Health concerns farther up the kinetic chain

The feet are the foundation of the body.

While 99 percent of all feet are normal at birth, 8 percent develop troubles by age 1, 41 percent at age 5, and 80 percent by age 20¹. By age 40, nearly everyone has a foot condition of some sort.

Many conditions start in the feet, but eventually contribute to health concerns farther up the kinetic chain, such as in the spine. Custom orthotics can help preserve the body’s optimal foot-spine connection.

Arch collapse and back pain

Most of us develop strong, flexible arches in childhood. Over the long term, the repetitive stresses of daily life lengthen the connective tissues, causing a slow breakdown of the normal support for the bones and joints of the feet and a decrease in elasticity, eventually leading to a sagging of the foot’s arch.

This gradual breakdown allows those stresses to move into the legs, the pelvis, and ultimately the spine. Back pain is often what brings patients into a chiropractor’s office, but treating the feet might seem counter-intuitive to someone with a sore back. If doctors can recognize and clearly explain the foot-spine connection, they can help to optimize their patients’ overall health.

Orthotics and the foot-spine connection

Static support

During a standing posture, the alignment of the arches in each foot has a significant impact on the position of the legs and pelvis. When the arches are low and/or pronating excessively, the knee will rotate medially. A research study using radiographic measurements found that custom-made, flexible orthotics can significantly improve the alignment of the arches when standing.³

Dynamic support

During gait, the foot must permit a smooth transfer of the body’s center of mass over the leg to conserve energy and keep the work expenditure to a minimum.⁴ This requires an orthotic to be flexible yet supportive, and orthotic designs must consider:
-weight and intensity of forces
-proper movement and function of the foot
-support of all three arches to prevent eventual arch collapse

Postural benefits

Improving foot alignment can help maintain knee, hip, pelvis, and even spinal postural alignment.⁵ Preventing hip, knee, or spinal joint degeneration requires the additional support and shock absorption provided by orthotics. And a pelvic or spinal tilt or recurrent subluxations will often respond rapidly to orthotic support.⁶

Tim  Maggs, Dc, has been in practice nearly 40 years, and is the developer of the concerned Parents of Young Athletes (CPOYA) Network, with the goal of offering every middle and high school athlete a biomechanical exam prior to each sports season. the network, in partnership with Foot Levelers, provides training, resources, networking opportunities, and more for DCs interested in working with young athletes. Maggs can be contacted at runningdr@aol.com or through CPOYA.com.

References

1. Schafer, R.C. Chiropractic Management of Sports and Recreational Injuries. Williams & Wilkins, 1982, p. 517.
2. White, A.A. and Panjabi, M.M. Clinical Biomechanics of the Spine (2nd ed.). Lippincott, 1990, p. 692.
3. Kuhn, D.R., et al. “Radiographic Evaluation of Weight-Bearing Orthotics and Their Effect on Flexible Pes Planus.” Journal of Manipulative and Physiological Therapeutics, vol. 22, no. 4, 1999, p. 221-226.
4. Kirby, K.A., “Biomechanics of the Normal and Abnormal Foot.” Journal of the American Podiatric Medical Association, vol. 90, no.1,2000, p. 30-34.
5. Baylis, W.J. and Rzonca, E.C. “Functional and Structural Limb Length Discrepancies: Evaluation and Treatment.” Clinics in Podiatric Medicine and Surgery, vol. 5, no.3,1988, p. 509-520.
6. Rothbart, B.A. and Estabrook, L. “Excessive Pronation: A Major Biomechanical Determinant in the Development of Chondromalacia and Pelvic Lists.” Journal of Manipulative and Physiological Therapeutics, vol. 11, no. 5, 1988, p. 373-379.