Being encouraged by health care professionals to keep as mobile as possible to sustain good health and wellbeing is sound advice but not always as easy as it sounds to follow especially by those experiencing painful, stiff or swollen feet. We know that a firm foundation is needed for stability of any structure, if we think of the feet as being the foundation from which the stability of the framework (skeletal system) of the body depends. Any change or irregularity in the foundation will affect general balance and function. The anatomy and physiology of the foot is complex. A simple explanation begins with the important function and action of the achilles tendon. Which raises the foot and is attached to the soleus and gastrocnemius muscles in the back of the lower leg where it inserts into the calcaneus bone in the foot. Four ligaments in the foot strengthen the ankle joint. There are seven tarsal bones of the ankle, five metatarsal bones and fourteen phalanges ( two in the big toes and three in all other toes) The three arches (medial and lateral longitudinal and anterior transverse arch’s) that are formed by the tarsal and metatarsal bones and supported by ligaments and tendons act as a spring, enabling weight bearing and absorbing the shock during walking or running. The foot nerves originate from the sciatic nerve, made up of the L4 to S3 nerve roots descending the leg from buttock through thigh to hamstrings and divides into the tibial and peroneal nerves to affect specific areas of the foot ( dorsum and plantar ) The blood supply to the foot is via the popliteal artery to digital arteries. Blood is taken from the foot back towards the heart via the superficial and deep veins. Lymphatic drainage of the foot comes from the popliteal lymph nodes that enter the superficial and deep inguinal lymph nodes. The lymphatic system does not have a pump ( unlike the circulatory system that has the heart as its pump) and lymph is moved around the body by muscle contraction. Excess lymph causing swelling around the ankle (or knee) can occur when lymph nodes are damaged or the muscles of the legs are not being used effectively. It is worth noting that as we age the structure and functionality of the foot and ankle may change. Over time and wear and tear the spring in the arches may diminish leading to “fallen arches” or “flat feet” the feet then pronate putting extra strain on the ankle, knees hips and pelvis resulting in inflammation, pain, and limited movement. Muscle density of the underside of the foot ( plantar) becomes less, nerves become more exposed and sensitive as we begin to feel every little stone, lump or bump through our shoes causing pain on movement. Ligaments and tendons may become lax causing us to “turn over “ the ankle more easily or if ligaments and tendons shorten through lack of use it will become more difficult to lengthen the calf muscle or put the heel to the floor. In some cases the function of the legs will adapt to changes in the anatomy of the foot and the gait will alter to compensate. This can be observed at consultation when I ask patients to remove their shoes and walk towards and away from me. “Knock knees” is an example of where the legs have adapted over time as a result of fallen arches( or from birth ) the feet pronate and the knees lean towards the centre of gravity trying to stabilise weight distribution. Being over-weight can exacerbate this condition. I also take note of how the foot is working and if there is a positive heel strike and toe push off motion with the stride. Very often there is not and a flat foot can lead to a shuffle or dragging gait increasing instability. A large number of reported trips and falls are attributed to balance problems stemming from issues with the feet. Symptoms in the feet and lower legs might occur as a result of diagnosed health conditions such as diabetes, effects from prescribed medication such as chemotherapy or physical trauma injury or surgery and will often result in further medication. Trying to get help to determine the underlying cause and ease symptoms to enable increased mobility can be frustrating. A visit to a Professional Clinical Reflexologist will include a visual observation of how the person stands and walks, paying special attention to the feet positioning when weight bearing followed by 45minutes of specialised treatment. The individual needs of each patient will guide treatment to ensure a successful outcome. Please note not all reflexologists are CLINICAL REFLEXOLOGISTS. If you are experiencing issues with mobility, balance or general wellbeing and think that your feet, knees, hips or spine might benefit from some treatment please get in touch…..always happy to try and help. You might be pleasantly surprised by the outcome.
