Healthy Step products support the foot, not the ‘arch’

At Healthy Step, we are obsessed with researching how the foot functions both naturally and healthily.

As a result, we understand how things can go wrong and cause discomfort. This knowledge provides the key information for designing and providing the best products to get feet back to health as quickly as possible.

When injury and disease mean that full normal foot health and function is not possible, we supply products that provide the best long-term protections to keep people mobile.

Mobility is movement and being mobile is the key to health.

Foot facts

Healthy Step’s expert clinical biomechanics and material science team know that the foot is a remarkable structure.

The foot can act as both a deformable spring for shock absorption and also a semi-rigid beam to propel forward off the ground with, towards the next step. This requires the foot to be able to alter its mechanical properties from greater flexibility to increased stiffness during each and every step.

Most importantly, it can change its mechanical properties in a variable manner. Thus, the amount of shock absorption at impact and under load, and stiffness used for acceleration is appropriate for every single step. This makes the foot a highly adaptable structure.

Any insole must be designed to assist these abilities rather than interfering with them.

Each and every Healthy Step insole (also known as a foot orthosis or foot orthotic device) is carefully designed to aid and assist foot health. Each insole is recommended to be used in conjunction with regular foot exercises and footwear with adequate toe space is preferred.

Here we explain in detail why we take such care in our designs and recommendations.

Why it is there an arch under the foot?

Why would a supporting structure at the end of long legs, require a hollow under the middle of it? Surely a flat foot offering a big surface area would be more stable than a foot where only the heel and forefoot significantly contact the ground?

The answers to these questions have now largely been answered by scientists studying both the mechanical efficiency and the material properties of the foot during walking and running.

The first important point is that the foot does not really have an arch, but a vault profile.

A vault is a more 3-dimensional supporting structure, whereas an arch supports primarily in two directions (as in creating a doorway). However, both structures utilise the engineering principles of span distance and radius of curvature in their stability. An arch provides a stiff, stable open space which has little in common with a foot, except when you draw the foot as a 2-dimensional structure as in shown in Fig. 1.

Figure 1. When the foot is flat, looking side-on gives the middle of the foot an ‘arched’ appearance. Span distance and radius of curvature principles can be applied to the foot’s profile. However, these measurements are constantly changing in a foot in motion.

The engineering behind a foot vault

There are two fundamental principles behind arch and vault stability.

The first is the span distance between the supports maintaining an arch/vault. The shorter the span distance the more stable the arch/vault. The second principle is linked to the amount of curvature that the arch/vault expresses. The sharper the curve (smaller radius of curvature), the more stable the arch/vault becomes. Thus, the larger the span, the higher the arch/vault should become to remain stable.

Arches, vaults, and beams are used to span or ‘bridge’ across open spaces. The shorter the span between supports, the easier it is to maintain the space below it. Just think about using a plank of wood to cross a stream. If the stream is narrow, then walking across the plank of wood will not bend the plank very much at all. However, if the stream is wide, the plank may sag downwards alarmingly as you walk across the middle as indicated in Fig. 2. It might even break!

Figure 2. A longer span results in exponential increases in bending stresses and deflection, which can be experienced by crossing different spans with a plank of wood.

If you double the span distance the amount of bending stress across the material quadruples (x4). However, the amount of bend (deflection) of the material in the middle of the span will increase sixteen-fold (x16). This explains why the span of a bridge is limited unless it has lots of supports propping it up along its length (or uses suspension cables). A way to improve stiffness is to curve its structure upwards. The more curved a structure, the stiffer it behaves. This is why so many bridges are humped-backed in profile or use an arched/vaulted profile as the support, as shown in Fig 3.

Figure 3. To stiffen a beam crossing a span, you can increase the number of supports A or the curvature of the beam, as seen in a hump-backed bridge B. Combining both arches and more supports is very successful but uses a lot of material. Modern bridges tend to use supports resting on a curved profile C. With bodyweight passing over a curved foot, a stable support is offered using less material than would a solid foot (D).

How both span distance and curvature influence stiffening can be easily demonstrated with a paper note and a coin. Place the coin in the middle of the note held between two hands across its length and watch the note sag downwards. It is unable to curve upwards against the coin’s weight. Holding and curving the note upward widthways causes the coin to rise, as the paper stiffens. The radius of curvature and the span distance have decreased, events that together stiffen the paper exponentially as can be seen in Fig 4.

Figure 4. The span distance is greater length-wise, making curving and stiffening the banknote impossible. However, curving a note width-wise makes it far easier to stiffen it because of the far shorter span distance. These are important concepts of how the foot works.

Changing stiffness

Feet can use spans and curvature principles to adjust their stiffness by having a vault profile. In feet, span distances and curvatures can be altered by weight-bearing and through contracting or relaxing muscles. The greater the muscle power and the move curved the feet become, the stiffer they will behave.

Buildings with vaults and arches often use ‘ties’ (iron or steel pins or rods) to compress and hold stone blocks together to aid stability. The foot uses a similar principle by having ligaments running between the bones to act as ties, helping compress bones together (see Fig. 5). Muscle link to ligaments, so their contractions are used to both compress bones together and increase the tensions across ligaments, making the foot stiffer.

Figure 5. Iron or steel ties are commonly seen running between the stonework of vaults, adding tension to assist the compression forces that hold the structure together. The underside of the foot is well supplied with some very strong ligaments that perform a similar job for the foot’s vault. There are also lots of smaller ligaments not shown in this diagram.

However, ligaments are slightly elastic. This permits muscles to move bone positions to change the foot’s shape. As muscles relax, the foot becomes more mobile and can flatten down further under load. However, the more the foot flattens down the more tensioned the ligaments become, stiffening them. This means that the foot can become stiffer as it flattens as well as being stiffer as it becomes more curved under changing muscle activity.

Therefore, by changing the vault curvatures, the amount and location of muscle contractions, and by changing ligament tensions the amount of stiffness and mobility can be controlled. It gives the foot a range of options and provides adaptability. This is why the foot is still made up of lots of bones like a hand, even though we no longer use the foot for fine gripping and manipulation, roles for which it initially evolved.

If the foot only offered a solid bony structure or a fixed highly curved undersurface, the foot would be too hard to walk safely upon. However, without an adjustable vault and the muscle power to alter it, the foot would be too soft for shock absorption and also to drive forward from.

The foot’s vault

The foot is raised on the inside and outside edges like a barrel vault. However, one side of the vault is much lower and shorter than the other. The type of barrel vault shape the foot represents is known as an expanded conical vault, which is compared in Fig. 6. Its highest point in is curved shape is within the middle area, where the talus and navicular bones meet.

Figure 6. Arches and vaults exist under the same curvature and span rules (A) with a barrel vault (B) commonly used in buildings and under bridges to extend the support of an arch over a bigger distance. The foot is more similar to an expanded conical vault (C) because one side is higher and longer than the other.

By using an expanded conical vault, the foot creates a number of different span distances, both longitudinally along it and transversely across it. The areas with shorter spans distances are along the outside of the foot and across it from left to right. As a result, there are naturally stiffer than the longer span found on the inside. Curvature is easier to control across the foot from left to right. The inside foot profile is harder to maintain stiffness within it and its curvature changes the most during gait. This means that the inside of the foot can change its stiffness and mobility properties more and in consequence, has the many powerful muscles controlling it.

The foot’s is concave underside is not symmetrical. The five long metatarsal bones are all different lengths and decline downwards at different angles from the middle of the foot. The foot is also wider across the forefoot than the rearfoot and middle area (midfoot). As a result of this variability in length and width, the foot’s vault should be termed an asymmetric expanded conical vault. This arrangement creates lots of different span distances and variable amounts of curvatures across the foot. This creates areas of different levels of intrinsic stiffness that can be adjusted individually.

The foot has 28 bones, not the frequently stated 26. This is because people forget the two bones under the big toe joint. Of these bones, 12 are directly used to form the vault but much assisted by the presence of the toe bones. The bones are held together by ligaments, tendons, and other tough connective tissues, such as the plantar fascia. These soft tissues act as adaptable and elastic engineering ties. Muscles acting through these living ties increase or decrease the compression forces across joints as they work to permit motion and maintain stability (see Fig. 7).

Figure 7. The foot’s 28 bones viewed from below, include the sesamoids that sit under the big toe (A). In life these are held together by the tough but slightly elastic ligaments but also by tendons from calf muscles such as tibialis posterior (1), peroneus longus (2), flexor hallucis longus (3) and peroneus brevis (5) as illustrated in B and C and its insert. There are also muscles under the foot, such as abductor hallucis (4) and Abductor digit minimi (5), but there are many more not shown here.

Vaults reinforced by ties make effective structures that hold up rooves or upper floors on static buildings. However, the bones of the of vault must move relative to one another, requiring ties to have some flexibility. Ligaments and tendons from muscles are quite elastic in their behaviour. They can stretch and recoil in response to the changing amounts of stress put upon them. This creates feet that can adapt to uneven surfaces and walking speeds during locomotion.

Soft tissues express a property known as viscoelasticity. This allows them to be more flexible when loaded slowly but they behave more stiffly and elastic when loaded quickly. The presence of viscoelastic soft tissues holding the vault together creates a deformable viscoelastic asymmetrical expanded conical vault that behaves like a spring. A similar behaviour is seen in structures such as ‘pop-up’ tents. The slower stress is applied across both a pop-up tent and a foot, the more they will deform but the faster stress is applied to them, the more spring-like their behaviour and the less they deform under load. Most importantly, once offloaded a pop-up tent and a foot wish to spring back into their resting state. The concept is illustrated in Fig. 8.

Figure 8. Pop-up tents express properties that apply to the foot. When you load a pop-up tent with force it deforms, but it wishes to spring back to its relaxed shape. Pop-up tents better resist loads that are applied faster to them by reacting more elastically than when loaded slowly. The foot also behaves more stiffly under rapidly applied loads.

Variable springs within feet

The flexibility and stiffness across the foot are not even. Some areas are intrinsically less flexible than others. Some bones articulate in joints that are shaped in such a way as to profoundly limit motion. The heel bone (calcaneus) and ankle bone (talus) do not usually permit much motion between them. This is also true of the second metatarsal bone’s base joint with the 3 cuneiform bones in the middle of the foot. The 3rd metatarsal bone next to it is also relatively immobile. This makes the heel and the middle of the forefoot areas of stability without the need for strong muscular effort

Some joints potentially have a lot of motion, particularly the joints in the middle of the foot. All the toe joints across the forefoot should also provide high mobility. This arrangement gives the foot areas with reliable stability and areas where shape changes and motion can occur more easily. As long as the motion is kept under control, motion is good for shock absorption. For example, the joints at the proximal ends of the 4th and 5th long metatarsal bones on the outside of the foot, are quite mobile. This is useful as the outside of the forefoot often hits the ground before the rest of it. Having flexible joints here means that the outside of the forefoot can shock-absorb at the start of forefoot impact, while the stiff central metatarsals can then supply stability after some impact force has already been dissipated.

For a safe landing of the leg on the ground when the heel impacts, it is important for the ankle and heel bones to be stable. The stiffer centre of the forefoot usually hits the ground after the heel, allowing weight to then load on a stable forefoot. These areas have fatty cushioning pads within them to cope with impact forces. However, when the whole foot has made ground contact, foot motion in the more mobile joints around the stiffer areas allows the feet to provide shock absorption. This mobility involves the bones of the vault, particularly those on the inside.

As the heel lifts towards the end of a step, the foot is required to push against the ground. At this time, inner forefoot stability is again very important as a point of leverage. The fatty forefoot pads help again as the foot pushes against the ground. Now the joints of the vault need to remain stable, particularly those on the inside.

The 1st metatarsal bone behind the big toe is quite mobile to allow it to act as a shock absorber on forefoot contact. However, when accelerating off the foot it must act as a stable support acting with the stiffer 2nd metatarsal. The big toe and 1st metatarsal are therefore supplied with some very powerful muscles within the foot and from the calf. These strong muscles can compress the inner forefoot together very firmly before the heel lifts. Weak muscles and badly directed forces here are linked to big toe arthritis and hallux valgus (or hallux abducto valgus and often incorrectly called bunions). The relative areas of flexibility are shown in Fig. 9.

Figure 9. Levels of flexibility are different across the foot (viewed from above), although at any given moment the level of mobility or stability will be dependent on muscle activity. The 1st metatarsal bone behind the big toe is particularly dependent on muscle activity to provide either high levels of stability or significant mobility.

Having some metatarsal bones move more easily than others causes the curved profile at the front of the foot to increase when it becomes more loaded towards the end of a step. Forefoot bone motion creates a greater curvature to form across the forefoot, running from left to right. As a result, the ligaments tension and help the forefoot to stiffen, making it easier for the supporting foot muscles to compress the rest of the foot together across it.

The result is that although the foot looks flatter longitudinally, its profile width-wise has now increased its curvature. The sharper curvature created stiffens the foot before the heel lifts. Getting the perfect level of stiffening/curvature requires calf and foot muscle activity at this time.

Why the foot is like it is

The foot is a variably deformable spring-like shock-absorbing structure that reduces its amount of flexibility before the heel lifts. Processes for changing foot flexibility are made far easier by having a viscoelastic asymmetric vault profile, with multiple curved profiles across it (see Fig. 10). It allows levels of flexibility across the foot to be more adjustable.

Figure 10. By being an asymmetrical and flexible vault, the foot offers several distinctively curved profiles that constantly change shape during a step. These can be divided into ‘arches’ on the inside (medial (A)), outside (lateral (B)), and those across the foot at the level of the forefoot (C) and across the foot (D), known as transverse arches. The anatomy of the foot shown in D is marked by the hashed line in C. Each profile exists as a continuum with the others, supported by ligaments and by muscles and their tendons, with two very important tendons shown in image D. (See also Fig. 7 again).

By reducing muscle activity and decreasing the amount of curvature, the foot can become more flexible and therefore better at shock absorption. The foot tends to do this as soon as the forefoot hits the ground, whereupon it lowers its profile quite quickly. To stiffen the foot before heel lift, muscles increase their contraction power while ligaments and fascia become tensioned as the vault lowers. Both of these actions increase the forces that are compressing bones together.

Increasing the vault height and reducing span distances across a vault profile, also stiffens the foot. The foot tends to use this process before the forefoot hits the ground and after the heel leaves the ground. These are periods of lower muscle activity when the foot must still provide stability. The foot should not try to raise its vault from front to back when full body weight is on it. This is because it would take up far too much muscle power to achieve and also it would stop the foot from being a shock absorber. It is left to increasing ligament tensions and muscle contraction to compress the foot together. This action also curves the foot from left to right across it to create some stiffness in the transverse arches of the vault (see Fig. 10 C and D again).

Soft tissues are viscoelastic. A bonus of this is that the foot vault is harder to deform and more spring-like when we walk fast or run. These are both higher-energy activities that benefit from a return of elastic energy after shock absorption. Also, stability is usually more important than mobility at these times. When slow walking, the foot is more deformable, allowing it to dissipate (lose) most of the energy and power put into it. This permits us to move very quietly, while the increased flexibility permits the foot to better mould into uneven surfaces associated with difficult terrain that usually slows down gait speeds.

Having a vault held together by viscoelastic soft tissues increases the foot’s adaptability across it beyond properties set by joint shapes, muscle contraction powers, and ligament tensions. Being able to change vault shape alters the foot’s material properties differently in multiple locations across the foot as it goes through cycles of decreasing and increasing foot stiffness during a step.

An adjustable flexibility across an asymmetrical foot vault (hopefully) allows the correct amount of mobility and stability in the right place at the right time, as body weight passes over it.

A rough guide to effective foot function

When walking, the heel hits the ground first creating a separate impact from the forefoot and toes. The benefit of this is that the body is spared the higher forces caused by a single impact by instead spreading touch-down forces over two smaller collisions. Having a hollow vault under the foot exaggerates this effect by creating distinctly separate heel and forefoot areas.

As the heel first impacts, some foot muscles stiffen the vault. This makes the foot more elastic before the moment of forefoot touch-down. This muscle activity largely ends when the forefoot contacts the ground, allowing the foot’s profile to lower and bring the toes onto the ground. With all body weight now loaded onto one foot, vault flattening is quite rapid to act as a shock absorber. The foot’s action is much like pressing down on a shock-absorbing spring. It is easier to ‘squash down’ the spring at the start of compression and harder the greater and longer it is compressed. This is because flattening the foot vault creates tensions across the ligaments and tendons holding the bones together.

Vault lowering increases the sole’s surface area in contact with the ground. This improves stability and lowers peak pressures on the foot’s sole.. Pressure is force over area. With more foot surface in ground contact, forces spread out and peak pressures on tissues under the foot can be kept within a safer range. Thus, dynamic spring-loaded foot flattening helps avoid damaging foot tissues in several ways.

The foot continues to flatten as the ankle rotates forward. However, the tensioning of tissues as the foot flattens and the reactivation of foot muscles at this time starts to increase foot stiffness. Foot flattening continues until the heel lifts, but the rate slows down. The other foot that is still swinging forward, should not contact the ground until the weight-bearing foot undergoes its heel lift. At heel lift, the foot is usually flattest and stiffer than at any other time during the step. As body weight forces transfer onto the next step after heel lift the now offloaded foot can spring back into shape as shown in Fig. 11.

Figure 11. The foot deforms under body weight, stretching out the soft tissues that hold the foot together. On removing loading forces, the foot can start to spring back into shape with the assistance of important muscles located within the calf and under the foot.

The power to lift the heel off the ground towards the end of a step arises from the Achilles tendon. The Achilles is stretched as the ankle rotates forward with the body passing above and over the supporting foot as it flattens. The Achilles tendon should be so full of elastic power towards the end of a footstep, that it wants to recoil and pull the heel away from the ground. This becomes easier as body weight moves away from the heel towards the forefoot. However, to achieve an efficient heel lift, the foot needs to be semi-stiffened to act as an acceleration beam. A stiffer foot means that the forefoot can more easily push against the ground as the heel lifts off, without buckling in the middle.

Here is a potential issue!

The foot is required to flatten down flexibly for shock absorption and to reduce pressures under the foot. However, the foot must be stiffer at the point the heel leaves the ground, just when the foot is flattest. Problems should be avoided by the action of flattening the foot that widens and lengthens it. This process stretches ligaments and tendons under the forefoot, which in turn causes the curvature between the long metatarsal bones across the forefoot, to increase. This increased left to right curvature across the foot and increased muscle activity, stiffens the forefoot without the need to raise the vault longitudinally from front to back. With a stiffer forefoot, making the rest of the foot stiffer lengthwise is far easier without the need to raise the vault.

Despite the foot still looking flattened longitudinally, the foot becomes more curved and stiffened across it. With a stiffer foot, Achilles tendon recoil-power can lift the heel and force the ankle to rotate downwards and forward without the middle of the foot buckling. The foot pivots over the big (1st), 2nd, and 3rd toe joints as shown in Fig 12. Now the offloaded longitudinal vault profile can rise up again easily.

Figure 12. After the leg has functionally lengthened through hip and knee extension during the first part of a step, the foot increasingly stiffens. Ankle rotation is slowed by calf muscle power pulling on the back of the leg as body weight (black spot) falls forward. This action stretches and tensions the Achilles elastically. Once body weight has moved over the forefoot the heel ‘pops up’ under the recoil power of the Achilles, rotating the foot at the toe joints, raising the vault height back up.

Muscles within the calf and under the foot, control the rate of foot flattening and stiffening during each step. They are aided in this task by changing the curves across the foot vault.

Adaptability in stiffness is necessary because different surfaces under the foot require different degrees of foot flexibility/shock absorption at different moments. A permanently solid or floppy, or high-arched or low-arched foot could not provide the necessary variability. Appropriate foot flattening controls the peak foot pressures and provides stretching tensions on ligaments and tendons, allowing the foot to act as both a shock absorber and a recoiling spring.

Elastic power released under the foot at heel lift ‘recoils’ the foot back into shape after heel lift. This is assisted by the foot rotating at the toes after heel lift, which tightens the fibrous band under the foot called the plantar fascia. Controlling height and stiffness across the vault appropriately avoids ligament, tendon, and joint damage that could result if the foot squashes down too much or insufficiently.

The foot is essentially a squashable spring that can be stiffened or made more flexible by changing its vault shapes.

That is basically how a foot works!

What are flat feet and fallen arches?

Human foot vaults exist on a continuum. Some are high vaulted and others rather low. Most are somewhere in the middle. None have the perfect vault profile that makes them immune to all foot problems.

Children do not develop their vaults significantly until around the age of 6, just as they are starting to walk more like adults. Young children should not be treated for flat-looking feet. Only simple arch-developing exercises should be encouraged unless feet are painful. Painful feet in children require treatment, which might include insoles.

Different profiled feet tend to work slightly differently. Lower vaulted feet tend to be more flexible and are often harder to stiffen because of their lower curved profiles across their longer supporting span distances. As flatter feet generally tend to be more flexible, it will come as no surprise that higher ones are usually stiffer. This vault effect on foot behaviour probably explains why most people have a middle-of-the-range vault profile. By offering a middle-profiled foot vault you offer a foot nicely compromised that it is not too stiff or too flexible in a ‘Goldilocks” zone that can be adjusted more easily. This means the foot can easily swap from flexibility to stiffness without too much muscle effort. However, strong flat feet and more flexible high-arched feet can work perfectly well.

Remember, the foot should change shape as we move. Foot vaults should variably and controllably fall during every step, and each foot should appear flatter before the heel lifts from the ground. Generally, foot vaults that flatten too early, too rapidly, excessively, or insufficiently are the most associated with foot discomfort. Terms like ‘flat feet’, ‘fallen arches’, ‘dropped metatarsals’ and ‘pronated feet’ are still commonly used to explain the development of aches and pains within the feet. However, these terms make little sense in explaining poor foot function!

For more about these terms, click here

What does all this mean?

By understanding how a deformable vault under the foot offers several great advantages, Healthy Step experts can appreciate why dysfunction can cause discomfort and fatigue in the foot. It also indicates how insoles should be designed to work to assist the foot and its vault perform their important roles.

How to assist the foot using the most appropriate insoles, the correct shoes, and exercises

Rather than considering feet to be the wrong shape, it is more important to consider if they are functioning correctly. Healthy feet easily control the changes in their shape during every step.

It is in consideration of the ability to function that an insole should be selected. If you just wish to give your feet help and assistance in the long term, consider using Healthy Step insoles in the shoes you are most active in. The Arch angel in particular, is a great extra help for getting the best out of your foot vault’s clever mechanical properties when muscles are at risk of becoming tired (fatigued).

If you have recently developed some discomfort and aching in your feet, the X-Line Standard or the Arch Angel are the perfect options (see Fig. 13). These are the perfect choices if you have not worn supportive insoles before.

Figure 13. Make sure you pick the right insole for the correct task. The X-Line standard (right) and Arch Angel (left) are the ideal insole for ‘first-time’ mildly painful, achy or tired feet.

If you have had achy, tired, or pain in your feet before and now they are staring again or if you have had foot pains for over 12 months, the X-Line RIF is likely to be the best choice of insole. Many foot and ankle discomforts derive from simple issues that cause muscle fatigue and excessive soft tissue strains. They result in the loss of good control of the foot to change its mechanical properties as we walk. Healthy Step offers a great range of insoles that provide foot function assistance.

Figure 14. The X-Line RIF (left) is a long-lasting firmer supporting insole. The X-Line ¾ length (middle) enables the use of a vault-supporting insole in footwear with less toe space. while the X-Line. Pressure Perfect (right) is soft and cushioning for high-impact activities or more sensitive feet.

Feet that remain too stiff will need some extra help with their ability to shock absorb. Stiffer feet also include the feet of diabetics and those with arthritic feet. High-ached feet also benefit from the addition of extra cushioning. Healthy Step offers the X-Line Pressure Perfect insole for these foot types.

Specific injuries, such as Achilles tendinitis, plantar fasciitis, big toe osteoarthritis (degenerative joint disease), and tibialis posterior dysfunction, require specific features within an insole to assist them improve. This is why Healthy Step has a range of X-Line Condition Specific Insoles. Achilles tendinopathy and calf injuries require the AT insole, plantar fasciitis the PF insole, big toe joint degeneration the DJD insole, and tibialis posterior injuries, the TPD insole (see Fig. 15).

Figure 15. Healthy Step’s clinical experts have designed a range of insoles that assist specific injuries around the foot and ankle. From left to right, the AT is for calf and Achilles problems, the PF for plantar fasciitis (plantar heel pain), the DJD for big toe joint arthritis and pain, and the TPD for problems with the tibialis posterior muscle/tendon and weak feet.

Not all problems relate to a clear injury. Walking on hard flat surfaces in shoes restricts natural foot motion. This problem, known as an environmental mismatch, seems to be the source of lots of minor foot ailments through the weakening of the muscles and the sensory nerve supply that provides the controls for foot motion. Many feet require assistance because of the weaknesses developed from footwear use. Using TOETOE® socks offers a simple way to improve your toe function, and can be used in combination with insoles (See Fig. 16).

Figure 16. TOETOE® socks are a great way to spread your toes, just as nature intended.

When using insoles and also for general foot health, Healthy Step recommends using foot and ankle strengthening and mobility exercises frequently. Click here

Exercises greatly improve the situation for your feet in the long term.

The best shoes

We advise the use of lace-up shoes with removable insoles/in-socks for fitting our Healthy Step range of insoles.

However, we do appreciate that it may not be possible to fit Healthy step insoles in all shoes. Rather than make your shoe too tight around your toes, consider the X-Line ¾ length when your shoe space is more limited (see Fig. 14).

We also offer support for sling-back sandals with our unique Sandal Saviour and we can also help reduce forefoot pains and burning feet developed during the wearing of high heels by using Heavenly Heels. These are perfect for dancing or during those formal occasions where nothing else but a heeled shoe will do (see Fig. 17).

Figure 17. Healthy Step’s clinical designers appreciate that comfortable lace-up shoes cannot be worn all of the time. Heavenly Heels (left) and Sandal Saviours (right) give added comfort in the most difficult of footwear.

Sources of Information

The information provided here was sourced from the two medical textbooks written by Healthy Step’s Research and Development Consultant and Product Designer. Both books are extensively referenced from peer-reviewed medical and scientific literature and are published by Academic Press, an imprint of Elsevier.

Clinical Biomechanics in Human Locomotion: Origins and Principles.

Andrew Horwood, with contributions from Nachiappan Chockalingam

ISBN 978-0-323-85212-8

Clinical Biomechanics in Human Locomotion: Gait and Pathomechanical Principles.