Samuel G Oltman, ND, RMSK
The human foot is designed to support itself. A regenerative foot health approach that restores alignment, builds strength, and promotes self-healing, can improve all types of foot pain without surgery. The unifying factor is circulation and blood flow. If you don’t use it you lose it. There is nowhere we see this dynamic play out more often than in the feet with too much constriction, too much external support, and too much distortion for the sake of fashion. Correcting these factors and, if needed, using prolotherapy, PRP, and MFAT can resolve most foot pain. From bunions to plantar fasciitis, and achilles tendonitis to neuromas, regenerative foot health can help you get back on your feet.
The alignment of the big toe is where we start with our patients. The big toe is a part of the arch support system and if it’s crowded in toward the other toes it cannot function properly. This misalignment degrades the 1st MPJ joint, which is why it’s a common location for arthritis (1). Big toe position also dictates the tension in the muscles that are connected to it, thereby affecting strength and blood flow (2). This is why we utilize Correct Toes with most patients and why we carry them in our clinic: to restore natural alignment.
Human feet have 3 arches. Arches are very strong structural compositions, which is why they are so common in architecture. Nowhere in architecture or engineering do we see “arch support” strategies employed that prop up arches from underneath. Aside from being impractical (imagine a bridge with a foam insert underneath it for “support”), it’s counter to the entire notion of arches in the first place: the structure itself is what distributes force and creates strength. To have the arches in the foot function properly and with optimal strength, they need to be put in a position where they can do their job: unconstricted, on the same height from front to back, and aligned to distribute force dynamically.
Use It Or Lose It
Overly propping up and constricting the foot decreases muscular strength because an external device (shoe and/or orthotic) is reducing demand and distorting movement (3). This leads to muscle atrophy because if you’re not using your muscles they are getting weaker. We tend to uniquely burden the foot in this way. If you have a shoulder injury, you don’t wear a sling for the rest of your life– you may in the short term prior to doing strengthening exercises. But if you have foot pain, you’re often told to use supportive measures for the rest of your life and never go barefoot. Muscular strength is our greatest compensation strategy and it’s under voluntary control. By aligning the foot, you allow muscle activation under proper conditions and strength increases (4). The stronger your feet are, the better off you’ll be, period.
Regenerative Therapy for Powerful Self-Healing
In most of my patients, optimizing the factors above is enough to regain pain-free movement. Align the toes, strengthen the foot, and wear shoes that are shaped like feet. However, for many reasons, someone may have an injury or condition that requires more than just conservative therapy: A severe tendonitis, a partial tear, moderate-severe arthritis, or many other examples. This is where prolotherapy, PRP, and MFAT have enormous benefits in promoting self-healing. These regenerative therapies fit in cohesively with the alignment and strength-based approach because it’s all about circulation and blood flow: stimulating and promoting self-healing. Prolotherapy is very effective for addressing instability after ankle sprains. PRP addresses the inflammation and structural damage of tendonitis and arthritis. MFAT has a similar benefit in more severe cases and can heal partial tears without surgery through the use of mesenchymal stem cells.
A Plan Tailored For You
Each of the above factors and many more can be customized and tailored to fit your individual needs– there isn’t a “one size fits all” approach, there are just consistent themes. This is an overview to show how all these parts fit together in the Regenerative Foot Health approach used at Cascade Regenerative Medicine.
There is so much you can do to improve your foot health simply through alignment and strength. If that is not enough, there are many regenerative options that restore tissue health and improve pain. All without surgery, without drugs, and without a lifetime of orthotic shoes. Your feet can support themselves. You can heal yourself. Discover what your personalized plan is with Dr. Oltman at Cascade Regenerative Medicine today.
Dr. Oltman has seen patients part-time at a specialty foot & ankle clinic, Northwest Foot & Ankle, for over 6 years. His unique expertise combines the natural foot health approach developed by Dr. Ray McClanahan, DPM with cutting-edge delivery of regenerative orthopedic treatments and ultrasound diagnostics, distinguishing his practice from almost any other in the world.
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Jacobs JL, Ridge ST, Bruening DA, et al. Passive hallux adduction decreases lateral plantar artery blood flow: a preliminary study of the potential influence of narrow toe box shoes. Journal of Foot and Ankle Research. 2019;12(1):50.
Protopapas K, Perry SD. The effect of a 12-week custom foot orthotic intervention on muscle size and muscle activity of the intrinsic foot muscle of young adults during gait termination. Clin Biomech (Bristol, Avon). 2020;78:105063.
Xu J, Saliba SA, Jaffri AH. The effects of minimalist shoes on plantar intrinsic foot muscle size and strength: a systematic review. Int J Sports Med. 2023;44(5):320-328.