By Jon Lewis

What do we need our feet to do?

1. Absorb shock during loading
2. Adjust to different terrains
3. Become a rigid lever capable of forward propulsion
FLEXIBLE
RIGID
Barefoot Biomechanics
The ankle
Made up of:
Tibia
Fibula
Talus
Hinge Joint
PF/DF
The ankle
+ External
Rotation
+ Internal
Rotation
Subtalar Joint
Formed by Talus and
calcaneus
3 articulating facets
Important for walking on
uneven ground

The Subtalar Joint
Triplanar Joint


Midtarsal Joint
Articulations:
Talonavicular Joint
calcaneocuboid joint
Movements:
Abd Add
Circumduction
PF DF
= PRO/SUPINATION
Ankle, subtalar, Midtarsal Complex
Mitred Hinge

Arches
Arches
Arches 3D
The foot is a tripod
Concave zone of
stability

Arches
Arches
Higher arches =
Bones lock together
Higher mechanical stability
Less stress on Tie beam
Tensile strength/rigid

Lower Arches =
Bones unlock
Less stable
Stress on tie beam
Shock absorbing

Function of the foot
Rigid lever for Propulsion Shock absorbant/flexible
Muscles acting on foot
Types: Intrinsic & Extrinsic
Function: Propulsion & alter
rigidity of arches during gait cycle

Force couples
Force Couples with opposing actions:
Tib Post : peroneus longus: rigidity transverse arch

Windlass Mechanism
Contraction EHL/EDL
Passive tension of
Flexors and P.Fascia
Sesmoids move
anteriory increasing
tension of FDL
Raise arch strong tie
beam - RIGID

Somatosensory Feedback
Gait Cycle

Pro Pronation Supination Sup
Shoes prevent all these mechanisms
from happening properly
Act as cast restricting foots natural biomechanics
Cushions feet dampening sensory feedback and reflex
activity
Alters biomechanics up kinetic chain
Results in:
Muscle/Bone atrophy
Faulty remodeling
Weakened biomechanics
Footwear Pathologies
Caused of foot pathologies:
Genetics
Footwear
Pathologies:
Metatarsalgia
Plantar Fasciitis
Hallux valgus
Heel Spurs
Neuromas
Achilles tendonitis
Shin Splints
PTFM probs
Hip/Back Pain

Footwear Design Characteristics
Heels
Shift centre of mass forward
Adjustments to keep
upright
Problems up kinetic chain
Heels
Unequal WB Heel
forefoot
Increased speed of Pro/PF
=> Shock absorbing (Slap)
Increased pressure on
forefoot
Shortening TA reducing
efficiency of propulsion
Heels
Toe Spring
Compensates for reduced sole flexibility at ball
Raised toes create a rocker
FHL, FDL inhibition
=> reduced propulsion, muscle atrophy
Shoe flexibility
Barefoot flexes at ball
All shoes flex 30-80% less
Sole creates flex resistance
=> fatigue
Stair climbing in elderly
Shoe Fit
Evidence that no footwear fits properly
Sizing system 630 years old
90% all shoes built snug (for support)
Restrictive toe box
Natural expansion of foot (pronation)
Poorly formed arches

Restricted Natural Biomechanics
SHOD
BAREFOOT
Great toe DF = Windlass
Mechanism
Lacing prevents arch raising
Stiff upper preventing hindfoot
supination
MT DFd relative to midfoot
Posterior sesamoids
Stress on Plantar tie beam


Great toe DF =
MT PF
Anterior sessamoids
Dome shaped arch
Free hindfoot
Tension on soft tissue
Arch support
Stabilise subtalar by
supporting arch
Shod vs unshod
No difference in
alignment except heel
height.
Cushioning

Dissapates vertical shock
=> 10% at best
Pronation control more important for shock absorption
Cushioning proprioception for pronation

Desensitisation
Cushioning Rigid soles Arch supports
Inhibits sensory stimulus needed to align bones for
stability
Chronicly unstable=>degen up Kintetic chain
Expensive protective running shoes => more injuries
Unshod population = No foot pathologies

Unhealthy Bone Remodelling
Wolfes law
Chinese foot binding
Restrictive toe boxes
Weakened bony arch structure
Childrens feet negatively affected by 6 yo

Physiotherapy
Rx for foot related pathologies
Cushioning
Not as effective as efficient pronation
Orthotics
Plantar contact angle
Short term
Exercise therapy
Not functional => low compliance
Concentrates on flexors