Kevin's Drop of Knowledge Pt 2

Foot, Ankle, and Hip Function Part 2

'Toe Splay'

Continuing our series on the foot, ankle and hip function, I will talk about toe splay (spreading out your toes) and how the narrow toe box design of modern shoes impacts the function of your foot and can lead to injury.

The design of modern shoes has a narrow toe box. This design is not built for a healthy foot because when you look at the design of your foot, the toes are the widest part. A wide toe splay is necessary for stability and balance. You might have noticed that many people, especially women who wear high heels, often have deformities such as bunions. We grow up with our feet spending a large amount of time in shoes which, while putting even the slightest amount of pressure on our toes, dictates the direction of the bone growth.

Like a weed that weaves and winds its way through the tiny cracks of a cement sidewalk, our toes will grow in the direction that they are essentially shoved through. This can have a big impact on your balance and stability on your feet.

Is it easier to stand on something narrow or something wide?

As you may have guessed, having a wide base of support is optimal. A shoe should be designed to allow our feet and toes to splay out wide to increase our base of support.

The 'big toe' plays a major role in your gait, the structure of your arch, and overall stability. The big toe is the last part of the foot in contact with the ground as you push off the back leg while walking or running. It is the strength and alignment of this big toe that allows for proper stability and force production to transfer through the ground to propel you forward.

Wearing a narrow toed shoe will push your big toe in medially, and will change the toe off point from the end of your big toe to the outside of the big toe. The result is more stress on that big toe and it will move in closer to the other toes. It then reinforces the stimulus to direct the big toe in.

If the big toe is out of alignment, you will create an unstable arch. The flexor tendon of the big toe (flexor hallucis longus) originates from the muscle that sits on the backside of your shin (tibia). The tendon of the flexor hallucis muscle runs down, behind the ankle bone (malleolus) on the inside of your leg, under your foot where is stabilizes the Medial longitudinal arch and attaches to the tip of your big toe. As the big toe gets pushed in, the flexor tendon moves with it which decreases the stability of the medial longitudinal arch.

This contributes to the collapsing of the arch. The collapsing of the arch can also lead to problems such as plantar fasciitis. This collapse and lack of stability leads to over pronation. Over pronation, in turn, allows for excessive internal hip rotation, which is visually seen as the knees collapsing in toward each other. (see pic below)

When knees are collapsing inward, it puts excessive wear and tear on the knees.

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Putting it all together now, we have a big toe shifting medially, which can cause a bunion that may need surgery later, as a consequence of that, a collapsed arch can lead to plantar faciitis, and internal hip rotation, which weakens the external hip rotators. This over-stresses structures in the knee which can cause knee pain. It also compromises your ability to balance on your feet. Lack of balance is a safety issue, especially for older adults, who are already at high risk of falls. As you can see, everything is connected. When you alter what is thought to be one little, insignificant structure, it can have a large impact later on.

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All of these problems can stem from extremely poor shoe design and/ or wanting to look good in something like a high heel shoe. If you don’t want to suffer these consequences, you can start working on regaining the structure and function of your feet. I can help you move towards better foot function and stability in our new class at Serratus Movement Centre coming in January 2019.

Yours in Fitness,

Kevin and Team SMC

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Kevin’s Drop of Knowledge Pt 1

First things first...we don't know everything.

So for that reason alone, we want to continue to educate ourselves and in turn help enlighten you with what we discover.

We would like to officially announce our commitment to providing you with quality content to inspire, motivate and educate you on a variety health and wellness topics. You will see content here through email, facebook, instagram and on the website, so please click on the icons at the bottom and follow us!

You can expect to see posts from your very own SMC team as well as guest material from people we think are super smart.

Speaking of peeps who are super smart, this inaugural post comes from our very own Kevin Coates, a trainer here at SMC.

Let's see what his work playfully labelled as his 'Drop of Knowledge' is delving into this week

Enjoy!

Foot, Ankle, and Hip

Why do you need to pay more attention to these areas?

Feet are the foundation upon which your entire skeletal structure is carefully crafted. Just like the foundation of a house or a skyscraper, if it is weak, shifting or crumbling, the integrity of the entire structure is compromised. It will not be able to withstand the forces it was designed to take and could potentially collapse.

Our foot and ankle joints evolved in an environment that required the foot to be a stable, strong, pliable, dexterous, and mobile, resulting in a foundation which functions effectively and efficiently and with minimal protection from a variety of surfaces. If your feet do not have these qualities, every single step you take through your life time will transfer stresses and forces through your joints, skeleton, and muscles in an ineffective and inefficient manner. This may lead to a breakdown of structures that are not designed to take the stress. It may also limit the range of motion of some joints, leading to compromised movement, muscle weakness and instabilities.

In this blog post series on foot, ankle and hip function, I will explain how these three body parts can have a serious impact on your posture and your ability to move correctly and pain free. I will also help you understand why and how certain shoes and orthotics may be contributing to your lack of quality movement and may be putting you at risk of injury if they are not used wisely.

Part 1-Support

“I thought supportive shoes and orthotics were supposed to be a good thing”

Well, I’ll put it this way: Our feet are very complex so that our shoes don’t have to be. Our feet have 33 joints, which makes up approximately one quarter of our entire body’s joints. There are more than 100 moving parts in the foot and ankle, including muscles, tendons, and ligaments. Our feet are designed to support, balance, and cushion without the need for modern shoes.

Unfortunately, from the time that we are able to walk as toddlers, we are put in a tight, narrow, supportive shoe with elevated heels. This alters our gait and changes our posture at a critical time of motor development and growth. A life time in shoes does not provide the stimulus needed to develop pliable, strong, stable feet that function well.

Even if you are active and moving your legs, it does not mean the joints in your feet are moving enough, or are loading the muscles enough. All those joints and muscles in our feet need to be moved, torqued and stimulated with a variety of surface shapes, textures, and loads of work. Without this level of stimulus, we become adults with feet that cannot support our own body weight.

There is a time and a place for support, heel lift, cushioning and some of the other technologies that come with modern shoes and orthotics, however; all day, every day is not appropriate.

Why don’t we brace, cast or support any other joint or group of joints for our entire lives? For the same reason it is not a good idea to sit on a couch to support your body or to lie in bed your entire life. The body adapts to the stresses and stimuli that you give or don’t give it. The simple concept that the body needs movement to stimulate growth and development of your bones, muscles, tendons, and ligaments applies here as well as with feet. Without enough stimuli the body adapts by breaking down bone and muscle.

When it comes to general injuries, you may need to use a brace or cast in order to give that limb/joint the rest that it needs to heal. Once the brace/cast comes off, you have to rehabilitate that area to regain the mobility, strength, and stability you had prior to the injury. The treatment plan for foot injuries, even simply the maintenance of the feet, doesn’t usually get this kind of care. Most treatments for foot injuries and collapsed arches consist of a couple stretches, perhaps an exercise or two. It does not end there; orthotic devices and supportive shoes are also recommended for the rest of your life. This goes against the principal that splinting or bracing is meant to be used temporarily.

In conventional practice, little thought is given to try to mobilize the stiff joints of the foot and ankle, splay out the toes, strengthen the muscles, and rewire the nervous system which controls the function of all that hardware. We can make the changes necessary to rewire our nervous system to promote healthy feet and ankles. This will take some work and attention but the results may surprise you.

With all of this in mind, transitioning to more natural footwear requires slow, progressive loading, time and consistency. PLEASE DO NOT THROW OUT YOUR SHOES AND ORTHOTICS!!! This is especially important if they have been prescribed. Logically, if you were going to a gym for the first time, you wouldn’t try to squat 300 lb because it would likely cause a debilitating injury. The same logic applies to feet…DO NOT go for a five kilometer run barefoot on your first day without shoes/orthotics!

I would like to help you learn how you can get healthier, stronger feet and ankles. My new Foot, Ankle, and Hip class at Serratus Movement Centre will begin in January 2019. Please stay tuned for Part 2 of this series on foot, ankle and hip function and further details on the new class.

Team SMC

Ps. If you have questions, concerns or you agree to disagree, we want to hear from you! If you have feedback or ideas for future blog posts, we are listening.

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