Vail health column: Pain in the leg and hip can often be traced to lack of mobility in the foot
May 23, 2016
Try standing up with your feet turned out. At first, you'll feel tension on the sides of your hips. In time, you may feel a burn. Now try walking around this way. Feel all that pressure in your big toes? Imagine hiking this way or riding a bike. Imagine what it would do to your knees on up through your spine. It would hurt.
To walk efficiently, we need to have a certain amount of mobility in our feet and ankles. Many people lack this. Be it from shoe choice, injury or activity level, we develop restrictions. A quick way to test this is a kneeling lunge. You should be able to advance your knee forward of your toes by about 4 inches. If you can't do this in kneeling, you can't do it walking.
If our feet aren't mobile enough, something upstream has to compensate. If we can't swing through in gait, we'll swing around. Think of advancing an L-shaped object. It is easier to tip it sideways than to roll it end over end. Similarly, we turn our stiff feet out to advance through the gait cycle. This not only changes the forces on our joints, but also the muscles we use.
With the foot out, the inner groin muscles (adductors) have no choice but to act on behalf of the hip flexor muscles (iliacus). The external rotators of the hip (piriformis) are forced to do the job of the hip extensors (gluteus maximus). We also end up pushing off with all our weight in the big toe. Pain typically ensues.
Where we fail is by looking only at what hurts: meniscus tears, bunions, labral tears/hip impingement, piriformis syndrome and sciatica are common examples. The pain may be in the knee or the hip, but what started it all? The body is a closed system. If something isn't moving enough, another structure will have to make up the difference. Rather than chase the pain, treat the source.
Google "foot mobility" and you get 84,000,000 hits. Each foot contains 26 bones, 33 joints and more than 200,000 nerve endings. When it comes to learning potential, it seems the odds are in your foot's favor.
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Julie Peterson, MPT, is the owner of Concierge Physical Therapy Colorado. She is a certified neurokinetic therapy specialist with a strong background in manual therapy. She can be reached at 970-306-3006 and firstname.lastname@example.org. For more information, visit http://www.conciergeptcolorado.com.