DID YOU KNOW – Foot Facts

Four Arches

Each foot has four arches. There’s the medial arch (the one you think about) on the inside of the foot, a lateral arch (outside of the foot), a transverse arch (across the foot), and a metatarsal arch (ball of the foot). All are vital to the correct alignment of the feet and, in particular, the ankle joint on which all your weight initially rests. One or more of those arches (usually the medial and/or metatarsal) out of alignment can start a chain reaction of muscle imbalances throughout the body. Consequently, these may be at least part of the reason for headaches and migraines.

Level Toes

When the weight is off your feet (as in sitting or laying down), the top of your feet and toes should be level. If your toes pull back and then curl down and your big toe is starting to pull inwards, that is a sign the metatarsal arch (ball of the foot) is starting to collapse due to too much pressure on the ball of the foot. It is also usually indicative of high arches. In some cases, you will notice the tendons to the toes in the top of the feet are visible and hard. All those effects will take your foot alignment out of neutral and will contribute to a range of muscle imbalances throughout your body.

Ankle Joint Alignment

The alignment of the ankle joints is critical for correct alignment of the hips. Poor hip alignment creates postural/muscle imbalances throughout the body. You can easily check if your ankles are rolling in or out with a credit or business card. Stand the card on its end; hold it flat on the floor with one side up against the outside of your heel. If the side of your ankle bone – known as the Lateral Malleolus – is not also touching the side of the card, your ankle is rolling in (pronating). If the Malleolus pushes the card away from the side of the heel, the ankle is rolling out (supinating). At times the ankle may appear to be in neutral but other factors (e.g. high arches) may offset that benefit and cause tightening of leg muscles leading to shin splints.

Flat Feet or High Arches?

Some people think they have flat feet when in fact they have high medial arches that have collapsed to some extent. If your ankles overpronate (roll in too much), that can give the appearance of flat feet. Ankles in their correct alignment are critical to have good muscle balance throughout the body because the whole weight of the body is supported on the ankle joints. If your ankles pronate, relatively cheap orthotics from most pharmacies, some shoe stores or on-line can prove a major benefit.

Cheaper Orthotic Options

Poor foot alignment can cause back pain, among a number of other ailments. If you’re worried about the typical $500 to $1200 cost of custom-made orthotics from a podiatrist (some may be slightly cheaper and less health fund rebates), there are significantly cheaper options available. Many pharmacies have a range of generic orthotics (generally between $20 and $60) that suit pronating (rolling in) ankles and arches. Some shoe stores have electronic foot testing equipment and carry semi-generic orthotics (generally about $60-$100) that can ideally match your needs. People with high arches and toes pulling back and curling down often need an orthotic with a “metatarsal dome.” This is a small hump near (but not under) the ball of the foot, which helps to flatten the toes and take the pressure off the ball of the foot. Most brands carried by pharmacies don’t have this dome. I can check your feet and advise on various options. If you can’t afford very expensive sports or work shoes, sometimes the best option is to buy your shoes (without any internal arch support) from a much cheaper store and then add a generic orthotic from a pharmacist.

Avoid Hard/Rigid Orthotics

Avoid using hard, inflexible orthotics at all costs. These may be made from resin, fibreglass, very hard plastic or other very stiff materials and usually have a slight padding layer on top. In my opinion, these hard orthotics can wreck your feet and ultimately cause a range of muscular and postural imbalances throughout the body. Each foot has 26 bones, all attached by small ligaments. The two feet account for more than a quarter of all the bones (206) in the body. We were never meant to be wearing shoes. All those bones and ligaments were meant to be able to move and flex to allow us to walk over uneven ground, sand, rocks, etc. Hard orthotics prevent that. Insist on rubberised orthotics and make sure any orthotic has at least some flexibility.

Proprioception

Every muscle and joint in the body (plus the Middle Ear) has what is known as proprioceptors. They are neurotransmitters – like nerve terminals – that send signals to and from the brain about the body’s balance, position and movement. Because the whole weight of the body is supported on the feet, and particularly the ankle joints, there are many proprioceptors there. So if the feet and ankle joints aren’t in their correct alignment, some of the proprioception signals from the feet to the brain will be compromised, causing muscle and postural compensatory effects that could result in muscle or joint pain anywhere in the body. It can also lead to headaches and migraines.

Plantar Fasciitis

Do you experience pain in the feet when you first get out of bed in the morning? It may last for only a few steps or a few minutes. If so, you’ve probably got Plantar Fasciitis. The plantar fascia is like a connective tissue or ligament that helps create the arch in your foot. It attaches to the front of the heel bone, to a fibrous covering of the bone called periosteum. When the feet and ankles are out of alignment, the plantar fascia begins to pull the periosteum away from the bone. Overnight (or after long periods off your feet), the body starts making repairs. Then you stand up (as in getting out of bed) and it damages those repairs, causing your pain. I can advise on some simple options to avoid and/or correct Plantar Fasciitis.

Ice or Heat for Plantar Fasciitis?

One bit of advice you will be given by various physical therapists if you have plantar fasciitis is to roll the foot on a bottle of frozen water (ice). I cringe when I hear that advice. Ice is great because the “itis” in Plantar Fasciitis means your Plantar Fascia is inflamed, so ice is exactly what you need. But whereas HEAT helps to stretch muscles and other soft tissue like fascia, tendons and ligaments, ICE will help to shrink them. So if you roll your foot on a frozen bottle you are trying to stretch and shorten your soft tissue, like the Plantar Fascia, at the same time. That doesn’t make sense. I suggest you place your feet on ice to reduce the inflammation, then let your feet warm up naturally, then do some gentle foot and leg stretches. Putting some mild heat on your calf muscles and tendons to help them stretch when your feet have warmed up wouldn’t hurt.

Heel Spur

Heel Spur is an advance on Plantar Fasciitis (see above). If you have Plantar Fasciitis and do nothing about it, the bone may start growing out to meet the periosteum. Hence the bony growth called Heel Spur. That can be much harder to fix, more painful and sometimes requires other medical intervention. In some cases, surgery is suggested but a number of my clients have mentioned this has not only NOT worked, but led to even more foot problems.

Charcot Foot

Charcot Foot (pronounced Shark-oh) is a particularly debilitating foot condition that, if left untreated, can lead to amputation. It is best treated by your doctor (and possibly your surgeon) in conjunction with a podiatrist. It is not something physical therapists can specifically deal with, but remedial massage therapists are able to help with the painful muscle and joint consequences for the rest of the body through the various compensatory effects it causes, and by easing your tight leg muscles. Charcot Foot can manifest itself in various ways, primarily with the main arch totally collapsing and a “rocker bottom” hump forming below the normal level of the heel and ball of the foot. This can often lead to serious infections. Charcot Foot is usually caused by nerve damage (neuropathy) – often from diabetes – which stops you actually feeling any initial pain and the condition developing. If you notice your foot changing shape significantly, especially the main arch collapsing, consult your doctor and/or podiatrist as soon as possible. Steps can be taken to minimise or avoid the condition.

David Hall ©

MASSAGE TOWNSVILLE THERAPIST – REMEDIAL

Townsville Massage therapist based in Mount Louisa and specialising in Remedial Massage for all types of muscle and/or joint aches and pains, headaches and migraines. Guaranteed best value for money remedial massage in Townsville. CALL NOW on (07) 4774 6973 or CALL/TEXT 0438 774 819 to book an appointment.