So - tired of moving forward? Good - that can get quite boring, right? But don't think that just because you're feet are moving forward they aren't also moving side-to-side. Well, it's actually a lot more complicated than that. Unless you want to walk strictly like a robot, that is. You see, we humans have evolved to move in many directions, but especially forward - how else do you expect to get away from a sabertooth? You have to be able to run both fast, and possibly, for quite a while. This means you had better evolve in several directions - for strength, for speed, and for efficiency - energy efficiency, that is. You wouldn't want to run out of steam at the last second, would you? because that might be really bad - for you, not for that big pussy-cat!
Just as the foot needs to be able to adapt to the changing surface of the ground heel to toe, so does it need to adapt laterally and medially. The foot, in fact, is essentially an adaptable triangle, with the heel being one apex, and the first and fifth metatarsal heads being the other two. It is the job of all the other bones, joints, muscles, ligaments and nerves to make those two adaptable triangles work as efficiently as possible to keep the entire organism they support moving as smoothly and efficiently as possible. But for that to happen, they need to be interact properly with the other mechanisms proximally - that is, above them - so, the ankle, lower legs, knee joint, femur, and, most critically, the hip/pelvis/sacral components. Each plays a role that both affect and is affected by the joints above and below them.
And besides needing to interact according to some pretty basic mechanical concepts, they need to do so with a fairly high degree of symmetry - the right and the left have to work in near-mirror opposition. They have to do this with the nervous system firing in efficient and repetitive sequences, over and over, for your entire life. If just one part fails to work properly, however, the entire shebang can go off-kilter pretty quickly - just look what happens when you do something pretty basic like bang your shin on the coffee table!
First, you will hop on the un-banged side until you can sit down and rub the new contusion. When you are finally ready (no matter how reluctantly) to attempt to get back on your feet, you will try to put less weight and motion on the affected side, and thereby, limp. Limping is the most basic form of compensation - no, not like a paycheck, sad to say, but compensation as a method to relieve the temporarily impacted part. Now, odds are, you won't be limping very long, so unless you already have your back out of joint, this type of compensation - by limping - won't have any long-term negative impacts, and will only involve a few joint segments. But for this brief period, your body will still follow some basic rules until it is able to move without pain. At which point, you will go back to your "normal" way of ambulation.
Now, note I said "unless you already have your back out of joint," above. If you are already compensating for some other asymmetrical musculo-skeletal defect, then adding another level of compensation can have a decided impact on the pre-existing levels of compensation, possibly making the original issue, in this instance, your back spasms, much worse, which can really muddy the waters when the body works to deal with the new reason for additional compensation. But again, the basic rules apply - inner ear balance, and a level visual horizon.
But regardless of the reasons, compensation is largely an unconscious response and reaction to anything that modifies the symmetrical nature of human gait. It might start off conscious, as in the limping example above, but that is usually only the case when you respond to immediate trauma. The matter is, however, quite different when the asymmetry is from a birth defect, disease process, or early-infancy etiology (cause). Then, compensation is slow and steady, and can be influenced by a variety of other factors as to the degree of compensation, how many levels of the body it impacts, and what compensatory-related pathomechanics may result over time.
For our concern right now, lets just consider what happens when one foot is slightly different in the range of motion than the other. Say, your first ray - the first metatarsal and the big toe, or the Hallux. If you have a higher range of dorsiflexion and plantarflexion of the first ray on one side than the other, that side is likely to have a higher degree of pronation than the opposite side does, and this extra amount of pronation can have some pretty complicated compensatory reactions. (Dorsiflexion is movement upward, or toward the joints above the joints in question - plantarflexion is motion downward, toward the ground. So when you raise your big toe, or Hallux, you are dorsiflexing it, and when you point your Hallux downward, you are plantarflexing it. Just another little service we supply here at Definitions-r-Us!)
OK, next time, we will follow this problem in greater detail. Why, you ask? Why do I need to be confused by all this detail? Well, if you want to understand your own feet, and you don't want the medical professionals you have to deal with to hold all the cards, having a working knowledge of how your feet work - or don't - will put some of the power back in your own pocket. The aim is to enable you to understand your feet, your footwear, your orthotics, and why they work, or don't, and what you can do to make sure they do work better. And you should definitely consider asking questions - having more knowledge helps you ask better questions.
Even if it's just to fluster the doc!
Just as the foot needs to be able to adapt to the changing surface of the ground heel to toe, so does it need to adapt laterally and medially. The foot, in fact, is essentially an adaptable triangle, with the heel being one apex, and the first and fifth metatarsal heads being the other two. It is the job of all the other bones, joints, muscles, ligaments and nerves to make those two adaptable triangles work as efficiently as possible to keep the entire organism they support moving as smoothly and efficiently as possible. But for that to happen, they need to be interact properly with the other mechanisms proximally - that is, above them - so, the ankle, lower legs, knee joint, femur, and, most critically, the hip/pelvis/sacral components. Each plays a role that both affect and is affected by the joints above and below them.
And besides needing to interact according to some pretty basic mechanical concepts, they need to do so with a fairly high degree of symmetry - the right and the left have to work in near-mirror opposition. They have to do this with the nervous system firing in efficient and repetitive sequences, over and over, for your entire life. If just one part fails to work properly, however, the entire shebang can go off-kilter pretty quickly - just look what happens when you do something pretty basic like bang your shin on the coffee table!
First, you will hop on the un-banged side until you can sit down and rub the new contusion. When you are finally ready (no matter how reluctantly) to attempt to get back on your feet, you will try to put less weight and motion on the affected side, and thereby, limp. Limping is the most basic form of compensation - no, not like a paycheck, sad to say, but compensation as a method to relieve the temporarily impacted part. Now, odds are, you won't be limping very long, so unless you already have your back out of joint, this type of compensation - by limping - won't have any long-term negative impacts, and will only involve a few joint segments. But for this brief period, your body will still follow some basic rules until it is able to move without pain. At which point, you will go back to your "normal" way of ambulation.
Now, note I said "unless you already have your back out of joint," above. If you are already compensating for some other asymmetrical musculo-skeletal defect, then adding another level of compensation can have a decided impact on the pre-existing levels of compensation, possibly making the original issue, in this instance, your back spasms, much worse, which can really muddy the waters when the body works to deal with the new reason for additional compensation. But again, the basic rules apply - inner ear balance, and a level visual horizon.
But regardless of the reasons, compensation is largely an unconscious response and reaction to anything that modifies the symmetrical nature of human gait. It might start off conscious, as in the limping example above, but that is usually only the case when you respond to immediate trauma. The matter is, however, quite different when the asymmetry is from a birth defect, disease process, or early-infancy etiology (cause). Then, compensation is slow and steady, and can be influenced by a variety of other factors as to the degree of compensation, how many levels of the body it impacts, and what compensatory-related pathomechanics may result over time.
For our concern right now, lets just consider what happens when one foot is slightly different in the range of motion than the other. Say, your first ray - the first metatarsal and the big toe, or the Hallux. If you have a higher range of dorsiflexion and plantarflexion of the first ray on one side than the other, that side is likely to have a higher degree of pronation than the opposite side does, and this extra amount of pronation can have some pretty complicated compensatory reactions. (Dorsiflexion is movement upward, or toward the joints above the joints in question - plantarflexion is motion downward, toward the ground. So when you raise your big toe, or Hallux, you are dorsiflexing it, and when you point your Hallux downward, you are plantarflexing it. Just another little service we supply here at Definitions-r-Us!)
OK, next time, we will follow this problem in greater detail. Why, you ask? Why do I need to be confused by all this detail? Well, if you want to understand your own feet, and you don't want the medical professionals you have to deal with to hold all the cards, having a working knowledge of how your feet work - or don't - will put some of the power back in your own pocket. The aim is to enable you to understand your feet, your footwear, your orthotics, and why they work, or don't, and what you can do to make sure they do work better. And you should definitely consider asking questions - having more knowledge helps you ask better questions.
Even if it's just to fluster the doc!
Thanks, I certainly can see how this tips if I could call them so, might be of a real use for some readers facing this problem.
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