How Feet Can Literally Give You A Headache

Many people will instantly recognize the old rhyme song which includes the absolute gem: "the thigh bone’s connected to the hip bone" and ... "doing the skeleton dance". If you didn't know, anatomically the song, which is called "The Skeleton Dance", is absolutely correct, but most people might not realize the significance of this and the consequences of all that inter-connectivity. 

The fact that all our bones are interconnected means that if you have problems with your feet – which may not even cause any pain – these may be reflected in pain elsewhere in the body. That's right, foot pain could lead to pain in your knees, hips, back, and even cause some painful headaches!

There’s more to walking than you might think

Because most of us do it with such ease and we don't even think about it, walking seems very simple and not something we normally even think about. But it’s actually a complex and carefully orchestrated succession of events, enabling us to move forward by passing our bodyweight over our feet. This is well summed up in the description of walking as ‘controlled falling over’ (think about this next time you take a step!).

At any one time in the gait (walking) cycle, we have one of our feet in contact with the ground and the other foot is in the air – at the end of what is called the ‘swinging leg’ motion. This leg has swung forward from behind us, to in front, of us and in this position it touches down to the ground – with the heel striking the ground first (this is called ‘heel contact’).  There then begins the process where bodyweight is transferred to this leg from the other leg, which then loses contact with the ground and becomes what is known as the swinging leg.

At the same time as the transfer of bodyweight from one leg to the other, the foot which has contacted the ground needs to flatten out to accept the bodyweight and then lift up again as we propel ourselves forward for the next step.  The foot undergoes two major manoeuvres – called pronation and supination. 

What is pronation and supination?

Pronation is essentially where the foot rolls inwards and lowers the arch, as it absorbs the shock from heel contact and accepts the transfer of bodyweight. It lasts for a fraction of a second, before supination starts.  This is where the heel rises and the foot rolls outwards, so that the front outer part of the sole is the last part to leave the ground as the next step is taken.

So how exactly can foot problems cause knee pain?

Among the most common problems or abnormalities seen in walking or running is where someone's pronation is excessive. This means that when you walk, the rolling inward of the foot is sustained for too long or perhaps at the wrong stage in the gait cycle. The problem with this is that when the foot rolls inwards it takes the big weight-bearing bone in the shin (the tibia) with it, which rotates towards the other leg. 

Are you starting to see where the 'thigh bone' song comes in now?

And one thing leads to another

Similarly if the knee is twisted inwards by excessive pronation, this will make the thigh bone (femur) rotate inwards, as it forms the other half of the knee joint.  As the femur is part of the hip joint, this can often lead to hip pain.

Because excessive pronation may occur in just one or both feet, the knee and/or hip pain it causes may be felt on one or both sides.

What’s the link between back pain and poor foot function?

As we transfer bodyweight from foot to foot as we advance, we necessarily rotate about the middle of the body, with first one hip being in front, then the other.  Our backs are covered by layers of muscles, some of which cross from one side to the other, and some extend into our buttocks (the ‘gluteal’ muscles or ‘gluts’), while others are wrapped around our hip joints.  So as our pelvis (which contains the hip joints) rotates with each step, these muscles are being pulled in different directions. If gait is not well-balanced, there may be strain on the back leading to muscular pain.

Posture also depends on our feet

Our back naturally has a gentle ‘S’ shape to it, from the base of the neck to the bottom of the spine.  

  It is not uncommon when people are given special insoles (orthotics) to correct excessive pronation they immediately feel taller when they walk with them in their shoes – this is an illusion caused by improvement in their back posture and hold their head up more. The effect of excessive pronation on posture can often cause back pain.

And so to the head

We have a very large kite-shaped muscle covering the upper part of the back, extending up the back of the neck and onto the base of the skull, called trapezius.  The distortions and imbalance that excessive pronation can cause through the skeleton and muscles of the back, can be transmitted to this muscle, causing uneven tension in it, leading to ‘tension’ headaches.  (These can also be caused by other problems such as teeth clenching and other postural problems leading to strain on the neck muscles).

What can be done about excessive pronation?

If you think this might be your problem you need to see a foot specialist (podiatrist) as they are trained in analyzing gait and treating associatedproblems.