UBC Theses and Dissertations
Investigating the mechanical relationship between the feet and low-back Duval, Karine
Introduction: Claims that foot orthoses can resolve low-back pain are common in the marketing of these devices. The claims are based on the notion that wearing the orthoses will limit excess pronation at the subtalar joint thus reducing excessive internal tibial and femoral rotations. Excess leg rotations increase the anterior tilt of the pelvis and subsequently the degree of lumbar lordosis. Since lumbar lordosis has been suggested as a cause of low-back pain, it is speculated that foot orthoses could be used to treat and prevent pain to the low-back by reducing the forward curvature of the spine. This mechanical link between foot function and the low-back has not been investigated by experimental studies. Purpose: The purpose of this thesis was to investigate whether increased internal rotation of the femur induced an anterior tilt of the pelvis thus increasing the degree of lumbar lordosis and if external rotation induced a posterior pelvic tilt thus decreasing the degree of lumbar lordosis. Methods: In order to internally and externally rotate the femur, participants placed their feet in 18 different foot positions. Seven of these positions ranged from 15 degrees of foot eversion to 15 degrees of foot inversion and 11 positions ranged from 40 degrees of external foot rotation to 40 degrees of internal foot rotation. Six cameras surrounded the motion capture area and angles of pelvic tilt and lumbar lordosis were calculated. Results: Foot eversion and inversion did not have a statistically significant effect on pelvic tilt and lumbar lordosis. In-toeing had a statistically significant linear relationship with anterior pelvic tilt (R2=0.35, F1,131=69.79, p=0.00). Internally and externally rotating the feet had no effect on lumbar lordosis (R2=0.001, F1,153=0.09, p=0.77). Conclusion: Internally rotating the legs caused the pelvis to tilt anteriorly but only at extreme ranges of motion, much greater than what would normally be seen during gait. At which point, lumbar angles remained unaffected. This study does not dispute the effectiveness of foot orthoses to treat low-back pain but the results do not support the mechanical link proposed as the mechanism by which they work.
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