Feet. Something I avoided for years given a propensity to tickley feet myself and just simply blocking them from my mind. It’s over the last 12-18 months that I have become OBSESSSED with feet. They tell us so
much about the story of someone’s body and can act as great guide do identifying dysfunction in our clients. What I want to give you today is an idea of what the foot could be telling you at the most basic level to give you an insight into why you need to look whole body, when you are suffering pain or dysfunction in just one area. First time I see a client I like to do a ‘Toe to Top’ visual assessment. What can I see just by looking at how my client stands or walks. Is the arch overly high? Are the feet flat? If so what does that tell me? Well it may not tell me anything definitively but it certainly gives me clues as to what to check next.
Let’s take the flat foot. The flattened foot could be an everted foot, everted to the extent that it flattens on to the ground. Yes it’s true that the ligaments may be shot and so the foot is splayed to the ground but what I generally find in a lot of clients is that this is may not be the case and it is a symptom of biomechanical dysfunction which we can work together to correct. Let us look at what the possibilities may be. From our anatomy we know that Peroneus Longus, Peroneus Brevis and Digitorum Longus evert the foot. Are they short and tight? When lying on your bed does their foot turn out or their toes curl up away from the foot? If these muscles are shortened – are they pulling on Tibialis Anterior and Posterior – the inverters of the foot. Sometimes clients complain of shin pain and you work away releasing the Tibialis Anterior to relieve the pressure on the shin pushing them further into this dysfunction. Maybe releasing the Peroneals will have a longer lasting effect. Now let’s look further up the chain – why is the foot and lower leg presenting in this way? My next thought is how is the pressure/weight of the body acting through the feet, I watch my clients walk, I look at them do a soft half squat. Are their knees tracking inwards perhaps? The middle of the knee should be aligned with the 2nd toe, ensuring the support structure of the musculoskeletal systems is being utilised as effectively as possible. If the client’s knees are tracking inwards – sometimes so far over that the big toe is being severely overloaded this pressure will flatten out the foot to support the body. Is their first metatarsal tender to touch? Why are they knees tacking inwards? Weak Gluteus Medius? Overly tight Adductors? Release, fire up and send your client in the right direction to cure themselves. Think clues, clues, clues.
Next up we have a client with an overly raised arch. Again, let’s think about the muscles that may or may not be involved, this is why your touch is so important – is a muscle tight… palpate and see. Is the Tibialis Anterior and Posterior short and tight? Are the Peroneals lengthened and weak. Is the outside of their foot sore, tired and stiff? Again what is playing at the knees? Do the knees bow outwards on walking or squatting? Are the hips rotating outwards – those clients whose legs flop out when they lie on the bed. Are overly tight lateral hip rotators playing a part? Perhaps balancing the hips will fix not only their foot complaints but the ITB syndrome they may have had over the years. It is all coming together, making sense and giving you a clear plan of action for the treatments ahead.
Once you have looked up the chain and have a good idea what is going on your treatment can be tailored to get great results from the offset with homecare that hits all the spots. As you can see, a foot is more than just a foot – it is a gateway to the body, a major clue in the detective work needed to resolve your client’s issues for the long term. Remember to look local but think global, be a body detective!