Steps For Keeping Your Feet A Healthy Foundation

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Important Steps For Good Health

This is Dr. Kelly Starrett. He’s a physiotherapist, author, speaker, trainer. He has been described as a “celebrity” and “founding father” of CrossFit. He mostly speaks and writes about mobility in general; today we’re going to be looking at what he has to say specifically about our feet.

A strong foundation

“An army marches on its stomach”, Napoleon famously wrote.

More prosaically: an army marches on its feet, and good foot-care is a top priority for soldiers—indeed, in some militaries, even so much as negligently getting blisters is a military offense.

Most of us are not soldiers, but there’s a lesson to be learned here:

Your feet are the foundation for much of the rest of your health and effectiveness.

KISS for feet

No, not like that.

Rather: “Keep It Simple, Stupid”

Dr. Starrett is not only a big fan of not overcomplicating things, but also, he tells us how overcomplicating things can actively cause problems. When it comes to footwear, for example, he advises:

❝When you wear shoes, wear the flat kind. If you’re walking the red carpet on Oscar night, fine, go ahead and wear a shoe with a heel. Once in a while is okay.

But most of the time, you should wear shoes that are flat and won’t throw your biological movement hardware into disarray.

When you have to wear shoes, whether it’s running shoes, work shoes, or combat boots, buy the flat kind, also known as “zero drop”—meaning that the heel is not raised above the forefoot (at all).

What you want to avoid, or wean yourself away from, are shoes with the heels raised higher off the ground than the forefeet.❞

Of course, going barefoot is great for this, but may not be an option for all of us when out and about. And in the home, going barefoot (or shod in just socks) will only confer health benefits if we’re actually on our feet! So… How much time do you spend on your feet at home?

Allow your feet to move like feet

By evolution, the human body is built for movement—especially walking and running. That came with moving away from hanging around in trees for fruit, to hunting and gathering between different areas of the savannah. Today, our hunting and gathering may be done at the local grocery store, but we still need to keep our mobility, especially when it comes to our feet.

Now comes the flat footwear you don’t want: flip-flops and similar

If we wear flip-flops, or other slippers or shoes that hold onto our feet only at the front, we’re no longer walking like we’re supposed to. Instead of being the elegant product of so much evolution, we’re now walking like those AT-AT walkers in Star Wars, you know, the ones that fell over so easily?

Our feet need to be able to tilt naturally while walking/running, without our footwear coming off.

Golden rule for this: if you can’t run in them, you shouldn’t be walking in them

Exception: if for example you need something on your feet for a minute or two in the shower at the gym/pool, flip-flops are fine. But anything more than that, and you want something better.

Watch your step

There’s a lot here that’s beyond the scope of what we can include in this short newsletter, but:

If we stand or walk or run incorrectly, we’re doing gradual continual damage to our feet and ankles (potentially also our knees and hips, which problems in turn have a knock-on effect for our spine, and you get the idea—this is Bad™)

Some general pointers for keeping things in good order include:

  • Your weight should be mostly on the balls of your feet, not your heels
  • Your feet should be pretty much parallel, not turned out or in
  • When standing, your center of gravity should be balanced between heel and forefoot

Quick tip for accomplishing this last one: Stand comfortably, your feet parallel, shoulder-width apart. Now, go up on your tip-toes. When you’ve done so, note where your spine is, and keep it there (apart from in its up-down axis) when you slowly go back to having your feet flat on the ground, so it’s as though your spine is sliding down a pole that’s fixed in place.

If you do this right, your center of gravity will now be perfectly aligned with where it’s supposed to be. It might feel a bit weird at first, but you’ll get used to it, and can always reset it whenever you want/need, by repeating the exercise.

If you’d like to know more from Dr. Starrett, you can check out his website here 🙂

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  • Health Insurers Limit Coverage of Prosthetic Limbs, Questioning Their Medical Necessity

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    When Michael Adams was researching health insurance options in 2023, he had one very specific requirement: coverage for prosthetic limbs.

    Adams, 51, lost his right leg to cancer 40 years ago, and he has worn out more legs than he can count. He picked a gold plan on the Colorado health insurance marketplace that covered prosthetics, including microprocessor-controlled knees like the one he has used for many years. That function adds stability and helps prevent falls.

    But when his leg needed replacing last January after about five years of everyday use, his new marketplace health plan wouldn’t authorize it. The roughly $50,000 leg with the electronically controlled knee wasn’t medically necessary, the insurer said, even though Colorado law leaves that determination up to the patient’s doctor, and his has prescribed a version of that leg for many years, starting when he had employer-sponsored coverage.

    “The electronic prosthetic knee is life-changing,” said Adams, who lives in Lafayette, Colorado, with his wife and two kids. Without it, “it would be like going back to having a wooden leg like I did when I was a kid.” The microprocessor in the knee responds to different surfaces and inclines, stiffening up if it detects movement that indicates its user is falling.

    People who need surgery to replace a joint typically don’t encounter similar coverage roadblocks. In 2021, 1.5 million knee or hip joint replacements were performed in United States hospitals and hospital-owned ambulatory facilities, according to the federal Agency for Healthcare Research and Quality, or AHRQ. The median price for a total hip or knee replacement without complications at top orthopedic hospitals was just over $68,000 in 2020, according to one analysis, though health plans often negotiate lower rates.

    To people in the amputee community, the coverage disparity amounts to discrimination.

    “Insurance covers a knee replacement if it’s covered with skin, but if it’s covered with plastic, it’s not going to cover it,” said Jeffrey Cain, a family physician and former chair of the board of the Amputee Coalition, an advocacy group. Cain wears two prosthetic legs, having lost his after an airplane accident nearly 30 years ago.

    AHIP, a trade group for health plans, said health plans generally provide coverage when the prosthetic is determined to be medically necessary, such as to replace a body part or function for walking and day-to-day activity. In practice, though, prosthetic coverage by private health plans varies tremendously, said Ashlie White, chief strategy and programs officer at the Amputee Coalition. Even though coverage for basic prostheses may be included in a plan, “often insurance companies will put caps on the devices and restrictions on the types of devices approved,” White said.

    An estimated 2.3 million people are living with limb loss in the U.S., according to an analysis by Avalere, a health care consulting company. That number is expected to as much as double in coming years as people age and a growing number lose limbs to diabetes, trauma, and other medical problems.

    Fewer than half of people with limb loss have been prescribed a prosthesis, according to a report by the AHRQ. Plans may deny coverage for prosthetic limbs by claiming they aren’t medically necessary or are experimental devices, even though microprocessor-controlled knees like Adams’ have been in use for decades.

    Cain was instrumental in getting passed a 2000 Colorado law that requires insurers to cover prosthetic arms and legs at parity with Medicare, which requires coverage with a 20% coinsurance payment. Since that measure was enacted, about half of states have passed “insurance fairness” laws that require prosthetic coverage on par with other covered medical services in a plan or laws that require coverage of prostheses that enable people to do sports. But these laws apply only to plans regulated by the state. Over half of people with private coverage are in plans not governed by state law.

    The Medicare program’s 80% coverage of prosthetic limbs mirrors its coverage for other services. Still, an October report by the Government Accountability Office found that only 30% of beneficiaries who lost a limb in 2016 received a prosthesis in the following three years.

    Cost is a factor for many people.

    “No matter your coverage, most people have to pay something on that device,” White said. As a result, “many people will be on a payment plan for their device,” she said. Some may take out loans.

    The federal Consumer Financial Protection Bureau has proposed a rule that would prohibit lenders from repossessing medical devices such as wheelchairs and prosthetic limbs if people can’t repay their loans.

    “It is a replacement limb,” said White, whose organization has heard of several cases in which lenders have repossessed wheelchairs or prostheses. Repossession is “literally a punishment to the individual.”

    Adams ultimately owed a coinsurance payment of about $4,000 for his new leg, which reflected his portion of the insurer’s negotiated rate for the knee and foot portion of the leg but did not include the costly part that fits around his stump, which didn’t need replacing. The insurer approved the prosthetic leg on appeal, claiming it had made an administrative error, Adams said.

    “We’re fortunate that we’re able to afford that 20%,” said Adams, who is a self-employed leadership consultant.

    Leah Kaplan doesn’t have that financial flexibility. Born without a left hand, she did not have a prosthetic limb until a few years ago.

    Growing up, “I didn’t want more reasons to be stared at,” said Kaplan, 32, of her decision not to use a prosthesis. A few years ago, the cycling enthusiast got a prosthetic hand specially designed for use with her bike. That device was covered under the health plan she has through her county government job in Spokane, Washington, helping developmentally disabled people transition from school to work.

    But when she tried to get approval for a prosthetic hand to use for everyday activities, her health plan turned her down. The myoelectric hand she requested would respond to electrical impulses in her arm that would move the hand to perform certain actions. Without insurance coverage, the hand would cost her just over $46,000, which she said she can’t afford.

    Working with her doctor, she has appealed the decision to her insurer and been denied three times. Kaplan said she’s still not sure exactly what the rationale is, except that the insurer has questioned the medical necessity of the prosthetic hand. The next step is to file an appeal with an independent review organization certified by the state insurance commissioner’s office.

    A prosthetic hand is not a luxury device, Kaplan said. The prosthetic clinic has ordered the hand and made the customized socket that will fit around the end of her arm. But until insurance coverage is sorted out, she can’t use it.

    At this point she feels defeated. “I’ve been waiting for this for so long,” Kaplan said.

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

    This article first appeared on KFF Health News and is republished here under a Creative Commons license.

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  • Cauliflower vs Carrot – Which is Healthier?

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    Our Verdict

    When comparing cauliflower to carrot, we picked the cauliflower.

    Why?

    In terms of macros, cauliflower has nearly 2x the protein while carrot has nearly 2x the carbs and slightly more fiber; we’re calling it a tie in this category.

    When it comes to vitamins, cauliflower has more of vitamins B2, B5, B6, B9, C, K, and choline, while carrot has more of vitamins A, B1, B3, and E. Thus, a 7:4 win for cauliflower here.

    In the category of minerals, cauliflower has more iron, magnesium, manganese, phosphorus, selenium, and zinc, while carrot has more calcium, copper, and potassium. So, a 6:3 win for cauliflower here.

    In short, for overall nutritional density, adding up the sections makes for a clear win for cauliflower, but of course, enjoy either or (preferably) both; diversity is good!

    Want to learn more?

    You might like to read:

    What’s Your Plant Diversity Score?

    Take care!

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  • Pelvic Floor Exercises (Not Kegels!) To Prevent Urinary Incontinence

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    It’s a common threat, and if you think it couldn’t happen to you, then well, just wait. Happily, Dr. Christine Pieton, PT, DPT, a sport & women’s health physical therapist, has advice:

    On the ball!

    Or rather, we’re going to be doing ball-squeezing here, if you’ll pardon the expression. You will need a soccer-ball sized ball to squeeze.

    Ball-squeeze breathing: lie on your back, ball between your knees, and inhale deeply, expanding your torso. Exhale, pressing your knees into the ball, engaging your abdominal muscles from lower to upper. Try to keep your spine long and avoid your pelvis tucking under during the exhalation.

    Ball-squeeze bridge: lie on your back, ball between your knees, inhale to prepare, and then exhale, pressing up into a bridge, maintaining a firm pressure on the ball. Inhale as you lower yourself back down.

    Ball-squeeze side plank: lie on your side this time, ball between your knees, supporting forearm under your shoulder, as in the video thumbnail. Inhale to prepare, and then exhale, lifting your hip a few inches off the mat. Inhale as you lower yourself back down.

    Ball-squeeze bear plank: get on your hands and knees, ball between your thighs. Lengthen your spine, inhale to prepare, and exhale as you bring your knees just a little off the floor. Inhale as you lower yourself back down.

    For more details and tips on each of these, plus a visual demonstration, plus an optional part 2 video with more exercises that aren’t ball-squeezes this time, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

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    You might also like to read:

    Psst… A Word To The Wise About UTIs

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  • Apples vs Bananas – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing apples to bananas, we picked the bananas.

    Why?

    Both apples and bananas contain lots of vitamins, but bananas contain far more of Vitamins A, B, and C.

    Apples beat bananas only for vitamins E and K.

    This may seem like “well that’s 2 vs 3; that’s pretty close” until one remembers that vitamin B is actually eight vitamins in a trenchcoat. Bananas have more of vitamins B1, B2, B3, B5, B6, and B9.

    If you’re wondering about the other numbers: neither fruit contains vitamins B7 (biotin) or B12 (cobalamins of various kinds). Vitamins B4, B8, B10, and B11 do not exist as such (due to changes in how vitamins are classified).

    Both apples and bananas contain lots of minerals, but bananas contain far more of iron, magnesium, phosphorus, potassium, zinc, copper, manganese, and selenium.

    Apples beat bananas only for calcium (and then, only very marginally)

    Both apples and bananas have plenty of fiber.

    Apples have marginally less sugar, but given the fiber content, this is pretty much moot when it comes to health considerations, and apples are higher in fructose in any case.

    In short, both are wonderful fruits (and we encourage you to enjoy both!), and/but bananas beat apples healthwise in almost all measures.

    PS: top tip if you find it challenging to get bananas at the right level of ripeness for eating… Try sun-dried! Not those hard chip kinds (those are mechanically and/or chemically dried, and usually have added sugar and preservatives), but sun-dried.

    Here’s an example product on Amazon

    Warning: since there aren’t many sun-dried bananas available on Amazon, double-check you haven’t been redirected to mechanically/chemically dried ones, as Amazon will try that sometimes!

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  • Macadamias vs Hazelnuts – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing macadamias to hazelnuts, we picked the hazelnuts.

    Why?

    In terms of macros first, hazelnuts have 2x the protein, and slightly more carbs and fiber. We call this a win for hazelnuts.

    When it comes to vitamins, macadamias have more of vitamins B1, B2, and B3, while hazelnuts have more of vitamins A, B5, B6, B7, B9, C, and E. Notably, 28x more vitamin E, so that’s not inconsiderable. Also 10x the vitamin B9, and 5x the vitamin C, and the rest, more modest wins. In any case, clearly a strong win for hazelnuts here.

    In the category of minerals, macadamias have more selenium, while hazelnuts have more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc. Another clear win for hazelnuts.

    In short, hazelnuts win in all categories. However, by all means enjoy either or both (unless you have a nut allergy, in which case, obviously don’t).

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  • Brain Maker – by Dr. David Perlmutter

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    Regular 10almonds readers probably know about the gut-brain connection already, so what’s new here?

    Dr. David Perlmutter takes us on a tour of gut and brain health, specifically, the neuroprotective effect of healthy gut microbiota.

    This seems unlikely! After all, vagus nerve or no, the gut microbiota are confined to the gut, and the brain is kept behind the blood-brain barrier. So how does one thing protect the other?

    Dr. Perlmutter presents the relevant science, and the honest answer is, we’re not 100% sure how this happens! We do know part of it: that bad gut microbiota can result in a “leaky gut”, and that may in turn lead to such a thing as a “leaky brain”, where the blood-brain barrier has been compromised and some bad things can get in with the blood.

    When it comes to gut-brain health…

    Not only is the correlation very strong, but also, in tests where someone’s gut microbiota underwent a radical change, e.g. due to…

    • antibiotics (bad)
    • fasting (good)
    • or a change in diet (either way)

    …their brain health changed accordingly—something we can’t easily check outside of a lab, but was pretty clear in those tests.

    We’re also treated to an exposé on the links between gut health, brain health, inflammation, and dementia… Which links are extensive.

    In closing, we’ll mention that throughout this book we’re also given many tips and advices to improve our gut/brain health, reverse damage done already, and set ourselves up well for the future.

    Click here to check out “Brain Maker” on Amazon and take care of this important part of your health!

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