In Chiropractic we strive to help align your body. This is done through a series of adjustments to areas of the body that are subluxated. A subluxation is defined as a mal-alignment of the joint or vertebra. That is correct I said joint not just vertebra. Typically, Chiropractic doctors are put in the category of being back pain doctors, or spinal adjusters that is often the definition given to the profession by certain medical entities. In reality Chiropractors focus on re-establishing function to the body, be it the ankle joint, vertebra of the back, wrists, occiput or foot. Today we are going to discuss the importance of a proper foot alignment.
Let’s start with some basic anatomy: Each foot is made up of 26 bones, 30 joints and more than 100 muscles, tendons and ligaments, all of which work together to provide support, balance and mobility, which can be impacted by a poorly functioning foot. Without going into a full blown anatomy lesson let’s look at the main structures I as a doctor of Chiropractic am interested in and can help you with.
Here’s a look at the main structures of the feet.
Nearly one-fourth of the body’s bones are in our feet. The bones of the feet are:
- Talus – the bone on top of the foot that forms a joint with the two bones of the lower leg, the tibia and fibula.
- Calcaneus – the largest bone of the foot, which lies beneath the talus to form the heel bone.
- Tarsals – five irregularly shaped bones of the mid-foot that form the foot’s arch. The tarsal bones are the cuboid, navicular and medial, intermediate and lateral cuneiforms.
- Metatarsals – five bones (labeled one through five, starting with the big toe) that make up the forefoot.
- Phalanges (singular: phalanx) – the 14 bones that make up the toes. The big toe consists of two phalanges – the distal and proximal. The other toes have three.
- Sesamoids – two small, pea-shaped bones that lie beneath the head of the first metatarsal in the ball of the foot.
Of the foot bones I want to talk about the Tarsal, Cuboid, Navicular, cuneiforms, second metatarsal and sesamoids.
Joints in the feet are formed wherever two or more of these bones meet. Except for the big toe, each of the toes has three joints, which include:
- Metatarsophalangeal joint (MCP) – the joint at the base of the toe
- Proximal interphalangeal joint (PIP) – the joint in the middle of the toe
- Distal phalangeal joint (DP) – the joint closest to the tip of the toe.
Each big toe has two joints:
- Metatarsophalangeal joint
- Interphalangeal joint
The surfaces of the bones where they meet to form joints are covered with a layer of cartilage, which allows them to glide smoothly against one another as they move. The joints are enclosed by a fibrous capsule that is lined with a thin membrane called the synovium, which secretes a fluid to lubricate the joints.
The primary joint we will discuss is the Metatarsophalangeal joint.
Twenty muscles give the foot its shape, support and the ability to move. The main muscles of the foot include the:
- Tibilias posterior, which supports the foot’s arch
- Tibilias anterior, which allows the foot to move upward
- Tibilias peroneal, which controls movement on the outside of the ankle
- Extensors, which help raise the toes, making it possible to take a step
- Flexors, which help stabilize the toes. Flexor Digitorum Brevis
TENDONS AND LIGAMENTS
Many tendons attach these muscles to the bones and ligaments that hold the bones together to maintain the foot’s arch.
The main tendon of the foot is the Achilles tendon, which runs from the calf muscle to the heel. The Achilles tendon makes it possible to run, jump, climb stairs and stand on your toes.
The main ligaments of the foot are:
- Plantar fascia – the longest ligament of the foot. The ligament, which runs along the sole of the foot, from the heel to the toes, forms the arch. By stretching and contracting, the plantar fascia helps us balance and gives the foot strength for walking.
- Plantar calcaneonavicular ligament – a ligament of the sole of the foot that connects the calcaneus and navicular and supports the head of the talus.
- Calcaneocuboid ligament – the ligament that connects the calcaneus and the tarsal bones and helps the plantar fascia support the arch of the foot
Anatomy helps you to understand what I am going to be discussing today. With 26 bones, more than 100 muscles, tendons and ligaments it is important to ensure they are all performing properly, after all your feet are your foundation and as your foundation goes so goes the rest of your or any other structure. The first and most important part of this discussion is the term proprioception. Below is a definition and some diagrams that will allow you to understand and a much quicker pace than having me explain them to you.
PHYSIOLOGY: perception or awareness of the position and movement of the body.”exercises to improve performance and proprioception.”
As you can see from the diagrams proprioception is very important to support, balance, and mobility.
Well how is that corrected? As I mentioned up above there are certain joints and bones that can subluxated and need to be adjusted.
The first one and most common joint adjusted by Chiropractors in relationship to restoring proper foundational performance is the talus joint, it typically subluxates to the lateral side of the foot (see red arrow).
This adjustment is best known as a good ole’ ankle adjustment. A subluxated Talus can leave the foot rolling in on the arch and may cause some pain and discomfort.
This adjustment is the start of the readjustment(reconstruction) of the foots primary arch support. Although the Talus is commonly known as the primary bone for the arch I like to refer to the Navicular as the key stone to the arch.
It typically will subluxated downward or better known as posterior (see blue arrow). Next in line for adjustments are the Cuneiforms, yellow arrows, and last but not least is the second Metatarsal-Phalangeal joint.
The Metatarsophalangeal (MTP) joint is key to proper foot dynamics, you can correct the feet all day but to best hold them in the proper adjustment will take a little support. The kind of detail I would have to provide would take this blog way to long to keep your interest, however, if you want to learn more I will be coming out with a blog talking about this simple inexpensive simple insole that provides a lift under the Metararsophalangeal joint. See my blog on the proper insole for a full explanation on how they work and why they are so vital to your over all health.
For those of you suffering from the second picture of the MTP joint, a gnarly looking painful BUNION, I have good news for you, yes they can be adjusted and in some cases corrected through manipulation. It all has to do with correcting your feet in the proper manner and sequence, hint it has to do with the Sesamoid bones so go back up and see what they are. I will bring more info on that in another blog. Hope you enjoyed this little presentation and feel free to contact me with questions or a reply.