你的脚趾能预测你是否会早逝，以及如何治愈足底筋膜炎！——足部专家Courtney Conley博士

是的。

Yes.

所以当脚跟到脚趾的落差为零时，脚跟和脚趾处于同一平面。

So that is when the heel to toe drop so the heel and the toes sit in one plane.

但当你有较高的脚跟到脚趾落差时，就像穿了一双迷你高跟鞋。

But when you have a higher heel to toe drop, it's like you have a mini high heel on.

是的。

Yeah.

那有什么问题呢？

And what's the problem with that?

因为我的脚本应平放，腿后侧的组织处于良好的长度和张力关系中。

Well, if my foot is supposed to sit flat, I have tissues in the back of my leg that are in a good length tension relationship.

我的脚底压力分布均匀。

I have even pressures across my foot.

一旦我改变这种状态，穿上高跟鞋，就会增加前脚掌的压力，缩短腿后侧的肌肉，从而开始改变脚部乃至其上方所有结构的功能和形态。

The second I go and change those things, where I go into a heel, you put additional pressure on the front of the foot, you shorten the muscles in the back of the leg, so you start changing the function and the structure of not only the foot, but everything that sits above it.

你的小腿、腘绳肌、背部。

Your calf, your hamstring, your back.

你会看到很多背部损伤都与穿高跟鞋有关，是的。

You see a lot of back injuries that are relating to things like heels and Yes.

没错。

You do.

大多数人来看病都是因为脚痛。

It's all see mostly people come in for foot pain.

我总是对我的病人说，真希望问题只出在脚上。

And I always say to my patients, I wish it was just about the foot.

真希望我只要看看你的脚，就能说：问题就在这里。

I wish I could just look at your foot and say, This is what it is.

所有问题都集中在这里。

It's all right here.

但事实并非如此。

But it's not.

因为有一个身体是坐落在脚上的。

Because there's a body that sits on top of the foot.

例如，臀部的力量控制着脚部。

The strength of the hip, for example, controls the foot.

它控制着脚部的解锁方式。

It controls how the foot unlocks.

因此，当你查看足痛患者时，必须考虑到这一点。

So you have to take that into account when you're looking at patients with foot pain.

但这是因为时尚的形状。

But this is the shape because it's fashionable.

对吧？

Right?

是的。

Yes.

我总是告诉我女儿这一点。

It's my biggest always tell my daughter.

因为我的女儿总是说：你让我穿这些鸭嘴兽鞋。

Because my daughter, she's like, You make me wear these platypus shoes.

而我会说：听好了。

And I'm like, Listen.

功能比时尚更重要。

It's function over fashion.

但我理解。

But I get it.

我最大的挑战就是找鞋子。

That is my biggest challenge, is looking for shoes.

但鞋子已经进步了很多。

But they've come a long way.

它们进步得非常、非常大。

They've come a very, very long way.

我认为我们正在逐步达到目标。

And I think that we're getting there.

这些鞋子的鞋跟厚度有问题吗？

Is there an issue with the thickness of the heel on these shoes?

我说鞋跟厚度时，其实指的是鞋底的厚度。

This big when I say the thickness of the heel, really mean the thickness of the sole.

所以鞋里的缓冲垫

So the cushion in the

缓冲垫。

The cushion.

我的意思是，它真的非常柔软、有弹性。

I mean, it's really, really soft and cushiony.

在这里的后跟处大约有一英寸厚的鞋底。

And there's about an inch at the back here of sole.

是的。

Yeah.

关于缓冲垫的讨论总是很有趣。

The cushion conversation is always very interesting.

总会有权衡。

There's always a trade off.

现在有很多流行的鞋子，它们的鞋垫非常厚实。

So there's a lot of popular shoes right now that have a lot of cushion on them.

是的。

Yeah.

当有人走进商店，拿到一双像枕头一样柔软的鞋子，只站了三秒钟就感叹：‘哇，这感觉真好’，你很难反驳这种感受。

And it's hard to argue when someone goes into a store and they're given this shoe that has this pillow on it and they're standing on it for three seconds and they're like, Man, this feels really good.

鞋垫过多的问题在于，脚和地面之间的缓冲物越多，你感受到的就越少。

The problem with cushion is that the more stuff that's between your foot and the ground, the less you feel.

因此，感官敏锐度会下降。

So there's a loss of sensory acuity.

感官感知能力也会减弱。

There's a loss of sensory perception.

想象一下，脚其实是一个感觉器官，它确实是——因为脚上有成千上万个感受器，不断传递信息，帮助我们在双足直立时保持平衡。

Imagine the foot's a sensory organ, and it is, Because there's thousands of receptors that are screaming for information to help keep us upright in a biped.

因此，当我们开始干扰脚部的感知时，就可以预期会出现问题。

So when we start interfering with how that foot feels, you can expect there to be problems.

现在，如果你有一个人整天站在原地，比如站在混凝土或人造地面上，这种情况是有其时间和场合的。

Now, if you have someone that's standing in place all day long, right, on concrete, on man made surfaces, there's a time and a place.

但我的不可妥协之处是，至少要让脚保持其功能性位置，这意味着要有一个宽大的脚趾空间。

But my non negotiable is at least keep the foot in its functional position, which means a wide toe box.

所以，如果你整天站在混凝土上，没问题。

So you want to stand on concrete all day long, fine.

在脚底下加一些缓冲垫。

Put some cushion underneath your foot.

帮自己一把。

Help yourself out.

这没问题。

That's okay.

但至少要让脚趾能够舒展，这样你才能保持平衡，让脚处于能够推动你向前的位置。

But at least allow those toes to splay so that you can have balance, you can have your foot in a position that can propel you forward.

你说话的时候，我刚刚在想我的脚。

I was just thinking about my foot as you're talking.

我敢肯定，我敢肯定我的小脚趾看起来是歪的，我肯定没法在OnlyFans上卖我脚的照片，因为我的小脚趾都蜷缩起来了。

And I'm pretty sure, I'm pretty sure that my pinky toe looks I'm not gonna be able to sell pictures on OnlyFans of my feet because my pinky toe is kinda like crumpled in.

它会往里卷。

It like curls under.

对吧？

Right?

嗯。

Yeah.

它就是蜷缩着的。

It's like curled under.

对。

Right.

看起来像只鞋子。

Kinda looks like a shoe.

就像你那里穿了双鞋一样。

Like, you had a shoe there, like.

不好意思。

Excuse me.

不。

No.

不。

No.

但你说得对。

But you're right.

确实是。

It is.

就是那样的。

It is like that.

有点像是被压进去、藏到下面了。

It's kinda like been pushed pushed in and underneath.

我想这并不自然。

And I guess that's not natural.

不。

No.

确实不自然。

It is not.

一双自然的脚是什么样子的？

How does a natural foot look?

你有没有见过不穿这种缓冲鞋的部落？

Have you been to see a tribe who don't wear these cushion shoes?

你有没有见过没有缓冲的脚是什么样子？

Have you seen what an uncushioned foot looks like?

我着迷了。

I'm obsessed.

我总是盯着人们的脚看。

I watch people's feet all the time.

我刚和妈妈还有女儿去伯利兹度春假。

I was just in Belize with my mother and daughter for spring break.

有点 creepy。

Slightly creepy.

抱歉。

Sorry.

是啊，是不是？

It is, isn't it?

你度假时也在看别人的脚？

And you're looking at people's feet on holiday?

我总是在看别人的脚。

I'm always looking at people's feet.

因为这能讲述一个故事。

Because it tells a story.

就像一个人的步态。

It's like someone's gait.

观察一个人走路就能看出故事。

Watching someone walk tells a story.

你能看出他们是刚被解雇了，还是刚得到了晋升。

You can tell if they just got fired or if they just got promoted.

你知道吗？

You know?

但当你看一个人的脚时，我之前和妈妈、女儿在伯利兹，看到两个男人在离海滩不远的地方盖房子，光着脚。

But when you look at someone's foot, I was in Belize with my mom and daughter, and there were these two guys building a house, a little bit off the beach, barefoot.

我看着他们的脚，心想：哇。

And I'm looking at their foot and I'm going, Wow.

脚很宽。

It was wide.

看起来很厚。

It looked thick.

看起来很平。

It looked flat.

我认为在我们的社会中，当我们想到扁平足时，会觉得这是个坏消息。

And I think in our society, if you will, when we think of a flat foot, we think, Oh, this is bad news.

我们最好去配一个矫形垫。

We better go get an orthotic.

矫形垫是什么？

An orthotic is a?

一种放在脚底下面、帮助调整受力的装置。

A device that you put underneath the foot to help modify loads.

在英国，他们怎么称呼这个？

What do they call those in The UK?

鞋垫。

Insoles.

就像鞋垫一样。

Like an insole.

好的。

Okay.

是的。

Yes.

所以我看着这些人建房子，他们踮起脚尖，脚趾有极大的活动范围，脚部力量和爆发力都很强。

And so I'm watching these guys build this house, and they're coming up on their toes, and they have all this toe range of motion and all this strength and power to their foot.

我想，我们的脚本来就是设计成这样来强壮、支撑身体的。

And I'm like, that's what our foot was designed to do, is to be strong, to support.

这就像在沙子上建房子。

It's like building a house on sand.

你必须有一个可以依托的基础。

You have to have a foundation that you can build upon.

看到这一切真的太棒了。

And it was really cool to see.

真的非常棒。

It really was.

当我脚疼的时候，他们告诉我那是足底筋膜炎，并建议我去看看足科医生。

When I had that pain in my foot, which they told me was plantar fasciitis, they recommended that I go to some foot doctor person.

这位足科医生给我量身定制了鞋垫。

And this foot doctor person measured me up for insoles.

是的。

Yes.

我把鞋垫放了进去，然后又拿了出来。

And I put the insoles in, and then I took the insoles out.

取而代之的是，我只是换了双鞋子。

And instead of that, I just wore different shoes.

嗯。

Yeah.

很多人一出现脚痛、背痛或其他问题，首先得到的诊断和建议就是去配鞋垫。

A lot of people's first sort of diagnosis and the thing that they're told to do whenever they have foot pain or back pain or whatever is go get some insoles.

你觉得这才是我们应该做的吗？

Is this what you think we should be doing?

因为这真的非常普遍。

Because it's really, really common.

在医学上，似乎只要出现某些症状，他们就会给你开药。

Seems to be the like in medicine, they throw pills at you if you have certain symptoms.

当有人出现脚部或脚踝问题时，这似乎是我们首先会采取的做法。

It seems to be the first thing that we do when someone has a foot problem or an ankle problem.

干预的第一步就是如此，因此你希望改变我们对脚部的看法。

First line of intervention is that's why you want to change how we're viewing the foot.

如果脚疼，就给你一副矫形器，

It's either if your foot hurts, here's an orthoses,

也就是

which is

一种足部矫形垫或内垫。

a foot orthotic, an insert.

如果疼痛更严重，就去做手术。

Or if it hurts worse, get surgery.

如果你查看关于足底筋膜炎的研究，好吧，当它处于急性期时，会告诉你，使用矫形器或某种方式减轻足底的负荷，最初可能会有帮助，因为你希望减轻疼痛部位的压力。

If you look at the research on plantar fasciitis, okay, so it is being acute, it will tell you that putting an orthoses or something to modify the load underneath the foot can be beneficial initially because you want to offload something that hurts.

但是

But

如果你不用，就会失去它。

if you don't use it, you're going to lose it.

所以被忽略的对话部分是‘并且’这个部分。

So the part of the conversation that's being missed is the and conversation.

戴上这个鞋垫，同时加强足部锻炼。

It's wear this insert and strengthen your foot.

因为目标应该是有一个退出策略，不再依赖鞋垫，让足部重新接触地面。

Because the goal should be to have an exit strategy for the insert and get your foot back on the ground.

因为我有一些病人，史蒂文，他们带着二十双矫形鞋垫、二十个足弓支撑来就诊。

Because I have patients, Steven, they will come in with 20 pairs of orthotics, 20 pairs of inserts.

他们试过这个。

They've tried this one.

他们试过那个。

They've tried that one.

他们试过不同的鞋子，更高的跟趾落差，更多的缓冲。

They've tried different shoes, higher heel to toe drops, more cushion.

我坐在那里想，我们这里漏掉了关键点。

And I'm sitting there going, We're missing the boat here.

让我们来谈谈这个‘和’的问题。

Let's have the and conversation.

一个能很好预测足跟疼痛的肌肉是，它与足底筋膜平行走向。

One of muscles that is a good predictor of having heel pain, Okay, is it runs parallel to the plantar fascia.

那就是趾短屈肌。

So, it's flexor digitorum brevis.

它基本上是将四个脚趾向下压。

It basically takes the four toes and presses them down.

有几种方法可以评估这种情况。

There's ways you can assess for this.

我们会检查他们的脚趾力量，而这几乎总是与足跟疼痛的一侧相关，因为这种状况不应该是那种让人疑惑‘这到底是从哪来的’的对话。

So, we'll look at their toe strength, and it almost always correlates with the side that has the heel pain on because it shouldn't be one of those conversations where like, Man, I wonder where this came from.

不，你的脚很弱。

No, your foot is weak.

你的脚很弱。

Your foot is weak.

它承受着很大的负荷，结构正在受损。

There's a lot of load going through it, and the structures are getting beat up.

丹尼尔·利伯曼曾经对我说过一句话，我永远忘不了。

There's something Daniel Lieberman said to me, which I've never forgotten.

他说，如果你从孩子出生那天起就给他们戴上两英寸厚的手套，30年后再摘掉，你能想象他们的手会变形成什么样子吗？

He said, if you took a child and you put them in two inch thick gloves from the day that they were born, then you took those gloves off at 30 years old, can you imagine how deformed their hands would be?

这就像我们生活的常态。

And that's like very much the way that we live our lives.

我们几乎整天都穿着这种厚底缓冲鞋，有时还带有鞋跟。

We spend pretty much all day wearing these big cushioned shoes that sometimes have these heels on.

所以，很多人出现足部问题、脚踝问题和背痛也就不足为奇了。

So it's no wonder that so many people are getting foot problems, ankle problems, back pain.

三分之一的人。

One in three people.

三分之一的人。

One in three people.

足痛。

Foot pain.

我的意思是，这个统计数据确实值得我们关注。

I mean, it really is a statistic that we need to be paying attention to.

我们用了足底筋膜炎这个词，但没有解释它是什么以及它的症状。

We used this word plantar fasciitis, but we didn't explain what it is and what the symptoms of it are.

这本质上是不是脚后跟的疼痛？

Is it essentially like pain in the heel of your foot?

脚后跟疼痛，是的。

Pain in the heel, yes.

他们对术语进行过调整，将其称为足底筋膜炎，即更偏向急性问题，而与足底筋膜病相对。

And they've played around with the terminology, being it plantar fasciitis, so more of an acute issue, versus plantar fasciopathy.

因为很多时候，这些病例会发展为长期的脚跟疼痛。

Because oftentimes, these cases will turn into having heel pain for very long periods of time.

所以，你需要采取不同的治疗方法。

So, then you have to treat it differently.

你不能用治疗急性问题的方式去治疗慢性问题。

You don't treat something that's acute the same as you would treat something that's chronic.

因此，你需要思考：如何增强足部的韧性？

And so you have to look at, how can I build the resiliency to the foot?

这是怎么发生的？

How did it happen?

这一切是怎么发生的？

How did all of this happen?

足底筋膜炎是怎么发生的？

How did plantar fasciitis happen?

我是怎么得上的？

Like, how did I get it?

让我告诉你我当时在做什么。

So I'll tell you what I was doing.

我过着正常的生活。

I was living my life as normal.

是的。

Yeah.

然后我开始为这场足球赛训练。

And then I started training to play for this soccer game.

我开始每周训练两次左右。

And I started training several maybe twice a week.

到了第四、五或第六周，我开始出现持续的剧烈疼痛，整天都疼，走路都变得困难。

And then maybe by week four or five or six, I get this horrific ongoing pain, which lasted throughout the entire day, where I couldn't walk easily.

尤其是早上特别严重。

It was especially bad in the mornings.

我当时以为自己脚上可能骨折了或者撕裂了什么。

And yeah, I thought I'd like broken something or ripped something in my foot.

当他们告诉我这是足底筋膜炎时，我以前从未听说过这个术语。

And when they told me that it was plantar fasciitis, I'd never heard that term before.

但明白了我当时的所作所为后，我是怎么得这个病的呢？

But understanding what I did there, how did I get it?

对于这个诊断，我听过很多类似的故事。

I hear very similar stories with that diagnosis.

总似乎有个诱因，那就是我增加负荷太快、太早了。

There always seems to be some impetus of, I added load too fast, too soon.

我进行了一次更长的徒步。

I went on a longer hike.

这曾是我最喜欢的活动之一。

This was one of my favorites.

疫情期间，我光着脚在家里走来走去，大家都想把责任归咎于‘千万别光脚走路’。

I went barefoot during COVID around my house, and everybody wanted to blame the fact that, Don't ever go barefoot.

而我觉得，也许只是因为你的脚部肌肉太弱，还没准备好承受这些负荷。

And I was like, Maybe it's just because your foot was weak and you weren't ready to handle these loads.

你增加负荷太快太猛，脚就会说：你知道吗？

You add loads too fast, too soon, and the foot just says, You know what?

你还没准备好这么快就给我这么大的负荷。

You weren't ready to give me this amount of load this quickly.

好的。

Okay.

这正是你之前问我为什么要注意足部力量的原因。

And that's when you asked me earlier about why do we need to pay attention to our foot strength?

只是为了在70岁时防止跌倒吗？

Is it just because we want to prevent falls when we're 70?

这就是原因。

This is the why.

因为我们希望拥有健康、强壮的双脚，这样你就可以说：嘿，我想去踢场足球赛，而不必担心在30多岁时患上足底筋膜炎。

Because we want to have healthy feet, strong feet, so you can say, Hey, I want to go play a soccer game, and I don't want to worry about having plantar fasciitis in my 30s.

或者，我现在这个脚踝扭伤

Or, I mean, now with this ankle sprain that I have

是的。

Yes.

拉伤了我的韧带，这会让你长时间无法活动，太可怕了。

Pulling my ligaments, which takes you out of activity for so long, which is horrific.

这正是关键所在：如果你受伤了，尤其是严重的损伤，比如跟腱问题、像我这样的韧带撕裂，甚至足底筋膜炎，由此导致的不活动会引发一系列后续问题。

That's like a big part of this, which is if you get an injury, if you get a bad injury, if you get like an Achilles tendon issue or the you tear a ligament like I have or even plantar fasciitis, the inactivity that stems from that causes a bunch of downstream issues.

所以我的肌肉会萎缩。

So my muscles are gonna atrophy.

在未来几周内，我的下半身会流失肌肉。

I'm gonna lose muscle over this next couple of weeks in my lower half.

由于伤在右侧，我可能会变得左右不平衡。

I'm gonna get probably a little bit lopsided because the injury is on my right side.

现在我的左侧承担了更多的负担。

So now my left side's having more of the burden.

我的小腿、大腿，甚至下背部现在也可能容易受到损伤。

My my lower legs, my upper legs, my lower back is probably susceptible now to some kind of injury as well.

这感觉就像一场因我没有加强足部力量而引发的伤痛恶性循环。

And it feels like, you know, this down downward spiral of injury just because I didn't strengthen my foot.

你觉得这双鞋怎么样？

What do think of these shoes?

这是女士高跟鞋，但听好了，任何人都可以穿。

These are women's heels, but listen, anyone can wear them.

现在都2025年了。

It's 2025.

你觉得这双鞋怎么样？

What do you think of these shoes?

嗯，这看起来不像脚。

Well, it doesn't look like a foot.

你的脚处于这种姿势时，并不是它应有的正常位置。

Your foot in that position is not the position it is supposed to be in.

不过话又说回来，这种鞋也有它的适用场合。

Now, with that being said, there is a time and a place.

我不认为我能说服你每天24小时、每周7天都穿功能性鞋履。

I don't think I'm going to win the battle of you need to wear functional footwear twenty four hours a day, seven days a week.

穿那种鞋子的时间应该有限制。

Time in those shoes should be limited.

就像其他事情一样，关键在于适度。

Just like with other things, it's moderation.

你有没有看到很多女性因为穿高跟鞋时间过长而受伤？

Do you see a lot of women getting injuries because they spend too long wearing heels?

我不确定会不会有急性损伤，但组织变弱，是的。

I don't know if acute injury, but a weakening of tissue, yes.

因为我现在住在科罗拉多，所以我没有这种经历。

Because I live in Colorado now, so I don't have that.

科罗拉多穿高跟鞋的女性并不多。

There's not too many women in Colorado that are wearing heels.

然而，当我去纽约市时，情况就完全不同了，环境也不一样。

However, when I go to New York City, it's a different conversation, different environment.

所以我得说，你不应该让脚长期保持这种姿势。

So I have to say, I have to use the, That is not the position that you want to keep your foot in.

它改变了你组织的结构，改变了脚部的压力。

It's changing the structure of your tissues, changing the pressures in the foot.

更不用说，不管别人怎么说，这些鞋子。

Not to mention, those aren't I don't care what anybody says.

穿起来走路一点都不舒服。

That's not comfortable to walk around in.

人们会说：‘哦，我穿高跟鞋其实很舒服。’

People will be like, Oh, I'm really comfortable in heels.

我会问：‘你真的觉得舒服吗？’

I'm like, Are you really, though?

为了好看，我们真能付出这么多啊。

The lengths we go to to look good though.

对吧？

Right?

没错。

That's right.

好的。

Okay.

那我们来聊聊一些好鞋子吧。

So let's talk about some good shoes then.

行。

K.

我这里有两双鞋。

I've got two pairs of shoes here.

行。

K.

其中一双是Vivo Barefoot。

One of them is Vivo Barefoot.

是的。

Yes.

你

You

实际上是我赞助商。

are actually a sponsor of mine.

自从我开始谈论脚部问题以来。

Ever since I started talking about feet.

我不认识这个品牌。

And then I don't know this brand.

这个品牌是什么？

What is this brand?

这是超跑品牌。

That is ultra running.

那我们来谈谈你在选择功能性鞋子时需要注意的方面。

So let's talk about the things you want to look for in a functional shoe.

我不可妥协的是宽鞋头设计。

My non negotiable is the wide toe box.

脚趾必须能够自然展开。

The toes have to be able to splay.

当我们想到所有我们讨论过的诊断问题——拇外翻、神经瘤、锤状趾——当前脚掌能够展开时，脚的机能会更好。

When you think of all the diagnoses that we talked about, bunions, neuromas, hammertoes, when the forefoot can splay, the foot's going to function better.

所以这是第一点。

So that's number one.

第二点是脚跟和脚趾处于同一平面。

Number two is having the heel and the toe in the same plane.

第三点是鞋子要薄且柔软。

And number three is having a shoe that is thin and flexible.

当你穿着这种鞋时，我称之为‘工作鞋’，因为你的所有组织、骨骼、韧带、肌腱和肌肉都会承受更大的负荷。

When you wear this type of footwear, I call this a workhorse shoe, because there is more loads going through all of your tissues, through your bones, through your ligaments, through your tendons, through your muscles.

因此，当你穿着这种鞋时，脚会变得更强大。

So, your foot gets stronger when you wear this type of footwear.

这方面的研究是存在的。

There's research on that.

现在，你得争取这个权利。

Now, you have to earn your right.

这是关于足底筋膜病变的讨论。

This is the plantar fasciopathy conversation.

你不能刚从穿一双高缓冲、强支撑的鞋子

You can't go from wearing an aggressive, high cushion shoe

比如这双。

Like this one here.

还戴着鞋垫，就说：哦，这说法有道理。

Yes, With an insert, for example, and say, oh, this stuff makes sense.

我打算把鞋垫拿掉，然后全天候穿这双鞋。

I'm going go take that off, and I'm going go wear this twenty four hours a day.

你会受不了我的。

You won't like me.

为什么？

Why?

因为你会说，我的脚跟疼是因为你没做足功课。

Because you'll say, hey, my heel's hurting because you haven't done the work.

而是说，咱们来做这些足部锻炼吧。

It's, Hey, let's do these foot exercises.

每天穿这个十分钟。

Let's wear this for ten minutes a day.

然后人们会说，哇，确实感觉好多了。

And then people are like, Wow, that does feel better.

接着就会逐渐过渡到更频繁地穿这个。

And then it's a transition into wearing this more often.

现在，对于那些脚部非常虚弱的患者，或者有不同诊断但脚部都很弱的客户来说，这种鞋长时间行走会很困难。

Now, when you have patients that have had a very weak foot, or clients that have had a very weak foot with different diagnoses, this is a hard shoe to walk around in for extended periods of time.

这时我们会讨论那些依然保持脚部宽广位置、宽鞋头的鞋具。

That's when we'll talk about footwear that still puts the foot in a wide position, wide toe box.

我非常喜欢这双鞋。

I love this shoe.

我也喜欢网面鞋面，因为脚趾在这里可以舒展。

And I also like the mesh upper because the toes can expand in here.

我仍然保持零落差，也就是脚跟和脚趾处于同一水平面。

I still have zero drop, right, where the heel and the toe sit in the same plane.

但你会注意到这两双鞋的区别在于堆高或缓冲量的不同。

But you'll notice the difference between the two shoes is the amount of stack height or the amount of cushion.

这里有更多的材料。

There's more stuff.

是的。

Yeah.

所以这双鞋看起来确实像你所说的平面。

So on this shoe, it does look like the you call it a plane.

看起来是水平的。

Looks level.

是的。

Yes.

好的。

Okay.

而且它的前掌空间很宽敞。

And it's got a good toe box.

是的。

Yes.

从侧面可以看出，前掌部分很宽，脚趾可以自然舒展。

You can see from this side that the toe box is wide so you can splay.

但它是有抬高的。

But it is elevated.

它离地面有一定高度。

It's elevated off the ground.

是的。

Yeah.

但脚跟和脚趾处于同一平面。

But the heel and toe are in the same plane.

好的。

Okay.

很好。

Fine.

但它的脚跟仍然有抬高。

But it can it's it's still elevated, though.

它们的鞋底还是相当厚的。

They're still, like, quite a thick.

是的。

Yes.

这并不是太大的问题，因为

That's not too much of a problem because

这仍然取决于你的目标是什么。

it still It depends on what your goals are.

对于跑步来说。

From running.

我认为这双鞋非常适合跑步。

That is that is, I think, a great shoe to run on, to run with.

对吧？

Right?

如果你在混凝土或沥青路面上跑步，脚底下需要有一点缓冲。

If you're running on concrete, if you're running on asphalt, you want a little something underneath the foot.

那耐克的Alpha Flies呢，这是我的

What about the Nike Alpha Flies, which is my

它们让我开始出汗了。

They made me start sweating.

真的吗？

Really?

呃。

Ugh.

这是我的

This is my

现在的跑鞋。

current running shoe.

我买它是因为它看起来很棒。

I bought it because it looks great.

是的。

Yes.

我的意思是，你知道，它它它

I mean, you know, it it it's

我脚踝的韧带撕裂了，但我看起来很帅。

I have torn the the ligaments in my ankle, but I look good.

这是超级跑鞋。

Here's the super shoe.

对吧？

Right?

所以这双鞋，对吧？

So here's this shoe, right?

这是你的超级跑鞋。

And here's your super shoe over here.

嗯。

Yeah.

明白吗？

Okay?

当你看这双鞋时，它有一些特征是这双鞋绝对没有的，其中之一就是前掌上翘。

When you look at that shoe, there's certain characteristics to that shoe that you definitely do not see in this shoe, one of them being the toe spring.

你看鞋尖部分是不是有点翘起来？

So see how it kind of lips on the front of the shoe?

嗯。

Yeah.

明白吗？

Okay?

这里这部分，对。

This part here, yeah.

是的。

Yes.

所以如果我把这双鞋放在桌子上，然后这样向前推，它真的会像摇摆一样运动。

So if I had that shoe on this table and I went like this to the front of the shoe, it would literally rocker for me.

因此，它有助于脚部的摇摆动作。

So it facilitates the rocker of the foot.

听起来很棒。

Sounds great.

你穿上它，就会想：天啊，这太棒了。

You put that on, you're like, Man, this is great.

我都能飞了。

I can fly.

如果你不用它，你就会失去它。

If you don't use it, you're going to lose it.

因此，有研究表明，当你把脚置于带有趾部上翘的姿势时，脚部的内在肌肉会变得虚弱。

So, there is research that shows when you put your foot in a position with toe spring, you will weaken the intrinsic muscles of the foot.

所以，我不是说不要在比赛日穿那双鞋，对吧？

So, I'm not saying don't have race day and wear that shoe, right?

研究表明，跑步经济性可以提高2%到4%。

The research will tell you 2% to 4% running economy.

人们跑得更快，是因为这双鞋具备促进步态的技术。

People run faster because the shoe has the technology to facilitate gait.

但如果你一直穿着它训练，从不让脚部肌肉变强，那只是时间问题。

But if you train in that all the time and you never let your foot get stronger, it's just a matter of time.

你会说：我的腿筋、我的脚、我的这个、我的那个。

You're going to say, My hamstring, my foot, my this, my that.

所以必须进行这样的对话：这双鞋才是让你变强的鞋。

And that's why the conversation has to happen is this is the shoe that you're going to get stronger in.

在你的训练鞋里多花点时间。

Spend time in your training shoe.

然后那才是你的速度训练日。

And then that's your speed day.

那就是你的比赛日。

That's your race day.

所以你要拥有鞋款的光谱，并知道何时在光谱中灵活切换。

So it's having the shoe spectrum, knowing when to dance along the spectrum.

我觉得穿上这双鞋我能弹起来。

I feel like I can bounce in these.

我的意思是，你很可能真的能。

I mean, you probably can.

我刚穿上它的时候，真的觉得：哇，真的能弹起来。

I literally when I put it on, I was like, wow, can bounce.

没错。

That's right.

我觉得中间好像有一片金属片。

I think it has like a piece of metal going through the middle of

是的，里面有碳板。

the Yeah, there's carbon in there.

你知道另一个有趣的事实吗？

You know what another fun fact is, though?

某些弹跳训练，弹跳训练是锻炼身体的弹性。

Certain plyometrics So plyometric is training the spring of the body.

想想跳跃。

So think jumping.

有研究表明，弹跳训练能将跑步能力提升2%到4%。

There's research that will show you that plyometrics also increase capacity in running by 2% to 4%.

所以我和我的患者讨论的是：听好了，如果我们叠加多种疗法呢？

So my conversation I have with my patients is, Listen, what if we stacked therapies?

如果你每周做一到两次弹跳训练，

What if you did plyometric work

那是？

Which is?

同时加强力量训练，大部分时间都穿这双鞋，那在比赛日，你是不是就想穿上那双鞋？

Once or twice a week, and we worked on your strength, and I had you in these shoes the majority of the time, And then on race day, you wanna throw that shoe on?

你就像是一个跑步小仙子。

It's like you're you're a running you're like a running fairy.

你跑步的时候，一切都显得那么美好，因为你有一副强健的身体，再加上这双鞋。

You're, like, running, and things look beautiful, and everything is you know, because you have a strong body on top of the shoe.

但如果你用一个虚弱的身体和脚去穿这双鞋，那你得先争取这个资格。

But if you put a weak body and a weak foot in that shoe, you gotta earn your right.

我们是不是应该多站一会儿？

Should we be standing more often?

因为现在我们大多数人工作和生活都在办公室里，坐在桌前，我，呃，我做这个播客的时候也是坐着的。

Because most of us work and live in offices now, and we sit at desks, and I I, you I do this podcast, sat down.

你有没有多考虑过站立式办公桌，或者我们该多久保持一次双足站立的状态？我觉得你之前好像用过这个词？

Do you think much about standing desks or how often we should spend bipedal, I think that's what you referred to as?

我觉得更重要的是多动一动。

I think that it's more about movement.

好吧。

Okay.

我不确定原地站着比原地坐着更好，除非站着的时候你能真正走动起来，让站立变得更活跃。

I don't know if standing in one place is any better than sitting in one place, other than when you're standing, you can actually move around and make it more active standing.

但关键是要定期活动一下。

But it is a matter of taking movement breaks.

我管这叫‘活动小零食’。

I call them movement snacks.

我们所有人都花大量时间要么一整天坐着，要么站在办公桌旁。

All of us spend a lot of time either sitting all day long or standing at our desks.

如果我们每天能进行几次微散步，比如每次五分鐘，身体就能保持活跃。

If we were to take micro walks, a five minute walk, a couple times a day, the system stays moving.

你保持了活跃状态，并且缓慢地增加了步数，而我们知道，步数对身体健康、情绪和心理健康都至关重要。

You're staying active, and you're slowly inching up that step count that we know is so important for not only physical health but emotional and mental health.

这就是我喜欢这一点的原因。

That's what I like about it.

我记得你提到过，运动、走路与痴呆症、阿尔茨海默病之间有关联，科学上是怎么说的？

I think you mentioned there was an association with movement, walking, and dementia, Alzheimer's What does the science say there?

当你查看步数时，如果以步数为基准，每天9800步可以降低痴呆症的风险。

When you look at step counts, if that was going to be our baseline, 9,800 steps per day can reduce the risks of dementia.

但我觉得更有趣的是，只要走3800步，就能获得最大效益的50%。

But what I think is the cool part with that is 3,800 steps, you get 50 of the maximal benefit.

如果你目标设定为4000步，就能获得50%的益处。

If you were to, let's just call it 4,000, shoot for 4,000 steps, you're going to get a benefit, a 50% benefit.

我最喜欢的一些研究是关于步行与人际关系的结合。

And some of my favorite research on looking at that population with walking is relationship walking.

有一些非常有趣的研究探讨了老年人群体结伴步行，这种活动能建立社交联系，改善情绪健康，并对抗孤独和孤立感。

There's really cool studies looking at walking in groups for the elderly population and how that has a social connection, and it improves their emotional health, and it combats loneliness and feelings of isolation.

这正是散步的美妙之处。

And that is the beauty of a walk.

目前跑步俱乐部正变得极其流行，对吧？你是否看到越来越多的人因为这个来找你？

Run clubs are getting incredibly popular at the moment, aren't Are they, all around the you seeing more and more people come to you as a result

是的。

of Yes.

我觉得，你知道，这很有趣。

I think also, you know, it was interesting.

我当时在德克萨斯州奥斯汀的一个跑步活动中工作，也在那里授课。

I was working at the running event in Austin, Texas, and I was teaching there.

所以很多鞋店都到场了。

And so a lot of the shoe stores were there.

其中一家大型鞋店表示，他们现在的大多数客户其实是步行者，而不是跑步者。

And one of the bigger shoe stores had said that the majority of their clients now are actually walkers and not runners.

我觉得这相当有趣。

And I thought that was pretty interesting.

我在心里想，为什么会这样呢？

And I'm thinking to myself, I wonder why that is.

是不是因为人们在跑步时受伤，所以转而开始步行了？

Like, are more people reverting to walking because they're getting injured when they're running?

我在脑子里做了各种推断。

I'm making all these conclusions in my head.

我想，是不是我们的鞋类方向搞错了？

I'm like, Well, is it because we're going in the wrong direction with footwear?

因为我们做的鞋子基本上替我们完成了所有工作，感觉太舒服了，人们都不再自己努力了？

Because we're creating the shoe that is basically doing the work for us and it feels so good and people aren't putting the work in anymore?

我不知道。

I don't know.

但我一定会尽最大努力来改变这一点。

But I'm certainly going to do my best to change that.

你给我带来了一个盒子，我有。

You brought me a box, which I have Yes.

就在我面前。

Here in front of me.

足部健康套装。

Foot health kit.

是的。

Yes.

盒子正面就是这么写的。

That's what it says on the front of the box.

足部健康套装。

A foot health kit.

我的意思是，这盒子里有什么？

I mean, what is in this box?

就像我的小零食袋。

It's like my little bag of treats.

你知道吗，我刚开始做这个的时候，挺有趣的。

Know, when I started doing this, it was funny.

你给人的就是一袋零食？

This is what you give people is a bag of treats

没错。

That's right.

用来庆祝他们的生日之类的。

For their birthdays and stuff.

我希望人们开始关注自己的脚，因为我认为这对他们的健康有重大影响。

I want people to start thinking about their feet because I think there's such implications for their health.

我想让这件事变得简单，因为当我们想到为了保持健康需要做的一切时，就会觉得：我得进行力量训练。

And I wanted to make it easy because when we think about all the things we need to do to stay healthy, it's like, I have to strength train.

我得吃这个。

I have to eat this.

我需要提高我的最大摄氧量。

I need a VO2 max.

我需要提升我的心肺耐力。

I need my cardiorespiratory fitness.

要做的事情太多了。

There's a lot.

所以，我想让这件事变得简单。

So, I wanted to make it easy.

所以，首先，里面有一样东西是脚趾强化器。

So, first, one of the things that is in there are toe strengtheners.

那我把它从盒子里拿出来。

So I'll pull them out of the box.

这些是分趾器。

Those are toe spacers.

吐司分趾器？

Toast spacers?

是的。

Yes.

所以这些都是同一种东西，对吧？

So is this all the same thing, right?

是的。

Yes.

所以这些是分趾器？

So these are toe spacers?

没错。

Correct.

然后还有这个。

And then there's this.

是的。

Yes.

这是

What's

什么？

this?

这些是脚趾强化器。

Those are toe strengtheners.

脚趾强化器。

Toe strengtheners.

好的。

Okay.

所以这是

So that's

我的脚趾锻炼。

my toe workout.

是的。

Yes.

还有这个东西。

There is this thing.

一条带子。

A band.

然后还有这个球。

And then there's this ball.

是的。

Yes.

所以这个就像是我的足部健身房。

So this is like this is my foot gym.

没错。

That's right.

你能给我演示一下这些东西怎么用吗？

Can you show me how this stuff works?

当然可以。

Absolutely.

好的。

Okay.

所以这些是我的脚，这些是我的脚踝。

So these are my feet, and these are my ankles.

我之前得了足底筋膜炎，我想应该是这只脚。

So I had plantar fasciitis in I believe it was this foot actually.

而现在，我得了高位踝关节扭伤，就是这里的某条韧带撕裂了。

And then right now, I've got a high ankle sprain, which is some kind of ligament here has been torn.

他们告诉我，这条韧带在三面都撕裂了。

And they told me that it's torn on all three sides.

所以过去几周我一直穿着矫形靴，但过去一两周我已经把它脱掉了。

So I've been in a boot for the last couple of weeks, but I've taken it off over the last week or two.

我那时候还用了拐杖。

And I I was on crutches as well.

我一脱掉袜子，你就盯着我的脚看了。

What are you the minute I took my socks off, you became fixated on my feet.

是的。

Yes.

我需要关注些什么呢？

What what what do I need to be thinking about?

你单凭看我的脚就能看出什么？

And what can you see just by looking at my feet?

当你看这只脚时，你可以看到这里有一个小凸起。

When you're looking at this foot here, you can start to see this little bump here.

你还可以看到大脚趾顶部有凸起。

You can start to see bumps on the top of the big toe.

明白吗？

Okay?

诊断结果是第一跖趾关节活动受限或第一跖趾关节僵硬。

And the diagnosis is a hallux limitus or a hallux rigidus.

这基本上意味着你的脚趾顶部形成了关节炎。

And basically what that means is that you have formed arthritis on the top of the toe.

因此，这会妨碍你在行走和跑步时获得所需的完整活动范围。

So it prevents you from getting that full range of motion that we need when we walk and run.

好的。

Okay.

明白吗？

Okay?

如果突起向侧面突出，那就是我们所说的拇外翻。

If the bump goes out to the side, that's what we call hallux valgus.

那就是拇囊炎。

That's the bunion.

拇囊炎。

The bunion.

好的。

Okay.

好的。

Okay.

所以脚是生物力学的窗口，因为你能看到负荷和异常负荷，对吧？

So that's why the foot is a window to mechanics, because you can see loads, aberrant loads, right?

为什么这里会形成这种情况？

Why is this forming here?

所以，我首先想看一下活动范围有多大。

So, one of the first things I want to look at is how much range of motion.

一切都关乎大脚趾。

It's all about the big toe.

走路时，我们的大脚趾承受了很大的负荷和力量。

When we're walking, we put a lot of loads and force that go through the big toe when we walk.

走路时，你的大脚趾应该有大约40到45度的活动范围。

You should have about 40 to 45 degrees to walk out of that big toe.

这是埃迪。

So here's Eddie.

这里是45度。

Here's 45 degrees.

向上。

Up.

向上。

Up.

好的。

Okay.

好的。

Okay.

是的。

So yes.

所以我想看看有多少活动范围。

So what I wanna see is how much range of motion.

你能看到他脚离地了吗？

Can you see how he's off the ground though?

我希望大脚趾的脚掌部分贴地。

I want the ball of the big toe on the ground.

这个活动范围很不错。

That's a good amount of range.

这是你第一次夸我的脚。

That's the first nice thing you said about my feet.

我们才刚开始呢。

We're just getting started.

我会再找点别的来说。

I'll find something else.

然后你需要观察脚趾的灵活性。

And then you wanna look at toe dexterity.

换句话说，你能单独活动每个脚趾吗？

So in other words, can you isolate your toes?

那么，你能只抬起右脚的大脚趾吗？

So can you lift just your big toe on the right?

很好。

Good.

然后左脚也试试。

And then on the left.

这其实挺难的。

That's actually quite hard.

我以前从来没做过这种事。

Like I've never had to do that before.

有趣的是，当你看到那些对脚部缺乏感知的人，他们试图抬起脚趾时，你会看到他们的手也跟着动。

It's funny because when you'll see people that have poor awareness to their feet, when they try to lift their toes, you'll see them like, their hands.

我会说，你的背部不会让脚趾伸展。

I'm like, your back isn't going to extend your toe.

然后把大脚趾放下来，再伸展其余四个脚趾。

And then put your big toe down and then extend your four toes.