Foot Function & Fascial Lines Series

Tapping into Torsion | The Rotational Power of the Achilles Tendon

Power lies within the transverse plane.

We have all heard this concept at one point or another throughout our education or training career.  

javelinFrom the rotational moment of the trunk to generate power when throwing a javelin to the torque created from supination of the foot into the external rotational power of the glutes – rotational moments are in every aspect of human movement. 

The closer we look at the fascinating human body and the fascial system, the more we can find that spirals and rotations are everything and EVERYWHERE!

I want to take this time to explore an area of the body where rotational or spiraling properties are often under appreciated or perhaps not even know – within the human Achilles tendon.  

The Achilles Tendon

Enter the largest, strongest tendon in the human body – the Achilles tendon.   Formed by the gastrocnemius and soleus tendons (and sometimes plantaris), this fascinating structure is able to generate most of the elastic energy return during dynamic movement and from an evolutionary perspective is a critical structure in the spring-mass theory of movement efficiency. 

Now there are a few unique characteristics of the Achilles tendon that must be Achilles Rotationappreciated when training or rehabbing this structure.  All of these characteristics are emphasized in all trainings through EBFA Global:

  • The Achilles tendon is not one tendon but rather a stacked tendon 
  • 2/3 of the Achilles tendon is made of soleus fibers 
  • The Achilles tendon medially rotates toward its insertion
  • This rotation places the soleus fibers to the medial calcaneus 
  • While the MG / LG insert towards the lateral calcaneus

How cool are these facts?   But what does the above functionally mean?  

Functional Application #1 – Soleus Equals Power 

Since 2/3 of the Achilles tendon is soleus fibers this means that most of our elastic recoil and plantarflexion torque is coming from the fascial tension and loading of the soleus muscle and fascia.   

When you are training the elastic recoil of the Achilles tendon remember to incorporate soleus focused eccentric deceleration and acceleration training while the knee is bent or while transitioning through a knee flexion pattern.  

Functional Application #2 – Resupination of the Foot through Plantarflexion

The rotation or torsion of the Achilles tendon provides increased tensile strength IMG_9349and assists in fiber sliding during elastic movement.    In addition, due to the placement of the soleus fibers of the Achilles tendon plays a key role in thresupination action of the rearfoot during the push-off phase of gait.

This coupled concept means that when training jumping and push-off power drills emphasize a from the ground up approach the utilizes total ankle plantarflexion.   In EBFA Education we do this through teaching jumping by pushing off all 5 digits and envisioning a follow through with all digits (see image to the right) 

Functional Application #3 – Restriction of Blood Supply 

I must add that as much as torsion adds a rotational power to the Achilles tendon,  there can be a downside to this feature.   This rotation of the Achilles tendon fibers causes a disruption to the micro-circulation or blood supply to the Achille tendon. 

The area with the greatest compromise in circulation is called the watershed area and lies 2 – 6 cm above the Achilles insertion.   The mid-tendon or watershed area is the site of most Achilles tendon ruptures (especially as we age) and is the location of tendon degeneration.   

By appreciating this compromised Achilles circulation, professionals should ensurefullsizeoutput_1805 to properly warm up the elastic properties to the Achilles tendon and in those with a history of mid-tendon tendinitis to avoid movement patterns that increase stress to the watershed area of the tendon.   

In my office, I use the PowerPlate to increase micro-circulation to the Achilles tendon in my patients with a history of Achilles injury or degeneration.   Research has shown that 10 min of whole body vibration can create increased skin perfusion and decrease arterial resistance, both beneficial to tissue healing.   

Functional Application #5 – Non-Uniform Achilles Stress by Pronation

The non-uniform division of the Achilles tendon fibers with 2/3 being soleus, coupled with medial rotation of the tendon fibers there is a non-uniform stress placed on the Achilles tendon.  

Gils et al. has demonstrated that the soleus fibers are under the greatest stress with most Achilles tendon pathology occurring to the medial aspect of the tendon.   It was found that pronation increased this non-uniform stress to the soleus tendon fibers especially during the midstance phase of gait.  

Professionals who appreciate this concept can better assess how foot type and/ or a lack of foot stability can contribute to Achilles tendon pathology.    Foot strengthening and in some cases orthotics may be advisable for the prevention and management of medial Achilles tendon stress.  

To learn more about the fascinating functional foot please visit or check out my book Barefoot Strong.    

Until next time, stay #barefootstrong 

Dr Emily

Barefoot Science, General

NeuroRehabilitation with Naboso Technology

Balance impairment and gait instability are common symptoms in patients living with Parkinson’s Disease (PD).   From an increased fall risk to reduced independence, compromised dynamic stability can place a heavy emotional burden on these individuals.

When developing a balance and fall reduction program for PD clients, research has OLYMPUS DIGITAL CAMERAshown that stimulation of the foot with texture shows promising results.   Study after study has demonstrated that the seemingly simple intervention of texture is actually quite powerful in its postural effects.

Why the Plantar Foot? 

Our hands and feet are some the most sensitive sensory gateways of the human body and allow us to connect our visual and vestibular systems with the exteroceptive (external) world.

The skin on the plantar foot is packed with unique nerve endings called mechanoceptors or touch receptors.   There are four main mechanoceptors found on the bottom of the feet.

SAI – which is sensitive to two-point discrimination & texture (Naboso!)

SAII – which is sensitive to skin stretch

FAI – which is sensitive to low-frequency vibration (walking impact forces)

FAII – which is sensitive to high-frequency vibration (running impact forces)

Texture & the Plantar Foot 

Texture such as that of two-point discrimination (Naboso) have been shown to improve posture and sway in those with Parkinson’s Disease.

A 2011 study by Hatton et al. showed that pyramid-like textures had the greatest efficacy on reducing postural sway in PD patients.   This was both the eyes shut and unstable environment.

A 2013 study by Qui et al. compared the effects of smooth versus textured insoles on balance and stability in those with Parkinson’s Disease.  Qui et al. found that the greatest effect was with textured insoles on unstable surfaces with eyes open and eyes closed.

A 2017 study by Silva et al. showed that continuous use of textured insoles over a one week period not only improved gait but also improved foot sensitivity and sensation.

Naboso Textured Insoles

Insole Pic 2To date, Naboso Insoles are the only commercially available textured insoles that are designed to enhance posture, improve gait and reduce falls in people with neurological conditions such as Parkinson’s Multiple Sclerosis, neuropathy, and post-stroke.  There is so much exciting textured insole research but until Naboso none of this information was commercially applicable to these PD patients.

At Naboso we are so excited to see that the effects of Naboso Insoles match that of the research!    Below are a few videos of just how powerful the Naboso Insoles are at improving gait in those with Parkinson’s Disease!

Coming Soon! – Naboso Clinical Insoles 

With these exciting results above Naboso Technology is working on a new version to their already existing Insole line – NabosoNeuro.   These clinical insoles will be specific to the enhanced somatosensory demands of Parkinson’s Disease, Multiple Sclerosis, diabetes (neuropathy), post-stroke + more!

To learn more about the benefits of Naboso Insoles in neurorehabilitation please click HERE

To carry Naboso Insoles in your office for patients and clients please contact Naboso Technology for our wholesale rates –

Barefoot Science

Foot Strength & Arch Stiffness in Relation to Minimal Footwear

GladSolesTrail1Earlier this week one of my master instructors shared an interesting article with me on the relationship between foot strength and stiffness in those who chronically wear minimal footwear.

For those who study barefoot movement and integrated foot mechanics, the association between minimal shoes and stronger feet may seem like an obvious finding but I wanted to delve into this article a little bit more for those readers who may not be as adept to some of the terminology.

Foot strength and stiffness are related to footwear use in a comparison of minimally- vs. conventionally-shod populations – February 2018


Concept #1 – Foot Stiffness is a Positive Characteristic 

I want to start off by explaining that anytime you read about foot stiffness or leg stiffness running-1in relation to barefoot running or minimal footwear – this is a GOOD thing!    The term stiffness does not mean rigid or non-flexible and is not synonymous with how we may say “I woke up stiff this morning”

During dynamic movement, the concept of stiffness is actually a fascial response that is used to help efficiently load and unload impact forces.   Think off stiffness as transient rigidity as a means to increase stability.   This stability is achieved through integrated isometric contractions which influence the surrounding fascial tissue and muscle compartment pressures.

In the above-referenced article, Holowka et al. found that those that chronically wear minimal footwear have higher arch stiffness upon foot contact.   This can be interpreted to mean that in minimal footwear the intrinsic foot muscles are more responsive and adapted to help stabilize the foot and absorb impact forces.

This finding further demonstrates that traditional footwear can actually make our feet weaker and less responsive to impact forces, quite possibly to the point that eventually we become dependent on the footwear to absorb impact forces.

Concept #2 – Minimal Footwear Increases Intrinsic Muscle Size 

Repeated use of any muscle will result in hypertrophy of that muscle, this includes the intrinsic muscles of the feet.    If the chronic use of minimal footwear is associated with increased foot stiffness this means that those feet are engaging and strengthening their intrinsic foot muscles with every step they take.

abductor-hallucis-strain220In the above study, Holowka et al. demonstrated that in those that chronically wear minimal footwear there was a noted 2mm increase in abductor hallucis diameter.   Now, 2mm may not seem like a lot but when you are dealing with small muscles of the feet, 2mm is considering statistically significant.

If you are unfamiliar with the abductor hallucis muscle, this is the intrinsic foot muscle that is responsible for controlling the lateral longitudinal arch.   Originating on the plantar medial calcaneus and inserting on the medial aspect of the proximal phalynx of the hallux, the abductor hallucis runs under and supports the navicular bone.

In the picture to the right, you can appreciate that the navicular bone is the highest point calcaneonavicular-ligament_blogof the medial longitudinal arch.   By strengthening the abductor hallucis and controlling how much that bone drops during dynamic movement is essentially saying there is control of the medial arch.

Chronic use of minimal footwear and the strengthening of the abductor hallucis muscle is demonstrated to be an effective way to build foot control and resist the stress of flat feet and over pronation.

Concept #3 – There Are Exceptions to Every Finding 

As a Functional Podiatrist, I must end by saying that the findings of the Holowka et al. study are very exciting and definitely do build the support for the use of minimal footwear.  Having said that, there are exceptions to every finding.

As we take these findings and use them to make footwear recommendations for our clients and patients we cannot forget that there are still a few patients who minimal footwear may not be appropriate for.

Some of these may include:

– Accessory navicular

– Posterior tibial tendinitis or PTTD or post tib tear

– Hypermobility of the 1st Ray

– Flexible flatfoot with symptomatic post tib tenditis, plantar fasciitis, sinus tarsi syndrome

– Rigid flat foot with arthritic changes to the midfoot or rearfoot

All feet should be assessed by a qualified professional before transitioning to minimal footwear and all transitions to minimal footwear should be coupled with a barefoot foot-strengthening program, such as that created by EBFA and our Barefoot Training Specialist® Team

To learn more about foot types and the power of barefoot science please visit or


Dr Emily Splichal

Founder EBFA Global & Naboso Technology


Barefoot Science, General

Enhancing Sensory Stimulation to Improve Balance in Multiple Sclerosis

Balance impairment is a common symptom in patients living with Multiple Sclerosis.   From an increased fall risk to reduced independence, compromised dynamic stability can place a heavy emotional burden on these individuals.

When developing a balance and fall reduction program for MS clients, research has shown that approaching it from a sensory perspective is the most effective.

Below are the top three sensory stimulation pathways that can be used to optimize balance and stability in your MS clients.

eyeSensory Gateway #1 – Vision

According to the Multiple Sclerosis Society, vision problems are some of the most common symptoms associated with MS.  The most common eye complications include optic neuritis, diplopia, nystagmus and internuclear ophthalmoplegia.

Our eyes are designed to move and accommodate for light, providing us with as much sensory detail about our environment as possible.  A decrease in visual acuity has been associated with impaired balance and delayed accuracy in motor patterns.

A 2018 study by Herbert et al. demonstrated the efficacy in the integration of eye movement exercises and visual stimulation in improving balance for those with MS.    The study that focused on the BEEMS (balance and eye motion exercises for MS) integrated the following exercises for improved sensory integration and brain balancing.

Sensory Gateway #2 – Vestibular

 The first sensory system to develop after conception is the vestibular system.  Often earreferred to as the gateway to the brain, the vestibular system is critical in how our brain and body relates to gravity.

In MS, vestibular disturbances typically present as vertigo, balance disorders, and the presence of nystagmus (rapid involuntary movements of the eyes).  When considering the implications of vestibular disturbances it is important to understand if the cause is related to disturbances in the peripheral vs central vestibular system.

The vestibular system can be divided into two main systems: the central system (the brain and brainstem) and the peripheral system (the inner ear and the pathways to the brainstem).   A 2008 study by Zeigelboim et al. found that vestibular disturbances related to MS were disruptions in the peripheral system, with a higher prevalence in female patients.

The following exercises are recommended to address the vestibular disturbances associated with MS.   You will notice that many of these exercises also integrate the visual system, as all of our sensory systems a linked in function with one input system enhancing the other.

Sensory Gateway #1 – Touch

104821576The final sensory system is one that is quite familiar to those who follow EBFA Global’s work and allows us to tap into the homunculus of the motor cortex.

Our hands and feet are some the most sensitive sensory gateways of the human body and allow us to connect vision with an exteroceptive world.   Neuropathies and disruptions in peripheral proprioceptive and vibratory input are often associated with MS and should be addressed before symptoms present.

The skin on the plantar foot and palmar hand contain four main mechanoceptors:

SAI – two-point discrimination & texture

SAII – skin stretch

FAI – low-frequency vibration

FAII – high-frequency vibration

Sensory Stimulation Balance Program for Multiple Sclerosis 

The following exercises integrate visual, vestibular and touch sensory stimulation into every exercise.   All of the exercises can be progressed from seated to standing to legs crossed and tandem to single leg stance.

Equipment needed:   Naboso Barefoot Mat, Ball (Textured), Card

To learn more about the sensory input systems and how they relate to brain, body and balance please visit: or

Dr Emily Splichal







Barefoot Science

Beyond Biomechanics | Addressing Foot Pain with Sensory Stimulation

I want you to picture a human foot.   Now picture a person standing barefoot, and then walking barefoot.   Do you see the foot striking the ground and flexing under impact, only to re-stabilize and push off just a few milliseconds later?


Often times when we think of human movement we can’t help but to be drawn to the thought of joints moving and muscles contracting.   Or in the case of foot function we are quick to consider the mechanics of flat feet, high arches, pronation and supination.   However when we delve deeper into the science of human movement there is more than meets the eye.

The Two Sides of Foot Function   

 When I teach on behalf of EBFA Global or speak to my patients I always emphasize that there are two sides to foot function (and dysfunction) – biomechanical and neuromuscular.    Now both play and important role in foot function which means that both must be appreciated – however to solely treat foot pain with just one belief system in mind is inherently flawed.

In most Podiatric Medical Schools we are taught foot function and foot pathology solely pronfrom a biomechanical perspective.   This means that every patient is tested for foot mobility and told to stand statically to determine arch height and foot type.   Based on this foot-focused biomechanical assessment and foot classification system the patient cause of injury and treatment protocol is determined.   Some of the favorite treatment recommendations include motion-controlled footwear and custom-posted orthotic both of which are prescribed with the hopes of controlling foot-focused biomechanics and thereby reducing their foot pain.

Beyond Biomechanics

The other side of foot function is one that is driven from a neuromuscular perspective and integrates the science of sensory stimulation and fascial systems.   In the case of neuromuscular function every patient would be assessed for sensitivity of plantar mechanoceptors as well as co-activation patterns between the foot and the core.  The role of minimal footwear, myofascial releasing, breathing patterns and compensation patterns more proximal would all be considered.

So which is more appropriate?  Well it depends.   In certain cases there will be a stronger argument towards a more biomechanical influence and in others it is more sensory.  This means it really is a marriage between the two approaches that provides the greatest patient outcome.

Sensory Stimulation in Foot Pain

My practice and Podiatry career is built around bringing an awareness to the important role sensory stimulation has on foot function and foot pain.

With every step we take impact forces are entering the foot as vibration.  This vibrational noise stimulates unique mechanoceptors on the bottom of the foot and is used to coordinate the loading of impact forces through coordinated contractions of the intrinsic (small) muscles of the bottom of the foot.   This co-contraction leads to a stiffening or strengthening response of the foot.

Researchers such as Nigg et al. and Robbins et al. have demonstrated a direct relationship between sensory stimulation of the plantar foot and intrinsic muscle strength concluding that one is necessary for the other.   This means that if our footwear or orthotics disconnect us from sensory stimulation – as in the case of cushioned footwear – this can actually weaken our foot making us susceptible to plantar fasciitis, Achilles tendinitis and stress fractures.

Beyond Vibration Stimulation

feet-mechanoreceptorsVibration stimulation is an extremely important sensory stimulation that enters our foot however it isn’t the only stimulation.   Another important stimulation is the ability for our foot to determine texture and if a surface is rough or smooth.   This information is used to help maintain dynamic balance (think walking on ice).

Enter the merkel disk mechanoceptors.   These superficial sensory nerves are used to determine what’s called 2 point discrimination which is translated to roughness or the texture of a surface.  Surface texture and insole texture is one of the most studied aspects of foot stimulation and posture or gait.  From decreased medial lateral sway in patients with Parkinson’s or MS to reduced prefrontal cortical activity in atheltes post-concusion the applications are promising!

One area that hasn’t been focused on for sensory stimulation and foot function is foot pain.  I am here to change the awareness around this concept and share the powerful application of sensory stimulation and foot pain.

As we mentioned earlier sensory stimulation of the foot leads to a contraction of the intrinsic muscles of the foot.   Intrinsic muscle contraction is not only is a criticial step in the damping of impact forces but has also been shown to increase the medial arch and build co-activation contractions in the core.

 The Evolution of Textured Insoles

In October 2017 Naboso Technology launched the first-ever commercially available OLYMPUS DIGITAL CAMERAtextured insole!   Naboso Technology essentially brought the science of touch and years of textured insole research to the market place giving new hope to people with foot pain.

Available in two strengths – Naboso 1.0 (1mm texture) and Naboso 1.5 (1.5mm texture) Naboso Insoles are designed to be worn without socks (or at the most very thin socks).  They fit into all footwear, are freely movable in all planes of motion and are only 3mm thick.

Learn more about the power of texture!


Barefoot Science, Foot Function & Fascial Lines Series

Feet, Fascia & Functional Movement Summit | London

Get ready for the first-ever Feet, Fascia and Functional Movement Summit coming to London on Sunday January 21, 2018!

As part of the EBFA Global Mentorship this one-day event features the global leaders in fascial fitness and functional movement including:

Dr Robert Schleip (via teleconference) of Fascial Fitness

Gary Ward of Anatomy in Motion

–  James Earls of Born to Walk

Dr Emily Splichal of EBFA Global

Experience lectures on the unique perspectives of these four educators and how each applies the concept of fascial integration into functional movement and human locomotion.

Let’s say hello to our Presenters!


Don’t miss out on this invaluable training!

Sunday January 21, 2018  | 8am – 6pm

50-60 Southhampton Row
London, UK

Registration Fee: $300 USD


Barefoot Science

The Evolution of Touch, Emotion and Barefoot Science

“Man’s mind, once stretched by a new idea, never regains its original dimensions.”
— Oliver Wendell Holmes

This is one of my favorite quotes.  In fact I love any quote that has to do with learning, expanding oneself and seeking self-improvement.  I have always held the belief that our ability to learn never stops, and would go so far as to say it is our responsibility to continue to learn and challenge our knowledge base.  This is especially true for professionals in health and wellness as our understanding of the human body, physiology and pathology is always expanding.

This is why EBFA’s education has continuously grown and expanded from simply foot biomechanics and short foot exercise to brain, breath, emotion and the neuroplasticity of barefoot science.

As I prepare for the re-brand of EBFA for January 2018 I want to share some exciting insight into the power of barefoot science and how our ability to discriminate surfaces, textures and touch is linked to emotional stability ind children and adults.

From Survival to Sophisticated

tumblr_ljt7kglHlv1qep95ho1_1280Touch is a powerful input system that 1.  allows us to navigate and manipulate our environment (i.e. feeling the sharpness of rocks under our feet cues us to walk slower) and 2. allows others to navigate and manipulate our environment (i.e. feeling someone grabbing you strongly warns you of a possible attack).

Now when it comes to evolution – touch is no different.   The art of touch has gone from simply survival (is this a threat or not) to more finite and discriminative.  This higher processing of touch refers to both the hands and feet – allows us to coordinate complex tasks such as micro-dissection surgery to the ability to read braille.

In present day man both the protective and discriminative aspects of touch still exist through a relationship that researchers call a dualism.   This dualism of touch requires balanced interpretation of touch.   Any deviation towards protective > discriminative and the individual has a heightened emotional “fight or flight” response to touch.

Enter the Tactility Defensive Child

The best example of this touch imbalance or altered relationship with touch can be observed is in a tactility sensitive or defensive child.   Have you ever seen or experienced a child who doesn’t like the texture of certain fabrics on their skin or doesn’t eat certain foods because of the texture?    Have you seen or experienced a child that doesn’t like to be hugged by other children or gets anxious and hostile when in close proximity to other people?

These are just a few of many examples of touch triggering a sympathetic / survival / fight or flight response in a child.

maxresdefaultResearch has shown that when these children are touched or touch a texture that they are defensive to, they will get a spike in cortisol levels which is indicative of a stress response.

It is well understood and accepted that elevated cortisol – even in children – can negatively effect the immune system (think auto-immune conditions and allergies), fat deposition (increase in childhood obesity) and learning / memory (ADHD, Autism, depression).

This is why I always say sensory before cognitive.   In order to allow the optimal cognitive development of children (learning, memory, attention) we need to ensure the foundation of sensory stimulation – and to their relationship to sensory stimulation is healthy.

(To learn more on this topic please check research Sensory Integration by A.J. Ayres)

Using Barefoot Science to Re-Balance Touch & Emotion

When it comes to Sensory Integration there are three main areas that need to be optimized during childhood development – vestibular, proprioceptive and tactile.

What’s interesting is these are the main somatosensory input systems to allow human locomotion – with human locomotion being linked to higher level cognitive functioning and emotional awareness.

The bare foot is a powerful tactile (touch) and proprioceptive-rich area of the body that in upright stance is the only contact point between the body and the ground.

Increased and earlier footwear use in children coupled with less foot sensory stimulation and exploration has paralleled the rise in ADHD, Sensory Processing Disorders, emotional disconnection and aggression in children.

Could there be a link?    I would say so!

But it is not too late.   We can use the understanding of barefoot science to help children and adults with sensory processing disorders as well as anyone along this spectrum.

Below are a few guidelines I recommend for integrating barefoot stimulation with these individuals:

  • Start with small doses and increase duration
    • Those with tactile defensiveness can reach sensory fatigue very quickly so start slow and gradually increased based on their response.  Also allow them to control the amount of stimulation.
  • Ensure the feeling of safety is re-enforced throughout their barefoot stimulation and combat any anxiety that may arise
    • Discuss the concern of anxiety and have them mentally prepared for the barefoot / sensory stimulation that will be happening throughout the session.  Talk about how it is a positive association and describe the texture or sensations they are feeling under their feet.
  • Avoid sharp / defined textures in the beginning but rather shutterstock63299443start with morestrong / broad stimulation
    • Progress from flat stones to smaller stones progressively based on their acclimation to textures
  • Re-inforce how barefoot stimulation is linked to safety and integrate foot stimulation into any vagal tone training, diaphragmatic breathing or cranial sacral therapy programming

To learn more about how practitioners are using the Naboso Proprioceptive Mat and tactile stimulation for the sensation of “safety” please look at Lois Laynee’s Restorative Breathing Program (