Feet and Posture

Role of feet on Posture

Ankle pain, knee pain and foot pain are very common and seen in almost all people walking. Pain in these areas can be caused by a number of conditions including direct injuries but is it?

Most people do not look past the area of pain in order to get to the root of the problem. You have to ask, is your knee pain really a knee problem? Or is it something else? More often than not, you don’t actually have a knee, foot or ankle problem!

Poor posture affects the body as a whole, which is not always apparent to an untrained eye. We develop poor posture primarily as a result of our poor lifestyle. Now you may think that you are active and go to the gym several times a week so your lifestyle is that of an active person. The truth is that most of the day, you are behind a desk or doing a repetitive task. THEN you go to the gym (maybe). The impact of the posture at your work, for example, required cannot be disregarded. Next time you experience knee pain, foot pain or ankle pain evaluate your posture. Are you developing or falling back into bad habits? Or perhaps your posture has been incorrect for some time now? There are many things that can be done to not only alleviate the pain but correct the cause of the problem!

How can back problems cause knee or foot pain?

Problems originating from the hip or back will impact the structures above and below and that is a fact while the time varies. For example, a weak Psoas muscle will lead to a decrease in hip flexion so every time you walk, which requires the hips to flex to lift the foot up to take a step will do the minimal task, why? Because they are tired and weak. Now the feet have to flex and extend more than they are designed to do normally to accommodate what the hips are not doing to clear the feet for every step taken. This means that now the ankle stabilizers have to do more than the stabilization!! The extra work makes them tired since they are pulling double duty. The end result is the collapsed arch. Now you are walking with the bottom of the feet being too close or ON the ground which irritates that part of your feet which is called Plantar Fasciitis. The solution to many is Cortison shots, orthotics and not walking or being active because it hurts. I know so many people who walk in to my practice depressed because they don’t run anymore or they hardly do any of the activities they enjoyed doing (including going to places with their family members) because their feet hurt. As you see, addressing the feet is hardly the solution because the SOURCE of the foot problem was in the hip. 

Many times, the hurt foot leads to a shifted posture which in turn causes a back problem. The involved foot feels better because you are not walking on it but now there is lower back pain. Accommodating the back pain requires walking on both feet clearly which then creates the foot problem all over again. The tag game goes on and on and you wonder if you will ever feel normal again!! So discouraging and so annoying. So many patients I see have tried so injections, a variety of shoes, shoe inserts, seen podiatrists, physical therapists, orthopedists and of course, their general practitioner but still with the same problem. As this improper posture manifests, specific areas begin to fail, resulting in pain and of course, depending on the area of pain, see the related ‘specialist’.


Correcting the poor posture or inadequacies begins with realigning your spine with adjustment not because that is going to do the magic!! Adjustment simply stimulates the nervous system- sort of like when a teacher comes to the class and tells the students to listen up! The kids sit up straight and start paying attention. If nothing happens, they go about to the old way of sitting and not paying attention. That means what comes after the adjustment is very important. This is when we have the ‘eye’ of the brain and nervous system. This is when the beginning of the correction and the removal of the cause of the problem starts.


The first step in correction is bringing back the proper breathing pattern. Yes, breathing pattern!! This is an absolute requirement to build over the foundation; this is how we all started at birth and during infancy and before we started building muscles, move joints and start moving. At my practice, strengthening does not necessarily consist of lifting weights. Strengthening with good form and using the correct muscles while going through movements is the focus and can be achieved by holding a specific pose PROPERLY. These poses are very challenging because of their specificity and work to not only correct the posture but to maintain the great posture thereon.

Movement is a concert and a concert does not take place without an Orchestra leader. The orchestra leader is your brain and it is fully able to do what it is designed to do- control every function within your body, including the proper posture and movement. With that said, if it responds to what it is exposed to. This is called Neuroplasticity which means if it is exposed to something negative, a negative movement pattern due to an injury or lifestyle of sitting for instance, it reacts negatively. With brain-based neurology and posture exam, the map of the weak parts of the brain with regards to holding the proper posture is determined; now with appropriate activation, the weak becomes strong and the proper posture is attained. Next time you have to tell yourself to sit up straight, to roll your shoulders back, to not stick your back out, etc. think of your brain and how when IT tells your body, the proper posture and movement is restored.

Pain and pathological movement?

To put it simply, your brain wants you to have the most pleasant day given what you throw at it and also for you to live a long life; it will do what it must to make it so that life is more pleasant. In the presence of pain, we will unknowingly change the way we walk in order to protect the area causing pain.

When we have ankle pain, for example, we walk with a limp to accommodate the pain we feel. This is referred to as an ‘Antalgic Gait’. This is seen in those who have undergone a variety of injuries and very common with knee injuries. To avoid bending the knee, the person dramatically may lean to the opposite side and swing the extending leg forward, rather than experience the pain of bending the knee while walking. Getting physical therapy for the knee may help the knee but has nothing to do with the Antalgic Gait that the person resumed for the given length of time. This ‘pathological pattern of movement’ becomes the ‘normal’ movement pattern which in turn leads to more decline in movement and posture.

Unfortunately once the injury is healed, the posture does not always automatically go back to normal because the brain was activated based on the new need. The pain will be gone, but the poor posture stays, leading to new problems down the road. This is why it is important when rehabbing an injury to make sure that maintaining adequate posture throughout the healing process is a part of that treatment plan.

How to fix flat feet?

Someone who has a flat feet problem, also known as fallen arches, lacks the medial or inside arch that most people naturally have and in most cases is NOT hereditary. This will result in walking on the inside of the foot which can then lead to knee problems and furthermore to hip and back problems.

Having flat foot is actually not a foot problem necessarily! Fallen arches are primarily caused by a strength deficiency in the Anterior Tibialis which attaches directly underneath the medial arch. When this muscle weakens due to a direct injury or decrease in strength of the Hip Flexors, the tendon becomes weak and no longer supports the arch. The ‘fallen arch’ causes pain overtime and definitely affects posture when walking or with movement. The good news is, there is a fix.

Getting a foot scan is a great way to identify functional imbalances. Some foot scanners not only scan for weight distribution but can also identify hip inequality and overall postural misalignment. I am personally not a huge fan of foot orthotics and certainly don’t look at them as a solution but a supportive instrument while working on strengthening the very muscles whose weakness lead to the issue.

In order to get to the root of the issue there are some specific fallen arches exercises that can be performed to strengthen the right leg muscles in order to lift the medial arch. 

Will correcting posture help with the pain?

When it comes to musculoskeletal (muscles, bones and joints) pain focusing on only the area of pain, may alleviate pain, but will not fix the problem. Taking the whole body and movement into account helps to ensure that the pain does not come back. Correcting the posture is much more than remembering to sit up straight. Brain Based Neurology and Posture exam is reversed engineering the process to the source and the allows focus on the true solution and putting an end to pain, discomfort, and propensity for injuries to name a few.

Dr. Shakib