This Foot Health Week, Associate Head of the Charles Sturt School of Allied Health, Exercise and Sports Sciences Associate Professor in Podiatry Caroline Robinson explains how common ailments experienced by many are often caused by the most unsuspecting of body parts – our feet!

How can foot posture cause pain in other parts of the body?

“The human foot is a masterpiece of engineering and a work of art” (Leonardo da Vinci).

Foot posture (pronated, neutral, supinated) is determined by the alignment of 26 bones connected by ligaments and small muscles in your feet, the structure of your ankle joint, the alignment of your legs and the function of core muscles around your buttocks, hips, abdomen, and lower back.

This short video illustrates the effect of altering foot posture on the alignment of your leg and knee. A problem with foot posture might be the cause of pain in another part of your body.

Why does my ankle hurt ONLY when I walk?

Excessive pronation in the foot can be the cause of ankle pain. People with sinus tarsi impingement syndrome (STIS) experience pain on the outside of the foot, just below the ankle joint and may feel unstable when walking on uneven surfaces, such as a gravel path. Excessive pronation causes increased motion at the subtalar joint, resulting in compression of soft tissue and nerves, which causes pain.

Ankle pain or restricted movement might also be caused by a stiff big toe (hallux). The joint which connects the hallux to the foot is called the first metatarso-phalangeal joint. This joint needs to flex sufficiently to allow the foot to function normally when you walk or run. If this joint becomes damaged by arthritis or injury and doesn’t move freely, it affects the function of the ankle joint.

Why does my knee hurt when it is bent or when I run?

Foot position and function directly influence the position of the leg and knee during walking and running. As the foot pronates, the leg rotates inwards (towards the other leg). If pronation is excessive, this repetitive rotation with every step can result in injuries, such as medial tibial stress syndrome (shin splints) and knee pain (patellofemoral pain). Over time, the knee joint can become damaged with osteoarthritis. It has been found that people with knee osteoarthritis (affecting the medial compartment) are more likely to have a pronated foot posture.

Why does my back hurt all of a sudden?

Pronated foot function has also been linked with lower back pain, particularly in women. Excessive motion in the foot and leg can cause instability and repetitive strain in the lower back. This is made worse if the core stabilising muscles in the buttocks, hips, abdomen, and lower back are weak.

Painful feet might also lead to lower back pain due to less physical activity and the de-conditioning of core muscles. Guidelines for lower back pain include encouragement to ‘stay active and continue, or return to usual activity, including work, as soon as possible’. Having painful feet and a painful back is likely to create a vicious cycle that is difficult to manage.

Why do I get headaches or neck pain after sitting for a while?

Poor posture might be associated with having painful feet and walking unevenly. Poor posture can create misalignment of the pelvis and curvature of the spine. This might be noticeable if one of your shoulders is lower than the other. A curvature of the spine can lead to nerve compression, neck pain, and headaches.

Foot pain is also linked to mood. One study showed that people undergoing bariatric surgery to aid weight loss had improvement in depressive symptoms and reduced foot pain, even though the weight loss did not result in a significant change in foot posture or foot function.

What can you do if you think your feet are the problem?

Make an appointment to see a podiatrist. Podiatrists are the experts in foot health who can provide a holistic assessment to analyse the relationship between your feet and overall health.

A podiatrist may prescribe an exercise program to target foot, leg and core muscles and improve your foot posture. A prescription for a pair of orthoses may also be appropriate to modify your foot function to treat foot, ankle, knee, or lower back pain.

Talking with your podiatrist to understand how foot dysfunction may cause problems in other parts of your body is valuable education and could save years of pain.

ENDS