You and Your Feet
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. The further out you rotate your foot, inherently it tends to get less stable. As you stress out the plantar fascia, the flat connective tissues (ligaments) that connects the heel bone to your toes, the transverse and longitude arch will collapse without external rotation.
It is important to keep your feet pointing forward when you're walking and stable while lifting. If turned out of alignment, the knee and ankle will be open and the hip therefore be unstable. Instability can lead to hip, knee, ankle problems or even skeletal issues 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 performing at the single leg squat.
Set up a camera straight on
Stand on one leg and drop into a single leg squat.
Repeat on the other side.
Start by looking if any knee rotation occurs in or out but your feet appear relatively set. If so, the problem may be coming from your hips.
Do your knees remain stable, but your foot rotates in or out? Then it’s likely due to your feet.
Possibilities also include poor motor control, tight calves or an issue with your anterior tibialis (the muscle next to your shin).
The majority of cases I work with have exhibit some combination of the two.
The Good News
The good news is that you can fix muscular imbalances and improve subsequent motor control discrepancies.
The most common way doctors choose to remedy this problem is with the use of orthotics. They artificially create stability though the feet, which works great until you have to shell out a good chunk of change for a new pair. An expensive solution to a problem that can be remedied by training the intrinsic foot muscles and improving internal hip rotation.
Below is a whole post I created on Instagram around the topic:
It’s All in the Hips
Practice standing, walking, and running with neutral feet. People watching in public places and see who walks/runs neutral and who has funky movement. If you can spot the error in others than you will be more cognizant of your own movements. In most cases, being aware of the issue is more than half the battle.
Organizing our feet is easier if you are in a braced position as well.
1. Being Aware of Your Balance
A few key components to achieve neutral resting position (balanced 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)
5) Weight distribution (tripod positioning, heel, ball of the foot and outside of the foot)Internal hip rotators
Tension is held in the following: Calf complex, peronal complex, bottom of feet.
Strength of: TFL, glute medius, glute minimus.
2) Strengthening the Hips
My favorite movement to use is the RNT split squat. It works to train both hip and foot muscles in one movement.
Place a band around your knee and have it pull you INTO collapse which will force the muscles to engage harder and thus help groove the motor pattern. You can load it with a dumbbell or kettlebell in a goblet position at chest level for added resistance.
Clamshells are a great exercise, big coaching cue is to make sure you aren’t rocking backwards as your open the hips. Think about keeping the hips stacked on top of each other.
Glute bridge variants are fantastic, you can start with the basic two legged bridge and progress to a single leg version, before trying things like marching or incorporating sliders.
Improve general glute strength (single leg work like the RNT split squat, clamshells, Glute bridges)
Strength in plantar muscles
Strengthen dorsiflexors (mainly the anterior tibialis, shin muscle)
3) Begin Mobilizing and Incorporating gait patterning
Single Leg RDL: Fantastic movement to train the hip in multiple planes of motion. Problem? It’s usually too hard on balance and subsequently a lack of tension in the right places.
Here I’m performing a TRX assist SLRDL where as you hinge back, reach with your arms and hands forward and back. As you go further, you can spread the arms to widen your balance.
Seated 90/90 mobilizations: The full movement might be too difficult for some, you can work on the 90-90 shifts first
Split stance kneeling adductor mobilizations: Good adductor length is important in maintaining good balance during lower body strength exercises. While it may not directly influence hip and foot dynamics, it can still have an indirect negative effect.
Good ankle dorsiflexion: here is a whole post I made about this before.
First about good foot balance
Ankle PAILs and RAILs
Start by placing the ankle in as deep of dorsiflexion as possible. Then relax for at minimum 1 minute
Then start by contracting down towards the floor for 10 seconds as hard as you can manage (PAILs)
Immediately without changing positions, try to pull your foot up towards your shin. Even if no movement occurs, continue pulling. It’s all about intent (RAILs)
Then relax into the new end range and repeat 2 more times. You can begin the PAILs contraction once you feel like the tissues have “relaxed”