The pelvis is one of the commonly problematic areas to experience musculoskeletal pain and inefficiency with movement. This often manifests as pain in the lumbar spine, sacroiliac joint, or the posterior hip capsule and musculature. These issues are incredibly common, and there is good reason for that. Anatomically, the lumbopelvic area is a crossroads for many different muscles, kinetic chains, and important bony structures.
Assessments are meant to give us an idea of what is not functioning optimally, what is comprising said function, and how we can get a big picture idea of how those pieces fit together in order to create a corrective and preventative strategy to restore function and optimize movement.
Many of us are at least partially familiar with the idea of being right brain or left brain dominant. To what extent we identify with our left brain or right brain is shaped by our genetics as well as our environment. It is also important to note that while we may be dominant in one, we are always utilizing aspects of both in our processing and decision making…..When and how we tap into our thinking, reasoning, and logic-based brain versus our feeling, sensing, intuitive brain is a balancing act; it is an art. Having the ability to tap into both is incredibly valuable in fostering our ability to operate functionally and with purpose in the world.
For most of us, the ability to adequately use our hips leaves a lot left to be desired, and unfortunately a lack of adequate movement in the hip joint can be a precursor to lower back pain, knee pain, and increased susceptibility to injury, particularly during athletic endeavors.
Outside of the lower back, the knee is one of the most common areas of the body we experience injuries and chronic pain. For professional athletes, more games are missed and money lost on knee injuries than almost any other type of injury. For recreational movers like you and I, it is just as common for knee issues to prevent us from staying on top of our fitness and physical activities…
In this next installment of our foot series, we are going to be taking a look at the anatomy of the ankle, the biomechanics of the ankle with particular emphasis on the talus and rearfoot tripod (yes, we have another tripod in the foot!), and the role these structures play in our ability to supinate, pronate, and ultimately integrate our feet with the rest of the body.
Anatomy of the Ankle
First, let’s review the anatomy of the ankle. The ankle is comprised of two primary joints, the subtalar joint and the talocrural joint. Just briefly watch a few seconds of the video below to get a visual of the structures involved.
What is important to notice when it comes to these two joints is that they have one key component in common: the talus. The talus is a very unique bone in the body in that it has no muscular attachments, and because of this, it provides a very specific type of proprioceptive feedback to the rest of the body. The talus serves as a gyroscope of sorts. Check this out:
Pretty crazy right? What this means is that ankle function is of utmost importance. If our talus is malpositioned or unstable, it will adversely affect how muscles not only in the lower extremity, but throughout the entire body function. In order to restore and maintain optimal position and movement of the talus, we need to make sure to have adequate control through the pronation-supination continuum. We need to ensure that not only do the talocrural and subtalar joints of the ankle function well, but also ensure that the midfoot integrates with the ankle as well.
The Second [Less Often Talked About] Foot Tripod
In a previous article [CLICK HERE], we went over the forefoot tripod, and the role it plays in foot function. What we didn’t talk about is that there is technically another tripod within the foot. The two are intrinsically linked together. The three points in the rearfoot tripod are the:
If you read the previous foot tripod article, you might remember that we briefly talked about the importance of these joints and how to mobilize them. The ability to respond to load in these joints has a drastic effect on the talus and vice versa. Because we know the talus has large-scale effects on proprioceptive input and neuromuscular control, maintaining optimal foot function must involve the integration of the forefoot tripod, rearfoot tripod, and ankle joints. This is what will ultimately allow for the fluid control of pronation and supination in the foot and ankle.
Supination vs Pronation
When we are talking about pronation and supination, we mostly associate these joint motions with walking gait. Pronation and supination allow the foot to have the dynamic stability required for shock absorption, as well as allow for the storing and releasing of kinetic energy through the lower extremities. The feet are highly involved in the Deep Longitudinal, Lateral, Anterior and Posterior Spiral kinetic chains. It at all starts with the feet.
One simple way to think about supination is to liken it to inversion, or simply the foot pointing down-and-in. We mostly utilize the foot in a supinated position in gait when we are pushing off and extending through the hips. Pronation is simply the opposite; liken it to eversion, or the foot turning out and up.
Our conversation around ankle mobility is most often centered around the idea of restoring dorsiflexion, which is primarily motion happening at the talocrural joint. Adequate ankle dorsiflexion is an important component for deep squats and activities like olympic lifting. However, as important as talocrural joint-focused ankle mobility is, we need to also appreciate the importance of subtalar joint function. I don’t think we talk enough about the rotational and lateral motions that also occur at the ankle when it comes to performance.
Chronic instability or lack of mobility in the subtalar joint will often lead to issues like knee pain and hip immobility. This has implications with almost any athletic endeavor.
In the case of the feet and ankles, my clinical experience has shown me that no matter what type of athlete you are, whether you are a weightlifter or runner, skier or cyclist, crossfitter or yogi, the feet and ankles are almost always in need of improvement. We usually get drastic improvements in strength, flexibility, power and overall athletic performance when we restore and maintain optimal foot and ankle function.
Integrating the Feet & Ankles
My usual approach foot and ankle integration is focused on simplicity. What will give us the most bang for our buck with our self-administered corrective protocols?
Focusing on restoring mobility in the requisite joints, and make sure that those joints have the ability to appropriately respond to load is a good place to start. I showed you a few drills in my Foot Tripod article that focused on three key joints of the foot tripod; here they are again in case you missed them:
Typically, if the joints feel stiff and achy while performing these drills, chances are that they need improvement. Doing them regularly and prior to any lower body training days will help to slowly progress the function of the joints over time.
Once we’ve mobilized the foot, the next step is to focus on integrating the foot and ankle with the knee, hip, and spine. There are many ways to do this depending on what your training goals are. However, I am of the opinion that the absolute best way to integrate the feet with the rest of the body is incredibly simple. The magic exercise that makes this happen that almost everyone needs to do more of is…..
Yes, you read that right. Walking is one of the most under-appreciated and under-utilized forms of exercise out there. Granted, not everyone’s gait pattern is a thing of beauty, but even then I recommend more walking for improved overall function. More minimal the footwear the better. Chances are high that if we ensure the feet and ankles are functioning well, and we then integrate our feet and ankles with our walking gait through copious amounts of walking, we will be well on our way to functioning and feeling a lot better. Sometimes it is that simple.
In order to further help integrate your walking gait, here are a handful of drills that can also help:
Rolling Patterns: Sequential rotation of the legs, hips, spine, and shoulders is incredibly important for walking gait. One of the primary problems that shows up in gait is a lack of rotation happening through the hips and thoracic spine. Rolling patterns are a great way to work on improving sequential rotation throughout the body, particularly because we can do so without loading the joints which helps to minimize compensation. I consider this to be a regression of walking. This drills does not allow you to use your large prime mover type muscles like your quads, lats, hamstrings, etc. and so you are forced to use your deeper stabilizing muscles predominantly.
Slow Gait Walking: With any exercise, one way to really make sure you are owning it and able to do it properly is by slowing it down. Slowing things down forces you to recognize and work through suboptimal compensation strategies. Performing a skill more slowly forces you own each phase or aspect of that skill.
By that logic, walking incredibly slowly will make it apparent to you where you might need to improve stability, or joint response, or load capacity. By slowing down, you can pay more attention to the areas that need improvement, and then incorporate additional drills that can improve upon and reintegrate the pieces that are not functioning optimally.
If rolling patterns and slow, gait-mechanics-focused walking are feeling good, go walk! Walk your dog! Walk to work! Walk a handful of miles a week at least. It’s one the simplest and most effective ways of improving overall biomechanical function.
The feet and ankles are one the most important key areas in the body when it comes to restoring and maintaining full-body biomechanical efficiency and movement capacity. The more efficiently we move and larger capacity we have for good movement, the smaller our chances are in regards to sustaining injuries, struggling with chronic pain, and greater our overall performance.
Hopefully this article gave you guys some good insights and understanding as well as some useful tools to help facilitate better function in your feet and ankles! Stay tuned, we’re just getting started. Over the coming weeks and months, I will be continuing to write articles like this going through every area of the body.
When I work with clients, the feet are an area I am always paying attention to. Some of the most common dysfunctions and symptomatic presentations throughout the body often involve compromised function of the feet. If you think about how often we use our feet when we move, most of the time we are on our feet….
Even though muscle function and movement are ultimately determined by the outputs of the nervous system, understanding the components of the human machine and how things work together biomechanically is still important.
Clients come to me for a variety of reasons, but by and large, they mostly show up at my clinic for two primary reasons. They either want help resolving their pain, or they want help improving their ability to perform better. Whether or not we are working to address and resolve pain, working to improve movement capacity and functional strength, or working toward building more mental and emotional resiliency, our ultimate goal is to become a better, stronger, wiser, more self-actualized version of ourselves…
Hey y’al, in case you missed Part 1, click here. Bringing it full circle here.
Movement Restored: How Exercise & Training Helped Me Find My Path
Fast forward to college. At this point I had now dealt with my fair share of lower back and shoulder issues throughout high school, and my sense of wanting to play basketball regularly waned because of this. Past injuries and a lack of confidence in my body in conjunction with my still-present lack of identity when it came to being a gaming nerd or an athlete, really played into my hesitation of committing to playing sports or partaking in recreational fitness activities.
When I started my first semester of college, I didn’t really know what I wanted to do (and honestly, what 18 year old does?). I initially decided that I wanted to declare psychology as my major. Growing up, I had always been particularly good at connecting with people deeply at an individual level, despite my lack of ability to connect with larger groups or be one of the popular kids. I always felt that I was a good shoulder to cry on. A good listener. I have always been a deeply introspective and curious person, wanting to both understand and provide help when it came to helping friends with stresses or emotions they were dealing with. Someone who could provide solace and sound advice to those needing it. I figured hey, clinical psychologist, I could do that, and I might really enjoy it. Well, my undergrad classes quickly allowed me to realize that this was not my calling, at least not at this stage of my life. My own lack of self-awareness and understanding of myself made me realize that I was not ready, nor did I have the capacity at least at that stage of my life to be a therapist. It simply did not feel right.
I decided to look at my passion for movement and working out, which had really taken off my freshman year of college. Lifting weights really gave me something to rely on as I navigated my way through a new and overwhelmingly large environment. It served me in a way that allowed me to build self-confidence. To avoid my social anxiety and ineptitude, my perceived inability to make friends, my lack of self confidence and insecurity about my body, and the fact that I’d never had much luck with girls at that point. I was so afraid of trying alcohol or weed in order to socialize to be comfortable around people. I grew up in a conservative Christian bubble, and it severely impaired my confidence and social skills in many ways, despite the great education I received.
Weightlifting became my safe haven. It became my way for building up confidence in myself. I was starting to look better. I was able to handle myself better and better in the gym. I started getting more attention from girls. My friends started to want to workout with me as their guide. I still occasionally l dealt with my lingering shoulder instability from the multiple dislocations and subluxations over the years, but perseverance really paid off. As my body began to feel better, and my injury history seemed to hinder me less and less, I rediscovered my love for playing basketball.
Ultimately, strength training set in motion my path to self discovery and finding my true self. To finding out who I was and what made me tick. Getting stronger and more confident in one arena of my life really allowed me to start branching out and strengthening myself in other ways beyond just the physical. I am still on that journey to this day. Movement and training is a big part of how I first began a deep and spiritual relationship with myself. Ultimately, strength training gave me an outlet to discover myself, heal my pain, and restore confidence in who I wanted to be in the world.
After I graduated college with my degree in kinesiology, I knew I wanted to utilize training as a tool to help guide other people on their own journey to personal growth and self-discovery. Originally, my plan was to go to physical therapy school, but that was financially unfeasible. Looking back now, I’m glad I didn’t, because most of what can be learned in traditional educational settings, at least in the physical therapy realm, can be learned just as well if not better through independent study.
Throughout this process, I have learned that self-confidence and self-love are the backbone to being able to thrive in the world. We are constantly bombarded with fear. Fear of our health. Fear of dying. Fear of rejection. Fear of not being able to live the lives we want to live. Fear of never living up to expectations (others’ or our own). Fear of failure. There is no true way to making fear disappear. However, there are many ways to become more and more confident in our ability to handle the things that we fear. Maybe even at some point, we get to a place where our fears no longer control us at all. I believe this is an ongoing process throughout life, and for me, strength training was the jumping off point for that process for myself.
My Movement Philosophy: Love, Commitment, & The Process
The dynamic of how the health and fitness industry at large markets to us is still largely focused on catering to our insecurities, our body-image issues, our lack of confidence in the way we look, and our lack of self love and appreciation for our body. As I’ve developed a more thorough understanding of the human body (functional anatomy, biomechanics, physiology, neurology, etc.), it has become clearer to me that not everyone is a healthy 20-something that can just pick up any cookie cutter program and start getting results with it. Most of us do not have a large capacity for quality movement. We are struggling with a negative self image of how we look and what our bodies are capable of. The consequences of living a sedentary lifestyle have really started to plague modern society. More people need to restore function and restore confidence in their ability to use their body, not necessarily to focus on achieving a certain physique.
There is nothing inherently wrong about having an aesthetic purpose for training, but it should never be coming from a place of, “my body sucks,” “I hate the way I look,” or “I wish I had his/her body.” If that is your motivation for training, then it is my opinion that you probably have some soul searching to do. Figure out why you feel that having a better body, losing weight, or having more muscle, running longer distances, or lifting heavier weight is the thing that will ultimately determine your self-confidence and ability to thrive in your life.
That said, whatever the reason for training, even if initially your motivation may be coming from a more shallow, insecure place, the commitment to the process of training is just as important. As you continue to progress with your training, the commitment to the process will eventually force you to confront some of your biggest mental hurdles. You will inevitably start to hit roadblocks. With enough persistence, you will eventually come to realizations about what are causing those roadblocks. Sometimes those roadblocks are mental, sometimes they are physical. Regardless of where the roadblocks are stemming from, in owning the process of training regularly, you will learn a lot about yourself, about what motivates you, and about what your core values are. You’ll eventually discover the WHY behind your training. Everybody has those days where the energy just is not there. Your motivation to train that day might be completely vacant. It’s important to stop and think, “why am I not motivated today?” Personally, some days I love to train, and some days it’s a total drag. What determines that, and why? Committing to the process of training helps you to learn more about yourself and forces you to grow, not just physically, but mentally, emotionally, and spiritually as well.
For me personally, I have developed more and more confidence in myself in a variety of other areas in my life NOT related to the way I look, or my competence in the gym, but instead working on expanding my intellect, my ability to connect and to foster meaningful friendships, to have been in a long-term healthy and deeply fulfilling committed relationship with the love of my life, to have gained new skills and knowledge and expertise in my ability to provide good training and therapy for my clients, and to have continued to progress my career and grow my business and experience varying levels of success. Each of these things have contributed to creating a greater sense of confidence in myself and in my identity.
It is interesting in that it feels like I’ve come full circle. I’ve always been a deep thinker, an introspective type of person. I now feel like 12 years later, I finally am ready to fulfill my deeper sense of wanting being able to help others become the most strong, fully-integrated, self-actualized version of themselves, free of the fears that have been holding them back and preventing them from thriving in their lives. Movement coaching, strength training, and therapy are now my primary vehicles for helping others on this path.
I hope that this incredibly long-winded article hits home for some of you. Hopefully you all got to know me just a little better by giving this a read. My journey to find myself is starting to fully blossom just shy of age 30, and movement has been my vehicle for doing so. I have a strong conviction that strength training is for everybody. I have a passion for wanting to bring these ideas to the world. I want to help all of us shift our perspective, and to continue thriving in our lives and being driven by love and commitment to the process of finding our true selves and sharing it with the world. That is what life is all about.