Two Feet or Not Two Feet; With Back Pain,
That Is the Question

By

Victoria L. Magown, CMTPT, LMT and George S. Pellegrino, LMT, CMTPT

Most people with back pain can recall the incident when their injury occurred.  They were either bent over and picking up something heavy, slipped and fell or had some other obvious mishap.  For others, back pain seemed to come on gradually over many years.  For these people, age appears to be the culprit.

Although time is involved, age has nothing to do with it.  For some of us, various foot structures place demands on our muscles causing them to become overloaded or work inappropriately.  Over time, the muscles involved will become shortened or contracted and this will make them painful.

When muscles are contracted over a long period of time, they place abnormal stress on our joints.  In time, our joints tend to become irritated.  The body reacts to this irritation in the joints with inflammation.  Joint inflammation, in the advanced stages is called arthritis.  “Arthro” is the Latin word for joint combined with “itis”, Latin for inflammation.

In the early stage of this process, massage to unwind our muscles or postural repatterning will produce relief that is often, at best, temporary.  Joint manipulation will also produce results but, when this too fails to give permanent relief, it is a good indication that only the symptoms are being addressed. The root cause has been overlooked.

For example: Darlene, a 15 year old high school tennis star suffered multiple ankle sprains with complaints of intermittent knee, hip and low back pain.  When she came to MyoRehab, she had just invested in expensive orthotics and had to tape her right ankle whenever she played tennis. This provided partial resolution but, pain was interfering with her performance.

After evaluating her, Myofascial Trigger Points were located in the muscles of her low back, hips, thighs and calves.  A Myofascial Trigger Point is a hypersensitive spot in a muscle that when stimulated, produces pain that is referred in a predictable pattern away form the Trigger Point. During our evaluation, we found the root cause of Darlene’s pain.  She had a common foot configuration, Morton’s Foot Structure.  This is often referred to as Long Second Toe or Short First Toe.  (Illustration A)

People with this foot configuration (40% of the population has Morton’s Foot Structure) are often plagued with foot calluses, frequent ankle sprains, and knee and/or hip pain. They can also develop a neuroma (painful nerve damage) between the second and third or third and fourth toes. Darlene had the callus configuration shown in illustration B. She thought the calluses were the result of her sports activity. In fact, this configuration can be found on anyone with this foot structure.

Combined with the Myofascial Trigger Point Therapy Treatment Protocol for her pain, special insoles were fitted into her shoes to produce proper motion of her feet and eliminate both the pain and its cause.

People with Morton’s Foot Structure walk on their heel and the base of the second toe; that is, on only two points of the foot.  Walking on three points with the heel and the base of the first and fifth toes provides much more stability.  With Morton’s Foot Structure, the rocking motion of the foot caused by walking on two points is like walking on a “knife edge”. This instability overloads the leg, hip and low back muscles in their attempt to stabilize the ankles and feet when walking.

Paula, a 53 year old woman, had a double bunionectomy and removal of a painful neuroma from between her second and third toes of the right foot.  She was suffering from ongoing left low back and hip pain for as long as she could remember.    Even after the surgery, she continued to experience pain in the right foot that caused her to walk with a limp, putting more weight on the left. This continued to perpetuate her left hip and low back pain. Once again, our evaluation revealed the root cause, Morton’s Foot Structure.

In both of these cases, these women suffered muscle pain from the same root cause.  In Darlene’s case, Myofascial Trigger Point Therapy together with special insoles resolved all of her pain.  In Paula’s case, several years of stress on the joints of her feet, ankles and knees produced irritation and inflammation.  Myofascial Trigger Point Therapy and the insoles took the stress off the joints and, over time, will allow them to heal.

Two feet or not two feet, with back pain, this is the question one needs to ask!  Are there two feet in your life at the root of your pain? Give us a call at MyoRehab.