07/10/2019
As David Harvin and I continue in our work, one thing I have been finding is a recurrence of back pain that has it's genesis in an imbalanced foot. Over and again we find that pronated or supinated feet, or medially or laterally rotated feet, have caused a kinetic chain nightmare for our clients. Those of you who've worked with me know I grind on about feet a lot, shoes in particular. Chairs and shoes, I hate 'em both.
One of the most common conditions I see is a pelvic tilt that came from one specific condition - that being - having a Classic Greek Foot (as described by Janet Travell), also known as a Morton's Toe. In this, the second metatarsal is longer than the first, usually with the second toe extending farther out than the big toe. This causes an inherent foot instability as you are meant to balance on the tripod of bones below your big toe, little toe and heel. When the second metatarsal is longer, your weight is shifted to that second metatarsal instead of the first metatarsal under the big toe. This throws your foot off balance, giving it a wobble, causing your big toe to grip for balance. Over time, this generally causes the big toe to migrate towards the second toe. At the same time, your weight shifts towards the outer edge of your foot and generally the feet turn out from your midline to maintain stability, resulting in a splay foot stance. Which, if you were disconnected from your body from the knee down, it wouldn't be a problem, except...
The fun doesn't stop there. With the knowledge we have now about the interconnectivity of the myofascial system, any deviation from the natural and neutral body posture carries right up the kinetic chain of the body. Depending upon which way the body shifts it's weight to maintain balance on it's wobbly base, differing lines of pull will be placed upon the stirrup muscles of the lower leg - those being the tibialis anterior and the peroneus longus. Those two muscles meet up under the foot to form their stirrup, andagain at the side of the knee. Here they split off - The tib.ant. line going up the re**us femoris and medial edge of the TFL to stop at the ASIS, and the peroneus longus joins up with the biceps femoris to stop at ischial tuberosity. It is at this point where we can see where the movement of our pelvis can be a puppet show put on by our feet, because generally speaking, whichever way your foot has to turn to maintain balance, your femur has to follow to maintain it's line. Again this creates an instability as you shift forward and back to gain a balance. Now, depending on which direction you shift, forward or backward - toe or heel, is the direction your pelvis will tilt.
In the case of a forward, or anterior, pelvic tilt, you will have a dip in your low spine. In the case of a backwards, or posterior, pelvic tilt, you will have a flattened lower back. Which now causes another set of problems as the body now has to balance the weight of your head, so here's the next set of issues...
Remember at all times that your body is trying to keep your head centered in line with your pelvis. Going from a anterior pelvic tilt while trying to balance the head, your spine, which has a natural curvature, will have to flex even farther back to compensate for the forward movement of the hip and it's subsequent dip in the lower spine. Thus, you will curve backward in your mid back, coming back forward in your upper back at the neck, creating an S like curvature of the spine with a very forward head presentation. In the case of a posterior pelvic tilt, where your weight is already far back with a flattening of the lower spine, you will develop a C shape curvature of the spine in the upper mid back with a somewhat forward head presentation.
This has been Brandi's geek moment of the day - enjoy!
