Dem Bones is a well-known spiritual song in which the first verse says:
Toe bone connected to the foot bone |  |
This wisdom that the human body is a unit where each piece is connected to the next is often lost in current treatments for musculoskeletal pain. Let's help restore that wisdom...
Foot posture directly influences leg posture just as leg posture directly influences foot posture. The two cannot be disconnected from one another. Why is it that many current treatments for foot pain only look at and treat the foot without looking at the leg? And why is it that many treatments for leg pain only look at the leg without regard for the foot?
Let's talk about foot and leg anatomy, biomechanics, and the interconnectedness of the foot and leg. The foot can do on a basic level pronation, supination, eversion, inversion, dorsiflexion, and plantar flexion. Looking at a more complex level we commonly see misalignments like pes cavus (flat feet), pes planus (high arch), forefoot eversion or inversion, hind foot inversion or eversion, big toe adduction, hallux valgus (bunion), hyperextention of the metatarsophalangeal joint, flexion of the proximal phalangeal joint, and adduction of the metatarsophalangeal joint.
Each of these movements of the foot/ankle cause a change in the tibia/fibula position. A change in tibia/fibula position causes a change in femur and patella position. Change in femur position cause a reaction in pelvic position and all the way up the body.
Each of these movements of the foot/ankle cause a change in the tibia/fibula position. A change in tibia/fibula position causes a change in femur and patella position. Change in femur position cause a reaction in pelvic position and all the way up the body.
 | Pronation is something commonly talked about and often treated by using an arch support or custom orthotic and stability shoes. But what causes pronation? The causes of pronation can be many things, and often a lot of them combined together. Hallux valgus which is the combination of abduction of the first metatarsal and adduction of the phalanges and this changes the line of pull of the flexor hallucis longus and abductor hallucis and causes further adduction of the big toe and a collapsing of the medial arch. The collapsing of the medial arch will cause pronation and eversion of the foot. This subsequently causes internal tibial rotation which causes internal femur rotation. |
| But what if internal femur rotation happened first? The internal tibial rotation would cause eversion and pronation of the foot. This would cause pes cavus (a collapsing of the medial arch or flat feet) and the changes this creates during gait would start causing hallux valgus. Since the body is a unit, a change in position or posture of one bone or joint will cause a chain reaction up and down the body affecting every other joint in your body. (Today I'm just focusing on the foot and leg and in a future blog posts will talk about the rest of the body.) |  |
Understanding how the body is a unit and any deviation in foot alignment will affect leg alignment and vise versa, we must now approach pain treatment the same way. If someone has foot pain like plantar fasciitis or fasciosis which might be caused by collapsed arches, we must look at big toe alignment, tibia alignment, femur alignment, and the entire kinetic chain and make sure we are addressing all the imbalances related to the collapsed arches. Any treatment that focuses on the symptoms or the site of the pain will only at best offer temporary relief. The only way to eliminate the foot pain is to address the underlying cause of the problem by taking a holistic approach to whole body posture realignment.
Read part 1 of this discussion: Understanding human anatomy requires looking at the body as a unit.
Read part 3 of this discussion: How hip and spine posture influence each other and cause pain.
Read part 4 of this discussion: How upper back and shoulder posture influence each other and cause pain.
Read part 3 of this discussion: How hip and spine posture influence each other and cause pain.
Read part 4 of this discussion: How upper back and shoulder posture influence each other and cause pain.
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