Gaining a New Under-Standing

January 24, 2014 in STSMPT

Most people never stop to think about the fact that their whole body rests on just two feet. Biomechanical distortions in the feet are common, and these distortions can have repercussions in the form of pain, injury, and athletic performance. Anything that requires balance, good posture, or rapid neurological response can suffer due to distortions in the feet.

Structure of the Feet:
The most common biomechanical distortion in the feet is falling arches (also known as pes planus or hyperpronation). The structure of the foot is analogous to that of a bow that shoots arrows. All the bones make up the relatively straight piece of wood. A band of connective tissue called the plantar fascia connects the heel to the balls of the feet and pulls them together. The pulling force created by the plantar fascia causes the foot to bow, much like a string on a bow creates its shape and function. Over time, for many people, the plantar fascia begins to stretch and lose the shape it had when we were young. The visible effect of a stretched plantar fascia is a foot with a falling arch. There are currently no worthwhile procedures that can restore the plantar fascia itself, but your feet can have a youthful structure again.

The Whole Body Gets Thrown Off:
The biomechanical distortion of a falling arch does not stop at the foot. A flat foot misaligns important structures from the ankle to the neck. The ankle inverts, becomes moderately hypermobile, and more prone to sprains. The shin bone (tibia) rotates and shifts toward the body’s midline. The knee both rotates and shifts toward midline. This predisposes the knee to patellofemoral pain and pre-loads the anterior cruciate ligament with excess pressure. This causes the thigh bone (femur) to tilt to the outside. The hip bone then rotates forward and contributes to an exaggeration of the forward curve in the lower spine. Since the arch on one foot often falls more than the arch on the other foot, one whole side of the body drops down as much as half an inch, creating a functional scoliosis. So falling arches don’t just contribute to lower leg problems like heel pain and shin splints. Falling arches predispose a body to pain and injury ranging from knee pain to headaches. The serial distortions are subtle in appearance and happen in very healthy looking people. It typically takes a trained eye to point out these distortions.

Athletic Performance:
Because the biomechanical distortions force a suboptimal posture and gait, falling arches can have far reaching implications in athletic performance. Flat feet need to flare out (like a duck), but this is inefficient for running. Balance is harder to maintain, and one study actually demonstrated how wearing orthotics improves golf performance. One of the distortions that happens is that the head must be carried in a more forward position – the head pokes forward. The neck and the shoulder are essentially one functional unit. When the neck is leaning forward, the shoulder loses range and power. In ideal standing posture, the hole of one’s ear lines up vertically with the bump in the shoulder (the acromioclavicular joint). When this is not the case, throwing can be affected.

The Fix:
Unfortunately, there is no exercise, surgery, or procedure that can restore the arch of the foot in any meaningful way. The fix for a falling arch is a pair of modern, custom-made foot orthotics. Modern materials and fabrication techniques make orthotics quite comfortable, lightweight, and appropriate for use in many athletic activities. Give us a call if you experience injury or pain that may be stemming from postural distortions. We can assess your posture to discover the true root of your problems, whether it may be your feet or a tight iliotibial band. There’s a lot we can do to correct these situations, and we can make referrals as necessary for additional solutions that will get to the foundation of your problems.

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