Walking Towards the Light 

Getting up early and walking at sunrise is one of my favorite things to do. I head  east and usually start off running. Once I reach a steep hill I start to walk and soak  in the first rays of red light for some free red-light therapy. God’s Magnificence! I  wish everyone would experience this, but there are many excuses for why they  don’t: I’m not getting up before dawn, it’s too cold, I’m too tired, my feet hurt!!!  

Foot pain is a problem for many people, but after the various lockdowns it became part of a new pandemic. People stayed indoors and avoided outdoor  activities. By the time they decided to go back to their exercise routine it felt like starting from scratch, and of those who did, many never made it back to their pre pandemic level. Some never even tried. It’s not easy! Meanwhile, we stopped  wearing shoes because we were at home most of the time. People were at home  in slippers, sandals, socks or simply barefoot all day. Add to that the fact that many of us dealt with our pandemic related boredom and anxieties by eating.  Lack of exercise and increased caloric intake led to increased obesity, medical  issues, and ultimately inflammation. All of these things make exercise more  difficult. Did you know that fat cells carry all of the toxins that lead to inflammation? It’s a vicious cycle. 

So how do we get out of this unhealthy cycle? Let’s start with shoes, specifically  Athletic Shoes. The ideal athletic shoe is a running shoe. I recommend these even if you’re not a runner, and all you’re doing is wearing the shoes inside your  house. Running shoes are light weight, more cushioned, and have diverse colors  and styles. Companies make different running shoes for people with flat feet  versus high arches. Ideally you should buy your shoes at a specialty running shoe  store, where the employees can help you choose the right shoe for your foot type  and gait. These stores usually have 3-D scanners to scan your feet, and can digitally obtain your foot size, width, and shape. They also perform gait analysis  using treadmills and/or digital gait plates. With these analyses the computer can choose 3-4 different shoe models that should work for your feet. You should consider going up ½-1 size bigger than your sandal size, or what the 3D scanner tells you, especially if you are considering an orthotic. This will ensure your toes  have plenty of room in the toe box of the shoe, avoiding blisters, nail trauma and  numbness due to swelling after walking or running for a while. Choose the shoe 

that fits you the best with your desired level of cushioning. Some prefer more cushion and some prefer a firmer ride, there’s no wrong answer. Some shoes  have a higher stack height (cushion), and many come with a rocker bottom  outsole. Generally, people with heel pain benefit from running shoes with a  greater amount of cushion (higher stack height), and people with pain on the ball  of their feet benefit from a rocker bottom shoe. But that’s not always the case. I  take many things into consideration when I evaluate my patient’s feet, and I can  help figure out what’s best for you based on your foot problem. 

Bring on the shoe inserts and orthotics! These are insoles that can replace the  thin layer insole that come with your running shoes. They can be pre-fabricated (over-the-counter), which you can find at a specialty shoe store, a podiatry office or online. Avoid inserts from the pharmacy! It’s always a good idea to have an  expert fit you and help you choose them.  

Custom-made orthotics are more precise, usually more rigid, and can take up to a  few weeks to get used to, much like a new pair of prescription glasses. They will  give you the support and stability that your feet are lacking and usually last at  least 5 years. They do come at a cost, but for most people they are the answer to  defeating nagging foot pain, especially when paired with the right shoe. A  podiatrist can take an impression of each foot and order a specific type of  orthotic. The orthotics will be based on the shoes you’ll wear them with, your  gait, your preferred activity, foot type and weight. There are also custom-made orthotics specific for people with diabetic foot problems and/or foot deformities.  Pediatric orthotics can also be ordered for kids with in-toeing, severe flat feet,  tippy toeing, etc. For days when you need to wear a casual shoe, or a dressier  shoe, there are orthotics for those occasions as well. For men’s shoes it is generally easier to get a dress orthotic to fit, but for women’s shoes it’s not  always as easy. I usually wear my dress orthotics in boots, semi-boots, T-strap  and ankle strap shoes. I get these shoes ½ size bigger to fit a small, ¾ length thin  orthotic. They don’t fit in sandals, ballerina flat shoes or pumps. For most daily  activities I wear running shoes to avoid this dilemma.  

Now that you have the proper shoes and inserts, it’s time to take the first step! If  you have a medical condition that makes it difficult to walk, try first making it to  the end of your driveway or outside your door, and slowly increase your distance  as you get stronger. Start with 5-10 steps, and come back. Do this every day, 

and eventually you’ll be walking around your block. The most important part of  any exercise routine is consistency, not distance or intensity. As your fitness  increases the latter two things will come. Keep turning that doorknob and  eventually you could be hiking up mountains! Take my hand, and I can help your  feet get there. 

Just remember to always hydrate well, catch the sunrise, and walk towards the  Light! 

“For the Lord God is a sun and shield; The Lord gives grace and glory; No good thing  does He withhold from those who walk uprightly.” Psalm 84:11

Nora Zoe Ramos-Carthew, DPM

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