Avoiding Injury and Preserving Musculoskeletal Health – A new way to resolve foot, ankle, knee, hip and back pain.
By Bjorn Svae, Posture Dynamics, Inc.
You don’t have to be in you 30’s, 40’s or 50’s to suffer from foot, ankle, knee, hip and back pain. In fact, the rate of sufferers among teens is amazingly high, and if they are active in sports, complaints of ankle and knee pain and shin splints are very common. This spring Posture Dynamics, Inc. provided a Lake Washington Youth Soccer Association team with Posture Control Insoles™ (PCIs), because we wanted to establish how PCIs worked with soccer cleats. Here is a short list of results collected after 3 months:
|  |  Ankles roll in and knees torque with every step. |
|  Ankles roll in |
There is a well-documented connection between musculoskeletal health and posture. Moms always used to and some still tell their kids to “Stand up and sit up straight” It just seems logical, but if you look around these days either moms aren’t harping on it as much as they used to, or kids aren’t listening. A healthy posture is described by a posterior rotation of the pelvis (the tummy and bottom are tucked in) the upper body is erect, shoulders are straight and pulled back and the head is over the spine (ears over the shoulders). What you see most often is a classic forward leaning posture which typically worsens with age.
There is a reason why healthy posture doesn’t come naturally. It’s a chain of events starting with our feet. Dr. Janet Travell, Whitehouse Physician to Presidents Kennedy and Johnson, identified Morton’s Foot Structure (MFS) as a major perpetuating factor in musculoskeletal disease. People who have MFS also have Rothbart’s Foot Structure which causes hyper pronation – the ankles roll in and the foot twists when walking and running. Hyper pronation causes an interior rotation of the legs (knees rotate toward each other) which causes the pelvis to roll forward, and the upper body to lean forward. Good looking and healthy posture comes more naturally for those who do not hyper pronate.
What is the relationship between posture and injury? The most obvious relationship is joint alignment. The interior rotation of the legs caused by hyper pronation causes the knees to travel to the inside of the middle of the foot.
To check for this on your children or spouse, have them stand with their feet parallel and 8-10 inches apart. Stand behind them while they bend their knees (upper body vertical not squatting, don’t let the heels lift off the floor). This simulates what the legs and feet do when walking and running. Observe the motion of their ankles and knees. The more the ankles roll in, the worse the hyper pronation.
A joint that is in alignment can transfer lots of power, but a misaligned joint can be easily damaged. The reason so many adults need arthroscopic knee surgery for fractured meniscus and ultimately knee replacement is years of rotational forces across the knee that literally tries to torque the joint apart. In athletics this torque is magnified in frequency and range, leading to torn ligaments. It has also been established that women tear their Anterior Cruciate Ligaments (ACL) much more often than men. Everyone needs to pay attention to their posture and body alignment, but especially athletes – even when they are young.
The chain of events that is set off by hyper pronation is significant and is a major cause of not only pains in the foot itself such as heel and arch pain or Achilles pain, but shin splints (muscle cramps from over use), knee pain (stressed ligaments), hip pain (stressed posterior ligaments), low back pain (forward rotated pelvis causing an excessive spinal curve, and a forward leaning posture causing muscle over use), shoulder and neck pain and headaches (head forward posture). Dentists have identified that a forward leaning posture causes a change in the bite and is often a contributor to Temporal Mandibular Joint (TMJ) problems.
Morton’s Foot Structure (MFS) is easy to recognize by an apparent longer second toe compared to the big toe, and/or a deeper web space between the first and second toe than the second and third. Take a minute to look at your feet and then check the rest of your family’s. The first metatarsal bone is actually shorter than the second. A little over 20 years ago, Dr. Brian A. Rothbart, DPM, PhD, made a discovery, something Dr. Travell considered to be “the third dimension of MFS.” The first metatarsal bone is not only short, but when the ankle is aligned in its optimal position, so the heel is perpendicular to the ground and the knee travels over the foot (as it should), the first metatarsal and the big toe is elevated off the ground and slightly rotated. In order for the big toe and first metatarsal to become weight bearing in normal standing, walking, and running, they have to travel a small amount down to reach the ground. In doing so, it takes the whole inside of the foot and ankle with it. The arch collapses by some amount and the ankles and knees roll in.
Orthotics have often been prescribed if the problem has been very bad, but the problem doesn't have to be very bad to cause long term damage. Athletic activity hastens the pace simply by the increased usage.
The effects of hyper pronation can be prevented by wearing Posture Control Insoles™ (PCIs). PCIs are not foot supports. The small wedges placed underneath the first metatarsal and big toe act as a neuromuscular stimulus causing the body to self-correct for hyper pronation.
The results quoted above were achieved with generic 3.5mm (height of the wedge on the inside) PCIs. The girls received the insoles and fitting instructions and fit them in their shoes and cleats themselves. The results are very encouraging, by all appearances, the PCIs work well in soccer cleats and there were no adverse reactions reported.
To learn more, go to MortonsFoot.com If you have questions, you can also call Posture Dynamics at 888-790-4100.