Are you wearing the right footwear? Grant Foster explains the long and short of how back and lower limb pain can be alleviated by simply wearing the correct shoe….
Bio – What??
Basically it is a science that looks at the mechanical functions of the body, how the body moves and the science of the laws of mechanics, to help explain how injuries occur either by overloading or accidents.
It can be used to explain how the human body interacts with its environment and how it deals with the stresses of the body itself.
Today I am only going to touch briefly on one aspect of this amazing subject, and that is lower limbs and how they affect our daily life.
Where do the problems start?
Most of our problems start with our feet, something that most of us neglect to look after even though in hot countries they are on show a lot of the time. Without going into too much detail, our feet are very much like our hands, in that there are a lot of bones. The reason we have so many bones in the feet is that they were designed to walk on uneven or soft surfaces, not like the hard, ridged concrete we all do today.
When we walk the initial contact is with the heel, then the pressure goes towards the outer 3 toes before rolling over to the big toe as you push off (fig 1).
This rolling over effect is called PRONATION and most of pronate to some degree with some less than others. Once of the reasons we pronate is that there is nothing to support the arches underneath our feet any more so consequently this starts to cause problems elsewhere in the body, usually the knees and back.
Apart from pronation some people suffer with a leg length problem. This can be what we call functionally or anatomically short.
What does this mean?
When we say functionally short we mean that it is the way that the hips are lower on one side due to the over-pronation of one of the feet causing the hip to drop on the affected side. When a person has an anatomically short leg the leg is physically shorter. A persona may not be over-pronating on the lower side but on the loner leg in order to try and balance the hip (fig 2A/2B).
When we run, the problem with pronation can be made worse especially if we are wearing the wrong shoes. Most people on the coast are wearing the wrong shoes, due to the face that the staff in the sports shops are not trained properly to deal with anybody who runs. We’ll talk about the correct shoes later.
How does it cause problems?
- Your lower limb bio-mechanics can cause various problems, but the two most common ones are lower back and knees.
- Functional or anatomical short leg can cause complications of the lower back, not only muscular but joint problems as well, especially around the lower lumbar and pelvis.
- Over-pronation will also cause problems with the big toe putting undue pressure on the main bones around it.
- Muscles spasms in the glutes area causing pain is transferred into the lower back and down the leg to the foot.
- Muscle imbalance in the abdominal, buttocks and lower back, also may be excessive tightness in hamstrings and iliotibial band (long tendon that runs down the side of leg).
- If both feet are pronated then this results in a forward tilt of the pelvis and excessive curving of the lower back.
- With knee problems, excessive pronation will cause injury to the inside of the knee. This is because the Tibia carries on rotation inwards, due to the lack of support and the femur starts to rotate outwards when it has reached it maximum point of flexion (fig 3).
What treatments can help?
- Wearing the correct shoes can help a lot and avoid wearing flip flops. If you must wear sandals or flip flops then information can be found on the web as to the best type which can offer arch support and are professionally recommended.
- Tightness in the Achilles, hamstrings or iliotibial band can be helped with massage and stretching.
- Weakness of the abs, lower back muscles and glutes should be corrected with core stability exercise.
- Manipulation of the lower joints may help in the short term providing there no compression or nerve root irritation.
- Orthotics – basically there are inserted into the shoe and can help correct any imbalances that occur either with pronation or leg length problems. But, they are only effective while you wear them, as soon as you stop wearing them the problems will return. For most people these are the best way to recover from the above problems. See a Podiatrist (foot specialist) or Physiotherapist regarding the fitting of these as it is a very precise job.
- An important note is that most foot problems are genetic, so it is MOST IMPORTANT, that you look after your children’s feet and prevent them getting your problems.
What type of running shoe?
When you are looking for a running shoe the best advice is from someone who knows about running. Most shop assistants wouldn’t know a decent running shoe if it hit them in the face unfortunately. That is unless you go to a specialist running shop who will allow you to try them on a treadmill. They will look at your weight, ask how far you intend to run per week and also look at your running style.
In this area of the Costa, I am not aware of any shop that does this. So far the best place I have come across is Decathlon, which at least has a good range of running shoes.
You can spend an awful lot of money for what they call a running shoe which offers no support at all. Some of the running shoes I have examined in my years as a Sports Massage Therapist are dreadful. Looking at a persons running shoes will give me an indication of their running style, (fig 4) show the common wear patterns for a lot of runners.
Here are some general pointers:
- Just because it costs a lot doesn’t mean it’s any good
- If you can bend it in the middle if offers no help when driving off on your run. The picture (fig 5) is an example of a common air trainer.
- Make sure if can’t be twisted as this will offer no medical support (fig 6).
- The only part that should bend is the toe area (fig 7). It must be noted the trainer in the picture is for excessive pronators.
- Most people pronate as I have mentioned some people will need different levels of support, but there are very few neutral running shoes readily available on the Costa del Sol.
- These pictures are of two brands (fig 8) the lower being Decathlons own make, both for over-pronators.
Anti – pronation running shoes are not expensive.
You only have one pair of feed and you cannot change them like you can change the tyres on your car. You would get your wheels balanced if the car is not steering correctly; your feet are no different.
This article has only scratched the surface of a complex subject and is not in the remit to cover specific problems. Always get a correct assessment of any problems by a recognised professional. Remember be fit, be healthy.