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Biomechanics

Foot pain is not normal, but our feet do more work than most other parts of the body so its not surprising things sometimes go wrong. Some problems with feet are inherited; some develop through illness, some through the pressure of ill-fitting shoes or poorly aligned bones. Our feet mirror our general health and pain, or persistent soreness are warning signs which should not be ignored. Problems in the foot can be the cause of back, hip or knee pain and vice versa. Certain ailments such as diabetes, neurological and vascular disorders, kidney and heart disease and rheumatoid and osteoarthritis can show early warning signs as symptoms in the feet.

The most common biomechanical ailments that require attention are:

SHIN PAIN / SHIN SPLINTS

Pain in the shins is usually a result of shin splints. This is caused by poor foot biomechanics resulting in the pulling of the muscle (Tibialis anterior) which runs between the bones in the lower leg. You may find this is normally aggravated when running and can instantly affect your sport/training or hobbies.

ANKLE PAIN

Pain in this area can be caused by a misalignment of the subtalar joint (main joint of the foot). This misalignment can lead to an instability of the ankle and can cause pain in the medial or lateral side.

ACHILLES PAIN Achilles Tendonitis

An instability in the subtalar joint can push the foot into pronation. This in turn forces the calf muscles to work harder to attempt to keep the foot in a neutral position. Since the Achilles tendon attaches onto the calf muscle and heel bone this can result in a constant pull and lead to inflammation of the Achilles (Achilles tendonitis). The Achilles is avascular and can be slow to heal. Therefore, the condition can be extremely debilitating.

Plantar fascittis / Painful Heels

If you suffer from sharp pain in your heel, you could be suffering from a common condition called plantar fascittis. The plantar fascia is a band of tough, fibrous tissue that runs underneath the foot, connecting the heel bone with the base of each toe. This important structure helps to support the arch of the foot and tightens during walking to help lift the heel off the ground. Pain in the plantar fascia has a number of causes. You may have recently taken up a new activity or sport. The condition is particularly common if you are overweight or have had a baby, or have tight calf muscles meaning that more strain is placed on the plantar fascia. Finally people who stand for long periods, or have a very low or very high arched foot may be at increased risk of developing this problem.

Plantar fascittis occurs when excessive strain is placed on the tissue, causing pain and inflammation. The strain tends to occur over a number of weeks and months, and is rarely attributed to a sudden accident or injury. The most common site is the front part of the heel, but this stabbing pain can occur at any point of the plantar fascia. The pain is at its worst first thing in the morning, but often occurs during the day, especially after any periods of sitting or standing.


KNEE PAIN Patella-Femoral Syndrome

Pain which is localized to the front or medial aspect of the knee is normally caused by over pronation of the foot (flat feet). The pronated foot can cause the knee to internally rotate resulting in a misalignment of the knee cap leading to irritation of the Patella Tendon known as Patella Tendonitis or Chondromalacia.

HIP PAIN Piriformis Syndrome

Pronation of the foot can have an effect on the knee, causing an internal rotation. This can have an impact on the muscles that support the leg. In some cases this can lead to a pain in the outside of the thigh (Ilio Tibial Band syndrome) and into the hips (Piriformis syndrome).

LOWER BACK PROBLEMS

Lower back pain can often be a result of poor foot function and can occur if a patient has a condition known as Ankle Equines. Ankle Equines can cause a hyper extension of the knees and a forward tilt of the pelvis resulting in the patient suffering from Sacroiliac joint pain. Lower back pain can also occur from other biomechanical imbalances of the feet such as pronation and supination.

Bunions: In the normal skeleton, the big toe is lined up with a long bond in the main part of the foot called the metatarsal. The problem begins when this metatarsal bone starts to drift away from the rest of the foot. This may be caused by poor foot function, for example if the foot rolls in excessively, pronation. As the tendons which control the movement of the big toe no longer work correctly, this causes the big toe to be pulled towards the second toe. If a bunion becomes painful, its best to seek advice from a registered podiatrist who can provide specialist insoles (orthotics) and protective devices to relieve pain and pressure.

Metatarsalgia: Metatarsalgia is a pain that occurs in the ball (or metatrasal region) of the foot. The pain can range from mild to severe and often gets worse when you stand or move. It is tingling or numbness in your toes. Some people also experience a ‘walking on pebbles’ sensation. Metatarsalgia is a common foot problem with a number of different causes, such as badly fitting footwear, being overweight and certain medical conditions such as arthritis. Metatarsalgia often occurs in the area where the second, third and fourth toes meet the ball of the foot (the metatarsal heads). Metatarsal pads and orthotic insoles for your shoes may help to relieve pain in your foot by reducing the pressure placed on the heads of your metatarsal bones.

Mortons Neuroma: A neuroma is a thickening of the nerve tissue that may develop in various parts of the body. The most common neuroma is in the foot it occurs between the third and fourth toes. The thickening or enlargement of the nerve is the result of compression and irritation of the nerve. The compression leads to enlargement of the nerve resulting in nerve damage. One of the most common causes of Mortons neuroma is wearing narrow shoes or high heels. People with certain foot abnormalities such as: bunions, hammer toes, flat feet and more flexible feet are at a risk of developing a neuroma. Other potential causes are running and court sports. The symptoms are usually tingling, burning or numbness, the feeling like you have a knot in the toes or your sock is bunched up. You often feel the need to take your shoe off and massage your foot but when replacing your shoe the pain returns. It is best to seek advise as the nerves will not ‘calm down’ without professional advise in the form of paddings, strappings, medication and orthotics. Podiatrists can examine your walking characteristics to identify biomechanical problems and check to see if the joints and muscles in your feet and legs are functioning normally. They can then prescribe bespoke insoles (orthotic). Orthoses are designed to alter the way your feet and legs work, restoring more normal function and relieving stress on the painful areas. So if you … this may be due to the way you are walking. Biomechanics refers to the complex series of movements that make up walking and any anomalies in the process can lead to pain, not only in the feet, but elsewhere in the body such as the knee and lower back.