Can foot motion be the major contributor to lower back and pelvic pain? 0

Posted on 8, August 2013

in Category Back and Neck Pain, Exercises, Pilates Classes

How abnormal foot motion can be a major contributor to lower back and pelvic problems.

The foot contains many bones, joints and tendons that work together to enable gait. Dysfunction of any of these aspects of the foot may cause problems anywhere along the kinetic chain and in the lower back.

Pilates has developed a reputation for building core strength, especially once the fitness and physical therapy worlds came to Pilates in the 1990s.  Along the way, the core became the mantra of Pilates. However, with so many people suffering from lower back pain and pelvic problems I thought having a look at the foot from a biomechanical point of view can perhaps help explain some of the conditions we suffer from and perhaps focussing on restoring great foot function can help to reduce some of these symptoms if not help them to disappear all-together!
In Pilates, the feet are very important to the way we engage the body, and they deserve more attention. Feet bring to mind metaphors for moving us forward in life and finding our sense of place and existence in the world. Yet in our bodies, we pay little attention to them. We squish them into shoes, stand for long periods of time, If we paid more attention to our feet perhaps, we may lessen back issues, hip and knee pain, and release our necks.

Our feet are not only our sensory input telling us where and how to step, but also they set up the balance of our pelvis and translate through the spine. How you use your feet has a direct influence on your core.

The way we stand on our feet, or how we move the feet, recruits different muscle lines up the leg into the pelvis. Body weight from our spine and pelvis is placed on the legs through the femur into the tibia (lower leg) at the end of the tibia sits the talus (foot). That song the hip bones connected to the thigh bone etc. really does make sense and so one affects the other without us giving it much thought. We often just complain about lower back pain or that our hip hurts! So let’s look at the foot and how we can correct its function to reduce these symptoms.

The foot has 3 very demanding roles

  1. It must be a loose adaptor to accommodate uneven terrain
  2. It must be able to absorb shock on impact
  3. It has to form a rigid lever during push off

If the foot fails to function correctly, problems can arise anywhere along the kinetic chain and in the lower back. Abnormal movement and incorrect timing of movement may predispose the individual to injury or make the problem worse.  Some people inherit foot types; some arise due to injury or disease.

Many people unfortunately pronate or collapse the medial arch and roll the arch in toward the floor or even onto the floor. When this happens, the foot is pulled down out of its neutral position. The whole pull of the pronated foot influences the femur to roll in and pull on the pelvis anteriorly. Now, we have an anterior pelvis on this side. You can see how if you continue to look globally, the pull continues all the way up the body. By correcting the foot position you will see the body move back into a more neutral position globally. The neutral pelvis then provides the balanced position from which to engage the deep abdominals and strengthen the core. With all the issues we have out there, one thing we can try and do is to resume a neutral function of the foot. Try the following exercises and see how you get on….. This should create awareness and eventually help you to find your ‘neutral’ foot position.

Arches In, Arches Out

Stand with the feet in a parallel position, legs straight and body upright, do not look down at your feet, use a mirror to watch the ankle bone moving down toward the floor and away from the floor. Roll the feet toward the lateral arch (outer border of the foot) lifting the inner arch. The big toe ball  will lift slightly off the floor. Roll the medial arch (inner border of the feet) in. The weight will be more on the big toe joint  and less on the little toe ball. Rhythmically move the arches out and in and finish on the lateral arch after about 8 repetitions. Then slowly move the ankle bone toward the midline but only until the Achilles tendon is straight, do not go past this point.

How does this feel? Try and stay in this position for 1 min and see if your body can adjust to this being a normal position for you. Then take a walk and come back and try again. You can do this daily to create awareness and see whether you are able to build strength into your foot muscles, ligaments and tendons to support a more neutral position for your foot.