You've got foot questions.... Rali's got answers...

If you have ever wondered questions about your feet or your clients feet like, "what do you think of bunion correctors", "is toe gripping bad", or "what type of split squat would you choose based on someone's feet", then keep reading to hear everything Rali Malcheva, (foot whisperer extraordinaire), has to say!

From Cynthia Croissant : Could it be that feet are really suck and it impacts how that feels?

Often when the feet get really stuck and they are not moving very well, this could impact the way we interact with the ground and the sensory feedback we get. 

 For example, think about a time when you got a small cut on one of your fingers. You may have felt  pain but because you were avoiding contact with this area your sensory receptors adjusted and you probably started to use your hand and fingers a little differently, moving and adapting to accommodate the changes. This is what could happen with the feet too. If a foot is not moving to its full potential, we can lose some of the awareness and the possibilities to move in certain ways. 

I often find that when people have very stiff feet they are not aware of how much  their  feet are moving and often these people  feel balanced in their feet , even when  the foot tripod is narrower or their toes are gripping the ground. 

Once the feet are moving better, these people can actually feel way more stable and connected with the ground, and also aware of what was missing. But sometimes we don’t know what we are missing  unless we experience it in the first place.

From Jo-Ann Deloge : Can you talk about change in arch post foot surgery and immobilization

So this question is very broad and I guess it will depend on the surgery and recovery time, but I would say once the person is cleared by their doctor and physical therapist for movement they will need to work towards restoring foot pronation and supination and  movement around all the joints at the foot and lower limb as much as possible. I know with some surgeries there are metal plates and pins used and they can restrict movement in some areas, but I would recommend working towards mobility and restoring range of motion anywhere else around this area. Also look above the foot and check if the rest of the joints (knee, hip, spine) are not compensating due to the surgery. 

From Kate : So if a client’s foot is always in a more pronounced position, is it a correct assumption that the plantar fasciitis that they struggle with is as a result of the instability- those muscles trying to create the stability the foot cannot get always being in pronation?

I did answer this question, but I think it is important to say it again. Often a foot can look flat or pronated, but in reality it is still a stiff foot that needs pronations. You will need  to assess the foot tripod and the movement quality at the foot and check if the foot can actually pronate and supinate and change shape. 

I will also advise to pay attention to the rear foot and the position of the heel bone and the ability of the heel bone to move when the foot is moving through  pronation or supination.  

People who struggle with plantar fasciitis and have a flat looking foot often have a heel that is stuck in eversion, meaning more pressure is shifted towards the inner heel and they can’t access the lateral portion of the heel. They also often have grippy toes. I will also check where their center of mass is. Often they will be in a posture that is falling forward. 

Flat looking foot is very often a rigid foot. 

 From Tricia Gordon : Do you suggest bunion correctors for a person with bunions when working to improve the tripod and the kinematic chain?

They probably will be useful, yes. We can also use small wedges or socks to support the foot and help the big toe to get a little straighter shape while the 1st met head is on the ground. 

I often use a folded sock between the 1st and 2nd toe so the big toe can access a more neutral shape and a folded sock under the 1st met so the foot can have access to the optimal food tripod. 

From Gus : Also left and right foot with different grades of pronation can be flexible and not be a real problem??

Absolutely. But we have to remember that the feet can hugely influence everything above and even if they don’t hurt they might be contributing to other problems up the chain. So it might be a good idea to keep the feet mobile and strong and restore access to the optimal foot tripod even when the feet don’t hurt. 

 From Lauren R : My apologies if this was covered at the beginning; I had tech difficulties getting on...what about our toes? Is toe gripping good/bad? How do the toes work within the tripod?

Toe gripping is not ideal. In the Toe off phase  of the gate the toes are pressurized and a lot of pressure is pushed forward towards the met heads and underneath the  toes, but that's not the same as toes that grip. If we grip with the toes we often lose  part of the foot tripod (often the transverse arch) which can change the way the foot moves and adapts to the ground. Gripping with the toes in my opinion is not a very useful strategy from an exercise standpoint. And if a person is gripping their toes a lot for me this is a center of gravity issue plus lack of foot pronation and supination. 

 From Petra : will you explain in which phase of gait (what type of split squat for example) would you start with which client?

This will depend on their whole body and foot assessment, so it is hard to say as I usually look at the way someone moves and self organizes their body in space. But one of my first priorities is to help a client  find a better center and  better base of support. After that I may work on what they already do well, so I can help them do it even better and then expose them to the movement patterns that they are missing. I talk about this a lot in the 4 Week Functional Foot course and we have a week for a case study where we go through full body and foot assessment and discuss exercises strategies based on the assessment results. 

From EV : Can you talk about the breath and pelvic floor with the absorption and push off phase?  Thanks so much!! This is great!!

I am not a certified pelvic floor therapist - trainer so it is a little bit out of my expertise, but I do teach my clients better breathing patterns and I pay attention to their breathing especially when they move upright with feet on the ground. Often people tend to brace or hold their breath so I do try to teach them not to, unless they are lifting something super heavy. Depending on what they need I may cue them to breathe softly and calmly, but in some cases I may want them to get more powerful and forceful exhalation. It will vary from person to person and what I am teaching them to do. Do we want to pressurize and load the foot, which may require a little less stiffness and calmer inhalation and exhalation, or I am teaching them to create max power and push off the foot, which may require more powerful breathing. 

 From Xi : Rali  where you are located for personal training?

I am based in Reading, England which is west of London. But I work mainly online and offer 1-1 consultations and training. 

From Rebecca’s iPhone : For people with bunions, the tripod is difficult because pressure in the first met head causes the toe to go off towards the other toes, exacerbating the bunion. What Recs do you have for split squats and single leg work.

We will have to set up the foot in a way that the foot tripod is on the ground and the big toe is facing forward a little better. As I explained on the call I usually use a sock ( because everyone has socks) between the big and second toes, and also another sock under the 1st met head if needed. People with bunions often need to work on foot pronation and restoring range of motion at the midfoot. The lack of movement at the midfoot forces the foot to move elsewhere and one of these areas is often the 1st met head that in a way takes the action of pronation. 

18:20:50 From [email protected] : Any suggestions for increasing supination/pronation motion?  After I sprained my foot, every time I try to supinate my heel automatically goes up.

I will check the knee and hip flexion and extension and work on making these motions better. Often a heel that is  lifting quickly off the ground is forced by the upper body or head position in motion forward. I know this sounds crazy but many people don’t know what true knee flexion is. 

 From [email protected] : When do you move away from toe separators?  Once you have adequate motion?

Yes, if the feet are moving better and the toes are doing what they are supposed to do I don’t see a reason to continue using them. 

To be honest I will always try to mobilize the feet and work on them without toe spacers first and only if I need constraints I will use them. But I am not against using props if needed. 

From Maja Graj : I have one question. I am dealing with pain in my medial cruciate ligament after walking or running. While watching my gait I realized in my mid stance my foot goes to pronation, but my heel goes to excessive eversion. I also have a very high medial arch. I guess it is somehow connected. But is it possible that my tibia doesn’t go to enough IR ? How can I change and promote this movement ? Thank you for your answer and the Webinar ! Greeting from Slovenia

So this is another complex question but this is how I think based on the information in it.

I will assess the resting posture and figure out where your center of gravity is, and how well you move side to side over each foot. Moving over your right foot looks similar to when you move over your left foot. 

Sounds like the foot is actually everting, but not pronating, so working on better pelvis and ribcage alignment and  knee flexion, could help. In ideal situations if we want a foot to pronate well we will need the body to be stacked over that foot and the knee to be able to flex and travel forward while the heel is on the ground and the spine is extending. 

From Theresa : Do you have any suggestion how to deal with pain/soreness with some swelling under 5th metatarsal (no known cause except maybe a shoe disintegrating suddenly). I usually do a lot of sports on balls of feet but currently don't even really walk :-(

I wonder how well that foot is pronating and also where the foot tripod is. I think this could be potentially a whole body issue and not just a foot issue. But pain under the 5th met head sounds like a pressure management issue. 

If you are interested in continuing to learn so you can help yourself and all of your clients then make sure to check out her course. 4 WEEK FUNCTIONAL FOOT COURSE