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. Learn more at www.GraMedica.com.

1. The Importance of
Foot Alignment

2. Our feet are the foundation of
our body.

3. The alignment of our feet is
extremely important as it sets the
stage for the rest of the body.

4. Properly aligned feet provide an
efficient foot machine.

5. There is a tremendous amount of force
acting on, and passing through, the 26
bones, 33 joints and over 100
ligaments and tendons of the
foot and ankle.

6. The foot,
while standing, walking or running,
acts as both a
stable lever arm
and
mobile adapter.

7. There are times when the foot
bones need to be “locked” to
provide for a stable lever arm.

8. Yet, at other specific times, the foot
bones should be “unlocked” to act
as the mobile adaptor.

9. The “locking” and “unlocking” of the
foot is completely dependent on the
alignment of the ankle bone on the
hindfoot bones.

10. The ankle bone (talus)
rests on and interacts with
the calcaneus (heel) and the navicular bones.
Referred to as the:
Talotarsal Joint

11. There are two primary complex
motions that occur within this
talotarsal joint mechanism.
Supination and Pronation

12. Supination
locks the bones of the foot.

13. Pronation
unlocks the bones of the foot.

14. During walking or running there are
very specific periods when the
talotarsal joint should be
supinating/supinated.

15. And other times when the talotarsal
joint should be pronating.

16. This is where the alignment of
the foot becomes important.

17. If the foot is still pronating when it
should be supinating/supinated, this
is an indication that we have a foot
alignment issue.

18. Why would this happen?

19. This is specifically an alignment issue
with the
talus
on the
tarsal joint.

20. When the joints have lost their
normal alignment this means there
is a dislocation.
Normal
Constant Congruent Contact
Abnormal
Incongruent Contact

21. A dislocation specifically refers to a
pathologic condition of a joint – a
location where two or more bones
interact with one another.

22. There are multiple forms of
dislocation, just like there are
multiple forms of fractures.

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. Dislocations, as with most
pathologic conditions, have a broad
range of severity.
Mild, Moderate, Severe

25. Someone could have what appears
to be a mild bunion deformity that is
extremely symptomatic yet another
patient could have a very severe
bunion deformity that doesn’t
bother them the least bit.

26. Does it mean that the person with
the very painful mild bunion
deformity has to wait until the
bunion increases in deformity to
initiate treatment?
A bunion is a pathologic disease process
that will not fix itself.

27. In the same manner, a dislocation of
the talus on the tarsal joint
represents a progressive disease
process that not only affects the
foot…

28. …it can lead to a
chain reaction to
the rest of the
body.
Normal Alignment Abnormal Alignment

29. When the hindfoot is aligned
this indicates that the talotarsal joint
is balanced and the articular facets
are in constant congruent contact.

30. There is minimal strain on the
bones, joints, ligaments, tendon,
and blood vessels and nerves of the
foot.

31. Individuals with properly aligned
hindfeet/talotarsal joints
are able to stand, walk and run for
extended periods of time
without suffering as a result.

32. Whereas,

33. Individuals with mis-aligned hindfeet
suffer from prolonged standing,
walking or running.

34. Individuals with a flexible
talotarsal joint
dislocation develop all
sorts of problems.

35. This is because a flexible talotarsal
joint is a lot more destructive than
non-flexible.

36. The flexibility induces a tremendous
stain on the osseous and soft tissues
whereas a rigid dislocation yields a
significantly less amount of force.

37. There are the ill-effects
to their feet.

38. Talotarsal joint dislocation
is named as the number one factor in
the formation of:
Plantar fasciitis/fasciopathy/heel pain
Posterior tibial tendon dysfunction
Bunions/metatarsus primus varus
Hallux limitus/rigidus
Hammertoes
Tarsal tunnel syndrome/posterior tibial nerve entrapment
Pathologic walking cycle/gait cycle
and the list goes on…

39. Then, there are the
affects to the rest of
the body.

40. When the talus, partially
dislocates on the tarsal joint,
this adversely affects the leg bones.

41. The leg bones (tibia/fibular) are
firmly attached to the body of the
talus.

42. When the talus dislocates
inward/downward/forward
the leg bones will also shift
inward/downward/forward.

43. This immediately places a
significant strain on the knee.

44. This completely destroys the knee
and is responsible for the
development of over-use injury or
osteoarthritis.

45. Every step taken leads to a
pathologic twisting along with the
normal bending of the knee.

46. The knee is able to deal with these
forces until the critical threshold is
reached when the tissues just simply
can no longer handle those forces.
This is because the average person takes
nearly 7,000 steps a day.
An active person can take up to 15,000 to
20,000 steps if they walk/run for exercise.

47. That’s 7,000 times a day the knee
is abnormally twisted.
2,555,000 times a year
12,755,000 times in 5 years
63,875,000 times in 25 years
127,750,000 times in 50 years

48. 127,750,000 times in 50 years
Then we wonder why we wear out
our knees by the time we are around
50 years old?

49. Sometimes the ligaments of the
knees are strong enough that they
are able to handle and prevent the
twisting within the knee.
But the excessive abnormal motion from the
dislocation of the talus on the tarsal joint has to
be compensated for somewhere.

50. The next level is the hip.
When the talus abnormally dislocates
on the tarsal joint, it twists inward
and/or downward and/or forward.

51. This dramatically affects the hip
joint.
The head of the femur
(thigh bone) is pulled
from the pelvis.

52. Same math applies that leads to
the destruction of the hip joint.
2,555,000 times a year
12,755,000 times in 5 years
63,875,000 times in 25 years
127,750,000 times in 50 years

53. Functional leg length discrepancy is
directly related to talotarsal joint
dislocation.

54. This is the number one reason
for the formation of sciatica.

55. Pelvic tilt leads to back strain.
The muscles are trying to balance the pelvis in order
to align the spine.

56. Pelvic tilt leads to a twisting of the
back which is the number one cause
of herniated discs.

57. The lower and/or upper back are
affected.

58. This can lead to neck strain.

59. And believe it or not, even TMJ.
The mandible is free-floating on the skull. If
the neck is tilted, the skull naturally tilts which
creates a situation where there is excessive
strain on one side of the jaw bone joint than
the other so the muscles on that side tighten
to try and realign the jaw = TMJ.

60. So, as you can now see,
the alignment of the talotarsal joint
is of extreme importance.

61. Not only for proper foot alignment
and function, but for the proper
alignment and function of the rest of
the musculoskeletal chain.

62. If you or someone you knows suffers
as a result of their talotarsal joint
dislocation or mal-aligned hindfoot…

63. …there are options depending on
the severity of the dislocation.

64. For more information and various
treatment options please visit:
www.alignmyfeet.com