The Foundation Concept

Our feet are complex structures designed to provide a stable foundation for our entire body. Yet despite their importance, we still understand very little about how foot function impacts not only our physical structure, but the health and well-being of our entire body.

Congenital (present at birth) foot shape variations are very common, affecting an estimated 70% of the population to some degree. Just as for many of us our eyesight is not perfect, foot shape differences reflect a natural variation in the alignment of our feet.

Just as there are two types of sight-related problems; short sight and long-sight, there are two types of abnormal foot shapes:

• inverted, or varus shape
• everted, or valgus shape.

An inverted foot shape is where, in relation to the leg and a parallel surface such as the floor, the foot naturally sits at an angle such that the inner (medial) side of the foot is a greater distance from the floor than the outer (lateral) side.

An everted foot shape is simply the opposite, where the outer (lateral) side of the foot is at a greater distance from the floor than the inner (medial) side.

In both cases, these two types represent different ends of a continuum, where normal, or ideal is located in between. Normal, or ideal is where neither problem exists. For eyes, this is 20/20 vision, for feet it is when the soles of both feet are parallel to the ground.

With feet and eyes, there is also a similarity with respect to the degree of any abnormality. Many people will have mild to moderate cases of the problem, whereas a fewer number will have a more severe form.

There is a difference, however, in the prevalence of one end of the continuum over the other. With eyesight, there is no excessive dominance of either short sight or long sight. With feet, however, the inverted or varus type is by far the most common, accounting for around 97% of all foot shape abnormalities.

With feet there is one other major difference; the actual bony alignment of the foot relative to the leg remains constant throughout life. It is only the resultant soft tissue adaptation, dysfunction and pain and degeneration of weightbearing joints that is progressive.

Foot shape type and stability

As you might expect, the normal foot shape, where the soles of both feet are parallel to the ground, is the most stable of the three foot types. It is therefore perhaps surprising to learn, that only around 30% of the population are lucky enough to possess it.

In comparison, only around 3% of the population have an everted foot shape. This basically equates with a high arch, where the foot rolls outward too much and cannot therefore properly absorb shock. This foot type is often referred to as a supinated foot.

Staggeringly, around 67% of the population are estimated to have some degree of inverted footshape, also known as a pronated foot. With this foot type, the foot must roll downward and inward to reach the floor with every single step. This repeated motion does five important things that affect the stability of the entire body:

• weakens the structure of the foot, leading to lowered arches, bunions, hammer toes and plantar fasciitis
• demands increased inward twisting of the leg, leading to shin splints, knee pain, Iliotibial Band Syndrome and hip pain
• unlevels the pelvis, leading to sacroiliac joint problems, "sciatica", groin pain and functional leg length discrepanices,
• twists the spine, resulting in the development of functional scoliosis, increased inward curvature of the lower back and increased outward curvature (roundedness) of the shoulders
• unlevels the shoulders, causing neck and shoulder tension, weakness of the chest and upper arm muscles, headaches, migraines and jaw misalignment

The above combine to create muscle imbalances (over and under-use of the wrong muscles) tension, stiffness, abnormal wear and tear on the joints and increased levels of chronic physical stress. The constant exposure of the body to these problems eventually leads to related problems in other areas.

A brighter future for hyperpronators

Of all the foot types, the pronated foot causes the greatest variety and severity of problems. It is therefore perhaps surprising to learn that its' adverse impact on the rest of the body is only just beginning to be appreciated and understood.

Until the publication of the paper by Rothbart in 2002, there was no obvious connection between different foot shapes and abnormalities during feotal development. This meant that previously, although the presence of inverted and everted foot types was recognised, the cause was thought to be due to over-use or mis-use of the body, environmental factors, or genetic "weaknesses".

The realisation that developmental abnormalities in the womb create abnormal foot shapes is brand new and because of this, few healthcare practitioners are aware of it. The implications of these findings for the long-term health of past, current and future patients, however, is huge.

If people are born with such a problem, rather than developing it as a result of lifestyle or other genetic factors, then there is suddenly a very plausible explanation for many types of chronic health problems that are unresponsive to current treatment methods. Going back to the meaning of Root2Being, if we treat the symptoms rather than the cause, we won't be solving the problem.

A new Era in healthcare

Another problem that has plagued the assessment and control of foot shape abnormalities has been the lack of any suitable methods for accurately assessing their effect on the rest of the body

Although the three foot shape types can be identified by trained professionals during a static or non-weight-bearing assessment, it is the effect that the foot shape has on the entire structure during movement that until now has been impossible to accurately assess and quantify.

The launch of TOG GaitScan in May 2002 (see photo opposite), makes it possible for the first time to easily assess and directly control the effect of pedal instability during both static and dynamic weight-bearing stances.

This new analysis tool, combined with the dedicated behind-the-scences technology and good old-fashioned hands-on assessment, means it is now possible to create a new generation custom biomechanical device that perfectly controls the inherent instability during both dynamic and static activities.

Such devices, if correctly prescribed, have a significant stabilising effect on the feet throughout the entire gait cycle. This in turn eliminates the need for the body to compensate, resulting in a significant and often dramatic improvement in the patients condition and overall health and wellbeing.