You may ask why a chiropractor is writing about feet. It all goes back to the old song, “The foot bone’s connected to the leg bone, and the leg bone’s connected to the knee bone…” I hope the person who wrote that song is not offended by my inaccurate representation of his or her work, but the ideas represented are, for all their silliness, very true.

Feet are the foundation of our structure for better or for worse. A foot has 26 bones and 107 ligaments (the plastic-like connective tissue that unite bones to bones), and 19 muscles have tendons, which insert onto the bones of the foot. Tendons are the connective tissue, which connects muscle to bone. This is the mechanism that allows muscles to move our bodies.

The foot is an amazing feat of architecture (pardon the pun), which allows us to move through gravity with buoyancy and spring. Each walking (not to mention running and jumping) foot strike transmits the equivalent force of two to three times our body weight. For most people, the arches of the foot absorb this impact effortlessly. As we age or have injuries, however, we all may need a bit of help in maintaining the proper support for this all-important structure.

New York Times health writer Laurie Tarkan says, “In a recent survey for the American Podiatric Medical Association, 53% of respondents reported foot pain so severe that it hampered their daily function. On average, people develop pain in their 60s, but it can start as early as the 20s and 30s.” When the arch of the foot fails to function optimally and begins to collapse, it is common to not only have foot pain, but a whole host of other problems. These problems, though they are often not felt in the foot, none-the-less often originate from the loss of proper foot arch bone alignment and the stretching of the supporting ligaments.

The three arches of the foot are the medial (the highest), the lateral longitudinal arches, and the transverse or metatarsal arch. Just like its name, the longitudinal arches hold up the long dimensions of the foot from heel to the base of the toes. The horizontal arch forms the ball of the foot, or shorter dimensions of the foot. Some people are surprised to realize that there is an arch at the ball of the foot, but there is. Chiropractors have historically paid attention to this arch and its effect on foot issues.

The longitudinal arch is mostly held up by the architecture of how the bones fit together. Like an arched doorway that was popular in days of old, the bones are fitted together with the narrower end on the bottom and the wide end on the top. The cuboid bone is often considered the keystone of the arch. The talus is the bone which connects with the tibia, or leg bone. The talus and all the bones of the foot derive most of their stability from the ligaments, which tie them all together, and the plantar fascia. This is a long band of fibrous tissue on the bottom of the foot that runs from the heel (calcaneus) to the toes (metatarsals).

As we age, the foot gives in to gravity and that band can start to stretch and become inflamed. This is called Plantar Fasciitis (also known as “policeman’s heel”). It can be very painful without the right correction and can be disabling for some people.

Plantar Fasciitis can also be caused by a tight Achilles tendon causing a subluxation (malposition) of the heel, which causes pulling on the plantar fascia.

Another painful disorder which arises from arch collapse is a condition called the bunion. It’s a big, commonly very painful bump at the base of the big toe. This bump can and usually does grow bigger as a person ages.

I have found that both of these disorders can be successfully treated by adjusting the feet and casting patients in corrective orthotics. Since everything that has a joint (a place where a bone meets a bone) can become subluxated (pulled out of its normal alignment), some chiropractors are trained in and specialize in adjusting extremities (arms, hands, legs, feet).

What is not so obvious is that often knee pain can be a result of some or many of the bones in the foot being subluxated. From the chiropractic perspective, most foot problems are the result of foot bones becoming subluxated and causing the accompanying collapse of the longitudinal and metatarsal arches and ligaments. As the foot structure drops, the tibia (the leg bone on the inside of the calf), drops as well and rotates where it contacts the foot, causing the knee alignment to change. When the knee alignment changes, the hip alignment can change as well, dropping so as to un-level the sacrum, where the spine originates in the pelvis. Spinal curvatures can also be affected by arch collapse. The ankle bone connects to the knee bone, the knee to the hip, the hip to the spine.

It is not well known that many knee problems and runners’ shin splints are caused by arch problems, which is why there is a gazillion-dollar running shoe industry. However, in my experience, these designer shoes fall far short of the correction most people need if they want to resolve a foot and knee problem. I unequivocally can say that custom corrective orthotics give a chance at correcting these problems. Without stabilizing the feet, leveling the pelvis and correcting the spine is very difficult. If a falling arch or arches are present, this must be addressed.

In my opinion, the best orthotics are custom made and are formed directly off a foot mold taken in the optimal arch position of toe-off. If you have orthotics that have not been made in this way and are not effective, it may be wise to look into finding a person who can cast orthotics in this way.

People often ask questions and assert beliefs about strengthening the feet through barefoot walking and running. It is probably possible for any younger person to do so for a while if they are walking or running outside on the ground. Many of these models originate from countries in which they do not run on pavement or hard flooring. Over time, I would wonder how many over 40 are free of pain and other dysfunctions with their knees, hips, and spines, not to mention falling arches. While the human body is masterfully designed, gravity is a force of it’s own. It’s a good thing that we have custom corrective orthotics to help.

Foot problems often run in families, so if you have foot problems, it’s wise to get children checked and give them a fighting chance at foot and spinal health before they develop problems that require correction.

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