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If you're reading this on your lunch break, take a minute to look up and watch people's feet as they walk by. It's safe to say a fair amount walk with their feet angled out (hint: they should be straight).

You and Your Feet

 Photo by  Imani Clovis  on  Unsplash

Photo by Imani Clovis on Unsplash

The foot is most stable when it is straight. When your feet are turned out, the integrity of your foot's arch is not being maintained. As you stress out the plantar fascia, which is the flat connective tissues (ligaments) that connects the heel bone to your toes, the transverse and longitude arch will collapse without external rotation. For example, when you sprain your ankle, the ligament gets loose which is a common way you end up with foot collapse.

It is important to keep your feet pointing forward when you're walking. If turned out, the knee and ankle will always be open and the hip will be unstable. Instability will lead to hip, knee, ankle issues or even skeletal problems like bunions or chronic knee and/or back pain.

Hips or Feet?

Is the root of the issue coming from your hips or feet being turned out? A simple test can be performed by looking at your legs:

  1. On a flat surface, lay on your back.
  2. Look at your knees. (really, that's it!)

Do your knees rotate out along with your feet? If so, the problem is coming from your hips.

Do your knees stay pointing up, but your feet rotate out? It is likely something below your knee. Possibilities include tight calves or an issue with your anterior tibialis (the muscle next to your shin).

The Good News

The good news is that you can fix muscular imbalances. Oftentimes when I assess someone with a toe out gait, their issue isn't their feet but their hips! Poor Posture and a lot of sitting can create an anterior pelvic tilt that sends your glutes and core into a deep sleep. This forces other muscles to pick up the slack, mainly your hip's external rotators. When those overworked muscles get too tight, they start to pull your leg outward. As a result, your feet turn out. 

The most common way doctors choose to remedy this problem is with the use of orthotics. This works because each time you walk, your feet aren't neutral, which means you're losing the arch in your foot and moving through a less than stable position which the orthotic is now doing for you. The orthotic artificially keeps your foot straight but like any good pair of sneakers, eventually they wear down and you need to purchase another. I'll let you in on a secret: Orthotics aren't cheap ($$$). 

Here are some examples: 
Have you ever sprained or broken your ankle?
Have you ever worn a cast or prolonged use of ankle wraps and/or athletic tape then seen the aftermath of what rigid supports do to your joints in the ankle/foot? 
Do you wear high heels daily?
Do you ALWAYS need to use weightlifting shoes to squat?

Rigid supports make them weak and atrophy; this making you MORE prone to foot and ankle problems. 

Practice standing, walking, and running with neutral feet.  Practice people watching in public places and see who walks/runs neutral and who has a movement faults.  If you can spot the error in others than you will be more cognizant of your own movements.

Organizing neutral feet is easier if you are in a braced position as well.

The simple four step activation process to achieve neutral spine position (good posture) is the following:

1)  Engage your glutes (pelvis rotates posteriorly)
2)  Engage your abs (ribs rotate downward)
3)  Move your shoulders back and down (palms should be touching the side of your legs with thumbs pointing forward)
4)  Tuck you chin backwards (like a turtle retracting its head back into the shell or double-chin)

Steps to Improve Gait

1) Improve Soft tissue quality

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  • Internal hip rotators: TFL, glute medius, glute minimus
  • Calves
  • Soleus
  • Peroneal complex
  • Plantar muscles

2) Work on static positioning

  • Improve general glute strength (glute bridges, single leg stance, clamshells)
  • Strength in plantar muscles
  • Strengthen dorsiflexors (mainly the anterior tibialis, shin muscle)

3) Begin Mobilizing and Incorporating gait patterning

  • Seated 90/90 mobilizations
  • Split stance kneeling adductor MOBS
  • Wall march iso holds
  • Bowler Squats
  • Single leg RDL