The foot being the base and foundation for our body, many back problems can be related to the way we stand and walk. Around 40 per cent of Australians will experience some form of foot problems in their lifetime. Low back pain is a very common complaint and not many people understand how movement and alignment of the pelvis, leg, ankle and foot is intricately connected to the development of acute and chronic low back pain. Yet it can easily happen to people young and old, male and female. There can many causes of low back pain. These may be osseous (bony), neuropathic (nerve damage) or soft tissue. Common causes can include:
Excess pronation, or ’flat feet’, causes various rotations throughout the legs during the walking cycle. The end result of these rotations is a forward tilt of the pelvis, which in turn increases the curvature of the spine and places strain on the muscles and ligaments of the lower back. We all pronate, this is necessary for shock absorption, but sometimes people may pronate more than what their body can cope with, and this can cause stress on tissue in the lower back.
Asymmetrical Movement of the Feet
If one foot is rolling in or out significantly further than the other, not only is there an increased curvature through the lower back, but a pelvic tilt can result. This can lead to scoliosis (a curvature of the spine), and once again places strain on the associated muscles and ligaments.
Structural / Functional short leg
One leg shorter than the other can be either structural (the bones in one leg are actually shorter than in the other leg) or functional. A functional short leg can be due to over-pronation in one foot more than in the other which rotates or twists the pelvis which becomes misaligned. When this happens, the leg is pulled up higher into the hip socket, the joints in the pelvis may be impinged, causing pain and discomfort and the leg muscle to shorten.
Incorrect Gait / Posture Posture and gait (walking/running style) are closely related and can heavily influence other areas of the body. Even the most minor abnormalities in posture and gait can result in increased stress on the lower back and other areas of the body.
Treatment of Lower Back Pain
Podiatrists are able to diagnose any lower limb problems causing lower back pains through Footwear Assessment and Biomechanical Analysis. Podiatrists assess the suitability of footwear for your individual situation and critically analyse your posture and movements while you stand, walk and run to identify the cause of your lower back pain. Through this analysis Podiatrists are able to accurately diagnose the lower limb cause and prescribe the right treatment to alleviate your back pain.
Custom-made orthotics are the best way to treat and prevent over-pronation. They are custom-made shoe inserts that give controlled support and improve abnormal movement patterns in the foot. Orthotics guide the foot to move with ideal biomechanics and improve posture of the lower limb, limiting pelvic tilt and muscular tightening of the lower back area. Heel lifts can be used to raise a structural short leg.
Stretching Exercises may be prescribed to relieve the gradual shortening of the affected muscles.