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Foot Care Q&A: Leg Alignment & Fixing Pronated Feet

Posted Jul 15 2012 12:36pm

I received some great foot care questions from Matt  about  leg alignment, toe out walking, and orthotics!  And  he’s not the only one out there challenged with these problems…

Foot Care Questions:

“I apparently pronate and have had custom orthotics for decades.  I hate them and am trying to wean off by way of store-bought supports which are less expensive.

No matter what I use, however, my feet toe out and I often click my heels as I walk (and ruin my pants!)

My question is, if my shoes wear unevenly and my heels are crooked, what good will holding my foot in place do if the shoe underneath it is at an odd angle?  And what can I do about it?

I absolutely love these foot care questions!  Because Matt’s becoming a critical thinker and really starting to notice more about his leg alignment, feet and ankles, and the results of poor functional movement habits.  There are thing he wants to fix, but investing in expensive orthotics doesn’t seem logical because he’s worn them for years and still has problems.  Matt’s observations are correct, orthotics aren’t entirely the solution because they don’t correct the toe-out gait pattern.  So what else can be done to keep from clicking the heels and walking like a duck?  Lots, actually…

Can you relate?  Do you know what direction your toes face when you stand and walk? Do your toes on both feet point straight ahead, or do you walk toe-out, or maybe only one foot toes-out?  Have you looked at the soles of your shoes and noticed the wear patterns?

I know that when I was younger, I had the exact same issues, I was a toe-out, heel-clicking, shuffling duck-walker!  So not only am I sharing my expertise as a foot fitness expert, but as someone who has firsthand dealt with the very same problems.

Personally, I experienced extreme foot and ankle pain, until I found a postural correction expert in college.  Dr Robert Irvin D.O.  was doing a posture research and I was lucky enough to get to participate in the study.  The very first thing to be evaluated was our foot and leg alignment.  I was instantly told I needed orthotics, since my ankles rolled in, my feet were flat, and nothing was lined up properly.  Its been almost 30 years since college and I still wear my custom-made orthotics daily!  I’ve replaced them a couple of times over the years, but if I’m wearing shoes, I’m wearing my orthotics.

Having an orthotic custom fit for your specific foot issues can be an excellent assistive device for better foot care.  But it’s just that – an assistive device!  Shoving a prop under your foot isn’t going to solve your problems, but can hopefully provide some relief and keep things from getting worse.  We’ve got 52 bones in our feet!  Plus lots of little muscles, tendons, and ligaments.  If even one of these is out of place, and unable to function optimally, the other 51 will be out of balance too.

A good custom-made orthotic is designed specifically for your unique pair of feet. And ideally, as your feet change, your orthotic should be able to be modified without necessarily needing to toss them out and buy a new pair.  I think people take a big risk to potentially create additional problems by buying a “one-size fits all” generic orthotic.  Yes, they might be cheaper, but we’ve only got one pair of feet.

Over your lifetime…what’s the value to you to be able to walk, run, and be active with healthy feet?  What would the cost, or financial strain be if you were unable to walk?  In the big picture, (if you need help with arch support and proper foot alignment)  is $200-$500 every couple of years for custom orthotics really that big of an investment for 80-90+ years of walking with pain-free feet?  Don’t just think short-term here.  Think about the years and years over your lifetime that your pounding your feet into the pavement…do you want your activities to be limited or enjoy a lifetime of good health?

Now, like I mentioned above, orthotics are a prop.  Helpful, but only a prop.  If you need orthotics you can be assured that your body is out of balance.  It might only be your feet that hurt right now, but over your lifetime you’re probably also going to experience, knee pain, hip pain, back pain, shoulder pain, and even neck pain.  All because those 52 bones and supporting muscles in your feet aren’t working like they need to.  Orthotics are going to attempt to hold the bones in better alignment from the outside, but we really need to have the strength with our own muscles to hold them in place from the inside!

How do we help our feet?  Targeted foot care exercises for your ankles, arches, and toes.  There are lots of simple and easy foot fitness exercises that you can do as a part of your weekly workout routine to maintain and improve the strength and flexibility of your feet.  We tend to exercise every other part of our body and forget about our feet (until they hurt, then we’ll spend almost any amount of money and time trying get our good health back.)

After my personal experiences with foot pain, once I started teaching Pilates and helping others improve their posture, body alignment, strength and flexibility, I wrote the book  “Fantastic Feet! Exercises to Strengthen the Ankles, Arches, and Toes” because so many of my clients needed help with foot fitness and the foot care exercises I knew were easy to do on your own at home.  You don’t have to spend 30-60 minutes a day exercising your feet!  (walking & running don’t count in my opinion as targeted foot training.) But a quick 10-15 minutes of targeted foot fitness training even 2-3 days a week can go a long way towards helping maintain healthy, happy feet.

Ok, we’ve discussed the value of orthotics to assist arch support, and  the necessity of foot fitness exercises, now let’s address what I think is the most important part of Matt’s question.  He says:

“No matter what I use, however, my feet toe out and I often click my heels as I walk (and ruin my pants!)  If my shoes wear unevenly and my heels are crooked, what good will holding my foot in place do if the shoe underneath it is at an odd angle?  And what can I do about it?”

Toeing out can be from the feet, but chances are its happening from the hip.  So the whole leg is involved in the problem.  Orthotics will attempt to keep the pronation problem at the feet from getting worse, but what really needs to be looked at is how the whole leg is working.  Chances are the bio mechanical habits being used to walk, run, and move aren’t functionally correct.  There may be other core, pelvis, hip, and leg muscles, (along with better foot fitness) that needs to be improved to create new, healthier habits.

Will changes happen overnight… Probably not, but the only way to facilitate positive improvements is to identify our strengths, weaknesses and muscle imbalances, and then learn how to do the right exercises, correctly, to facilitate improved results.

I’ve seen 80 year old clients who never “exercised” a day in their life improve their posture, body alignment, strength, flexibility, and fitness with Pilates.  If your alive and willing to put in some effort, there’s lots to discover to retrain the body for more optimal movement habits!

Custom-made orthotics can be worth the investment, but it’s also important to start a weekly foot fitness routine to improve the strength, flexibility and alignment of your feet so your own muscles become strong enough to reduce or eliminate the pronation problem.  Toeing out, clicking heels, and uneven wear patterns can be a result of alignment issues between the foot, ankle, leg, hip, and pelvis.  The dominant and weaker muscles through your whole body need to be considered, gait and functional movement patterns need to be evaluated to identify what specific exercises can be beneficial in correcting alignment for less of a toe-out stride and better balanced muscle development.

It’s never too late to start making changes!  If you’re willing to put in the effort, and the right exercises and functional movement patterns have been identified, with time, patience, practice you can improve your stride and strengthen your feet.

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Please Note:  The opinions in this article are just that – opinions.  I highly recommend that if this foot care issue (or something similar) is a problem for you, please seek expert advice and get a consultation to evaluate your specific issues from an orthopedic foot and ankle specialist, MD, or Podiatrist to rule out any medical concerns before proceeding with a orthotics, and/or a corrective exercise program.

Foot Fitness Resources:
Interested in learning more about foot care for healthy feet?  Watch this information-packed free Foot-Fitness video Training Class with  Aliesa George, PMA-CPT to discover simple exercises, strategies, and resources to help get your foot fitness program off to a great start.

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