CAN WALKING PATTERNS AFFECT FOOT AND ANKLE PAIN?
Stages of walking
The body moves in reciprocal movements, thus ensuring the economy of energy consumption. Very important evolutionary changes necessary for walking as we know it today are the arch of the foot, the anatomical proximity of the thumb and the angle of the femur(thigh) in relation to the pelvis.
The basic functions of gait are : propulsion, energy conservation, stability in the support phase and force absorption.
The Walking cycle can be simplified into 3 main phases.:
1. phase predstavlja fazu kontakta stopala s podlogom, odnosno heel strike i traje do kontakta glave prve metatarzalne kosti s podlogom. Stopalo je u supinaciji na samom početku kontakta. U tom trenutku stopalo treba određenu rigidnost (tvrdoću) radi apsorpcije sile prilikom kontakta. Sila reakcije podloge (ground reaction force, GRF) djeluje prema natrag (posteriorno) a sama faza služi i za usporavanje tijela.
2. phase odnosno mid-stance faza zahtjeva određenu mobilnost stopala koju nam uvjetuje dobra pronacija. The reaction force of the substrate is directed vertically in relation to the middle of the foot and the friction is greatest. At this stage, relative movements are necessary because we can say "joint is unlocking" in order for the foot to adapt to the walking surface and stretch the musculature of the same foot.
3. phase odnosno late stance je faza u kojoj je sila reakcije podloge usmjerena naprijed te zahtjeva ponovnu supinaciju stopala radi propulzije. Stopalo je rigidno uz vrlo važnu koncentričnu akciju mišića tibialis posterior.
Relative movements and their role in walking
In addition to the feet, very important prerequisites are relative movements at the pelvic level, since they affect each other. If a person has reduced relative movements in the foot during pronation, it can affect the biomechanics of the lower extremities, hip as well as lower back.
The opposite is true, if a person has a hip injury, the body can compensate for pain and discomfort and requires a different strategy of walking, which can be reflected in the biomechanics of the feet.
Through a few simple tests, we can easily determine at the level of the pelvis, knees, and ankles where movements are limited to "return" the movements that are necessary to the body. It is a common case of very rigid feet after an injury due to the protective mechanism of the body, there is a decrease in mobility.
In theory, such feet do not have the function of good absorption of force during repeated actions, such as walking and running which can impair the biomechanics of the lower extremities. We say that soft tissue movement (muscle) is a reaction to movement in the joint.
Test relativnih pokreta možemo izvesti tako da osoba iskorači nogom naprijed te klekne na stražnju nogu. Zatim prednjom nogom izvodi pokret koljena prema naprijed (dorzalna fleksija) uz zadržavanje pete na tlu.
Here we can estimate how much is the dorsal flexion of the ankle and what is very important, whether there is movement in the arch of the foot, or whether there is a lowering and raising of the arch of the foot during movement.
If there is no movement of the arch of the foot, then it is very likely that the relative movements necessary for good biomechanics are reduced.
Poor biomechanics affects the development of pain and pain syndromes
Poor biomechanics of the lower extremities over a long period can induce greater mechanical stress and the appearance of microtrauma of the connective tissue and muscles, which can manifest as an increased risk for :
plantar fasciitis – inflammation of the connective tissue that extends across the bottom of the foot and connects the heel bone to the fingers
tendinopathy of tibialis posterior – is a condition that begins with pain and inflammation around the inner side of the foot, especially around the arch and the inner side of the ankle
pain in the fibularis longus tendon - injury or dysfunction of the fibularis longus can cause pain or discomfort in the lower leg, ankle, or foot (especially on the outside)
Mag. Cin. Marko Drasković
Marko is a kinesiologist, kinesiotherapist and lecturer in biomechanics education, working on rehabilitation and recovery of top athletes within his clinic in Velika Gorica.
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