The Importance of an Efficient Foot and Ankle

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Greg Law

Foundation is key. Ask any builder and they’ll tell you cracks in the foundation can lead to problems throughout a house.  The same can be said for our body and movements. Foot and ankle efficiency is no different. If the part of the body that serves as our contact to the surface is not functioning efficiently, it can have a chain reaction of changes throughout our system.


Traditionally, there are 3 types of feet: Efficient, pronated (flat feet), or supinated feet (high arches).  I would argue that there are 4 types but that is for a different post on a different day.  Orthotics are often the first thought for people with foot pain, but manual therapy has shown to improve the efficiency of the foot and ankle to improve mobility, neuromuscular control, and can even give someone an arch that hasn’t had one in years.


Let’s look at the effects of a fallen arch or flat feet for the example of this blog post.  I am borrowing a picture from a reddit post because it does a great job showing the changes that can happen.  (Click here for the article) 


Foot and Ankle pain relief physical therapy

As illustrated you can see the reaction with the ground on a level foot can cause an internal rotation of the lower leg which can shift the patella and drive some knee pain.  On up the chain, we can see a slight internal rotation and shift of the femur leading to the pelvis dropping on the left side making the skeleton appear to have one leg shorter than the other.  As we continue to move up, there is compensation in the spine creating a functional scoliosis to compensate for the pelvis then there is further compensation seen at the shoulders and this can also lead to changes in the neck as well.


Long story short, issues at the foot cause a cascade of effects in the skeletal system. To complicate matters, this picture is a skeleton standing still.  It does not show the compensations that are made when movement is layered on top of the issue.  Let’s look at squatting as an easy example.


Do you have difficulty squatting to full depth?

Do you have trouble controlling the knees from drifting inward during your squat or lunges?

Does one hip pinch at the bottom of the squat?


While it’s no guarantee that these issues are coming from the foot and ankle, chances are that someone that can answer yes to these questions will have issues with at least one of their feet/ankles.


So now the big question.  How can I tell if my feet are efficient? 

While it can be difficulty via blog to tell you if your foundation is efficient, we can at least get you off to a good start:


  1. Stand with your eyes closed and focus on your feet. You should feel equal weight bearing between the ball and the heel of your foot.
  2. Stand with your eyes closed and focus on your feet.  You should feel equal weight bearing between the first and the fifth toes.
  3. Your Achilles tendon should be vertical. Have a friend take a picture of your legs from behind and look at the verticality of your Achille’s Tendon.
  4. Perform a squat while monitoring the front of the ankles.  You should see a folding at the ankle that is equal from the inside of the ankle to the outside.
  5. Perform a single leg heel raise with a count of one heel raise per second. Try to complete 20 repetitions and monitor what happens with your heel and Achille’s Tendon. It should remain in line as you perform the heel raises.  The inability to maintain a neutral position could indicate weakness commonly seen in those with “flat feet”.

Now the even bigger question.  I found out my feet are not efficient; how can I improve the efficiency and improve the quality of my movement?


First off, I would recommend visiting a physical therapist but not just any therapist. I would look for a PT with the certification of, CFMT, or Certified Functional Manual Therapist following their name which are highly qualified manual therapists that can help you improve your foot efficiency.  Click here for a full list of CFMTs and to search your area.  In the North Scottsdale area and want a free consult?  Email me at or click the link here to get setup for a free, 20-minute consult to discuss what we can do to help you.


Can’t find a CFMT and not in the Scottsdale area or want to try it on your own?  Follow us on Instagram @lawsofmotion or at least check out our post on sample foot exercises here.

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