Most people with ankle pain, knee pain, lower back pain, and foot pain notice their pain when walking or running, and while direct impact injuries can cause their pain, in most cases, the site of pain is not the source of the problem and that is what this blog is all about. You will soon learn
- How your bad posture manifests itself in your feet
- How to fix flat feet
- How back pain, knee pain, and foot pain are related and one can cause the others and
- How posture correction and functional movement is the answer to all of these pains
How Can Hip and Back Problems Cause Foot or Knee Pain?
The most important but also most disregarded fact in the treatment of musculoskeletal injuries is that no joint functions alone; an issue or pain in the foot, for example, is never isolated to just the foot. The body functions as a whole with every part playing its own role.
This means that problems originating from the hip or back will always impact the structures above and below over time. Let’s think about the hip and torso flexor muscle Psoas for a moment. When it is tight, it causes too much hip flexion and when the feet are both on the ground, it leads to slight forward flexion of the torso. Over time, with excess contraction of the Psoas comes its exhaustion and weakness which in turn means with every step, how far you lift your leg up decreases. To clear the ground, the ankle now has to do extra flexion which over time means exhaustion of the ankle joint. This then translates into the ‘plopping’ of the foot as it touches the ground and failed arch of the foot. That means Plantar Fasciitis and prolapsed arch over time!!
When this becomes your routine, the map of movement called homunculus that is in your brain changes. That is the beauty of us human beings- we are good at adapting and being flexible. Can you imagine if the map of movement was set in stone and there was no room for change how miserable we would all be given our sedentary lifestyle and injuries?
The issue here is that this change in the blueprint of movement means that the way the body moves in walking or running in this example changes and any deviation from the design of the body turns into a glitch down the road. You see, one of the major goals of the brain is to help us live a long life to procreate- after all, the survival of the species depends on that. A change in the blueprint of movement does not shorten our lives, it just makes it painful here and there and with this move and that move.
I know so many people who walk into my practice depressed because they don’t run anymore or they hardly do any of the activities they enjoyed doing (including going to places with their family members) because their feet hurt. As you see, addressing the feet is hardly the solution because the SOURCE of the foot problem was in the hip, lower back, etc.
The good news is there is hope for a better outcome and we’ve found the combination of Postural Neurology and Developmental Kinesiology to be the most effective method of treatment that puts an end to almost all musculoskeletal conditions.
How Does Pain Result in Dysfunctional Movement?
To put it simply, your brain wants you to have the most pleasant day given what you throw at it, and also for you to live a long life; it will do what it must to make it so that life is more pleasant. In the presence of pain, we will unknowingly change the way we walk in order to protect the area causing pain.
When we have foot pain or ankle pain, for example, we walk with a limp to accommodate the pain we feel. This is referred to as an ‘antalgic gait’. This is seen in those who have undergone a variety of injuries and is very common with knee injuries. To avoid bending the knee, the person dramatically may lean to the opposite side and swing the extending leg forward, rather than experience the pain of bending the knee while walking.
Getting physical therapy for the knee may help the knee but has nothing to do with the antalgic gait that the person resumed for the given length of time. This ‘pathological pattern of movement’ becomes the ‘normal’ movement pattern which in turn leads to further decline in movement and posture, and potentially pain and issues in other areas. This is dysfunction! The alternative is functional movement which is discussed in the video below.
Unfortunately once the injury is healed, the posture does not always automatically go back to normal because the map of movement in the brain has been altered. The pain will be gone, but the dysfunctional movement and the poor posture stay, leading to new problems down the road. This is why it is important when rehabbing an injury to make sure that maintaining adequate posture throughout the healing process is a part of that treatment plan.
Through postural neurology, we can assess which parts of the brain when it comes to posture and balancing are under-active or even over-active, playing a role in postural deficiency. This is like comparing your answered scantron to the key scantron to see what stands out. Exercising those differences is what positive neuroplasticity is all about and how the improvement in the right direction takes place.
Now what is absolutely necessary to correct the movement is Developmental Kinesiology or Dynamic Neuromuscular Stabilization (DNS). You see, despite our many differences, all babies on this planet go through the same developmental stages; that is because we are programmed to do it that way.
If movement is a concert, the brain is the conductor, the map of movement is the musical notes and the body parts are the musicians. To have a great concert, not only the musical notes have to be for the right music (postural neurology does the quality control there), but also the musicians have to know their part and know when to chime in and when to phase out. That is what Developmental Kinesiology or Dynamic Neuromuscular Stabilization (DNS) does.
The Best Way to Ged Rid of Foot Pain
So you have foot pain and let’s say we’ve narrowed down the source of your pain to an issue in the hips and lower back. Do we work on your hips, feet, or lower back? The correct answer is that we don’t stretch or strengthen any part of you in isolation because that’s not how the body works.
The first step is to always get you out of pain because we cannot have the full attention of the brain to rehabilitate and move correctly when the discomfort of pain exists. While there are medicines for pain, there are alternatives to the meds, and chiropractic adjustment is one of them. Spinal manipulation stimulates the nervous system which is the problem-solving system. This is similar to a teacher coming into the class and telling the students to listen up because she has something exciting to tell them. The kids sit up and are all ears and eyes but the teacher leaves the room. Chiropractic adjustment without anything to follow it is like that!
At our clinic following the adjustment are the strategic steps that are specific to the patients’ findings during the examination. The first step in correction is bringing back the proper breathing pattern. This is an absolute requirement to establish the foundation we need to build on and the video below tells you how that is done.
Breathing correction and chiropractic adjustment alone are not going to fix your foot pain! This is only the very basics of what it takes. In my practice, strengthening does not consist of lifting weights and we don’t use bands or do passive stretching. Strengthening with good form and using the correct muscles, not only at the area of pain but every joint, while going through movements is the focus and can be achieved by holding specific developmental poses PROPERLY. These poses are very challenging because of their specificity and work to not only correct the posture but to maintain the great posture thereon. The exercise shown below is a great example of this.
Every baby around the world is born and follows the same developmental sequence of movement patterns starting at about 3 months of age to roll-over, crawl, squat, all the way till they are walking. This is the natural design of what functional movement is and how to develop it. This is what DNS is and is our blueprint to correct movement and posture in the treatment of musculoskeletal injuries. Why reinvent the wheel?
How to Fix Flat Feet?
Someone who has flat feet, also known as fallen arches, lacks the medial or inside arch that most people naturally have. This will result in walking on the inside of the foot which can then lead to knee problems and furthermore hip and back problems.
While flat feet may run in some families, having flat feet or a flat foot is actually not a foot problem necessarily! I have many patients with flat feet that resumed the healthy presentation of their feet while the ones who are born and show flat feet soon after walking wear foot inserts for life.
Fallen arches are primarily caused by a strength deficiency in the Anterior Tibialis muscle which attaches directly underneath the medial arch. When this muscle weakens due to a direct injury or decrease in the strength of the Hip Flexors (like in the scenario mention above), the tendon becomes weak and no longer supports the arch. The ‘fallen arch’ causes pain overtime and definitely affects posture when walking, running, and really any movement on your feet. The good news is, there is a fix.
Getting a foot scan is a great way to identify functional imbalances. Some foot scanners not only scan for weight distribution but can also identify hip inequality and overall postural misalignment. I am personally not a huge fan of foot orthotics and certainly don’t look at them as a solution but a supportive instrument while working on strengthening the very muscles whose weakness leads to the issue.
To fully correct the issue you also have to address how the foot and ankle function together with the knee, hip, and lower back. This is why Developmental Kinesiology exercises are the best choice because they don’t disregard the rest of the body and strengthen in isolation, but focus on how the whole body functions together.
What Does Posture Have to Do With Foot Pain?
Poor posture affects the body as a whole, which is not always apparent to an untrained eye. We develop poor posture primarily as a result of our poor lifestyle. Now you may think that you are active and go to the gym several times a week so your lifestyle is that of an active person. The truth is that most of the day, you are behind a desk or doing a repetitive task. THEN you go to the gym (maybe). The impact of the posture at your work, for example, cannot be disregarded.
When it comes to musculoskeletal (muscles, bones, and joints) pain focusing on only the area of pain may alleviate pain, but will not fix the problem. Taking the whole body and movement into account helps to ensure that the pain does not come back. Correcting the posture is much more than remembering to sit up straight. A Brain Based Neurology and Posture exam is reverse-engineering the process to the source and allows the focus to be on the true solution and putting an end to pain, discomfort, and propensity for injuries to name a few.
These points should allow you to find the solution to your joint and muscle pains, if however, you still need help, contact me any time.
Dr. Shakib