“. . . according to the Yoga Sutra (3.1), the term [Bandha] refers to the ‘binding’ of consciousness to a particular object or locus (desha), which is the very essence of concentration.”
Georg Feuerstein

Friday, September 6, 2013

Connecting To Your Feet In Yoga

Greetings Friends, 

Welcome back to The Daily Bandha. I’m just now returning to the blogosphere after completing an intensive year of study in Sports Medicine and will be sharing with you some of the knowledge I gained about the body and how to apply it to your yoga practice and teaching. Our first post in this series looks at a common disorder that can affect the foot.

You can learn a great deal about the normal function of the musculoskeletal system by looking at what happens when things go wrong. This knowledge can be used to deepen your practice, prevent injuries and to understand the role of yoga as a therapeutic adjunct in the management of various disorders. With this in mind, let’s focus on the condition known as adult acquired flat foot deformity, it’s anatomical basis and how to work with yoga to maintain a healthy foot arch.

As I discuss in "The Key Muscles of Yoga" and "The Key Poses of Yoga", mobility and stability about the joints is a function of three variables; the shape of the bones, the capsuloligamentous structures that connect the bones to each other at the joints, and the muscles that surround the joint. Adult acquired flat foot deformity is a disorder that relates to a muscular insufficiency of the tibialis posterior muscle, which in turn leads to weakening of the calcaneo-navicular ligament and then collapse of the bony arch.

The underlying muscular imbalance in acquired flatfoot deformity is between the weakened tibialis posterior muscle on the inside of the foot and it’s stronger antagonist, the peroneus brevis muscle on the outside. This imbalance places undue stress the calcaneo-navicular ligament that can lead to pain and collapse of the medial foot arch.

The exact underlying cause of adult-acquired flatfoot deformity is unknown, but is thought to be multifactorial; however, the muscular imbalance I describe is well established. In addition, it is associated with tightness of the Achilles tendon and it’s associated muscles, the gastrocnemius and soleus (so stretching these muscles can be an important factor in management and prevention). This problem affects women more frequently than men, typically at around the 6th decade of life.

Here’s the anatomy:


(Note: if you’re new to anatomy, focus on studying the images.)

The calcaneo-navicular ligament runs between the calcaneus, or heel bone and the navicular bone. The navicular is a boat shaped bone in the medial mid-foot (hence it’s name). This ligament is an important stabilizer of the medial longitudinal foot arch.

The calcaneo-navicular ligament supports the medial arch of the foot

The key muscle providing support for the calcaneo-navicular ligament is the tibialis posterior. This muscle originates from the interosseous membrane, the upper 2/3rds of the posterior fibula and the upper posterior tibia. After passing under the calcaneo-navicular ligagment it splits into two parts: one inserts onto the navicular bone and the other divides again to insert onto the plantar surfaces of second through fourth metatarsals and the second cuneiform bones (of the midfoot).

The bones of the foot with muscle insertions

The principle action of the tibialis posterior is to invert (supinate) the foot, with secondary actions of adduction of the foot and flexion of the ankle. It is an important stabilizer of the midfoot during the “heel off” phase of walking. The tibialis anterior muscle, which inserts onto the inside of the midfoot, works with the tibialis posterior to invert (supinate) the foot.

Pressing down the outer edge of the foot engages the tibialis posterior and anterior

The antagonist to the tibialis posterior is the peroneus brevis muscle, which originates from the lower 2/3rds of the lateral (outer) fibula bone and inserts onto the styloid process at the base of the fifth metatarsal. It acts to evert (pronate) the foot and plantar flex the ankle. The peroneus longus works with the peroneus brevis to evert (pronate) the foot. It also helps to stabilize the transverse arch.

Pressing the ball of the foot engages the peroneus longus and brevis


Here’s the yoga cue…


In standing poses like Utthita Trikonasana, press the outer edge of the foot into the mat to engage the tibialis posterior. Holding this action, then press the ball of the foot into the mat to engage the peronei. Note how the medial (inside) foot arch lifts. This sequence of cues: 1) uses the tibialis posterior to support the medial arch and; 2) uses the peronei (on the outside of the lower leg) to provide resistance to strengthen it’s antagonist, the tibialis posterior. The biomechanical term for simultaneously engaging antagonist muscles is “co-contraction” or “co-activation”. We illustrate many examples of co-activation in the Yoga Mat Companion book series.
Co-activating the muscles that invert and evert the foot

Once you get a feel for this in the back foot, then try the same sequence in the front foot, and then in other poses such as tadasana. To see an example of this in downward facing Dog Pose click here. You can also combine it with engaging the thoracolumbar fascia to lengthen the trunk in Dog pose. Click here for more information on the thoracolumbar fascia.

Working with these types of cues strengthens the arch of the foot. This gives a feeling of lightness in the step as we go through the day. Remember that the feet are important centers in energetic anatomy and physiology and are thought to be the location of minor chakras. Finally, look at the importance of the feet for the mind-body connection, as illustrated by their representation in the brain on the homunculus.

If you would like to learn much more about combining Western science and yoga, please join us for a week in paradise at Blue Spirit Costa Rica for our second annual intensive on anatomy, biomechanics and therapeutics for Hatha yoga. I will be teaching state of the art techniques including much new material relating to therapeutic applications of yoga—all with great 3-D illustrations, great food, beautiful facilities and much practice of yoga.

Thanks for stopping by. Stay tuned for our next post on the foot and yoga. Also, please be sure to share us on Facebook and Twitter.

Namaste’,

Ray and Chris


References:

1) Alvarez RG, Marini A, Schmitt C, Saltzman CL. “Stage I and II posterior tibial tendon dysfunction treated by a structured nonoperative management protocol: an orthosis and exercise program.” Foot Ankle Int. 2006 Jan (1): 2-8

2) Imhauser CW, Abidi NA, Frankel DZ, Gavin K, Siegler S. “Biomechanical evaluation of the efficacy of external stabilizers in the conservative treatment of acquired flatfoot deformity.” Foot Ankle Int. 2002 Aug; 23 (8): 727-37.

4) Lin JL, Balbas J, Richardson EG. “Results of non-surgical treatment of stage II posterior tibial tendon dysfunction: a 7- to 10-year followup.” Foot Ankle Int. 2008 Aug;29(8):781-6


39 comments:

  1. Pls, where can I find more information about the week in paradise at Blue Spirit for our second annual intensive on anatomy, biomechanics and therapeutics for Hatha yoga.?
    I live in Portugal
    fatima b

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    Replies
    1. Hi Fatima,

      Thanks for letting me know we forgot the link ;)
      If you click on the link above where we mention Blue Spirit, that will take you to the info/registration site for the workshop.

      Hope to see you there!

      Ray

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  2. Glad to see this again. I have been wondering what happened to this 'gift.
    Thank you

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  3. As a yoga teacher who works primarily with professional athletes, proper foot function is critical to an effective kinematic sequence. This is great information and I look forward to learning more.
    Namaste,
    Katherine Roberts

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    Replies
    1. Good to see your comment, Katherine--delighted that you enjoy the blog~Ray

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  4. I have flat feet, and I consciously pull up the arches and go onto the ball & edge of the foot in yoga. Nice to have what I do confirmed by an expert!

    Thank you!

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    Replies
    1. He he, Thanks for validating it from your practice perspective, Cathy! Ray

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  5. great to see that you are back!

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  6. I have had flat feet since early childhood. Sixty years ago they put"cookies"in my shoes. Not sure really what can be done about this although I am a yoga teacher and have been practicing for many years.

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    Replies
    1. Hi Betsy,

      Thanks for posting. Usually if flat foot is present from childhood, it is likely flexible pes planovalgus deformity as opposed to adult acquired flatfoot deformity (which I discuss in this blog). Pes planovalgus is often associated with generalized ligamentous laxity, so the cues and info above may also apply. What I mean is that to compensate for a lesser contribution from the ligamentous stabilizers, we recruit the dynamic muscular stabilizers. Thanks for posting and let me know how it goes. Best~Ray

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  7. It is a fantastic job. Keep it up...

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  8. Ray,

    It was great to hear you present this at Kripalu and I'm glad you crafted this blog post. I have shared this with my fellow yoga teachers and movement specialists.

    Namaste

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    Replies
    1. Hi Heather,

      Delighted you enjoyed Kripalu--one of my favorite places for sure. Many thanks for sharing our info and hope to see you again at the workshop there! Namaste'~ Ray

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  9. I really enjoyed reading this article on Yoga practice and muscle interaction! I have the opposite issue "high arches" and when I was a child they would sometimes be painful and I used Dr Scholl's elastic arch supports. I feel that exercising pronation and supination of my feet improves my "base of support".

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    Replies
    1. Hi Anon and thanks for posting. No doubt practicing yoga techniques helps with both conditions. High arches are less common, but can also be associated with muscular imbalances. I will speak to that in a future blog post. Good luck with your practice! Ray

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  10. Dear Ray and Chris,
    Unfortunately, I won't be able to make it this year. I wish I could. Last year was indeed paradise: both the environment and the yoga experience, and of course the monkey in the forest right opposite our windows. definitely to be repeated. I wholeheartedly recommend this to other.
    Cheers
    Ron Kuzar
    Israel

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    Replies
    1. Hey Ron,

      Great to hear from you! Many thanks for posting about your experience at Blue Spirit--those monkeys were amazing. What a place! Sorry we won't see you this year, but hopefully I'll make it to Israel in 2014 as we are working on setting that up. Keep up your excellent practice and stay safe, brother~Ray

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  11. My mother had flat feet, and mine were relatively flat. I started building up arch strength through yoga by intuiting what you describe. I will incorporate your information more into my classes now that I understand why it works. Thank you so much! I hope to meet you one day.

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    1. Good to hear, Kumari. I found this helped build my arches too; all the best with your teaching! Ray

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  12. was missing the posts!!! thank you keep up the good work.

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  13. Yeah, you are back!
    Congrats on finishing your Sports Medicine course, and thank you for another great post.

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    Replies
    1. Thanks, SewDanish--much appreciated! Ray

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  14. Good news... you're back! I am eager to read you with much interest and enthusiasm.
    Thanks for your interesting articles and for the quality of your work.
    Namaste

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    Replies
    1. Thanks for stopping by, Harry. Look forward to publishing new material soon. Ray

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  15. Dear Ray I really missed your blogs , I have all your books and love to read them over nad over and I enjoy your kinesiological analysis of asanas and exercises , but I also very much love your anatomical drawings and animations. keep up with the good work

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  16. Dear Chris and Ray

    Did you ever wrote in yours blogs about side split if yes where can I find it?
    Andrzej

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    Replies
    1. Hi Andrzej--haven't released that blog yet, will be shortly. Thanks for stopping by. Ray

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  17. this notion carries over to ultrasound techniques in that ultra high frequency sound is used as a probe in order to visualize fine, small wavelength structures. if you were to use lower frequency sound, then resolution is lost. 
    Ultrasonic Imaging Winston Salem NC

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    1. Interesting thought on several levels Kevin--thanks for posting! Ray

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  18. Hey, you have awesome post, i love to see your all posts
    .Thank You.
    fitness ball.

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  19. I am so grateful to have discovered you. I bought your book on Standing Poses and feel like I have been given a monumental gift. Not only is the book full of information that will take me a while to process in my practice, but this website is very helpful. How freely you share the gifts which you could charge lots more money for. I am on a fixed income. This knowledge is gratefully received. Blessings and Love.

    March 10, 2014 at 9:29 PM

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  20. Getting to know the mechanics of your feet and the pivotal role they play in yoga, is the first step to establishing a solid foundation in your practice. Students touch or kiss the feet of beloved teachers as an act of reverence.The feet while practicing some of the Yoga Styles must be balanced and sturdy to support the legs, spine, arm and head. If our base is collapsed, it will be reflected up through the body as distortion or misalignment.

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