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Poor Foot Biomechanics
Ross Hauser, M.D.
Poor foot biomechanics may be responsible for a myriad of chronic complaints,
including pain in the feet, knees, lower back, and neck.
The
feet act as a spring, propelling the body forward with each step. If the spring
is not working, the propelling force must come from the knees, hip, or lower
back. Because these areas are not designed to function in this manner, they
eventually deteriorate and the chronic pain cycle begins.
The most important factor in evaluating a person’s gait (walking cycle) is to
observe the stability of the
arch and the
ability of the foot to spring the body forward. The most important arch in the
foot is the
medial arch.
It is abnormal for the arch to collapse during the gait cycle or while at rest.
This collapsing of the arch is known as
flat feet, or pes planus. A collapsed
arch indicates tissue breakdown. Supporting tissue is no longer able to elevate
the inside of the foot. The plantar fascia is the first tissue to be affected.
Pain resulting from this weakened tissue is called
plantar fasciitis.
If the fascia is not strengthened, a painful heel spur will result.
Prolotherapy
to strengthen the fascia is a treatment option.
The next affected structures are the ligaments that support the inside of the
foot, especially the calcaneonavicular ligament. When this ligament is weakened,
the arch pain will increase. Eventually, the
posterior tibialis tendon in the
knee must help support the arch. This tendon eventually weakens, resulting in
knee pain
added to the original foot pain, as the arch continues to collapse. Because the
arch and the knee can no longer elevate the foot, the entire limb must be raised
during a step, putting additional strain on the hip.
The spring in the foot and the efficiency of the gait are drastically reduced
due to the collapsed arch. This requires more energy from the foot, resulting in
further deterioration of the medial arch. The more severe the collapse of the
arch, the greater the likelihood of pain. The deterioration cycle will continue
until something is done to support the arch. Contrary to popular belief,
cortisone shots
will not accomplish this! Arch pain in the foot is not a cortisone deficiency!
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