The foot and ankle are unique in correspondence to each other. Their range of motion includes the front-to-back, hinge-like motion we associate with walking. The foot and ankle also provide the lateral or side-to-side movement needed to change directions quickly. A problem in the foot can alter the biomechanics of the ankles, knees, hips, pelvis, low back, and neck. This problem can potentially increase the risk of injury in each of these areas.
In 1995, Rothbart and colleagues reported that hyperpronation is a leading cause of pelvic repositioning and mechanical LBP. Watch as people walk in a mall or grocery store. You’ll notice almost everyone’s ankle rolls inwards as they step downward. To maintain proper foot posture, foot orthotics is the most practical approach coupled with wearing well-fitted, comfortable shoes.
In a 2017 study, researchers recruited 225 adults with chronic LBP and randomly assigned them to 1 of 3 treatment groups. These groups were shoe orthotic (SO)-only, a “plus” group (SO + chiropractic manipulation/CM), or a waitlist group. The research team measured each participant’s pain and function/disability initially, after six weeks, three months, six, and twelve months later.
After 6 weeks, members from the intervention groups reported any improvement in function. When comparing the waitlist and SO-only groups, the SO-only group demonstrated significantly greater improvements in both pain and function. The researchers also noted that members of the SO+CM group experienced even greater levels of clinically significant functional improvement.
This large-scale study supports the importance of examining the whole patient to identify and treat all factors that may contribute to a patient’s chief complaint.
