In 1980, I was traveling in Kenya's Aberdare mountain range with my father, Dr. Isadore Rosenfeld -- renowned cardiologist and host of Fox News Sunday's "Housecall" -- when a runner burst into camp, having run 26 miles to deliver an urgent medical message. Upon receiving my father's reply, he took a sip of water and ran back to deliver it.
Being surrounded by the creatures of the African highlands, and having recently left the plains, I managed an evolutionary perspective on the fact that a man could run a double marathon through the forest -- outrunning lions and all that -- but barefoot? How could his ankles, knees and hips take the pounding, never mind his feet? The deed was unimaginable to someone who wore leather loafers to work and soft sneakers to the gym.
At that time, I could never have imagined that more than 30 years later there would be a quiet revolution in the way we see running. In the wake of Christopher McDougall's bestselling "Born to Run" -- a chronicle of the exploits of the barefoot running of Tarahumara Indians of Mexico's Copper Canyon -- and perhaps coincident with a grassroots reevaluation of the role of the foot in life, if not love, athletes around the country are shedding their highly-constructed, heavily cushioned running shoes in favor of high-tech, minimalist shoes.
This change has been a long time coming. In 1997, Chinese scholar-warrior Jwing-Ming Yang discoursed on the evils of soft shoes at a martial arts symposium I attended in Virginia. Drawing on several thousands years of traditional Chinese medicine, he explained that from the standpoint of Chinese medicine there is a "heart" in the foot, one that functions like a fireplace bellows to aid in the circulation of fluid that would otherwise be trapped in the legs, pooling around the ankles -- because we are, after all, bags of water with a few stiff sticks thrown in. Wearing a shoe with too much padding on the bottom eliminates this effect; the sole of the shoe is compressed rather than the sole of the foot, and, to press the analogy, the heart of the foot does not beat.
Western medicine recognizes the importance of muscular action in circulation of two of the body's critical fluids, lymph and blood. Lymph resembles blood plasma and is vital to the immune system. It relies on a complex system of tiny valves and is slowly propelled through the small spaces between tissues and organs by the action of both smooth and skeletal muscle. Patients whose lymphatic system is obstructed (a condition called lymphedema that may result from parasites or from radiation treatment for cancer) often exhibit swelling in the extremities, the result of pooling lymph. One treatment is to wrap the legs with compression bandages to help accomplish precisely the circulatory "squeezing" to which Master Yang referred. Blood is moved by muscle, too. Arteries have muscular walls that contract to help them carry oxygen-rich blood to needy tissues, while veins, like lymph, rely on a combination of valves and the pumping action of skeletal muscles (including those in the hands, arms, legs and feet) to return deoxygenated blood to the heart.
Everyone knows that high heels are bad for the lower back, joints, intervertebral discs and overall posture, but it turns out that even the raised heel on most athletic shoes is less than ideal, as well. Thickly padded, laterally stabilized athletic shoes were initially conceived to protect ankles, knees, hips and spine from the repetitive torsional and shocking forces found in running. The idea had merit -- and still does for some people -- but the competition of the consumer marketplace led the idea to run amok. Aggressive marketing these days has most of us, even kids, wearing shoes that in many cases overprotect the foot. The result is that foot muscles never develop properly, leading not only to effects on circulation, but frequently to problems with tendons, toes and nails.
The feet also play a role in the circulation of energy. Acupuncturists, massage therapists and reflexologists will tell you that some of the most important "points" are in the foot, including the sole. Barefoot running or walking, particularly over uneven terrain, stimulates these important points, yielding benefits well known to Eastern medicine.
In our aboriginal days, we experienced the world through the digits and muscles and skin of our feet just as much as we do through our hands. Most of us have lost that interface with the world, but we can begin to get it back by engaging a mind/body practice that uses our whole body and increases our awareness. Tai chi is especially well suited to this task, as it deliberately concentrates our attention on balance, footwork and stability.
It may also help to choose a shoe that allows the foot to function the way it was intended to while at the same time providing a level of protection from hazards on the roadway or, better, on the trail. Many athletes have a favorite brand, but for my money a good first step in the awakening of the foot is Nike's "Free" line, available as both runners and cross-trainers. These shoes still have a raised heel and look and fit like regular athletic shoes, but they have minimal padding and a hyper-flexible sole. A good next step might be the "Barefoot" shoes from Merrell or the New Balance Minimus line. At the extreme end of the spectrum is Vibram's FiveFinger offerings, shoes that are like gloves for your feet, toes and all.
Transition slowly to one of the less constructed athletic shoes if you want to reap the benefits, though, because years of relying on cushion, padding, and ankle support weaken the feet and it takes time to strengthen them again. Many minimal workout shoes will cause foot pain if worn too often and for too long at the beginning. Specific medical/structural issues aside, the change may cure existing or incipient problems, but if you rush it, you're going to be uncomfortable and may even hurt yourself. Try a half an hour here or there, then an hour, then more, all over the course of a few weeks. Walk barefoot more often, too. Your feet will love you for it.