How your body moves can depend a lot on your feet. People only tend to think of issues with the foot being localised to this area, however, symptoms of unhealthy feet can spread much further up the body than you might realise.
To see the impact that feet may have on the rest of your body, try walking a few paces with your feet turned inwards or outwards, then again with your feet rolled inwards or outwards. You’ll notice each time that your knees and hips are twisted out of their natural position, making normal movement uncomfortable and athletic movement impossible.
Now imagine that’s how you walked every day (if you already do, you need to see us!). Over time, these unnatural movements may put excessive stress on your joints, tendons and muscles. Some muscle may be lengthened and develop weakness while others can become shortened and tight when they should move smoothly.
That’s how foot problems can throw off your entire body posture: if your feet aren’t positioned correctly, then your knees aren’t and your hips aren’t. If your hips aren’t positioned correctly, then this may affect your spine.
So what are the common foot health problems we see in our clinic and how can they be treated?
Flat Feet Versus High Arches
The most basic assessment of a foot is to determine whether it has a high or flat arch. The ideal foot arch is shaped like a half dome, which is no coincidence. Just like domes in architecture, this structure gets its strength by evenly distributing the force over a wide area instead of a single point. Unlike architecture, this dome is also flexible when the foot comes in contact with the ground.
If that arch is too high then the force is no longer evenly spread, focusing the force into a smaller area which increases pressure on structures in the foot. If, more commonly, the arch is too low then it no longer has the strong dome structure in place, weakening the foot and opening it up to an array of potential issues.
While a large component of foot structure is genetic, a normal arched foot may become flat over time. Certain injuries and weaknesses cause strain on the inner foot causing the arch to gradually collapse. If you’re noticing a change in your foot shape, you should see us as soon as possible.
Over Pronation
A term anyone familiar with running will have come across is pronation, which is a rolling inward of the foot when it comes in contact with the ground, caused by the flexibility of the arch that I mentioned above. You may have come across shoe stores with gait analysis machines recommending footwear based on the degree of pronation they observe.
What people don’t realise is that pronation is not only a natural mechanism of walking and running, it’s good for you too. When your foot strikes the ground, if it bends slightly inwards this motion spreads out the force, just like bending your knees when you land from a jump.
It’s when this bend is too extreme or occurs too quickly, something known as over pronation, that it can becomes problematic. People with flat feet are especially vulnerable as their foot lacks the structure to properly support the impact of running or even walking.
Treatment of over pronation includes extra support either from the shoe itself or from orthotics. Strengthening of the feet and calf muscles as well as muscles higher up the leg – particularly the gluteals – can also help to control over pronation.
Aches and Pains
The common pain inducing foot problems we see are:
Treatment for plantar fasciopathy has changed recently. It was once called plantar fasciitis, when the pain was thought to be primarily related to inflammation of the plantar fascia structure. The pain is actually caused by degenerative wear and tear with a failed healing response.
As inflammation is the body’s natural healing response we actually want a degree of inflammation to occur, which we aim to induce with our shockwave therapy. Once the healing is kick started, we recommend stretching as well as strengthening exercises for the calves to take some load off the heel.
For morton’s neuroma, we typically provide an orthotic called a metatarsal dome, which you can place inside your shoe. This causes your foot bones to be slightly spread apart, which can decrease pressure on the irritated nerve. We offer customised or off the shelf orthotics to provide support for feet that suffer from over pronation or other biomechanical issues and our industry leading Gaitscan helps tell us exactly what you need.
Suspected stress fractures are seen by a foot and ankle consultant (we work with some of the best consultants in London) who will typically order further scans for your foot and may place it in an air cast boot if necessary so that it can rest for a few weeks, after which we will gradually restore its strength.
Taking Care of Your Feet
Like every other part of your body, you can provide yourself some protection from injury and strain by strengthening your feet and the structures further up that impact them.
Balance exercises are an easy and convenient way to keep your feet planted firmly on the ground. Simply standing on one leg with your eyes closed deprives your brain from visual aids for balance, forcing the structures in your foot and ankle to make constant tiny adjustments to keep you upright.
Contrary to popular belief, standing on an uneven surface will not challenge your foot or ankle more. This simply shifts the working area further up your leg to the knee and hip – still good for healthy biomechanics but not too useful for foot strengthening.
Instead, if you want to give your foot and ankle the ultimate challenge, cancel out your inner ear balance along with your visual aids by slowly turning your head back and forth while keeping your eyes closed.
Most importantly, contact us the moment you start to feel any pain in your feet or notice something odd about your gait. It could be causing you more harm than you realise.
For any other questions regarding this topic please do not hesitate to contact West London Physio on 0207 937 1628 or email David at david@westlondonphysio.co.uk
David Wynne BSc (Physio) MSc (Sports and Exercise Medicine) MCSP MHCP
Musculoskeletal and Sports Physiotherapist, Research Lead at West London Physiotherapy
