Wednesday, April 3, 2013

My left foot

I want to challenge you to think of any joint pain/issues you may have in your lower body, and to think up and down stream of these pains...towards the next joint up or down.  Keep this in mind as you read further...

I have addressed the general effects that poor footwear can have, moving upward through the body.  To be fair, sometimes the footwear doesn't even need to be involved to have issues in the feet which then move upstream to the knees, hips, etc.  One of these possibilities in overpronation.

Pronation is the ability of the foot to "roll" slightly inward, toward the arch.  This type of movement allows for adaptation to uneven terrain and shock absorption, among other things.  But, with this kind of mobility in a joint or limb, much of the stability must be provided by the muscles and soft tissue in the joint and surrounding areas.  So, when there is overpronation, it can effect this soft tissue, and the effects are felt upstream, just like the effects of the wrong footwear.  Pronation = Good.  Overpronation = Bad.

(Underpronation is also bad, but that's a different story, altogether, and far less common.)

There are several things which might contribute to (or "cause") overpronation.  Weakness in the muscles which control that movement (namely tibialis posterior) can allow for overpronation.  Multiple
medial ankle sprains may overstretch the ligaments in the inner side of the ankle, making the muscles responsible for stabilizing the ankle.  Since muscles aren't really made to do that, they will likely wear out over time (think "fatigue" with a capital "F").

What are the kinds of problems that can arise from these things?  Firstly, pain in the muscles around the ankles, and the joints in the foot and ankle.  Moving up to the lower leg and the knee, overpronation causes the bottom of the lower leg to fall toward the instep, throwing the lower leg off its proper angle, and creating a faulty angle at the knee, as well.  With a faulty angle at the knee (known as the "Q" angle, because the angle is between the lower leg and the Quadriceps), the kneecap cannot move along its track properly, which can be a cause of knee pain. 

I believe that this a portion of the cause of my left knee pain.  I sprained my ankle frequently in high school, and I slightly overpronate now.  With my more active lifestyle, I'm putting more of a burden on that ankle and knee.  Sometimes I really feel the tracking get out of whack when it's multiplied by muscular imbalance in the quads.

So, I've made the decision to work on the strengthening and re-balancing of the muscles in my left leg, from the hip to the ankle.  For me, I'm working on achieving this from both ends - by being mindful of my glute activation and knee tracking in all my movements (especially squats and swings), and with some single leg balancing, and stability exercises for my left ankle.  These are the exercises that work for me, because they are the ones I will actually do.  There are plenty more options out there for me, and there could be plenty for you.

Take a moment of your day to consider any issues you may encounter in your lower body and then start by looking at your ankles, then your knees, and on up.  If you don't see anything that is obviously out of whack, then let's get together and we'll assess your movement together, and look for the corrective exercise options that will work best for you!