Understanding Feet

Drs. Root, Orien and Weed in the mid 1970’s wrote what became the bible for lower extremity biomechanics*. They stated that the mid tarsal* joint, the top of the arch, had two axes, which locked and unlocked the foot. And that it was this locking and unlocking mechanism which accounted for excess pronation* of the foot and leg and therefore most of the pathology that they and later investigators felt caused almost all orthopedic problems from the foot to the top of the spine.

I can explain a better working model that is not based on these imaginary axes, and they are imaginary, but on the actual anatomical structure of the foot and simple physics and engineering principles. To this point, my colleagues and I have found this model to work in almost every foot type except those compromised by neuromuscular disease. More importantly these concepts can easily be applied to young and old alike with great success. Furthermore, we have devised a way to measure the foot, which takes the guesswork out of fitting not only shoes that are comfortable, but also shoes that provide the proper support and alignment necessary to balance the body on its foundation. Just because old style shoe salesmen are extinct, doesn’t mean the need for their talent is gone. And today we can apply modern science and technology to this much overlooked aspect of this far-reaching problem.

What I am speaking of is a way to balance the body from the ground up. Providing stability to the muscles and joints by keeping them in the middle of their range of motion where they have the most strength and stamina. Going back to my previous point about concrete, the obvious conclusion is that concrete is hard, and that in itself is a problem. But that is only the secondary concern. The primary issue with concrete is that it is too flat and unyielding. Before concrete, man walked on a variety of surfaces, with a variety of densities, and what this imparted was a degree of strength based upon this variety of positions. Because the ground wasn’t exclusively hard and flat we developed the muscle balance necessary to function on these different surfaces.

As a simple illustration of how this works, anyone who has been on a modern cruise ship knows that you quickly adapt to the rolling motion of the ship in calm seas. Most people are surprised though to fine that when they get off the ship, their body is still rocking in harmony to the ship they are no longer standing on. To a much greater degree, imagine if your everyday life was filled with these varying terrains. You would naturally have greater strength through a greater range of motion because you would be using a greater range of motion to function in everyday life.

The conclusion is undeniable. When we paved the planet to make it easier for automobiles, in effect we destroyed our ability to adapt to the ever-changing terrain we no longer walk on. Thousands of years of evolution and we hardly changed and then in a point of time a hundred years ago, we changed everything. So… how do we handle this? By pulling up all the pavement? No, the answer, thankfully, is much simpler. What we must do is put something between the foot and the ground that not only fits the foot but that also fits the ground.

This is a fairly common concept in podiatry and to those who make orthotics designed to support the symptomatic foot. But as we have applied it, our ideas of biomechanics go much farther. In our practice we routinely correct patients gait and posture in such a way that most every patient finds relief to foot, ankle, knee, hip, and back pain.