Mike Pezzotta, C.PED, Pedorthist/Orthodist

What Does My Back Pain Have To Do With My Feet?

When people visit our office, they are often surprised to realize our concern with their feet. Your feet are the foundation for a healthy body posture. Like a building, the body’s foundation must be stable to correctly support your weight above. Musculoskeletal instability due to foot related problems causes stress on muscles, ligaments, tendons and joints and could make your body hurt all over. Below are just a few of the descriptions of the most commonly encountered foot related problems that we see in our office.

Pronation
One of the most common problems interfering with normal foot biomechanics is a condition known as excessive pronation – or dropped arch. This condition often occurs due to several factors, including loss of the medial longitudinal arch, eversion (tilting) of the calcaneus (heel), or excessive dropping of the talus and/or Navicular bones, and is routinely found in parasympathetically dominant patients in need of additional Calcium supplementation.

Excessive pronation interferes with normal gait patterns and is a common cause of decreased athletic performance. There is also the likelihood of developing painful foot and ankle disability over time and the probability of transferring abnormal stresses up the lower extremity and into the pelvis and spine is significantly increased as a result of excessive foot pronation.

Excessive pronation is associated with many musculoskeletol complaints – from the foot itself, up the leg to the knee, hip and even the pelvis and spine. The good news is that all of these conditions can be helped with custom-fitted orthotics. Many times, correction of recurring subluxation patterns of the spine can only be accomplished when an excessively pronated foot is provided with appropriate orthotic support. Preventive measures include wearing well-designed and constructed shoes, and considering orthotic support in those patients at risk for developing excessive pronation.

Morton’s Syndrome: Long 2nd Metatarsal
Morton’s Toe is the presence of a second toe being longer than the first toe. Morton’s Toe causes the weight bearing surface of the foot to shift laterally from the 1st metatarsal to the 2nd metatarsal. This creates a knife-edge rolling effect. This may occur in one or both feet. This is not an unusual finding. The patient must be fitted for orthotics as this is a mechanical problem that must be addressed. Failure to correct this problem will result in a continued major mechanical stress for the patient.

It is estimated that 40% of the population has a 2nd toe that is longer than the big toe. This creates instability in weight bearing, since the big toe is designed to bear weight when walking. A longer second toe allows the foot to roll and be seen as the lateral heel and medial sole wear out on shoes. The only possible answer is to support the 1st toe.

Supination
Another common problem with the foot is an excessively high arch of the foot. Perhaps more common than we realize, a high arch causes a variety of potential problems such as instability of the pedal balance, a tendency for easy ankle sprains (lateral rollover), excessive metatarsal and heel pressure which results in a “heavy foot” with callous formation. Because of weight bearing instability, the high arch individual may also experience claw toe as well as altered hip joint range of motion.

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