The foundation of all gait starts at the foot. There are various external factors that can influence the movement at the feet.
These factors could be mechanical instability, proprioception deficits, neuromuscular control deficits, postural control deficits and muscle weakness. Below are some examples of how each factor can impact the level of stability of the foot.
- Mechanical instability:- this relates to a structural problem including the alignment or function of bony structures and ligaments of the foot and ankle. Our bones make up the solid foundation that we stand on and the ligaments are what binds and holds the bones and muscles together, if there is an abnormality with one or the other, this can create instability or decreased function, therefore altering the way we move during gait. Here are two examples of mechanical instability
- Broken big toe:- affects balance and coordination
- Torn ligaments in the ankle:- affects ankle stability, balance and range of motions which all play a factor in ones ability to walk.
- Proprioception deficits:- Proprioception is our ability to grip and feel the world. In relation to our feet this means that there is information being relayed through the feet that can tell you what type of surface you are standing on. There can be a number of reasons for a proprioception deficits, including ligament or nerve damage, however, the most common is age. When we age there is a gradual decrease in the sensation that is relayed through the feet.
- Neuromuscular control deficits:- This involves abnormal changes in the neural pathways which innovate the muscles and provided feedback on proprioception. These changes can result in muscle weakness, numbness, burning and pain which can effect a person’s ability to walk or stand for any amount of time. An example of this can be seen in those what have peripheral neuropathy.
- Muscle weakness:- Muscles control the movements of the joints and structures in our body. They have the ability to lift the foot and control cadence during gait. If there is any weakness in the muscles this could lead to dragging or shuffling steps. With this altered movement patterning comes an increased risk of falls.