One of the most missed areas to look at when it comes to the treatment of pelvic floor dysfunction is the feet. On the flip side, everyone with a decreased range of motion and dysfunctional movement in the feet is highly prone to pelvic floor dysfunction. This blog is about exploring the relationship between the two and what you should do about it.
The Fundamental Role of Feet
Our feet are a diaphragm of a kind! They are the point of transition and our contact with the Earth. They have to somehow balance the weight above and do so when walking and beyond! Think about how your whole weight has to be balanced on only one leg with each step. How crucial its job is and how when not functioning correctly the fate of everything above is compromised. For the purpose of this blog, I will explore the connection between the feet and the pelvis and its role in pelvic floor dysfunction.
The Significance of Posture
Posture is the alignment of our body while stationary or in motion. It is a reflection of how functional/dysfunctional we move, we support ourselves, and we breathe. Most often I see people ‘faking’ a good posture by sticking their chest out or bending their knees to ‘stack’ their body above the knees better. Oftentimes, people support their torso above the pelvis by pulling their neck back beyond what is should be as if the neck is responsible for the whole area to be positioned right.
Your posture is a reflection of how healthy you are because when failed, even your internal organs are compressed and nothing in your body likes to be compressed.
Anatomy of the Pelvis
I have done a whole blog on the anatomy of the pelvis and pelvic floor that I suggest you read. The pelvic floor is not independent of the rest of the pelvis and consists of muscles and connective tissues that form a supportive structure similar to a hammock within the pelvic region. It will always be involved every time the pelvis, the house where the pelvic floor is the floor of, is unstable.
There are conditions affecting the connective tissue involving all of our joints and therefore whole posture such as:
- Ehlers Danlos Syndrome (EDS)
- Hypermobility
- Hypermobility Spectrum Disorder (HSD)
- Mast Cell Activation Syndrome (MSAS)
You don’t have to have these conditions, however, to have an unstable pelvis and pelvic floor dysfunction.
Our feet, when effectively aligned and supported, serve as the linchpin to maintaining an upright posture. In instances where the feet are misaligned or lack proper support, the body compensates through postural adjustments. Which may ultimately compromise pelvic stability and strain the pelvic floor muscles. Following are a few scenarios to explore:
Collapsed Arch & Flat Feet
The absence of the natural arch of the foot results in inadequate support and postural misalignment. Which forces the body to compensate through forward or backward tilting. This creates undue stress on the pelvis and pelvic floor that can show up in many forms. You will find the subtle signs of pelvic floor dysfunction in my previously written blog.
High Heels and Constrictive Footwear
You guessed it! High heels cause a forward pelvic tilt, pelvic instability, and undue stress on the pelvic floor. It boils down to what is more important comfort or dysfunction! Tight shoes cause weakness of the tendons going to the toes which can cause hammertoe and bunion!
Pronation and Supination
These irregularities in foot mechanics compromise pelvic stability and create issues above. Ankle movements come from the muscles of the leg and toe movements come from the muscles of the feet. When the arches of the feet are compromised, we need to look at the muscles of the legs AND feet!
Focusing on specific muscles, stretching and strengthening them is NOT the way to do it! The best rehab is incorporating the whole body in the exercise. The exercise method I use with my patients is Dynamic Neuromuscular Stabilization or DNS. I suggest you look into it.
How to Start Improvement in the Feet
Reminding you of the fact that you should not focus on your feet and think the rest will come! It is like making a big meal: you start with one thing and attend to the other things and at some point, everything thing is started and nothing is fully cooked. This is a process and not an event so be patient and don’t give up!
Appropriate Footwear Selection
Be as barefoot as you can be to allow the muscles in your feet and ankles to have room and opportunity to play. If at home and on hard flooring, wear thicker socks and stay as barefoot as you are comfortable. Investing in shoes with support is a good one and my favorite types of athletic shoes are Asics. I am not affiliated with them but truly love their shoes.
Be Aware of Your Posture
There is only a small percentage of your posture that is a decision you make and the rest is what the brain tells your body to do based on what you throw at it. I STRONGLY suggest you join over 90K followers of mine on Instagram to learn more about how to do this on your own if possible. Maintaining a conscious and upright posture should be an overarching objective.
Incorporating Exercise and Rehabilitation
Incorporating exercises aimed at enhancing foot and posture is the key but which ones? I am fully against isolating an area to strengthen or to stretch and can only suggest DNS or Dynamic Neuromuscular Stabilization. Here is a video explaining that:
Who Treats Feet and Pelvic Floor Dysfunction?
Foot-related issues involve a podiatrist and I have not seen any podiatrist that is versed in the realm of pelvic floor dysfunction. If you find one, make sure you seek their care and advice.
Frankly, when it comes to the world of pelvic floor dysfunction, most clinicians treating the condition do internal manual work and hardly ever address the posture. My suggestion is to seek care of a clinician who treats pelvic floor dysfunction and uses DNS so you are treated holistically.
It is so important to not complicate simple matters and to simplify more complex issues. The relationship between the feet and pelvic floor dysfunction is a complex one and the solution is a process and not an event. If you have pelvic floor dysfunction but are not happy with the results of your treatment or you suspect you have pelvic floor dysfunction, contact me.
Dr. Shakib
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