Our modern habit of confining our feet into the prisons of our shoes may be partly responsible for some of the problems we face. Our feet have evolved to manage the changing levels and types of surfaces as the toes grip the ground and reinforce the arches. With the universal use of shoes almost all of the time we have given our feet a much reduced role and they do not have to be able to manage the ground surface, being given a smooth firm plastic or leather one instead. The small intrinsic foot muscles weaken and lose function as they are deprived of their natural job, reducing the foot's effectiveness.
The arches of the foot and the function of the toes alter as the intrinsic muscles of the foot weaken as the toes lose the ability to hold themselves straight when gripping the surface. Due to this they start to bend or claw, and as this progresses the muscles which extend the toes can shorten in sympathy, drawing the toes up in a flexed position. This takes the pads of the toes away from any possible contact with the ground, obliging them to take force on the tips perhaps. Overall the foot becomes less functional and the arches decrease in height.
The medial longitudinal arch can lose some of its height, at times related to the person's typical gait with rolling the foot inwards, stretching the joint ligaments of the arch as they are tensioned and stretched. If this occurs then any length of time spent walking or standing can bring on aching and pain. The less marked transverse arch at the front of the foot can also suffer a reduction in its structure and strength. If this occurs the second metatarsal is forced to take the weight of the body during walking and standing which it is not adapted for.
Because it has little fat padding underneath it, the second metatarsal is less well designed to cope with the weight of the body, with sufferers feeling when standing that they have a stone under their foot. Callused, hard skin areas develop and indicate that the area is taking weight that it should not be. Women wearing shoes with high heels can force their body weight forwards over the forefoot and the narrow front of the shoe can compress the toes together so their ability to push off is compromised.
Bunions are a common deformity of the forefoot, with the joint between the first metatarsal and the big toe enlarging and the big toe migrating towards the smaller toes. As people report their relatives may have this problem there is some likelihood of a family trait. The joint itself can develop pain and cause space problems within shoes due to its position and that of the toes. The foot can gradually change from the springy and responsive part to a static and non-dynamic support for the body weight with consequent functional loss.
Severe bunions are not wholly to do with the joint between the first metatarsal and the big toes but there is also a degree of abnormality in the angle of the first metatarsal which moves towards the inside. This accentuates the deformity. Orthopaedic surgeons have a variety of operations available to correct severely painful feet, with osteotomy of the first metatarsal a common intervention to realign the relationship between the toe and the metatarsal. Most of these operations are now done as day cases provided post-operative pain is not too great and patients can mobilise non weight bearing (hopping) or weight bearing on their heels for six weeks or so.
Physiotherapy assessment and treatment of foot pain due to flat feet and other abnormalities is normally performed by physiotherapists who have specialised in this field to some degree due to its complexity. There is a large range of off-the-shelf insoles, known collectively as orthotics, which can be used to correct the angular imbalance of the heel or to support the medial and transverse arches of the feet. These are typically prescribed along with exercises to work at restoring the normal muscular balance of the feet. - 14130
The arches of the foot and the function of the toes alter as the intrinsic muscles of the foot weaken as the toes lose the ability to hold themselves straight when gripping the surface. Due to this they start to bend or claw, and as this progresses the muscles which extend the toes can shorten in sympathy, drawing the toes up in a flexed position. This takes the pads of the toes away from any possible contact with the ground, obliging them to take force on the tips perhaps. Overall the foot becomes less functional and the arches decrease in height.
The medial longitudinal arch can lose some of its height, at times related to the person's typical gait with rolling the foot inwards, stretching the joint ligaments of the arch as they are tensioned and stretched. If this occurs then any length of time spent walking or standing can bring on aching and pain. The less marked transverse arch at the front of the foot can also suffer a reduction in its structure and strength. If this occurs the second metatarsal is forced to take the weight of the body during walking and standing which it is not adapted for.
Because it has little fat padding underneath it, the second metatarsal is less well designed to cope with the weight of the body, with sufferers feeling when standing that they have a stone under their foot. Callused, hard skin areas develop and indicate that the area is taking weight that it should not be. Women wearing shoes with high heels can force their body weight forwards over the forefoot and the narrow front of the shoe can compress the toes together so their ability to push off is compromised.
Bunions are a common deformity of the forefoot, with the joint between the first metatarsal and the big toe enlarging and the big toe migrating towards the smaller toes. As people report their relatives may have this problem there is some likelihood of a family trait. The joint itself can develop pain and cause space problems within shoes due to its position and that of the toes. The foot can gradually change from the springy and responsive part to a static and non-dynamic support for the body weight with consequent functional loss.
Severe bunions are not wholly to do with the joint between the first metatarsal and the big toes but there is also a degree of abnormality in the angle of the first metatarsal which moves towards the inside. This accentuates the deformity. Orthopaedic surgeons have a variety of operations available to correct severely painful feet, with osteotomy of the first metatarsal a common intervention to realign the relationship between the toe and the metatarsal. Most of these operations are now done as day cases provided post-operative pain is not too great and patients can mobilise non weight bearing (hopping) or weight bearing on their heels for six weeks or so.
Physiotherapy assessment and treatment of foot pain due to flat feet and other abnormalities is normally performed by physiotherapists who have specialised in this field to some degree due to its complexity. There is a large range of off-the-shelf insoles, known collectively as orthotics, which can be used to correct the angular imbalance of the heel or to support the medial and transverse arches of the feet. These are typically prescribed along with exercises to work at restoring the normal muscular balance of the feet. - 14130
About the Author:
Jonathan Blood Smyth is the Superintendent of Physiotherapy at an NHS hospital in the South-West of the UK. He writes articles about back pain, neck pain, and injury management. If you are looking for physiotherapists in Nottingham visit his website.
No comments:
Post a Comment