Sunday, April 09, 2006

Are feet the keystone of physical health?:The footbones connected to leg bone

A surprising range of common health problems arises from dysfunctional feet. Apart from the obvious like calluses, bunions, heel and ankle-pains, other painful conditions such as shin-splints, anterior knee-pain syndrome and arthritis of the hip may be seen and there is even a clear association between dropped arches and low back pain, sciatica and neck/shoulder pain. To be scrupulously honest most of us take our feet for granted. Out of sight out of mind and provided the dogs are not barking, the dark is where they stay. Until that is, when things start to go wrong then we wish we could cut them off and stick them in our pockets until they get better.

The feet if they were stuck on top of our head would serve no functional purpose but I would wager would be better looked after. It is really miraculous most of us can go three score years and ten and longer, pain free. There is a complex relationship between the 28 bones in each foot and ‘30 something’ joints that make up the pedestals we take for granted. Take for instance one step. That usually takes one second in time to complete when walking normally. During which the foot of the leading extremity will contact the ground for about 6 tenths of the second. The rest of time is spent flying through the air. The humble foot has many different functions to fulfill during the short time they make ground contact in the cycle of walking. When the heel hits the ground it needs to lower the impact on the rest of the body. This is why human heels are so freshly and full of fatty padding. As we get older this fat pad becomes less obvious. The foot is tilted to the side as it lands and ground reaction causes the ankle to lower the forefoot and spread the weight as well as reduced peak pressure this is known as shock attenuation and many sport shoes will use other clever technology to assist this natural ability of the foot. No sooner has the foot made full ground contact then it acts as a mobile adapter to help spread the load across the sole of the foot. All this time the knee is bending, passing the body weight over the weight bearing foot. This finds the hip tilted inward as the body propels forwards.

The next task is for the 28 bones to lock together to form a rigid lever to push hard against the ground sending the foot into space ready for the next stance phase. The arched shape of the foot is essential to allow these changes to take place. Flat Feet sometimes reduce the efficiency of flexibility of the foot and sometimes can lead to many painful problems. Some of these arise simply from the loss of flexibility whilst others result from the foot's increased length and abnormal shape (so that pairs of shoes may no longer fit both feet properly). Less expectedly as the arch flattens with each step the tibia (shin-bone) begins to repeatedly rotate, putting considerable strain on the structures inside the knee joint. This in turn can upset muscular co-ordination in the thigh, causing serious damage to the hip joint. Yet other disorders result from the effective shortening of the leg caused by the flattened foot. When one arch drops more than the other, leg length is affected and tilting of the pelvis can occur. These changes may lead to a wide variety of problems including sore backs.

Now as always conditions apply and just because you think you have flat feet that does not mean to say you will be disadvantaged. After all many athletes and sports persons have flat feet (Carl Lewis) but if in doubt or pestered by persistent discomfort speak to your GP or podiatrist and be assured many of the consequential problems referred to above will improve dramatically through simply restoring the normal foot shape and it doesn't have to cost an arm and a leg!

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