According to Britain’s Chartered Society of Physiotherapy, up to 60% of sports injuries are caused by worn-out or unsuitable footwear.

Proper footwear can potentially prevent, reduce and/or treat mechanical factors associated with injuries to the lower extremities and the lower back. The foot provides dynamic stability for a person’s entire body weight, while simultaneously maintaining flexibility for shock absorption and propulsion along uneven surfaces. As a result, there are unique biomechanical demands on the foot.

One of the body’s adaptations to these demands is through specialized movements in the foot, such as Pronation. Unless there is a severe, acute injury, pronation develops as a gradual biomechanical distortion. Several factors contribute to developing pronation, including tibialis posterior weakness,  ligament weakness, excess weight, flat feet, knock knees, subtalar aversion, or other biomechanical distortions in the foot or ankle.

Tibialis posterior weakness is one of the primary factors leading to pronation. Pronation primarily is controlled by the architecture of the foot and eccentric activation of the tibialis posterior. If the tibialis posterior is weak, the muscle cannot adequately slow the natural pronation cycle. This can become a contributing factor to lower back pain and lower extremity disorders, such as plantar fasciitis, ankle injuries, foot pain, shin splints as well as various knee and hip injuries.

Back pain due to foot pronation

The inward rotation of the leg that occurs as the foot pronates causes the pelvis to lean forwards (anterior tilt) and drop. This increases the curvature of the lower spine (see picture below) and the muscles become tight and sore. If the foot pronation occurs more in one foot than the other, this will cause the pelvis to become uneven. The leg will become shorter on the more pronated side and the lower spine may tilt in the opposite direction to prevent leaning. As a result, muscles and joints become painful and walking becomes less efficient. Pronation usually is corrected with orthotics, which are especially designed shoe inserts helping to restore the natural position of your foot and/or strengthening exercises for the tibialis posterior.

Here are some strengthening exercises for the Tibialis Posterior:

1. Use a ‘theraband’ or the inner tube of a bicycle-

Place two fingers on the outside of your knee to stop it moving to the side.

Now contract the Tibialis posterior muscle by letting the ankle pull against the rubber tubing, trying to lift the foot arch off the floor by rolling the ankle outwards. Here, it is still only partially raised off the ground.

Note that this is the situation in a healthy, fully functional lower leg and foot. In the situation for an already over strained and insufficient tibialis muscle, the foot arch would not lift even this much.

2. Form foot arch as seen above.

Place the fingers inside of the knee, and encourage the knee to move to the side.

The femur thus laterally rotates to catch up with the lateral rotation in the tibia, and the knee is no longer twisted.

Note how the foot arch fully lifts by combining the twin strategies of contracting the Tibialis posterior muscle and moving the knee laterally.

Also, Deep Tissue Massage treatments can relieve myofascial trigger points in the tibialis posterior, and other muscles, and address any resulting neuromuscular dysfunction in the leg or foot.

Do I need Orthotics?

Many foot symptoms ranging from general aches to painful bone and foot problems such as heel pains, bunions, calluses and knee or back pain, can be caused by collapsed and fallen arches.

Orthotics are especially designed shoe inserts which help to restore the natural position of your foot and realigning the joints within the foot in order to relieve the various symptoms. Left foot is corrected with a casted orthotic.

Do I wear Orthotics all day?

Orthotics, like glasses, work only when you use them. They do not change the structure of a foot, but help realign its joints to improve posture and function and relieve foot pain.

All day use of your orthotics is generally recommended to control or reduce pain or fatigue.

This article was written and provided by Barbara Brunner of www.brunnertraining.com