Muscle training with every step

Light-footed through the summer without having to forego the usual support foot orthoses provide? The ErgoPad ID:Sandal combines the best of both worlds. Dr. Matthias Manke, orthopedist from Bochum, Germany, is also known as the “district doc” and put on the sandals for Bauerfeind life. He explained why strong foot muscles are so important.

Even deeper in the west than the city of Bochum that Grönemeyer sang about, lies the district of Wattenscheid, where the “district doc” has his practice. In this area between the clubs VfL Bochum and Schalke 04, the word “foot” usually ends in “ball”. Dr. Matthias Manke, however, the “district doc”, is all about the foot. The bearded physician is in his element. He vividly describes the bones of the foot (“joined like an old stone bridge”), the foot arches (“the body’s own shock absorber”), the significance of the foot in his specialist field (“the neglected child of orthopedics”), and the gap in medical training (“just about 90 minutes for the foot”). “As soon as I had my own practice, I constantly saw patients, even children, with arch decreased/splay feet. I asked myself if that could be normal. So I started to learn more about the subject.”

Almost a quarter of all human bones are located in the feet. If you think about it, natural walking comprising putting the foot down, the heel-to-toe movement and shock absorption is a dynamic miracle. The foot is evolution’s high-tech achievement but is looked after less well than an electric bike or a kitchen gadget. That is why, via special consultation hours, TV appearances and a book, Dr. Manke is trying to attract more attention to the significance of healthy feet for the whole body.

Healthy freedom for the feet

Orthopedic footwear technology has a lot to offer for the relief, support and correction of the feet. But summer seems to be the enemy of healthy footwear. People are desperate to lose all constraints, so they often end up in the simplest flip flops. The expert prefers a version with a footbed and calls it “sandal” even though this description doesn’t disclose how much expertise and technology are hidden away in this type of footwear. Matthias Manke walks through his office, wearing the new Bauerfeind sandals with green straps and explains their composition: “Every footbed is custom-modeled by the orthotist, taking into account the relevant misalignment. These sandals here are made just for me. The longitudinal arch is supported effectively with a slight pad, and the transverse arch has been adapted so I can walk smoothly. When I put my foot down, I get a stimulus to raise the foot arches.”

He feels something else is important, something that everyone knows who has ever seen toes trying to cling to basic flip flops in the search for grip: “At the front here, where the toes are situated, the material is raised. Thanks to this feature, I get the perfect foothold. The thong is inserted individually, too. So I don’t have to exert any force when I wear the sandals, and they don’t slap back up on the soles of my feet. Walking in these shoes actively exercises the muscles. It’s a proper training device.” The significance of strong foot muscles is central to Dr. Manke’s philosophy. But there’s a wide-spread lack of knowledge. “I had to look around initially, too: are there any studies relating to foot muscle training, or instructions on how to do it? And when I say foot muscle training, I mean the intrinsic muscles, i.e. the short muscles under the foot. Exercises that can easily be found on the internet usually relate to the extrinsic muscles that are attached to the lower leg. But these are not beneficial for the foot arches.”

First a comprehensive examination, then foot orthoses

These days, patients from all over Germany and neighboring countries attend Matthias Manke’s foot consultation hours. Not least, they value his thorough physical examination. “It’s totally old school. Patients have to take their shoes and socks off from both feet. Can I see skin changes, are there calluses? What do the longitudinal and the transverse arches look like, what are the soft tissue proportions? Patients have to walk on their tip toes and on their heels – do they perform compensatory movements? What impact is there on the leg axes, on the pelvis? Nothing is a substitute for experience, palpation and observation.”

The two-dimensional measurement on a pressure plate and the three-dimensional pressure distribution measurement during walking over a short distance supplement the findings. Once Matthias Manke has gained a comprehensive understanding, he will prescribe foot orthoses. As a foot expert, by definition, he looks at footwear critically – too tight, heels too high, soles too thick. What is left except sandals and going barefoot? The district doc laughs out loud: “It doesn’t have to be quite so radical. The best shoes for everyday activities are simple sneakers that fit well and have a thin, flexible rubber sole.”

Summery freshness: sandals by Bauerfeind

The ErgoPad ID:Sandal has an orthopedic footbed. Its cushion layer is custom-modeled and milled. This sole activates the foot muscles, thus positively influencing gait and posture. The ErgoPad ID:Sandal is available from medical retailers: via a new feature in the Bodytronic ID:CAM web application, the medical retailer can edit the data and order the entire kit. The cushion layer is CNC-milled by Bauerfeind and dispatched within 48 hours together with the other components (midlayer, outsole and leather straps). The orthotist then adapts the individual elements and assembles them. The thong is individually positioned and the length as well as the position of the straps are precisely adapted to the wearer’s foot. The cushion layer is available in gray-brown or black, the leather straps (wide or narrow) in black, white and five summery colors. The thong sandals are available in the sizes 35 to 50.

Can you do it?

It sounds easy: “Lift the big toe and leave the other toes on the floor. Then the other way around.” This little exercise tells Dr. Matthias Manke a lot about the state of the foot muscles. It doesn’t work? Then it’s time for the right training. www.revierdoc.de

Images: Michael Bause