Biomechanical problems of the feet
Our feet are often overlooked (pardon the pun) when it comes to pain in other parts of our bodies. Problems with the mechanics of how our feet work can put extra strain on structures in other areas of the body and lead to injuries such as low back pain, shin splints, knee pain or foot pain.
Problem with the feet include fallen arches (flat feet), over-pronation (feet roll inwards) or supination (feet roll outwards).
There may be several reasons why such problems occur, including weakness in the muscles of the hip or knee, tightness in some of the joints or muscles of the lower limb that alters the way you walk or run. Poor footwear can also be a cause.
Excessive pronation is the most common cause of running injuries. A pronated foot rolls inwards at the ankle, the midfoot bulges inwards and the longitudinal arch flattens. Those who over-pronate generally have very flexible and unstable feet. In comparison, a supinated foot rolls outwards at the ankle and has a high arch. They tend to be more rigid and are very poor at absorbing shock.
The mechanism of injury
A low arch, or flat foot, typically occurs when the foot is excessively pronated, turning it inward. A high arch supinates the foot, rolling it outward. Both of these structural variations can cause knee, hip, and back pain. When one arch flattens more than the other arch, that inner ankle moves closer to the ground. That hip then rotates downward and backward causing a shortening of that leg during walking and running.
Signs and symptoms
- Low back Pain
- Hip/Knee Pain
- Sciatica
- Leg/Foot Cramps and Fatigue
- Restless Legs
- Ankle Pain/Weak Ankles
- Tripping
- Achillis pain
- Burning sensations
- Arch/Heel pain
- Callous (Hard Skin)/Corns
Treatment and management
Physiotherapists are well equipped to treat injuries as a result of biomechanical problems of the feet. You can also work with your physio to prevent such problems occurring in the first place. Treatment options also include gait analysis/gait scan, orthotic devices and shoe modifications.
A gait scan is a detailed look at how you walk. There is a vast amount of information that your physio can determine from analyzing how you walk. The mechanisms by which the foot loads can affect the rest of the body. Your foot is in contact with the ground for about 0.8 of a second when walking and about 0.25 seconds when running. This is too difficult for even the most experienced practitioner to see with the naked eye.
There is a vast amount of information that can be received by having a gaitscan. For example, by looking at the results your physio will be better able to understand why you’re suffering recurrent shin splints, knee or hip pain. If a person’s feet are sore first thing in the morning or they have pain while walking on the balls of their feet, the scan will illustrate to your physiotherapist why it is likely these issues are occurring.
Biomechanical problems of the foot can be effectively treated with orthotics (special insoles) that provide biomechanical support and help feet to function more efficiently. The most effective orthotics are those which are custom made to fit your foot, but in some cases a non-prescription orthotics or insoles can be used. You can speak to your physio about this.
Sheena Kirtane - Physiotherapist and Director, Back In Motion Carrum Downs