Imagine you got involved in a very tough weight training session and unfortunately during this gruelling workout, you used bad lifting techniques!
The exercised muscles could become quite painful, if not actually injured! Again, imagine that in this tough exercise session you performed 2,500 repetitions on each side of your body with 11 to 13 kilogram weights!
Don’t be silly you say! Impossible you say? Not at all actually; as you’ve just described the technical loading of muscular work performed by your body in a reasonably ‘average’ day’s walking!
With every step taken, the weight of each leg, (which is equal to 15% of your bodyweight), must be lifted to move it forward. To perform this feat, we must use the muscles that originate directly from the lower portion of our spine. When this lift is performed incorrectly over a long period of time, the resulting stress can destroy even the strongest lower back.
Since this happens very gradually, one step at a time, damage occurs so subtly that those who experience chronic lower-back pain never think of improper walking as the real culprit. This process of subtle destruction is technically known as ‘sub clinical damage’ or ‘micro trauma’ and its result drains in the region of £6 billion pounds per year from the UK economy, because of sickness leave and medical treatments
A fairly recent approach to understanding stress on the spine in relation to exactly how we walk, appears to be reasonably close to providing a reasonable remedy for this troubling problem. With each step we take, we move forward over the leg that supports us. As the opposite limb swings forward from behind us, the toe joints in the weight bearing foot must bend freely so we can continue our walking. This swinging and bending sequence flows smoothly and the support limb moves out from under the torso. The technical term for this motion is called ‘extension’.
From this extended position, the limb can move forward again to begin the next swing action. To add sufficient power to this, a group of lower back muscles known as the ‘iliopsoas complex’ then take up the load and assist this forward swinging motion. Since each leg is fairly heavy, the precise position and motion of the limb about to be lifted is absolutely vital. If it fails to move into the proper location from which it is to begin swinging, then those assisting muscles in the lower back are significantly overworked!
The bending action of the foot’s toe joints is so crucial in this series of motions, that any malfunction in them can seriously affect the supporting limb’s ability to extend properly and cause the entire connected system to slowly break down. ‘Functional Hallux Limitus’ (FHL) is the discovery that describes this form of temporary malfunction in the normal flexibility of toe joints.
A very simple test can determine whether or not you personally have FHL. Stand barefoot in front of a partner with your bodyweight evenly distributed on both feet. Now have your partner attempt to lift your big toe! The toe should put up some resistance, but it should also bend considerably.
With this bending, you should notice the arch of that foot actually rise. This reaction is normal. If however, your partner’s attempt to raise your big toe meets with significant resistance, then you may well have FHL. While in itself this is not a problem, other areas of your body, such as the knees, lower back, neck, shoulders and in some cases, the jaw, may be painful. Each of these sore locations may be a site of compensatory/referred muscular overuse. Chronic pain in any one of these places should be viewed as a signal to check out your walk, so a call to your podiatrist or a health professional (who has the appropriate analysis skills) may prove positive and constructive
The hallux (the medical term for the big toe) becomes temporarily locked at its joint with the ball of the foot and what renders this FHL state so very unusual, is that this locking situation occurs only when the joint is momentarily supporting the bodyweight.
This painless locking at the foot end causes an adjustment to the normal sequence of motion in the upper portion of the limb and with this positional change, the lower back muscles are then repeatedly stressed, eventually developing into a chronically painful condition. This type of lower back pain generally develops when an otherwise perfectly healthy person hurts their back lifting improperly, falling, or simply just reaching awkwardly for something.
If they have FHL, any slightly inefficient style of walking, whilst normally is not enough to cause a problem on its own, will now directly aggravate any other injury sustained and each step taken then acts to constantly traumatise the damaged location. When this is repeated to the grand tune of 2,500 times on each side every day, you can then fully appreciate how what started as a small and easily repairable injury, can sometimes develop into a chronic dilemma!
Correcting significant degrees of FHL can be relatively simple and foot orthotics, which are devices that enhance the ability of the foot to function correctly, can sometimes be of great assistance in this area, although because we are all unique individuals, each case should be viewed on it’s own merits. The more knowledgeable we become about how we function, the better equipped we are to help ourselves, so heightening our everyday awareness will dramatically increase our potential ability to withstand and avoid chronic lower-back pain much more successfully in the future.
