Free your Feet!!

I love feet. And not because I have some kind of foot fetish. Well ok, maybe a little! But my “fetish” is purely clinical: I am truly mind blown by what I consider one of the most marvelously-built parts of the human body. Yet, for some reason they are often maligned. They are called ugly, and are taken for regular pedicures to make them look acceptable. They are called weak, and are supported with arch supports, soft soles or shoes with the latest technology.

Feet don’t just exist to take us from Point A to Point B. They are also inherently linked to the pelvic floor, and thus our pelvic health. Keep reading to learn more about this connection.

Let’s first learn about the intricate beauty that our feet possess:

They aren’t the rigid block they are often treated as, but host 28 bones, 33 joints, and over 100 muscles & ligaments!! All these structures come together to give them flexibility, strength, and resilience to keep this exquisite machinery running!

We all know about the arch in the foot, but how many of you know that there are not one but two arches in the foot?

The longitudinal arch: Runs from the heel to the big toe and helps in transmitting the weight from the back of the foot (heel) to the front (toes). It also acts as a shock absorber to shield the impact of running/walking/jumping etc.
The transverse arch: Spans across the ball of the foot from the 1st to the 5th toe.⁣ This acts like a springboard for the toes to push from. But that is not all it does – it also helps distribute our weight evenly.

In summary, these arches provide rigidity/stability to our feet, which is critical to bearing our body weight and propelling our bodies forward for locomotion. But this is not all they do! They also provide the flexibility we need by acting both as springs (storing and releasing energy that further helps locomotion) and as shock absorbers (absorbing the shock from the impact of our feet with the ground).

Now, let’s talk about why you might still be reading this post: What is the connection between your feet and your pelvic floor? Why do I often tell my patients to take good care of their feet in order to keep their pelvic floors happy? And by “care”, I don’t just mean weekly spas and pedicures (though those are great as well!) but actually making sure that your feet are getting the nourishment they need from the strengthening and flexibility exercises.

Let’s look at a few interesting facts about why you need to take special care of your feet, especially if you are someone with pelvic floor dysfunction:

GPS coordinates of the foot and our genitals are right next to each other on the ‘Somato-sensory Homunculus’. For the uninitiated, Somato-sensory Homunculus is the part of the brain that receives sensory information from different parts of the body, with the feet and genitals sitting right next to each other on it. So, it’s hardly surprising that these two regions talk to each other. It’s like accidentally receiving mail that belongs to your neighbor - the issues in the feet can be felt on the pelvic floor, and vice-versa. I often find overactivity in the pelvic floors of people with chronic ankle instability (multiple ankle sprains).

Both of these regions are also supplied by nerves with overlapping nerve roots (origins) from the spinal cord. The pelvic floor is supplied by the S2, S3, and S4 nerve roots, whereas the feet are supplied by L4, L5, S1, S2, S3, and S4. This makes them prone to cross-talk.
Both the pelvic floor and the feet function as shock absorbers during walking/running/jumping. Therefore, if the feet don’t do their job well, the pelvic floor may have to work extra hard, and can get overactive as a result. A study showed a statistically significant association between decreased foot flexibility and urinary incontinence.

A recent study also showed that the ankle position influences pelvic floor strength – whereas dorsiflexion positively influences strength, the plantar flexion influences it negatively. Attention high-heel wearers: you may experience low resting tone (reduced strength) in the front of the pelvic floor that supports the urethra, and as a result, you may be at a higher risk of urinary leakage, especially if you already have stress incontinence.

⁣Majority of my patients tell me that they were told that they have flat feet, and they have used everything from arch supports to the best shoes in the market, but I often wonder how different their experiences would have been had they been told to train their feet just like any other body part.

The problem is usually not the flatness of the foot as many people claim, but rather poor flexibility and strength in the small joints and the muscles of the foot… how many did we say? 33 joints and over a 100 muscles & ligaments!! This issue becomes even worse as we provide them with more and more support in the form of arch supports etc., and never bother to train them with the right combination of strength and flexibility workouts.

I’m curious: when exactly did we decide to be so overly protective of the one body part that’s supposed to do all our dirty work? When did our feet go from being probably the strongest part of our bodies in our hunter-gatherer days, to such small and rigid parts that can barely support the weight of a fully-grown human today? And why would we want to cage this beautiful creation from a very early age? Evolution developed the arch by walking barefoot and now we need arch supports to protect them? how did we regress this far?⁣⁣

I appeal to all of you to be kind to your feet… they don’t need to be pampered with a pedicure or new shoes as much as they simply need to touch the ground. Free ‘em! 😇⁣

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