This article is part of a series discussing the biomechanical connections between the feet, ankles, knees and hips and how they all impact knee health.
Our feet form the foundation for our upright body. Whether standing or in movement, whatever happens at the feet reflects all the way through the leg joints to the rest of the body. And when it comes to the healthy knees strong, aware feet are essential.
Pronation & supination
Two important actions for the feet are pronation, where the inner feet bear more weight, and supination, where the outer feet bear more weight. Both of these actions are required as part of our regular walking cycle.
Problems arise when we begin favor one action over the other and the favored position becomes over pronounced.
For example, many people tend towards pronation, where more weight lands and rests on the inner feet than on the outer feet. This can lead to problems at other joints further along the kinetic chain, such as the ankles, knees, hips and lower back.
When the inner feet collapse due to pronation the shin and thigh bones roll in and pull the knee joint along with them. Over time this can lead to uneven and excessive wear and tear at the inner knee joint. See figure 1 right.
The reverse happens in supination. When more weight lands and rests on the outer foot the shin turns out. This causes the knee joint to be pulled out and more wear and tear can show up at the outer knees instead. See figure 1.
The solution can be as simple as wearing shoe orthotics, especially in more severe cases. However, promoting healthy alignment by building strength in the arch of the foot as well as in the leg and hip muscles can help alleviate the issue, or better still, prevent it from happening in the first place.
On your toes
Out of all the toes the big toe is especially influential for knee health. If it’s unable to flex up or extend down the foot will pronate to help make up for the toe’s lack of movment. As discussed above, foot pronation can lead to further disturbances at the knee joint.
There is no one cause for stiff big toes, but the most common are overuse, genetic predisposition and osteoarthritis.
Treatment depends on how stiff the joint has become. Figure 2. on the right shows three different ranges of motion at the big toe: normal, limited and rigid. By the time the toe has become rigid medical help would be required, but in the early stages of stiff toes there is still potential for self-treatment. Just like all skeletal muscles and joints in the body, the muscles and joints of the toes and feet respond well to exercise, stretching and movment.
Wearing yoga toe spreaders might also be worth checking out. Try wearing them barefoot around your house. Start with 10 minutes and build up your time gradually from there. I’ve had several students over the years use them with success. Like many muscular-skeletal remedies however, it takes time. The toe spreaders worked because the students wore them consistently over an extended period.
Click here for exercises to help you discover what your own standing tendencies are
And check out part 2 of this article to find out what to do with your discoveries
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