Is your back issue coming from your foot? Or is your foot issue coming from your back? Ain’t no way to know until we assess! This blog post is dedicated to investigating this chicken-or-egg question.
Scroll down a little more to join me in a fantastic biomechanical nerd-out đ
This blog post is for you if you currently have a stiff spine, stiff foot, long time back issue, old foot injury, all of the above, or are just curious about how to get your body moving more efficiently by learning about the movement relationship between your feet and spine.
You are more than the sum of your parts
I know you know this already, but it cannot be repeated enough: The body is a beautifully connected whole system, and should be considered for the whole that it is, not reduced to individual parts operating in isolation from each other.Â
One of my online students (a musician) recently wrote to me about how useful it has been, through doing my sessions regularly, to become more aware of all the various connections between her body parts in motion.
Like understanding that if you canât move your big toe THIS way, then your hip is going to be restricted going THAT way, and maybe that’s why your left shoulder feels janky.Â
Janky: Junk + cranky. Technical term (which I stole from a client of mine, in reference to her janky shoulder).Â
I love discovering connections in the body, too. It really lights me up because it always leads to better flowing movement and less pain. This is the magic we tap into in studying Anatomy in Motion: How everything needs to coordinate with everything else for ideal gait.
But its not magic. Its biomechanics.
In the words of my wonderful mentor Gary Ward, creator of Anatomy in Motion: “Look for things that don’t move that give permission for other things to.”
That adds an additional layer of nuance to the stretch and strengthen conversation, doesn’t it??
And on this note, Iâd like to share with you a series of video clips from my most recent Movement Deep Dive session: Foot-Spine Connections.Â
As the name alludes to, this session’s investigative mission is to learn if there is a discombobulated relationship between the movement of your feet and spine that could be keeping your body stuck moving inefficeintly through each footstep, with discomfort or whatever jankiness youâre aware of in your body.
Understanding this foot-spine connection is extremely useful when we are working on helping our bodies move and feel better with less pain, because it helps us to become aware of how the causative root of a foot issue could be your spine, or visa versa.
This helps us to make better informed choices about what we can focus on in our movement practices, instead of just trying random stuff and hoping for the best.
And so on that note, please enjoy these 4 snippets from the Foot-Jaw Connections Movement Deep Dive.Â
I hope youâll be able to learn a little about how your feet and spine are moving, and how to restore ideal mechanics between the two structures to put more flow in each footstep.Â
Foot-Jaw Connections
So, how did stuff go? Did you discover anything new and useful? I’d love to hear how this little bit of movement detectivery went for you. Please write me a comment below if you’d like to share.
Obviously there is more to explore than this… But I hope to inspire you to use this way of thinking in all your movement endeavours. Think outside the box. Think of your body as more than the sum of it’s parts. Just… Think ;).
In the full session, we also explore new ways of moving that connect your feet and spine with each other to restore a more harmonious, flowing relationship. But I canât share EVERYTHING for free, because this is capitalist America.Â
If you’d like to see the full 50ish minute movement deep dive session and participate along, you can find it listed HERE, along with some other faves, for $20 each.
The general vibe I get lately is that a lot more folks are open to the idea that pronation of the foot is actually useful. This is fantastic. In much thanks to the work of Gary Ward and all the amazing Anatomy in Motion peeps around the globe.
Some of you might even own the ubiquitous AiM wedges to help your feet pronate more happily
I even got a delightful message last week from a lady asking how to help her daughter pronate her feet better.
Wow!
A few years ago nobody was asking how to pronate better. They (me included…) were condemning it and asking how to strengthen their collapsed arches. Preaching to push knees out over 5th toe. Walking on the outsides of their feet as a solution for over-pronation.
Times are changing, and Iâm optimistic for humanity… Well, mostly.
But in all fairness, in Canada we have a “May 24 weekend”, that doesn’t always land on May 24, but we still call it that… I don’t get the logic.
With pronation coming out of purgatory, embraced by the masses, letâs not forget that it is just one of two complimentary extremes on a spectrum. Just because one is trending and useful, not to forget the other.
Like when someone says âtoo many carbs are bad, go low carb!â, what do we do? EAT NO CARBS EVER because they are bad.
Or when someone says âyou should eat more fibre because it keeps you regularâ, what do you do? EAT 5LBS OF BRUSSEL SPROUTS EVERY DAY, because more is better.
Not that I’ve ever had problems with nuance, extremism, and carb-confusion. Not me. No way.
All that to say, letâs embrace pronation but…
DONâT FORGET THERE’S THAT OTHER THING THE FOOT DOES
Supination is still important. Always will be.
Pronation and supination are a both/and combo, not an either/or.
Doing something in an extreme, one-sided way should be practiced deliberately, like a medicine to restore balance. And an extreme medical intervention should not be permanentâŚ
The goal isnât to only work on pronation forever, but to be constantly re-evaluating what balance means, and choose foot exercises with a clear intent.
So please, at the risk of pronating the crap out of our feet becoming the next âtrendyâ thing to do that gets grossly misinterpreted, people get hurt from it, and pronation becoming demonized yet again, remember that the main benefit of pronation is actually to help better supinate the foot.
This blog post is to offer a bit more info on supination of the foot:
What it is.
What is isnât.
Can you do it well?
And what’s its relationship with pronation?
TWO FOOT SHAPES REVIEW
There are two main shapes the foot can make: Pronation, and supination.
Hereâs a slide from day two (foot day) of my workshop, Liberated Body, to describe what to look for in an embodied experience of pronation and supination. Notice how they are the opposites:
Every movement the body can do takes place on top of either a pronating or supinating of foot, depending on the moment in time in the gait cycle.
Some movements of the body happen only on a pronated foot, some happen on only a supinated foot, some happen on both, and some can happen on both but we don’t want to ever move that way if we value our joints…
For example, a hip can flex while the foot is pronating or supinating. Both happen in gait and are healthy, useful options.
Here is me flexing my left hip and *trying* to pronate my foot: Two motions which happen together in the loading phase of gait.
Here is me trying to flexi my left hip with a supinated foot (which happens in heel strike in gait)
However, hip extension should only happen on top of a supinating foot in gait.
This is helpful to know so that when you’re doing exercises to work on hip flexion and extension you can accurately sync up your body with your feet.
If we’re not moving in consideration of the hip’s relationship with the foot, then weâre not actually teaching the body to do anything new. Weâre just moving a hip in isolation from its role with the rest of the body.
(There are many more examples of this, and if youâd like to learn more about foot/hip things, I recommend Gary Wardâs online course, Closed Chain Biomechanics of the Lower Limb).
MORE THAN JUST SHAPES…
Pronation and supination are best considered as verbs, not nouns.
They are words to describe very specific patterns of movement that all 26 moving bones and 33 joints of the foot do, in three planes of motion.
Lots of bones down there folks!
Anything other than these specific patterns must be called something other than pronation and supination. If even one bone is going the wrong direction, it’s in foot purgatory. This degree of specificity is important.
(and if you have slightly OCD tendencies, you will love studying AiM.)
As verbs, the body should have dynamic access to both options end of the foot motion spectrum, never stuck in one or the other.
Now letâs dial in on supination.
WHAT IS FOOT SUPINATION?
First, follow along with this demo, which is the supination self- check from day 2 of Liberated Body:
So⌠Do your feet supinate well?
Hereâs what weâre looking for as a felt experience of supination:
All arches of the foot rising
Foot shortening and narrowing
Foot pressure distribution travelling to posterior lateral heel
Joints on dorsal (top) and lateral (outside) of foot opening
Muscles under the arch shortening
Muscles on dorsal, lateral foot and ankle lengthening
THREE POINTS OF FOOT TRIPOD ON THE GROUND (otherwise itâs not a real supination)
Could you feel all of that happening?
WHAT IS SUPINATION NOT?
Supination is NOT âarch strengtheningâ.
Supination refers to motion between the bones of the feet. Actual moving joints. Not just contracting foot muscles to strengthen them.
You can strengthen a muscle without actually articulating the bones in a new way. You can only strengthen muscles within the constraints of your current options for joint movement.
Interestingly, arch strengthening drills like towel scrunching and practicing âshort footâ may even block your ability to supinate well.
Whilst towel srcunching, you may be inadvertently pressing your big toe into the ground to grip the towel. Alas… Big toe flexion is actually part of the collection of motions that happen in foot pronation. Oops!
If you’re squeeezing with your big toe, it ain’t supination anymore
I appreciate the valiant goal of the short foot exercise, however the foot is still being treated in isolation from the rest of the body, inconsiderate of the specifc pattern of triplanar motion that is supination. In particular, the rotational component of supination (transverse plane) is lost, which you can see (rather, not see…) in the video below.
I have no doubt you can strengthen your foot muscles and get better at short-footy, towel-scrunchies, but does that equate to moving those feet differently, unconsiously, whilst walking? And consider them in relation to the rest of the body?
Supination is NOT the same as rolling to the outside of your feet.
That is just losing the tripod, which means youâre log-rolling the foot as a whole chunk, versus being able to articulate all joints with each other.
Remember, if you lose the tripod- 1st metatarsal contact, it is no longer supination. It’s inversion (aka how many ankle sprains happen).
Loss of 1st met head contact= inversion: Aka oh shit there goes my ankle again!
Itâs the difference between moving a collection of bones as a unit, through space, and moving the bones against each other, in one place, articulating on the ground.
Supination is NOT the same as having high arches.
You can have high arches but ankles that are actually internally rotated!
Remember, as I hope you experienced in the supination check-in video above, we want the ankle to externally rotate with a supinating foot. But many folks with high arches actually have internally rotated ankles!
Foot purgatory. Neither here nor there…
AN INTERDEPENDENT RELATIONSHIP
Pronation and supination together can be considered as a spectrum of movement we perpetually move through as we walk.
They are Yin and yang. They are the opposite and complimentary movement of the other. They are interdependent, not independent.
Pronation relies on supination. Supination relies on pronation. Mess with one, and you impact the other.
In pronation, all the muscles that supinate the foot (primarily muscles attaching under the arch) get loaded eccentrically (stretched like an elastic band), providing the necessary stimulus to contract them, pick up the arch, and generate a healthy supination.
This includes some lovely muscles like:
Flexor hallucis longus
Tibialis posterior
Peroneus longus
Tibialis anterior
Soleus
Gastrocnemius
Et al.
Loading up these muscles generates the stimulus for supination.
Then the foot can start pronating again from it’s fully supinated position, instead of still being half-way (or all the way) pronated. This gives the foot more time before the arch completely lowers on the ground, preventing us from âover-pronatingâ, the foot crashing into the floor too quickly.
As a bad analogy, imagine if Johnny starts the 100m dash from the 50m line⌠Heâs going to get to the finish line a lot faster than everyone else. But if your foot is like Johnny, starting to pronate from an already 50% pronated place, it will hit its full range a lot faster.
Johnny is like an over-pronating foot.
Healthy pronation sets up an environment for a healthy supination by virtue of muscular contraction.
Healthy supination sets up an environment for healthy pronation by virtue of allowing more time for pronation to take place within.
CONCLUSIONS?
Donât forget, in your excitement about pronation, that supination is important, too.
A main goal of pronation is actually to help your foot supinate.
A high arched foot is not the same thing as a supinated foot.
If you lose 1st metatarsal head contact (tripod), it is no longer supination.
Pronation and supination are interdependent, wholly reliant on one another.
Eating 5lbs of fibre every day might make your guts hurt⌠Take it from me.
Iâd love to hear if this blog post was useful for you. Did you try the foot supination check in? How did it go?
Again, helpful links if youâd like to learn more about your feet (and your body mechanics):
If I had only 15 minutes with someone to help them move and stand with more ease, but was not allowed to assess anything or ask about their injury history, I think the most impactful thing to do would be…
Teach them how to pronate their feet.
Pronation is not the devil, but the devil is in the details.
I’m here about the pronation!
Pronation is an important motion the foot must be able to do as we walk. Contrary to what your orthotics person may have told you.
With each step, the foot gets just one chance to pronate. Could you missing out on the important benefits of this moment in time? (more about that below, read on!).
At some point in my work with most clients, I know I’ll do eventually take them through an exercise to show them how to access a healthy pronation, its just a matter of when.
I think that the world of therapy and movement professionals is opening up to the idea that pronation is a healthy movement to promote, with much thanks to the work of Gary Ward. Which is awesome.
However…
Just rolling your foot IN is not the same as pronation.
Do you know the difference?
Eversion (rolling onto the inside of your foot… I know, it seems like it should be called INversion, just deal with the counterintuitive language), is the frontal plane component of pronation, not the whole shebang.
My intention with this blog post is to highlight the diffrences between pronation and eversion of the foot, so that you can liberate your feet and wake up their muscles instead of living with a problematic chunk at the end of your leg.
So before you read any further, stop what you’re doing (unless you’re saving your baby from being eaten by a dog or something) and follow along with the video below. Let’s see how well your feet move. Are you just everting, or are you actually pronating?
The clip is from day 2 of my Liberated Body workshop: Foot mechanics day, in which we explore healthy pronation and supination of the foot.
In fact, embracing pronation is often the biggest take-away for my students. One said: “I was convinced that pronation was a horrible thing until this class!”
Pronation is a tri-planar movement
Eversion describes only the frontal plane aspect of pronation
The main difference between pronation and eversion, in super simple terms (because my brain needs things to be simple):
Do you roll inwards on your foot, dump your knee wayyy inside of your big toe, and lose contact with the 5th metatarsal head on the floor? That’s eversion of the whole foot, not pronation.
Check out these images:
Accurately labelled. Notice the loss of 5th met contact in the eversion photo, and likewise, the loss of 1st met contact in the inversion photo. No tripod, no pronation.
Yes, these are also labelled accurately: Notice how the calcaneus (heel bone) is rolling into eversion, but it appears that the whole foot tripod is still in contact with the ground. Got tripod? That’s a pronation.
Notice how the labels in brackets underneath that say pronation and supination are not accurate, because the foot is clearly rolling off the floor, losing tripod contact.
Are you doing the right thing the wrong way?
As with anything, attention to nuance is the key for success. We could be doing the “right” thing the wrong way,
Like when I first tried a low carb, high fat diet in 2013ish because that’s what the whole internet was doing… No one told me how easy it was to eat 12483275939 calories of fat a day and gain weight on a “fat-loss” diet. Oops.
Could you be thinking you’re pronating, but just smashing the shit out of your first met by dumping all your weight onto it, with no muscles managing the situation?
Here’s one more nuanced pronation “DO” and “DON’T” that I hope you picked up from my video: We DO want the knee to go slightly inward to access foot pronation, but we DON’T want the knee to dump inward so far it generates eversion.
Check out this video by Gary Ward (which he created to illustrate the concept from his book What the Foot, that knee over second toe is not a thing we should get dogmatically locked into because it limits foot movement in gait):
Here’s your pronation vs. eversion check-list for success:
Eversion:
No articulation between foot bones
Foot “log-rolls” inward as one chunk
Loss of tripod (5th metatarsal head lifts from floor)
No change in muscles length or experience loading/stretching under foot
Joints remain in same position, nothing decompresses/compresses
Pronation:
Articulation between the foot bones with each other and the ground
Tri-planar motion of the foot (sagittal, frontal, and transverse plane components- eversion is just the frontal plane component of pronation)
All three points of the tripod in contact with the floor
Muscles on the bottom and inside surfaces of foot, and back of the ankle load and lengthen
Joints on the bottom and inside surface of the foot open and decompress.
Here’s a slide from my Liberated Body workshop day 2 presentation that outlines what we’re looking for in healthy pronation and supination:
Why is pronation actually useful?
Just to clarify: PronatING is great. Being stuck in pronaTION, the noun, is not so great.
Pronation is like going to Wal-Mart- Get in, get what you need, and get out as quickly as possible.
Here are a three amazing things our body gets from healthy pronation (but does not get from rolling in, aka eversion):
Natural lengthening and loading of the muscles under the foot with each step: Got tight feet? Stretching not really helping? Rolling fascia out feels good, but not changing anything? Foot pronation is the movement that naturally allows the muscles under your foot to lengthen with each step. Got plantar fasciitis? Letting your feet pronate could be a game changer for you.
Extensor chain (dem glutes) load: Looking for more ease and power with each stride? Or to explode up from a squat position? Or land from a jump with more control? At the same moment in time that we pronate our foot in gait, the entire extensor chain of the lower body loads up. Calves load to generate plantarflexion, distal quads load to generate knee extension, and proximal glutes and hamstrings load to generate hip extension. Want to jump better and run with more ease? Make sure your feet can pronate well.
Pronation and eversion (rolling in on the foot) are not the same. One is a useful experience for the whole body, the other just feels uncomfortable.
Eversion is just one component (frontal plane) of a healthy, three dimensional pronation.
Losing the foot tripod makes or breaks a pronation. And a tea towel might be your new best friend.
Pronation has important movement repercussions for the body, such as allowing us to mobilize our feet naturally with each step, helping us engage our glutes better, and even freeing our neck and jaw tension.
Wal-Mart sucks.
Want to learn more?
I think you’ll really love Wake Your Feet Up, an online course by Gary Ward that teaches foot mechanics in a way that even my simple brain can comprehend.
He designed this course for folks who want to learn more about their foot mechanics and explore exercises to give their tootsies back their full movement potential. This online course is appropriate for all humans with feet, not just movement and therapy professionals who can speak biomechanics.
Ok I realize this post makes me seem like a huge Gary Ward fan-girl. I kinda am. Deal with it. I think he was my dad in a past life.
That’s all for now, movemet pals. I’d love to hear if you discovered anything new about your feet: Are you pronating well, or just everting? And if you can get your feet pronating well, what does it feel like for your feet, and the rest of your body?
Leave a comment, or shoot me an email, and let me know đ
Why do they form? What do you do about them? Can you do anything about them? Aren’t they genetic? Do you need to get surgery? What about those toe spacer things and splints?
So many questions!
I’m not claiming to have any conclusive answers (and I think the moment we conclude something is the moment we stop learning anything new).
But what I do know is that bunions can be understood and worked with from a movement perspective. That is, movement of the big toe created the bunion, why could movement not also be at least part of the remedy?
I believe movement is medicine. But too much medicince can be problematic too, can’t it?
Here’s a key thing to know: The movement of the big toe that leads to a bunion forming- toe abduction/valgus- happens at a specific moment in time in the gait cycle. Things get problematic when that movement becomes the only option your foot has and becomes a structural adaptation, ie, the actual shape of your foot changes.
The bunion itself is the solution your body found for a problem.
The video below is a clip from a Movement Deep Dive Session I did recently with some of my amazing Liberated Body students. The session was to help them understand big toe mechanics with foot pronation and supination as we walk.
I think knowledge is power… Wanna geek out?
In the video I cover:
What joint motions are possible at the big toe joint (aka 1st metatarsalphalangeal joint aka MTPJ)?
How is movement of the foot on the floor- closed chain- different than when it swings through the air- open chain?
What does the big toe do when the foot pronates and supinates?
What big toe/foot movement creates a bunion over time and when does that happen in gait?
How can a bunion be seen as an indicator to that we need to pronate that foot better?
How could this be affecting stuff above, like your neck?
When we understanding how the big toe moves in relationship with the foot and the rest of the body, we have powerful information to inform the decisions we make for our bodies everyday.
I hope the video demonstrates how the big toe movement that leads to a bunion forming- toe abduction- is a totally natural event with each step we take. We just want to have other options, too.
Interestingly, while bunions are association with a more pronated foot, the bunion may form because the foot doesn’t pronate well! The big toe abducting away from the foot was the last ditch attempt to do something that resembles pronation. I often find that if we show the foot how to pronate better without relying solely on the big toe deviating into excessive abduction, good things happen.
So if you have a bunion, maybe your big toe is just stuck in a moment in time because it only has one option for movement? What if you could show it a new option?
I think its safe to say that before electing for an invasive buinion procedure, or using a medieval-looking toe stretching devices, or shoving spacers between your toes, why not try some natural movement, first? Give that foot some of its movement potential back.
Best case scenario, you can get that toe moving again and things will feel better. Worst case, you mobilized your feet and got some extra bloodflow. Win win.
This is why I’m so passionate about the work Gary Ward teaches in his Anatomy in Motion courses. What if we could restore the movement potential inherent in our gait cycle, so that each step we take has the ability to reinforce healthy joint mehcanics? Walk ourselves well.
Want to learn more? I think you’ll really enjoy my four day workshop Liberated Body. We spend the whole of day two moving your feet đ I have a live workshop every few months, and it’s also available as a home-study you can start today đ
In fact, here’s a story from one of my students, a dancer and yogi, who embraced pronating her feet and was able to free up her bunion:
“My most enjoyable class and the biggest change I noticed was in the FEET! I feel that I have avoided pronation like the plague which stems from ballet training for sure – but my feet, achilles, calves and even knees felt SO GREAT after that class. I purposefully went for a walk afterwards and could really feel a difference in my foot pressures as I moved. Also as I mentioned at the end of the session, my bunion on the right side felt released and not as painful – coming up to demi-pointe on that side was a breeze.”
Super cool, right!?
What do you think? Do you have bunions? Have you had a bunion surgery? Have you had success using movement to relieve bunion pain? I’d love to hear from you.
Leave a comment here, shoot me an email, or find me on the social media things you do. I’m pretty much the only Monika Volkmar on the planet, so I’m easy to find đ
