The feet are absolutely the foundation of the entire human body. Your feet literally cover tens of thousands of miles during your lifetime. If there is a problem with the feet due to some abnormality or medical condition, the result often shows up in other areas of the body, typically the knee, hip or even lower back. Foot pain can also lead to a serious reduction in activity level.
A recent podiatric survey done by the American Podiatric Medical Association (APMA) found that a majority of Americans (77%) stated that they have dealt with foot pain.(1) With that percentage in mind, it is highly likely that you will deal with foot pain at some point during your lifetime. Fortunately, advances in technology have made it possible for customized orthotics to be created for individuals that can improve improper mechanics and alleviate pain.
In order to determine how best to treat pain associated with improper foot mechanics, let’s first take a look at the basic anatomy of the foot and ankle.
The Foot and Ankle
The foot and ankle are amazing structures made of bones, muscles, tendons and ligaments. Feet are designed to be flexible, and to move in different ways in order to enable us to stand, walk, run and leap. The ankle, which must undergo great stress, is surrounded by ligaments that are designed to enhance stability.
The foot has three main sections:
- The forefoot, where we find toes and long bones called metatarsals
- The midfoot, where we find a collection of bones that create the arches of the foot, and
- The hindfoot, where we find the heel and ankles in the foot
Considering the multitude of moving parts that are located within the feet, it is clear that there are numerous possibilities where foot damage can occur, leading to foot pain.
The arches of the feet are a crucial feature of the underlying foundation. The arch is where the foot absorbs a vast amount of pressure each time we take a step.
There are three arches in the foot. These are the anterior transverse arch, the medial longitudinal arch and the lateral longitudinal arch. If there is a lack of support underneath the arches, persistent pain may result.
For some individuals, certain shoes may not supply proper support which can be remedied by the addition of appropriate arch supports. In other instances, such as when a person has a condition such as plantar fasciitis, the addition of arch support may actually eliminate most of their pain.
For individuals who suffer from a condition referred to as ‘flat feet’, which occurs when the arches in the foot have collapsed to the point that most of the sole is in contact with the ground, there may be a need for artificial arch support. This medical condition can lead to a wide variety of additional chronic pain issues.
Now that we have considered the basic mechanics of the structure of the feet, let’s look at proper foot movement.
How the Foot Should Move
There are two phases involved in walking: the stance phase and the swing phase.
Normal Foot Movement
Stance phase. This is the time when the foot is actually in contact with the ground. Surprisingly enough, this phase is almost two-thirds of the entire walking cycle.
Swing phase. This is the time when one of the feet is in contact with the ground whereas the other foot is in the air. The foot that is in the air actually goes through several stages to complete the swing phase.
Here are the stages of swing phase:
- Heel strike. This begins when the heel of the foot touches the ground and lasts until the entire foot is in contact with the ground.
- Early Flatfoot Stage. This begins when the entire foot is on the ground during the person’s stride. This stage is where the foot acts as a cushion for the pressure of the body’s weight. This stage ends when the center of gravity has reached a neutral position.
- Late Flatfoot Stage. This begins when the center of gravity has shifted ahead of neutral, and ends as the heel begins to lift up.
- Heel Rise. This begins when the heel propels the body forward.
- Toe Off. This is when the toes lift off the ground. Once this has occurred, the swing phase is complete. The cycle of taking a step begins again.
The mechanics of running are very similar to that of the walking gait, although the speed of the phases is increased. When running, the mechanics of gait includes a ‘float phase’, when both feet leave the ground during the stride. (2)
Abnormal Foot Movement
As one is walking or running, abnormal foot movement can create unusual stress, creating chronic pain issues. One such movement is called pronation.
Overpronation can occur when the foot rolls upon landing on the ground or when standing. Underpronation can occur when there is inadequate rolling of the foot after landing on the ground, leading to excessive pressure on the outside of the foot.(3) Both of these conditions, when taken to the extreme, can result in a variety of medical complications and/or pain issues.
Abnormal foot movement, which we refer to as poor foot mechanics, can place pressure on joints over time, resulting in chronic pain issues.
Conditions Related to Poor Foot Mechanics
What are some common conditions related to poor foot mechanics? Let’s look at four of them.
The plantar fascia is a ligament that runs the length of the foot, running from the heel to the tip of the foot. In cases where the arches of the foot are very high or very low, this ligament may be stretched to the point that the tissue becomes aggravated. When inflammation of this type occurs, the resulting pain can be severe. This is a common complaint in many individuals.
When the feet are not properly supporting the weight of the individual, it results in increased pressure on the joints above the ankle, typically the knee and hips. This pain can even extend to the lower back. One common cause of ankle pain is flat feet, or collapsed arches.
There are many causes of knee pain. Poor foot mechanics can have a definite impact on the knee. In cases where ankle mobility is limited, it can result in pain to each joint above the ankle: the knee, the hip and even as far as the shoulder.(4)
Ankle mobility issues can also hamper the foot’s ability to toe off to move the body forward. A problem with ankle mobility is a common cause of overpronation as discussed earlier that may lead to knee problems.
Poor foot mechanics can also lead to issues within the hip joint, resulting in chronic pain. If an individual’s feet roll in towards each other, it can result in a twisting action. The stress that results can be cumulative and even have a cascading-type effect. Once the feet are out of alignment, they can lead to pressure on the ankle joints. If the ankle joints become unstable, they can lead to a twisting action through the knees and upwards into the hip joints. The result is often pain and, in some instances, erosion of the impacted joints.
An individual suffering from foot or ankle pain usually goes to see their family physician, or in some instances, a podiatrist. There are several ways that a medical professional can evaluate the feet to determine what can be done to alleviate the pain.
Evaluating Your Feet
If poor foot mechanics are suspected as the culprit causing pain, an evaluation will be done to determine what is wrong. Two of the newer tools for this type of evaluation include multi-step gait analysis and 3D foot scanning.
Multi-step Gait Analysis
One relatively new technique that allows for detailed analysis of an individual’s foot is by use of a computerized multi-step gait analysis system. This allows for scanning of the individual’s gait while in motion. The platform records the individual’s footsteps and then provides data on the force exerted on the foot as well as the pressure placed on the foot. By identifying gait abnormalities, this device can aid in the development of a plan to alleviate pain.
An additional benefit of this device is that it can be used to evaluate improvements that take place following treatment. Comparisons can be drawn, as the data gathered prior to treatment can then be compared to data gathered in the midst of treatment and at the culmination of treatment. This allows for professionals to tweak the treatment plan as necessary to obtain optimal results.
3D Foot Scanning Systems
The use of the laser foot scanning system has resulted in advances in the creation of customer-specific orthotics that are based upon the individual’s unique foot shape. These scanning systems obtain highly accurate digitized images of the foot.(5)
Today there are even portable scanners, allowing medical professionals and orthotic specialists ease of access to accurate and detailed information of an individual foot. These scanners allow for images to be obtained while the foot is in a resting position and in various weight-bearing positions.
Once the scan is complete, 3D representations can be viewed on a computer screen. These images can then analyzed by a computer program to inform the creation of an individualized custom orthotic.
Once a diagnosis is determined, a custom orthotic device is often part of the recommended treatment plan.
The Difference Between General Shoe Inserts and Custom Orthotics
General Shoe Inserts
In-store kiosks where you can have your foot problem diagnosed by a machine are found in many of your local pharmacies and superstores. You may have seen them before: you stand on top of a platform and the machine evaluates where you place the most pressure on the bottom of your feet and then recommends a particular product. But do these over-the-counter diagnostic tools really work?
Off-the-shelf insoles or shoe inserts can make an ill-fitting or uncomfortable shoe feel a little better. But consumers should be aware that the wrong insole can actually exacerbate a pre-existing condition.
This is where custom foot orthotics come into play. With a custom orthotic, a medically trained individual evaluates the foot, taking into consideration the medical complaints and pre-existing conditions that may come into play with causing the pain in the foot, knee or hip.
A custom foot orthotics will be custom made in order to align your foot and ankle into what would be the more anatomically correct position. It will be designed to correct the specific foot imbalance that is personal to your foot. With the ability of this device to conform to your foot, it can lower stress and strain and work to bring your feet—and body—back into alignment.
Back in Action Through Proper Foot Mechanics
Once the underlying medical explanation for foot pain has been reached, in many instances the addition of a properly-manufactured custom foot orthotic can improve gait, reduce pain and allow the individual to return to increased activities.
Current technological advances in 3D scanning in order to create custom foot orthotics are viewed as one of the optimal means available to improve foot mechanics. (6)
If you are suffering from foot or other joint pain that may be associated with poor foot mechanics, perhaps it is time to consider consulting a professional about the medical avenues that are available to you.
Your feet will thank you for you.
If you have been having problems with your feet, ankles, knees or hips, the issues may be arising from poor foot mechanics. Call us today to schedule a 3D foot scan at 330-493-0009.