When you get right down to it, there’s really only one cause of injury…
Poorly managed force.
When you subject a muscle to more force than it can handle… it tears.
Too much force on a bone… it breaks (my son Harry seems to be an expert on this one!)
Overload a joint and you’ll get a torn ligament, capsule, or even a dislocation.
In every case, the issue is that you subjected a tissue to more force than it was designed for.
This also applies to things like overuse injuries…
Less force involved, but applied repeatedly over time, creates inflammation and damage.
When it comes to chronic degeneration, like osteoarthritis, the mechanism is similar. The body tries to deal with repeated excessive force by reinforcing the joint with more bone… leading to osteophytes, bone spurs and ultimately destruction of the joint.
We all see this every single day in our practices.
So where is all this force coming from, and how can we help our patients handle it better?
Ultimately all forces on the body either come from, or must be transmitted to, the ground.
This is simple, Newtonian physics.
When it comes to our purposes of working with the body, the key is Newton’s 3rd law, the law of action and reaction:
For every action, there is an equal and opposite reaction. When one object exerts a force on a second object, the second object simultaneously exerts a force of equal magnitude and opposite direction on the first object.
This applies every time we come into contact with an external force.
Let’s say someone tries to push you over. As they push, your body must provide an equal and opposite force against their hand, otherwise you fall over.
That equal and opposite force ultimately comes from the ground.
If they push your chest, your muscular, fascial and skeletal system must absorb that force, transmit it down through your core and legs to the ground, and transmit an equal and opposite force from the ground back up to your chest.
Now hopefully we live in a world where people aren’t trying to push us over that often…
But this also applies every single time your foot strikes the ground…
Which if we’re following the prevailing general health advice, is at least 10,000 times per day.
That adds up to a lot of force!
The average person generates about 1.5 times their bodyweight in impact force when they heel strike (because Force = Mass x Acceleration… Newton’s first law.)
That means the ground is effectively striking your heel with 1.5 times your bodyweight every time you take a step.
That force has to go somewhere.
When our gait mechanics are working effectively, that force is cleanly absorbed by our myofascial system- primarily our plantar fascia and our calf muscles.
It is then multiplied (due to the elastic properties of our fascia) and transmitted back to the ground at toe-off to smoothly propel us forward.
This creates a beautiful, efficient, gliding gait that requires minimal muscular energy to maintain.
(Notice the bare feet and upright posture of the women in this picture.)
However, when this mechanism isn’t working effectively…
(Say, from a lifetime of wearing shoes and walking on flat, unnatural surfaces…)
Then the outcome is very different.
Instead of being smoothly absorbed, multiplied and returned to the ground, all that repetitive force is absorbed and creates damaging levels of impact somewhere in the body.
Generally in our muscles and joints.
Is it any wonder that knee, hip and spinal degeneration are so common that many doctors consider them “normal” as we age?
I remind my patients frequently that “common does not equal normal!”
Just like a car with no shock absorbers will wear out mechanically much faster…
A human skeletal system that is not effectively dealing with Ground Reaction Forces (GRF) will degenerate and break down much faster.
Our joints were simply not designed for that level of constant pounding.
Our muscular system is also affected.
When we are not using our fascial system to absorb impact forces efficiently, we are forced to use much more muscular effort to walk, run, or even just remain upright.
This leads to fatigue, tight muscles, repetitive strains and injury.
These are the patients that get sore or tired when they are on their feet for too long.
Or just have chronically tight muscles.
(Any of those in your practice?)
As hunter-gatherers, humans operated as persistence hunters. We weren’t as big, strong or fast as most of the animals we hunted…
But we were more efficient.
Humans were able to continue chasing game until it eventually exhausted its capacity to dispose of its own body heat and had to rest long enough for the hunters to catch up.
In other words, humans were designed to be able to walk all day.
And do it day in and day out, 7 days a week!
Even without the latest Nikes!
The first thing that’s required for this system to work effectively is that we must be able to sense the ground reaction forces accurately.
This is why the smallest nerves in the peripheral nervous system are in our feet. We covered this in detail in last week’s email.
The challenge is that those GRFs enter the body in the space of under 50 milliseconds…
But it takes 70 milliseconds for the brain to activate our muscles.
This means we can’t operate reactively… the brain must actually anticipate the GRF and pre-activate neuromuscular responses to meet the ground with each step. Research has shown that this is effectively dialled in by the 3rd or 4th step we take.
The brain then uses isometric contractions of the intrinsic foot and leg muscles to create carefully calculated tension in the fascial compartments , which dampens down the impact forces.
This is known as Muscle Tuning Theory.
It is this precise, anticipatory control of muscles, joints and fascia that allows us absorb force, elastically multiply it, and use it for efficient propulsion…
Rather than experience it as damaging impact forces.
Better Balance Orthotics use their unique mechanism of dynamic, unstable stimulation to improve this whole process.
It is a two-pronged approach, increasing sensory feedback from the feet (firing the mechanoreceptors), as well as increasing activation of the intrinsic and extrinsic muscles of the feet (firing the proprioceptors.)
They are stimulating both the afferent and efferent pathways between the feet and the brain.
This is why they create such a dramatic change the instant someone stands on them.
Of course, the most obvious way of demonstrating this to your patients is with the standing hip flexor test… but this is really just the tip of the iceberg.
In practice we have observed that balance, range of motion, palpatory muscle tension and multiple neurological tests all improve immediately when a patient stands on the orthotics.
All those things are pretty cool to observe, but at the end of the day what really matters to patients is that they feel and perform better when they wear their orthotics.
So the next time you have a patient with tight muscles, stiff joints, reduced range of motion, fatigue or bad posture…
Don’t just assume it’s tech-neck and too much computer time (although those are very likely factors.)
A much larger portion of those symptoms than you realise are coming from the way they use (and don’t use) their feet.
I guarantee if you try this on at least one patient tomorrow you (and they) will be pleasantly surprised by the result.
Cheers,
