Have you been giving your feet any attention lately? If you are like most people, you probably don’t even notice them unless you need a pedicure. Even though this region is usually neglected by many people, our feet are very important structures and deserve some TLC.
Keep in mind that the feet are the main contact between the body and the ground when we are standing. They are responsible for establishing our base of support, which is vital for the maintenance of static and dynamic (during movement) balance. Anatomically speaking, the foot is a complex structure designed to support our body weight. In addition, the foot, together with the ankle joint, provides adequate range of motion necessary for walking, running, jumping, and swimming, among so many other activities. The feet also gather information about the terrain in which one is standing and transmit this information to the rest of the body. Because of this interconnection, any trouble in this region may lead to dysfunction in other areas and vice versa.
Foot and ankle problems may be caused by obvious factors such as poorly fitted shoes or excessive body weight. However, poor habitual posture and misalignments in other joints may lead to muscle imbalances that might affect this region. Thus, including the foot and ankle complex in an exercise program is essential to make this area strong, flexible, stable, aligned, and resilient.
Anatomy
The first step to prevent foot and ankle injuries is to understand its structures and functions. The foot is a complex structure composed of 26 bones, 31 joints, 19 large muscles, 20 small muscles, and more than 100 ligaments. All those ligaments guarantee stability of the bony structures, while mobility is granted by the combination of every single joint’s range of motion. The bones of the foot are arranged in a manner that creates three arches. Two of them run from the heel to the toes and are important for shock absorption and balance. The third one extends from the big toe to the pinky toe and is responsible for adapting the foot to uneven surfaces. These arches are designed to support our weight and are held in place by ligaments and muscles. The foot is connected to the lower leg through the ankle joint, which mainly enables us to extend (point the toes) and flex (bring the foot closer to the shin) the foot.
There are many muscles in this region, and in order to facilitate comprehension, I’ve separated the lower leg into four compartments: anterior (shin), posterior (calf), medial (big toe side), and lateral (pinky toe side). In the anterior compartment, we find muscles that flex the foot. Usually, running activities place heavy demands on these muscles. On the opposite side are the muscles responsible for extending the foot such as when you point your toe or perform calf raises. Wearing high heels on a daily basis tends to shorten these muscles, making them tighter. The muscles of the lateral segment (towards the pinky toe) turn the ankle and foot outward as when you step on the inside of your foot. The medial muscles do just the opposite by turning the ankle and foot inward (the weight is placed on the outer edge of the foot).
This is a simplified version of ankle and foot anatomy. Of course, there are other muscles involved in toe movement. The important aspect to keep in mind is that all those muscles work in synchrony to allow the mobility necessary for many activities.
Dysfunction and Injuries
The ankle seems to be the most commonly injured joint in both sports and daily activities. Ankle instability may be caused by local factors such as foot misalignment or local muscle imbalances as well as by problems in distant areas such as hip instability and muscle weakness in the lumbar region.
Foot trouble is often caused by improper shoes that may disturb foot mechanics and lead to gait abnormalities. For example, if the foot is too rigid, impact forces will not be absorbed, which will result in improper shock transmission to other joints.
A common foot and ankle misalignment occurs when the individual tends to put too much weight on the inner edge of the foot, which results in the flattening of the arches. This is usually caused by imbalances between the lower leg and ankle muscles in which the muscles of the lateral and the posterior compartments are often overactive, while the muscles of the anterior and the medial compartments are weak. This may limit ankle and foot mobility, which leads to compensations in other systems. In this way, foot problems can cause knee, hip, and lower back pain or injuries in the long run.
The problem is that when one component is out of alignment, it creates abnormal muscle activation patterns, which decreases neural control and creates micro trauma. This decreases performance, limits mobility, and eventually results in injury. That’s why it is important to take care of this so often overlooked region.
References
Calais-Germain, B. Anatomy of Movement. Seattle: Eastland Press. 2007.
Clark, M., et al. NASM Essentials of Corrective Exercise Training. Baltimore, MD: Woters Kluwer and Lippinicott Williams & Wilkins. 2011.
Floyd, R. T. Manual of Structural Kinesiology. New York: McGraw-Hill. 2009.