Friday, July 8, 2011

Ouch my feet! Flat feet and more...

Earlier in June, my classmates and I attended a workshop conducted by Dr. Mark Charrette. Dr Charrette is a chiropractor who has researched treated many people who suffer from foot problems. So I thought of sharing some key points:

1. Ligaments plasticly deform
Ligaments are connective tissues which function like straps to keep bones together. As you can see in the picture below (taken from Gray's Anatomy), there are *many* ligaments which keep bones in your feet together

Although flexible and quite tough, once ligaments are over-stretched or damaged, they will not return to their original shape/form... much like Cling Wrap (the plastic-like thing you wrap over a bowl of food and then put in in the fridge or microwave) which does not return to its original shape after being stretched.

2. We *develop* [over]-pronation and [over-]supination (ie, we are not born with)
Note: There are genetic factors that may make people likely to inherit flat feet (low arches), high arches, etc.

Pronation = sole out, toe up and out which creates the effect of knee and feet rolling inwards. Since, we develop this 'style', it goes without saying that even people with high arches or low arches may develop [over-]-pronation.

(Supination is the opposite)

3. It seems that tilting of pelvis occurs before feet problems
Dr Charrette gave a few reasons such as falling, sleeping or sitting in awkward postures, etc.

Due to these reasons, Dr Charrette suggests that we develop (learn and adapt) [over-]pronation (rolling inwards).

This makes perfect sense as I have mentioned elsewhere - the whole body is inter-connected. Hence, if there is dysfunction in say the pelvis (tilting, etc) then this can affect the direction or transfer of force elsewhere (knee down to the feet).

Surprise! Based on his experience and research, Dr Charrette said that 93-95% of the population are pronators.

4. Therefore, it may make sense that a lot of the population may need some form of orthotics (shoe inserts).
I went to one of the shopping centres a few years ago and they did the usual foot scan and custom-made orthotics... unfortunately they didn't really work (still had a lot of almost same amount of rolling in)... If youre going to spend $$$ on custom-made orthotics, I would now recommend that you go to a podiatrist (foot specialist) who would  be able to do a much better job at analysing how you walk, and more experience in measurements, etc. Some of the podiatrists in town also have a chiropractor to do some checks on your spine, etc. Alternatively, some manufacturers such as Foot Levelers will make a pair for you after you have been for the scan, etc at some chiropractic clinics in Malaysia.

>During the tea break, I asked Dr Charrette about the current hot trend -'minimalist' shoes ('barefoot', Vibram, Nike Free, etc) and he mentioned that he has been to Kenya and the people there did not run marathons barefooted. Furthermore, he reiterated that support for our arches is mainly from the ligaments, and not from muscles.

>So there you go, don't believe everything sport shoe manufacturers tell you!

Last point for this blog... gleaned during one of our class visits to an integrated (muscle / joints) healthcare  centre at HSC, Cheras. One of the chiropractors there (I think it's Dr Hayden Pooke) mentioned that:

5. [Asian] people don't wear shoes in the house, unlike European people. So, basically there is no arch support...

>Hmm, maybe it's time that children wore shoes in the house so that they get sufficient arch support and wear slippers less often.

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