Step 5 – Joint Mobility and Stability Equals “Mostability”
Mobility: the ability to move freely
Stability: the ability to maintain a position
All of us need three-dimensional mobility and stability, from the feet, ankles, knees, hips, pelvis, spine, ribcage, shoulders, and neck, to optimally and functionally perform our daily activities without injury, and this is known as “mostability.” Mostability is one of the first things I assess for my Pilates clients. What I’m looking for with this assessment is whether the joints move optimally during functional movement. Whether it’s playing a sport or simply getting in and out of the car, proper sequencing of the bones and joints is essential to efficient performance of these motion-based tasks.
I recommend performing three-dimensional, functional flexibility exercises and then applying them to the right stability exercises, to get great posture and a healthy functioning core.
Step 6 – A Functional Foot is Essential for Optimal Posture
As a Pilates instructor in Cape Coral, Fort Myers and Estero, I see all kinds of people with various postural and core weakness issues. As we go through an initial assessment, we frequently discover that their issues are coming from their feet, even when their pain is in another part of their body. Believe it or not, your shoulder pain can actually come from your foot!
What most people don’t know is that your feet have three responsibilities – shock absorber, propeller, base of support, and that’s why when they are not providing what the rest of your body needs, you get pain in the other parts of your body.
First, each foot is a shock absorber that allows for three-dimensional loading for the rest of the body; second, each foot is a stable propeller that allows the body to unload in all three planes; third, each foot is a base of support, providing the stability and mobility of the foot to balance the body.
The hips and trunk, or the core of the body are the internal power sources that drive the body. There are many ways to activate your power source, but probably the most important for upright function in our gravitational environment is eversion of the calcaneus (the heel bone). The calcaneal eversion during weight bearing produces three-dimensional reactions in the knee, hip, and spinal joints, because the joints of the ankle are three-dimensional, and all joints move in three planes. If the foot doesn’t properly load and pronate and then unload, in that order, there will be significant ramifications up into the knees, hips, spine, and even the shoulders.
For example, when you are walking, the knee flexes, abducts, and internally rotates. The hip, responding to the calcaneal eversion and ankle motion, will flex, abduct, and internally rotate. Motion will be created in the lower spine since the pelvis is also driven by gravity and ground reaction force. Muscles must first lengthen or stretch prior to creating the opposite motions of shortening or contracting. It is these motions that turn on the hip and core muscles, all initiated by the calcaneal eversion “switch” in the heel bone. (Informational source: David Tiberio PhD, PT, OCS, “CALCANEAL EVERSION: The Switch that Turns On the Engine.” The Gray Institute: News and Articles).”
A person who has a very high arch and a stiff foot has poor loading mechanics. Conversely someone with a flat foot has their own set of issues in that the foot is pre-loaded. With both scenarios it is likely that the pelvic core and trunk are not performing optimally, which can lead to dysfunctional movement and pain.
Orthotics – What’s the Point?
The name of the game in gait is to load the medial column of the foot. Most custom orthotics are designed to support the arch or create “neutral ankle” alignment. The problem is that functional gait (as described by the “switch” and calcaneal eversion above) is not usually considered. For my feet, I use a prefabricated orthotic system that considers the function of gait called “The Quadrastep System.” You can check them out at www.whatsmyfoottype.com . The Quadrastep System is based on founder Roberta Nole’s 24 patented foot-typing methodology, identifying six major foot categorizations. Each of these six major foot categories represents sub-groupings of four foot types. These six subgroups are referred to as “quads,” the derivative of the name Quadrastep System. The foot type classification method is the first of its kind, custom-to-foot type orthotic system.
How Callouses Tell a Story About Gait
The Quadrastep foot typing assessment has five parts: 1) examination of arch height, 2) examination of calcaneus (heel bone) position in standing, 3) examination of forefoot in standing, 4) callous examination and finally 5) gait assessment.
Callouses tell a lot about how your foot and body function in gait. Because “the foot bone is connected to the ankle bone, and the ankle bone is connected to the knee bone” I can get a picture of what your pelvis, your spine, your ribcage, and even your shoulders and neck are doing while you are walking, all based on your foot type, including your callous patterns. So, for example, if you have a large callous on your big toe, and a high arch, I know that you are probably not getting an appropriate loading of the foot, because you’re constantly propelling off your big toe. Which is why you have that callous. I’ll start asking you questions like “do you feel any pain or tightness in your hips or lower back?” and go from there. Because, as we learned from the “switch,” without good loading of the foot and eversion of the calcaneus, the hips and core don’t function optimally. So, I use The Quadrastep System not only as a foot orthotic, but also as a “butt orthotic” to get the foot to load and “switch” on the hips and core.
How Your Body Compensates, Changes your Posture
If you’ve ever had a blister on your foot, you’ve experienced how it changes the way you walk. Or perhaps you’ve been on crutches or had a sprained ankle, and you’ve noticed the marked change to your gait and posture to compensate for protecting that pain point. Because the human body is always in survival mode – reacting to gravity, ground reaction force and momentum, we’ll always choose quantity over quality of movement. We will subconsciously find ways to “work around” pain, discomfort, tightness – moving in the most efficient way to avoid the pain. However, efficient movement is not necessarily ideal in the long run since the changes to gait and posture ultimately causes issues in the other parts of your body that are having to compensate.
Overuse Injuries Are Not just for Athletes
Most people think overuse injuries only come from playing sports. While it’s true that many athletes create overuse injuries from repeating the same movements over and over and over again, almost anyone who does repetitive tasks and makes repetitive movements is at risk for overuse syndrome. And that’s pretty much everyone if you think about it. Think of all the things that you do day in and day out, like sitting for more than 30 hours per week, working on your computer, driving, etc. Now think about all the ways your body compensates for minor aches, injuries, a weak core, and poor body mechanics due to the “work around” and you’ve got overuse syndrome.
Step 7 will publish on Jan 11, 2022
