STEVE INSKEEP, host:
OK. So that's the face. Let's move next to your feet. Maybe you've had pain in your heels when you first put your bare feet on the floor first thing in the morning. If so, could be the beginnings of a common condition. It's known as plantar fasciitis. The problem could point to your shoes. NPR's Allison Aubrey reports on the kinds of shoes that contribute to this problem and exercises that can help prevent it.
ALLISON AUBREY: Elizabeth Kinkel has never had heel pain or heard much about plantar fasciitis. She's a 24-year-old architect living in Washington. And this time of year she likes to walk to work in her flip-flops, which she was happily doing the other day when we approached her, along with a foot doctor named Steve Pribut, who's not a fan of flip-flops.
Ms. ELIZABETH KINKEL: They're pretty comfortable. Keeps your feet cool. So it's nice.
AUBREY: And do you wear them all day long or do you just sort of wear them when you're commuting?
Ms. KINKEL: I just wear them walking back and forth to work and then put on the heels once I get into office.
Dr. STEVE PRIBUT (Podiatrist): I notice a Band-Aid on that foot. Is that from a heel?
Ms. KINKEL: Yeah. It actually is - well, they're actually really cute wedge sandals, but they kind of dig in because they're new.
AUBREY: Kneeling down for a quick examination, Pribut explains that both of Elizabeth's workday shoe choices - the flip-flops and the backless sandals - pose the same potential problems that could lead to plantar fasciitis. He says when your heel doesn't stay attached to your shoe, there's a lot of extra motion in the foot.
Dr. PRIBUT: Wearing an open-backed shoe, when the heel lifts off the ground, there's a lot of tension that develops in the plantar fascia, and it increases the angle that the whole foot makes with the ground, and the toes bend up further and that just stretches the plantar fascia more.
AUBREY: The plantar fascia is a band of connective tissue in the foot, similar in texture to a ligament. It runs all the way from the heel up through the ball of the foot, and strands wrap around each toe. It's vulnerable to injury, especially as we age. But your choice in shoes can make a difference.
To prevent injury, people don't have to toss out flip-flops or high heels entirely. But when you're walking a lot, presumably on hard sidewalks, Dr. Pribut says it's better to wear shoes with some support.
Back at his office, he picks up a pair of Asics jogging shoes that he says are ideal. They're lightweight, don't have too much heavy cushion, and most importantly, they do not bend in the middle.
Dr. PRIBUT: When I take this shoe and press it down, it bends just at the ball of the foot, where the toes attach to the foot. That's right where the shoe should bend.
AUBREY: When shoes have too much bend in the middle, Pribut says it puts tension on the plantar fascia.
One of the biggest offenders among fashionable shoes today is the ballet slipper, or very thin flats. Out on the street outside Pribut's office, we see lots of women wearing them.
Dominque Arvanitis says she likes them because they're comfy.
Ms. DOMINQUE ARVANITIS: I walk around a lot, so the flats are good for me.
AUBREY: Perhaps compared to heels. But Pribut says swapping them out for Crocs or sandals with a little support and a strap around the back would be a big improvement.
Dr. PRIBUT: The ballet slippers scare me just about as much as the flip-flops do.
AUBREY: If you're now wondering whether there are any fashionable dress shoes that may actually be good for your feet, it might be time to ask a different question. That is: What can you do to strengthen or stretch your feet when you're not wearing shoes? That's where foot doctor Colleen Schwartz comes in. She's merged podiatry with Pilates for a more preventive approach.
Dr. COLLEEN SCHWARTZ (Podiatrist): We ask a lot of our feet. There are so many bones, there are 26 bones. There are 33 joints and 100 muscles and ligaments and tendons. And in order to give them the attention they deserve, spending a little time every day can be so beneficial.
AUBREY: A little time means just three or four minutes of stretching and toning. And Schwartz says the best time to do it is first thing in the morning. Before even getting out of bed, she starts with an Achilles tendon stretch.
Here's how you do it. You take a towel or a strap and grab each end. You wrap the middle of it behind the ball of your foot and then stretch your foot towards your shin by pulling the towel.
Dr. SCHWARTZ: Getting an increased plantar fascia stretch at the same time is drawing the toes even further up.
AUBREY: Meaning flexing the toes as much as possible. The idea behind this stretch is that the fibers of the Achilles tendon go all the way to the heel. So there's a strong connection between a limber Achilles and a healthy plantar fascia.
Schwartz says all the foot exercises she does at home she does barefoot. It's also fun to go barefoot on the beach or in the grass, but when she goes about her daily life outside home, she does advocate shoes. As does podiatrist Steve Pribut.
Dr. PRIBUT: I think barefoot is good for some things, shoes are good for others.
AUBREY: Pribut says the barefoot movement may be gaining a little attention for its novelty. And the idea that thousands of years ago shoeless civilizations had healthier feet could be true. But Pribut says back then the average life expectancy was about 30. And cavewomen didn't have to contend with glass, nails, hard concrete - or fashion.
Allison Aubrey, NPR News.
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INSKEEP: And that's Your Health for this Thursday morning. Allison walks you through a slideshow of stretches to keep your feet strong at npr.org/yourhealth.
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