Foot And Spine Relationships
Throughout my life, my mom has modelled and encouraged physical activity, from teaching jazzercise and power-walking classes to running half marathons.
Recently, she has experienced increasing back pain, impacting her daily walks with friends. This has been frustrating, so when her upper thoracic pain peaked last month, I was glad to assist.
While my mom’s thoracic spine is quite rounded, two injuries have shone a bright light on her spine and created pain: a right ankle sprain from two years ago and a more recent hairline fracture in her right calcaneus. Rather than detailing these injuries, I will focus on how they contribute to her increased spinal discomfort.
Assessment of her right foot revealed that both the inversion ankle sprain and heel fracture have affected her foot shape and its mobility. Her rear foot now rests in a pronated position (everted), with limited inversion and restricted movement of the cuboid and talus. The talus is internally rotated and only returns to a neutral position, and the cuboid is quite sensitive, suggesting that it has dropped.
How does this relate to her upper thoracic spine pain?
The body functions as a system, with interconnected movements. For example, the foot and spine are linked: a pronating foot is accompanied by lateral flexion of the spine toward the same side to maintain balance during walking. However, remaining in this posture continuously isn’t ideal.
In my mom’s case, her pronated rearfoot and corresponding spinal alignment keep her upper thoracic region compressed, with tissues on the right side rarely relaxing and lengthening. Spinal flexion and her resting head position add further stress to these areas, resulting in pain and discomfort.
What steps can we take to address this?
I began by addressing the foot, helping the rear foot - specifically the talus, cuboid, and calcaneus - achieve inversion, external rotation, and dorsiflexion. Then we focused on the spine, encouraging it to experience opposing resting positions, such as extension and left lateral flexion.
After making slight adjustments to her foot yesterday, her pain decreased from 7 to 3, and she felt she stood taller. While further assessment and treatment are needed, we have made progress.
