Why are comprehensive lower extremity biomechanical evaluations important to athletes over 30?
by Vasile Faklis
I truly feel that people of all ages (young and old) would benefit from entire body biomechanical evaluations. Unfortunately, for various reasons (i.e. economics, time…) this does not happen very often. Often, only after an injury, we seek help and a quick fix for a problem that probably developed over time and many times could have been prevented. It is hard to debate that proper biomechanics (i.e. posture, body alignment…) over many years can aid in preventing injuries and issues that we often blame on getting older.
For every action, there is a reaction. A lower (lumbar) back pain may be coming from a true leg length discrepancy or a spinal alignment issue. Forefoot issues may develop from trying to compensate for knee pain and vice versa. In this article, I would like to focus on the feet as the foundation of the body. When we purchase new tires for our automobile or bicycle, we take time to make sure that we have purchased the correct size, that they have been properly inflated and aligned. This is one step in making sure that our car performs better with fewer hassles (i.e. breakdowns) down the road.
Why should it be any different with our bodies? As athletes, we put many stresses on our bodies and want our body to perform without injuries. Therefore, just like our car and its tires, the alignment of our entire body (i.e. knees, hips, lower back…) starts with our feet. They truly are the foundation.
A biomechanist, Douglas Stewart, Ph.D., made this analogy. The foot/ankle structure is like a stack of bricks. If the bricks are neatly stacked one on top of the other, without added effort they will stay there forever. On the other hand, if they are offset, you must hold them up to prevent further leaning. If one has to do this with their body, the supporting structures (muscles/ligaments) become fatigued. This allows even further leaning or lengthening. Therefore, when the plantar fascia (sole of the foot) is excessively long (i.e. excessive pronation), the foot drops and the supporting structures (i.e. plantar fascia) become overworked, tight and sore (i.e. plantar fasciitis, heel spur syndrome…).
From a physics standpoint, it is obvious and evident that it is easier to maintain an erect posture than it is to become erect after becoming offset. The same applies to our feet. Why wait until the problem arises. Preventative care is a lot easier and less painful than rehabilitative care, especially in athletics. Without going much further into physics and anatomy, simply put, an efficient runner is an effective runner. In order to be efficient, your body should work at its optimum levels and thus, not be overworked. You will perform better and feel better at the same time. You will have fewer injuries and be able to enjoy a much longer running life.
A conservative approach for proper lower extremity biomechanics is to first look at the equipment used while running. Running shoes, socks, footbeds or custom foot orthotics are just some of the main equipment that needs to be properly evaluated. Shoe types and styles as well as advances in sock technology are extremely important. Seek the advice of a professional to properly inform you on these materials. (We’ll leave this discussion for a future equipment article.)
As we age, our body changes. The shoe size you wore twenty years ago may not be the same size you wear now. Therefore, make sure that you are properly measured and fit for your shoes by an educated professional every time you make a purchase. Be careful, what you might think is a bargain today, might end up costing you tomorrow. Many injuries can be prevented if people take the time to be properly fit by a trained professional.
At last, foot beds or foot orthotics. Do you need them? If made properly for you and your sport, why would you not want to be proactive and give the foundation of your body the proper alignment, support and shock absorption available? A lot of people ask us why their shoes alone are not sufficient. Custom foot orthotics customize your shoes to your feet and body alignment. When a triathlete purchases a bike, he/she has that bike tweaked to his/her body alignment. Why should your feet be any different?
Professional plantar surface mapping and comprehensive, before and after, gait analyses by trained professionals are crucial to the success or failure of these customized devices. Also, there are many new materials that are made to help alleviate the pounding effects and the temperature and moisture changes that runners put their feet through.
Once again, it is paramount to be evaluated and fit by experienced, educated professionals. Don’t be fooled by gimmicks! As we age, we can age gracefully and enjoy our sport for a long time (injury free). We will purchase many cars in our lifetime, but we only have one body. That body deserves the best treatment. Don’t treat your car better than your body.