The most optimal and beneficial postural assessment performed by any practitioner should be executed whilst the patient is in a barefoot position. This stance gives the most accurate information on how our base of support, the feet are affecting structures up the body.
When assessing pain and problems through a postural assessment, practitioners should look at not just the sight of pain but the areas above and below. The body is one connected band of muscles, tissues, nerves and bones which we need to evaluate to determine why we may be having continuous pain or injuries.
Our feet are often misjudged when it comes to the strength and stability of the body when considering posture. For many years we have been told to support the foot through structured footwear. However, through supporting a body part we are not facilitating movement which can result in weakness.
When movement is involved we create strong and healthy muscles, joints and ligaments. With that in mind, if we are constantly supporting the foot and all its joints are we weakening this part of the body?
Through a typical postural assessment, we see many altered movement patterns and rotational changes through the pelvis, low back, knees and ankles which can arise from what we do daily.
Research suggests that flattened arches result in greater tibial rotation of our leg creating tensions through the iliotibial band (ITB) located on the outer surface of the thigh (Brandon and Patla, 2013). The iliotibial band attaches to major muscles in the hip and buttocks region and if tight or rotated can ultimately affect or rotate the pelvis.
As discussed above the body is one connected chain. The spine is connected to the pelvis, therefore changes in optimal function and movement of the spine can be compromised as a result of pelvic rotation starting from issues down at our feet.
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Therefore we need to consider that weaknesses in the feet can ultimately affect our posture and movement above. Strengthening our feet through movement and simple exercises just as we would any other part of the body can create better movement patterns and posture.
A study performed by the Brazilian Facility of Occupational and Physical Therapy in 2011 depicts an increased curvature in the low back area with a pelvic tilt from wearing heeled shoes. By placing the feet in a shoe with a thicker heel it will create an unnatural shift in the pelvis and low back. The study results demonstrate an increased curve through the spine which places more pressure on the spinal segments in which many people can suffer from back pain and greater issues later in life (de Oliveira Pezzan et al., 2011).
When we stand barefoot we are in our most natural postural position. Many modalities that require strong and well-balanced postures; yoga, martial arts, pilates will take their shoes off. The barefoot feel creates stability on the surface below, whilst allowing the foot to use its muscles, joints, and ligaments that stabilise above. Furthermore, it is easier for the activation of muscles up the chain of the body to ultimately make us more stable and balanced.
When considering this, why do we then put shoes on to move all day, every day?
As studies have demonstrated, our posture is altered when wearing footwear. Therefore we may need to look at how taking our shoes off can help strengthen any weaknesses in our feet, helping up the body.
Let’s consider how much more balanced, stable and a shift in our pelvis and low back can change the way we move and function more optimally every day.
If you have any further questions on this topic, don’t hesitate to come in-store and have a chat to Maddy about it in person. Otherwise, call the store on 03 9598 4859 and ask to speak to her.
Brandon, K. and Patla, C. (2013). Differential diagnosis and treatment of iliotibial band pain secondary to a hypomobile cuboid in a 24-year-old female tri-athlete. Journal of Manual & Manipulative Therapy, 21(3), pp.142-147.
De Oliveira Pezzan, P., João, S., Ribeiro, A. and Manfio, E. (2011). Postural Assessment of Lumbar Lordosis and Pelvic Alignment Angles in Adolescent Users and Nonusers of High-Heeled Shoes. Journal of Manipulative and Physiological Therapeutics, 34(9), pp.614-621.