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Feet provide stability to the legs and, like the foundation of a house, stable legs and feet support the first floor (the pelv is), which provides stability for the second floor (the rib cage) and third floor (the head). Unstable feet, however, can eventually throw the whole body out of alignment, working all the way up the kinetic chain from the ankles to the shoulders Most affected along the way are the knees and hips. According to the National Institutes of Health, close to 800,000 people in the United States have a hip or knee replaced each year . Four and a half million Americans are living with artificial knees. That number includes an estimated 500,000 who have had at least two replacement operations on the same knee. While older adults and women receive the majority of replacements, the last few years have brought an increasing number of younger, highly active patients under age 50 to replacement surgery for knee or hip pain relief. And some doctors warn that even though hip prostheses have significantly, this younger crowd might need one or more additional replacements to continue their active lifestyle. During long walks down busy Michigan Avenue, I've observed how faulty foot/leg mechanics affects the gait of one out of four people, if not more, and many of them are male and well under the age of 50. The most common scenario I observed was a ducking out(turning out) of either the right or left foot, not both feet. The accompanying hip flared out laterally and to the back, creating uneven pelvic torque, or twisting. Depending on the severity of the ducking angle, the knee hyper-extended and the leg shortened, causing a slight limp.
My interest in the fallen arch syndrome started several years ago when I saw my first case of talotarsal dislocation, a nasty condition in which an advanced stage of fallen arches causes the ankle bone to slip off the heel bone. My client's doctor had recommended surgery to pin the ankle back up over the heel, and he looked to me for a yoga alternative. Upon seeing the deformity, I gave an answer that I rarely give: "Have the surgery as soon as possible." Every step he took was reinforcing his faulty foot mechanics. We did, however, continue with our sessions to relieve his pain. We stretched his leg and foot muscles through reclining postures and worked out trigger points with the eraser head of a pencil. The surgeon said the procedure was the easiest he'd ever performed, due to the extreme flexibility of my client's leg and foot muscles. Yes, the surgery was a success--my client could walk pain free-- but there's more to this episode, which you will understand better if I first explain some simple anatomy. Two lower leg muscles (the anterior tibialis and the peroneus longus) and the Achilles tendon attach to the sole of the forefoot. The anterior tibialis runs down the center of the leg, crosses the medial (inner) ankle and wraps under the forefoot to meet the peroneus longus, which runs down the outer leg, crosses the lateral (outside) ankle, and wraps under the forefoot to meet the anterior tibialis. The meeting of the two muscles creates a stirrup for the arches. The Achilles tendon runs down the back of the leg from the calf and attaches under the hindfoot (heel and ankle). The hindfoot supports our entire body weight. Its mechanics include ankle and heel bones, each of which has its own joint. The two joints work in tandem to move the foot forward with minimum impact. Without these joints we'd be walking on stumps. The ankle joint sits right under the anterior tibia bone and curves across the entire front ankle. It allows the forefoot to flex upward and downward. The heel joint sits under the posterior tibia bone and curves around the back of the heel. It allows the foot to turn right and left (think of the heel joint as a rudder that steers you through life's many changes). If the two joints were joined, they would resemble an ankle bracelet encircling the ankle and heel bones and the tibia, which is considered a sacred area in ancient cultures. Holding the hindfoot bones and joints together is a pyramid of fibrous threads sitting right above the heel bone. The long and thin tibia bone rests in this pyramid. Although these threads are often called ligaments, in reality they lack sufficient density to warrant that classification, hence their vulnerability. I advise strengthening this complex of hindfoot bones, joints, and ligaments by flexing and circling the feet before getting out of bed. This also stretches the lower leg muscles and Achilles tendon. But while this daily ritual might keep the condition from deteriorating, it won't lift the arch. You'll have to get out of bed and bear weight into the feet to retrain the arch. I recommend warrior and balance poses. Both postures will help you center, focus, and set the direction of the day.
Standing postures are contraindicated for advanced stages of foot misalignments. Even those with mild over-pronation should use caution when practicing standing postures, especially tree pose. Balancing on a wobbly ankle or misaligned knee is unhealthy for the spine, as it creates more uneven torque in the hips and upper body. Hold onto the wall or a chair until you steady the ankle and align the knee. Never play hero in class. Respect your limitations and you will get through them more quickly. In warrior pose, pay close attention to the knee of the back leg. Most of us know that the knee of the front bent leg must align vertically over the ankle. The same is true for the back leg. The golden rule of leg stability is knees always follow the forefoot. To stabilize the arch of the back leg, press into the outer side of the foot. Then try to rotate the quads outward around the femur (thigh bone) to open the hips Hip flexors and adductor muscles also play an important role in foot stability. But rather than go on about alignment and anatomy, which can be learned through books and the Internet, I'm going to introduce a little known fact: the feet are holy. They are the structural foundation of our skeletal system. Many cultures, recognizing the sacredness of the feet, place ankle bracelets on infants and keep them on until they master walking or the ability to support themselves. We grow physically and spiritually from the ground up. In addition to its 26 bones, 33 joints, and 107 ligaments that enable it to adapt to many terrains, the foot contains four triangular structures: the plantar muscle running from the hindfoot to the forefoot the pyramid ligaments supporting the hindfoot complex the anvil-like structure of the calcaneous (heel bone) a mysterious empty triangle within the calcaneous Though the common injury has long been known as Achilles tendon or Achilles tendonitis , it should be called Achilles triangle. Homer's famed archer in the Iliad was aiming for the pyramid of ligaments supporting the hindfoot. To destroy Achilles' physical prowess, the arrow had to pass through the tendon to shatter the hindfoot.
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