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Foot Alignment -


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The foot is the foundation to the body. The alignment of the foot is crucial for proper foot function. This lecture discusses normal and abnormal alignment and the exact cause that leads to a faulty foot structure.

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Foot Alignment -

  1. 1. The Importance ofFoot Alignment
  2. 2. Our feet are the foundation ofour body.
  3. 3. The alignment of our feet isextremely important as it sets thestage for the rest of the body.
  4. 4. Properly aligned feet provide anefficient foot machine.
  5. 5. There is a tremendous amount of forceacting on, and passing through, the 26bones, 33 joints and over 100ligaments and tendons of thefoot and ankle.
  6. 6. The foot,while standing, walking or running,acts as both astable lever armandmobile adapter.
  7. 7. There are times when the footbones need to be “locked” toprovide for a stable lever arm.
  8. 8. Yet, at other specific times, the footbones should be “unlocked” to actas the mobile adaptor.
  9. 9. The “locking” and “unlocking” of thefoot is completely dependent on thealignment of the ankle bone on thehindfoot bones.
  10. 10. The ankle bone (talus)rests on and interacts withthe calcaneus (heel) and the navicular bones.Referred to as the:Talotarsal Joint
  11. 11. There are two primary complexmotions that occur within thistalotarsal joint mechanism.Supination and Pronation
  12. 12. Supinationlocks the bones of the foot.
  13. 13. Pronationunlocks the bones of the foot.
  14. 14. During walking or running there arevery specific periods when thetalotarsal joint should besupinating/supinated.
  15. 15. And other times when the talotarsaljoint should be pronating.
  16. 16. This is where the alignment ofthe foot becomes important.
  17. 17. If the foot is still pronating when itshould be supinating/supinated, thisis an indication that we have a footalignment issue.
  18. 18. Why would this happen?
  19. 19. This is specifically an alignment issuewith thetaluson thetarsal joint.
  20. 20. When the joints have lost theirnormal alignment this means thereis a dislocation.NormalConstant Congruent ContactAbnormalIncongruent Contact
  21. 21. A dislocation specifically refers to apathologic condition of a joint – alocation where two or more bonesinteract with one another.
  22. 22. There are multiple forms ofdislocation, just like there aremultiple forms of fractures.
  23. 23. Just like fractures, or broken bones,dislocations can be classified as:simple or complicated,traumatic or atraumatic,incomplete or complete,partial or full.
  24. 24. Dislocations, as with mostpathologic conditions, have a broadrange of severity.Mild, Moderate, Severe
  25. 25. Someone could have what appearsto be a mild bunion deformity that isextremely symptomatic yet anotherpatient could have a very severebunion deformity that doesn’tbother them the least bit.
  26. 26. Does it mean that the person withthe very painful mild buniondeformity has to wait until thebunion increases in deformity toinitiate treatment?A bunion is a pathologic disease processthat will not fix itself.
  27. 27. In the same manner, a dislocation ofthe talus on the tarsal jointrepresents a progressive diseaseprocess that not only affects thefoot…
  28. 28. …it can lead to achain reaction tothe rest of thebody.Normal Alignment Abnormal Alignment
  29. 29. When the hindfoot is alignedthis indicates that the talotarsal jointis balanced and the articular facetsare in constant congruent contact.
  30. 30. There is minimal strain on thebones, joints, ligaments, tendon,and blood vessels and nerves of thefoot.
  31. 31. Individuals with properly alignedhindfeet/talotarsal jointsare able to stand, walk and run forextended periods of timewithout suffering as a result.
  32. 32. Whereas,
  33. 33. Individuals with mis-aligned hindfeetsuffer from prolonged standing,walking or running.
  34. 34. Individuals with a flexibletalotarsal jointdislocation develop allsorts of problems.
  35. 35. This is because a flexible talotarsaljoint is a lot more destructive thannon-flexible.
  36. 36. The flexibility induces a tremendousstain on the osseous and soft tissueswhereas a rigid dislocation yields asignificantly less amount of force.
  37. 37. There are the ill-effectsto their feet.
  38. 38. Talotarsal joint dislocationis named as the number one factor inthe formation of:Plantar fasciitis/fasciopathy/heel painPosterior tibial tendon dysfunctionBunions/metatarsus primus varusHallux limitus/rigidusHammertoesTarsal tunnel syndrome/posterior tibial nerve entrapmentPathologic walking cycle/gait cycleand the list goes on…
  39. 39. Then, there are theaffects to the rest ofthe body.
  40. 40. When the talus, partiallydislocates on the tarsal joint,this adversely affects the leg bones.
  41. 41. The leg bones (tibia/fibular) arefirmly attached to the body of thetalus.
  42. 42. When the talus dislocatesinward/downward/forwardthe leg bones will also shiftinward/downward/forward.
  43. 43. This immediately places asignificant strain on the knee.
  44. 44. This completely destroys the kneeand is responsible for thedevelopment of over-use injury orosteoarthritis.
  45. 45. Every step taken leads to apathologic twisting along with thenormal bending of the knee.
  46. 46. The knee is able to deal with theseforces until the critical threshold isreached when the tissues just simplycan no longer handle those forces.This is because the average person takesnearly 7,000 steps a day.An active person can take up to 15,000 to20,000 steps if they walk/run for exercise.
  47. 47. That’s 7,000 times a day the kneeis abnormally twisted.2,555,000 times a year12,755,000 times in 5 years63,875,000 times in 25 years127,750,000 times in 50 years
  48. 48. 127,750,000 times in 50 yearsThen we wonder why we wear outour knees by the time we are around50 years old?
  49. 49. Sometimes the ligaments of theknees are strong enough that theyare able to handle and prevent thetwisting within the knee.But the excessive abnormal motion from thedislocation of the talus on the tarsal joint has tobe compensated for somewhere.
  50. 50. The next level is the hip.When the talus abnormally dislocateson the tarsal joint, it twists inwardand/or downward and/or forward.
  51. 51. This dramatically affects the hipjoint.The head of the femur(thigh bone) is pulledfrom the pelvis.
  52. 52. Same math applies that leads tothe destruction of the hip joint.2,555,000 times a year12,755,000 times in 5 years63,875,000 times in 25 years127,750,000 times in 50 years
  53. 53. Functional leg length discrepancy isdirectly related to talotarsal jointdislocation.
  54. 54. This is the number one reasonfor the formation of sciatica.
  55. 55. Pelvic tilt leads to back strain.The muscles are trying to balance the pelvis in orderto align the spine.
  56. 56. Pelvic tilt leads to a twisting of theback which is the number one causeof herniated discs.
  57. 57. The lower and/or upper back areaffected.
  58. 58. This can lead to neck strain.
  59. 59. And believe it or not, even TMJ.The mandible is free-floating on the skull. Ifthe neck is tilted, the skull naturally tilts whichcreates a situation where there is excessivestrain on one side of the jaw bone joint thanthe other so the muscles on that side tightento try and realign the jaw = TMJ.
  60. 60. So, as you can now see,the alignment of the talotarsal jointis of extreme importance.
  61. 61. Not only for proper foot alignmentand function, but for the properalignment and function of the rest ofthe musculoskeletal chain.
  62. 62. If you or someone you knows suffersas a result of their talotarsal jointdislocation or mal-aligned hindfoot…
  63. 63. …there are options depending onthe severity of the dislocation.
  64. 64. For more information and varioustreatment options please