How would a dysfunction of the foot affect the rest of your body?

By, Brian Van Hook, CSCS
Van Hook Sports Performance Training, Las Vegas, NV


How would a simple impairment in you foot affect the rest of your body?...Really makes you think about the little things!! lets start with something called "Hallux Valgux", so what is that you may ask? well read on and find out!


The big toe of the foot is called the Hallux, and Valgux refers to the abnormal angulation. If the big toe starts to deviate inward in the direction of the fifth toe or “baby toe” the condition is called hallux valgus. As the big toe drifts over into valgus, a bump starts to develop on the big toe over the metatarsal bone. The condition can lead to painful motion of the joint or difficulty with wearing shoes.

Poor muscular integration of the distal segment of the foot such as left foot hallux valgus can result in the dysfunction or impairment of the lumbo-pelvic-hip complex, the cervical spine, or even resulting in shoulder or elbow pain. A person with hallux valgus changes the way they transfer weight in standing posture, and gait. People with hallux valgus avoid placing weight over the medial part of the foot, and instead place a greater proportion of weight on the lateral portion and posterior portion of the foot.

As we all know changes in normal weight bearing movements affects the entire kinetic chain, from the ankle, knee, hip, and spine to the upper extremities. Hallux valgus can create weak hip lateral rotators as a result of excessive hip medial rotation. This will impinge on the normal length-tension relationships of the lateral subsystem and the anterior subsystem (gluteus medius, abductors/adductors, and tensor fascia lata). The deep longitudinal subsystem (erector spinae, biceps femoris, sacrotuberous ligament, and thoracolumbar fascia) is also affected because the biceps femoris becomes the dominant synergist in push off phase of the gait cycle. This will also affect the erector spinae and sacrotuberous ligament in stabilization of the Sacroiliac joint. The posterior oblique subsystem (gluteus maximus, latissimus dorsi, thoracolumbar fascia) is also affected in creating stability of the Sacroiliac joint during gait. Overactive Sacroiliac joint stabilizers, affected by the force-couple relationships between the deep longitudinal subsystem and the posterior oblique subsystem may affect neuromuscular control resulting in instability during movement.

Changes in gait cycle due to changes in weight displacement may result in excessive lumbar lordosis or excessive thoracic kyphosis. Because the body will find ways to move and to balance despite the dysfunction, several compensatory postural shifts may occur. Anterior head positioning may result in cervical or thoracic misalignment, which may impinge the neural innervations of the shoulders, arms, elbow or hands. The impingements may cause pain and affect neuromuscular control. All subsystems are affected with altered synergistic dominance, force-couple relationships, length-tension relationships, and neuromuscular control. There are many potential dysfunctions in the body, especially when the problem begins at the base of support.


References:
1. Neumann, David A. Kinesiology of the Musculoskeletal System: Foundations for Physical Rehabilitation. Mosby. 2002.

2. Sahrmann, Shirley A. Diagnoses and Treatment of Movement Impairment Syndromes. Mosby. 2002

4. Athletic training and sports medicine, By Chad Starkey, Glen Johnson, American Academy of Orthopaedic Surgeons

5. Hall, S. J. (1999). Basic Biomechanics (3rd ed.). Boston: McGraw-Hill.