While many patients will seek treatment for pain in the hip, calf, or knee, they often forget that pain starts in the place that is closest to the ground – your foot. Issues that begin at the ground level can affect things further up. The way you foot moves can, in turn, affect the movements of the lower leg, knee, hip and even low back. Your pedorthist can identify movements that may be contributing or causing you problems. Foot type, strength, flexibility, range of motion and lower limb alignment are a few of the factors we assess within our patients.
Considering foot type is important when dealing with lower limb issues. There are three categories of foot type: low arch, normal, or high arch. A ‘low’ arch is characterized by a foot that rolls inwards, with the arch lower than average. A ‘normal’ arch is neither flat nor high, and may or may not flatten as a person stands.
A ‘high’ arch is noticeably high, and often does not flatten when a person stands up. The three arch types can be differentiated by where the foot contacts the ground, or also where the sole of the shoes shows wear patterns. Wear patterns can also change over time. Your pedorthist can help by measuring the amount and speed of change to your arch.
Observing the changes in the position of your foot as it bears your weight will allow your pedorthist to isolate potential painful issues that your foot position can cause in your lower limbs. If the arch in your foot does not change when you move from a seated position to a standing position, your will foot more likely be rigid during gait. Feet that are rigid are typically are not as good at absorbing the shock caused by daily motion, causing pain further up your leg. If your foot moves through a wider range of motion while you are walking, you may be more susceptible to overuse injuries or strains.
You may have heard the term ‘pronation’ on this blog before – this term describes a natural motion of the foot. Pronation allows the foot to adapt to different types of terrain, absorb shock, and helps move the body through a normal gait. It can be observed as the arch moves during gait, helping us to absorb shock at the level of the foot without having our other lower limbs absorb the force of our walking and running. Many patients come in and say that they pronate, thinking that this is what causes their issues. In truth, it is usually too little pronation or too much pronation that can be a cause for concern! Individuals who over-pronate will be more susceptible to injuries inside the leg and knee as the tissue is stressed by repetitive motions cannot recover quick enough.
Pronation, when excessive, can lead to other excessive motions around the ankle, lower leg and as far up as the hips and low back. With an increased amount of pronation, we often see rotation of the lower leg, which can cause alignment issues at the knee. If the rotation continues up the leg as far as the hips, it can be one of the causes for some discomfort in the low back as the rotation pulls across the low back. Correcting excessive movements at the feet can have a very positive impact on symptoms at not only the feet and ankles, but also in the knees, hips and low back.
On the other end of the spectrum, people who have very little movement within their feet are described as ‘supinators’. Often seen in people with a ‘high’ arch, supination is the opposite motion of pronation. As pronation assists in shock absorption, too little pronation can lead to more bony related injuries or an increased risk of ankle sprains.
Another potential cause of lower limb pain can come from your gait. When compared to the action of standing motionless, the walking motion places different stresses on the lower limbs. Together with the foot type assessment, the gait assessment will provide your pedorthist with a complete picture of what is happening throughout the kinetic chain.
As you can see, movements at the foot can have a big impact on the lower legs, knees and even the hips and lower back! Do you have questions about how your feet affect the rest of your body? We are here to help — Book an appointment today!