Functional Friday Episode #12: Foot Function and the Running Athlete.
Feet are possibly one of the most overlooked areas of our body as it relates to movement. Of the 12 million runners in the United States, the annual injury rate is around 50%. Injuries can range from plantar fasciitis, stress fractures, strains, sprains, low back pain, piriformis syndrome, hip impingement, and knee pain (patellar tendonitis or tendonopathy). These are just some of the conditions that runners are regularly faced with, and this creates problems when runnners can’t get back to doing what they love. To run injury free for decades you have to be strong, coordinated, and most of all well informed. This video is a TINY piece of the biomechanics of running, but it does cover two very common and important aspects that can cause problems.
Ankle dorsiflexion is our ability to move our foot up, toward our shin bone (tibia). There is generally 10 degrees past neutral of ankle dorsiflexion needed in order to go through a “normal” running/walking gait. This is key because if you lack the ability to dorsiflex your ankle, your body will find a way to compensate around that loss of movement. Typically this can present with foot flare (duck footed) stance and gait, along with knee valgosity (the knee diving in towards the midline). This compensation mechanism is more common than most people realize and may seem like a small deal. But when it is added up over time with thousands and thousands of steps being taken while running, these small problems can lead to wear and tear and eventually pain and injury.
Another common finding we see in the feet is a lack of calcaneal eversion. The calcaneus (heel bone) needs to be able to move in and out during a normal walking movement. If it doesn’t, the force then just gets transferred up the kinetic chain to the knee, hip, and low back. It can also lead to excess movement happening in the forefoot, leading to the middle of the foot diving in excessively (pronation).
A lack of joint movement in the foot is something that chiropractors specialize in correcting. Like I mentioned, many clinicians overlook the feet for a variety of reasons, but if you are truly assessing someones full movement system, the feet are a vital part.
When assessing a distance running athlete, I will always say that you have to look at the patient in front of you, and not just the pain they are presenting with. If someone has knee pain, but their foot is dysfunctional, there is a decent chance that correcting the foot problems can have a long-term impact on their musculoskeletal health. This is why we always assess function, and not just pain.
Dr. Kirk Mason, Premier Chiropractic, Minot Chiropractor