Foot Problems – The Truth

Treating the cause not the symptom!

SOLVING FOOT, ankle, knee, hip, and back problems is usually not as simple as putting an arch support into a properly fitted shoe, as many ads claim. Anti-inflammatory drugs, cotisone shots, heel lifts, heel cups, and cushion shoes may treat the symptom temporarily but do not address the cause. There are no miracle shoes.

THE HUMAN BODY is made up of bones, joints, muscles, tendons, and ligaments. The mechanics of the body are all interconnected, functioning at different times in the walk cycle, and having a certain range of motion. Anytime there is a breakdown in the muscular/skeleton system, the affects can transfer the pain to another part of the body. Understanding the biomechanics of the body and being able to trace the symptom area back to the cause of the pain is the more effective solution of solving the discomfort for the future.

OUR PEDORTHIST take their experience and knowledge of lower limb musculoskeletal biomechanics and apply it to either the doctor’s diagnosis or to their own assessment of the patient’s symptoms. Their goal is to balance both sides of the lower extremities, from foot and ankle through knees to hips. As our pedorthist assesses the biomechanics, he gives the physician or the patient many conservative, or non-surgical, treatment options. These can range from shoes professionally fitted, shoe modifications to assist in the control or realignment of the foot deformity, to over-the-counter or custom-made foot orthosis for improved support.

The main functions of the foot in gait

The human body while in motion goes through three phases while on the ground; heel strike, mid stance, and toe off. The foot acts as a ridged break at heel strike to slow the forward motion of the body, acts as a mobile adapter to absorb the shock of the body forces as it goes through the mid stanc and to maintain stability given the type of terrain and then becomes a rigid lever during push off. As a mobile adapter, the foot is pronated. When the foot is pronated, its joint structures are loose, hence its ability to adapt to the terrain. As a rigid lever, the foot is supinated. The joint structures fit tightly into one another like a wooden puzzle, providing a solid lever arm to slow the forward motion at heel strike and to create a solid lever arm for the heel to lift and propel the body forward at toe off. Therefore while in gait the foot will supinate, pronate, and then supinate.

Muscle function of the leg in walking

The primary functions of the muscles are to decelerate, stabilize, and accelerate movement of the skeletal body. Muscles do not pull or push, they only contract to create the forces that encourages movement. As one set of muscles contract, opposite muscles relax and as the muscles work in harmony they create stability as you go through the gait cycle. Primary muscles of the leg and foot that work together during walking include:

  • Quadreceps muscles
  • Hamstring muscles
  • Gastrocnemius muscles (CALF)
  • Anterior Tibialis muscles and toe extensors
  • Peroneus longus and brevis muscles
  • Posterior tibial muscles
  • Intrinsic muscles of the foot

Abnormal foot function

Abnormal function of the foot occurs when the biomechanics of the muscleoskeletal makeuip of the lower extremity is forced to deviate from the norm causing an abnormal structural breakdown. These occurrences are mostly the result of the following.

  • Abnormal Supination
  • Abnormal function due to restricted joint motion
  • Abnormal Pronation

Abnormal Supination:

Supination as we have explained is a rigid lever and when pronation is not allowed the ability to adapt to different terrain or to absorb the forces of the body are prevented, and then structural damage occurs. Supinated foot is characterized by a high arch and is further associated with stiffer joints.

Abnormal function due to restricted motion in joints

Every joint in the human body has a certain range of motion that it must work within. When a joint is restricted the joint in front and behind must work extra hard to compensate. This in time will cause those joints to break down and placing more stress on the set of joints. Hence, structural breakdown.

Abnormal Pronation

Pronation is considered abnormal when it is excessive or occurs at the wrong time during the gait cycle. An overpronated foot is a more mobile foot and when asked to resupinate for push off it is sometimes unable to, causing further structural breakdown.

Problems associated with these abnormalities

The following list of foot prolems are just a few of the more common problems associated with the abnormal function of the foot and ankle.