Thursday, June 14, 2018

Feet: Your are in the army now

In 1690, it was expected the musketeers would perform their rifle duties with a graceful readiness and exactness, which entailed being trained to adopt the appropriate stance when using the early rifles. Solders were required to shoulder their musket with feet one step apart and their heels parallel with the toe slightly turned outwards. This position was thought to balance the body mass evenly. (Bennet, 1989). Today this would be called the "at ease", stance. In 1792 the position was changed to what we now recognise as the "attention" position. Knees and ankles together with the feet pointing outward to form an angle of sixty degrees. This caused the centre of mass to lie forward over the pelvis causing body weight to be taken on the forepart of the foot.

By 1739, solders were trained to stand to attention, awaiting their officer’s command. Sometime between 1867 and 1870 the foot angle was reduced to 45%. The army recognised the position of attention was detrimental but did little to change the tradition until 1909 when a committee was formed to look at the physiological effects of food, training and clothing on the soldier. The report acknowledged the position of attention was detrimental to body physiology, anatomy as well as wasteful of energy they did however, defend it as a mark of discipline and ceremony. Eventually an amended position was adopted by the infantry in 1911.

. The experiences of the Great War provided a window of opportunity for testing many theories including screening for flat feet. Logically it was better to screen out civilians who were not in both physical and mental A1 condition. The feet presented a problem albeit the stereotypical ideal foot was easy to recognise i.e. because of the well-formed arches. Some recruits appeared to have normal feet but many failed to complete their basic training and required to be discharged. This came at considerable cost to governments and politicians were eager to keep costs to a minimum.

By 1924 it was recognised to frame effective regulations to prevent enlistment of men likely to develop flat feet was impossible. Medical personnel however, had to distinguish between apparent flat feet which had no effect on efficiency and genuine pathological flat feet which had. Due care and attention was given to the management of recruits reporting painful feet. This included forced rest and deployment and the development of a recruitment boot or modified army boot with modified training regimes. Major concerns were expressed at this time in history as to the general lack of fitness of young men in particular. Much was blamed on the poor nutrition caused by the Great War. Between the wars improvement in living conditions became a priority as did the promotion of healthy pursuits such as exercise and sport. All in an endeavor to have available fit young met to defend national borders.

The role of the Army Medical Officer took on greater importance in screening potential recruits. This has fashioned the direction and approach of orthopaedic care of the feet to the present time. Sadly, many young men served their country because they had arched feet and in the case of rigid pus cavus, rather painfully too. On the other hand, or should it be foot, probably more men avoided the services because they had mobile feet which collapsed on weight bearing. Life has never a dull moment.

Reviewed 14/06/2018

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