Method!  

We also offer in person or online Initial Consultations with any of our qualified Gokhale Method teachers.

Spring is in the air! As the temperature rises, we go for lighter footwear, exchanging our shoes for sandals, or going barefoot. It may have been a while since our feet had so much exposure - what can we do to benefit our feet and put a little spring into them?

Babies and Toddlers

For babies, the question about ideal footwear is easily answered - a baby is best off barefoot so she can feel the stimuli of different contours and surfaces. These induce her to engage and strengthen her arch muscles as she learns to crawl and then walk. Minimize putting shoes on infants, as this inhibits the natural development of their feet and affects their learning to move and walk well.

Toddlers and older children, as they venture into unfamiliar or less friendly terrain, may need protection for their feet. For any age group, choose a shoe that allows the foot to retain its natural kidney-bean shape.

Choosing Healthy Footwear

Avoid shoes that point or curve the big toe away from the inside edge of the foot. Heels that are higher than 1-2 inches pitch your weight forward onto the ball of the foot – avoid shoes with very high heels.

Well-designed shoes have a kidney-bean shaped footprint, pronounced arch supports (unless your feet are super strong and/or you're paying attention to your gait), and shock-absorbent soles
 

Healthy Foot Practices

Adults sometimes develop foot problems like bunions despite wearing well-shaped shoes. They may even see this as something that runs in the family – “my mom’s feet are exactly the same”. While it is true that our genes predispose us to certain problems, often it is poor postural habits that actually allow structural problems to develop. For example, if we have copied how our parents stand and now also park our pelvis forward and lock out our knees, then an excessive amount of our weight will fall on the front of the foot.

A pelvis thrust forward displaces body weight forward and puts excessive pressure on the delicate structures in the front of the foot

This is problematic because it flattens the transverse arch and causes distortion through the delicate joints of the forefoot – result: bunions, hammer toes, sesamoiditis, metatarsalgia, etc. It is the sturdy heel bone with its dense, cross-fiber construction that is perfectly adapted to take most of our weight. In Lesson 3 of the Gokhale Method Foundation course, when we teach this shift in tallstanding, most people feel somewhat odd, and have to reassure themselves that they don't look odd by looking at their reflection in a mirror!

The heel bone in our species is a sturdy bone adapted for weight-bearing. The bones in the front of the foot, by contrast, are delicate and not constructed to bear the weight of the body.

Bear in mind that our ancestors continually exercised their feet by walking on softer, more contoured surfaces than we encounter today. Compared with a hunter gatherer's foot, the modern urban foot tends to be underused and weak. Flat, or pronated feet misalign our ankles, which results in misaligned knees and hips, wear-and-tear, and arthritic change in the lower body.

Walking barefoot on the beach - depending on how you do it, this can be great foot exercise or destructive for the ligaments of your feet.

Supportive foot-beds, orthotic insoles, and arch supports can be a real help in correcting this sort of distortion. However, while shoe inserts do help to reshape the arches and restore mechanical advantage to the foot muscles, they are no substitute for learning to actively reshape, exercise and engage the feet. The inchworm exercise below is a great way to begin strengthening important muscles in your feet. After you master this exercise, integrate it into every step you take - grip the ground ahead of you, "pull" the ground towards you and then "push" it behind you. This builds the kind of strength and spring you want from your feet, and an elegant glidewalk will result from it!

Click here to watch.

Best,
Esther