The human foot is one of the greatest engineering marvels found in Nature. More than any other species in the animal kingdom, human beings use their feet in a wide range of ways and for a wide range of purposes. This has helped human feet evolve through the ages and achieve a high level of perfection as seen today.
The human foot is made up of 26 bones, 33 joints, and over 100 muscles, tendons, and ligaments. The functions and design of the feet are equally interesting. While the front portion and toes act as lever, allowing the individual to compress this portion and break into a run, the natural arch of the heel and the heel act as shock absorbers when the person is walking, running or jumping.
The human feet along with the head, neck, back, lower back, hips and legs form a continuous chain of components that help control or regulate movement, balance, posture and gait of the individual. Needless to say, they are connected with and dependent on each other. So an imbalance in one of the members of this chain can affect another. That is precisely why foot problems can trigger back pain and sciatica, or sustain it in people who already have these ailments.
Pronation and Supination
To understand the connection between foot and back, we need to understand two phenomena related to the feet.
Pronation refers to the inward curling of the feet which happens when we stand up, walk, run and while gripping support, like the rungs of a ladder while climbing, or while lying on the stomach, which is called the ‘prone’ position and hence the name. Mild pronation is natural and desirable. However, in some people, the foot pronates more than desired (called hyper-pronation) which affects the knees, hips, lower back and the overall posture of the person.
Supination is the opposite of pronation where the feet curl outwards which happens when we jump, stretch, exercise, flex our feet, while sleeping or while lying on the back, which is called the ‘supine’ position and hence the name. Again, mild supination is natural and desirable. However, the problem occurs when some people display more than natural supination (called hyper-supination) which puts pressure on the outer parts of the legs causing leg pain and lower back pain.
The causes for hyper-pronation or hyper-supination can vary from genetic disorders that cause improper development of the body, a sedentary lifestyle in childhood or adulthood, obesity or overweight, and significantly – wrong footwear!
Wrong footwear as the culprit
A wrong design of the footwear may provide insufficient support, compress the feet or not complement the natural arch of the feet causing leg pain, back pain, lower back pain and sciatica over the years. It can also nullify the shock-absorbing capacity of the feet triggering intense pain in the hips and lower back, and in rare cases a slipped disc or fractured hip bone. Wrongly-designed footwear such as heels tends to push the pelvis region forward and the hips behind, triggering irregular menstruation and infertility in women.
If you suffer from recurring or long-term back pain, it’s time to meet a physician. A general physician will conduct tests to first rule out conditions like a herniated disk, spinal infection, bone fracture, arthritis or cancer. Once ruled out, he/she will refer you to an osteopath or podiatrist who will examine your feet thoroughly. This is to rule out visible conditions like flat feet, bunions, an inward growing toe-nail or unequal leg lengths.
He/she will then examine the footwear you use for work, walking and running to see if their design is causing the problem. The specialist will then provide recommendations on the kind of footwear to use or avoid, and insist on the use of insoles to correct the problem. Finally, there are various points to be borne in mind while buying the right footwear and the specialist will familiarize you with all of them.
Some tips on choosing or using footwear
- Check with your doctor if your existing footwear needs orthotic insoles as these can provide the desired support and comfort to your feet.
- Choose shoes that have some inbuilt cushioning which reduces shock and impact to your feet.
- Ladies should avoid high heels as much as possible and restrict their usage. Also, the height of the heels should not be more than an inch. Heels that are 2 inches or more should be discarded.
- Flats are not always a good option unless they are well designed. Check for the natural arch support while buying flats.
- All footwear must fit comfortably. Avoid loose or tight ones as they can affect your gait.
- Replace shoes as often as possible, especially if the cushioning inside is worn out