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Walking - Falls and Injuries

I have always loved to walk! My mum and I have spent many happy hours walking all over Troon, right from my teenage years, when I daresay many of my friends thought it was a bit sad that I was out walking with my mum!

Walking is a great way to keep fit, and while walking injuries are rare, there are some things to watch out for. I am going to use my mum as an example, and tell you a little bit about her walking injuries.

My mum Alys, walks several times a week. A few years ago she was out for a walk and sprained her ankle. She was crossing the road and as she stepped off the pavement she went over on the outside of her ankle and fell. A fall is a really traumatic event! It doesn't matter if you are a child, a young fit athlete, or an older person.... having the full weight of your body come down quickly and heavily to the ground can not only cause an injury, but really give you a fright and damage your confidence.

So why do people who are out for a walk, fall in the first place? Well you will always have the cases where someone is just unlucky, and trips.

Perhaps on an uneven pavement, an untied shoe lace or a pot hole. However some people may be more likely to fall due to their underlying medical history. For example, someone with Parkinson's disease often exhibits what we call a shuffling gait. This means that they do not get a good heel strike, and then foot flat to toe off position, making them more prone to a fall. People with balance problems may also be more likely to have a fall.

Looking at it from a Podiatry point of view, your foot type may also predispose you to a fall. So back to my mum.... she has a very good range of motion in her foot joints. There is little stiffness, and she shows no signs of arthritic changes in her foot joints. She is however, and over pronator. In simple terms, this means that she has quite a flat foot, and that when she is standing her feet roll in. This is due to calcaneal eversion at the subtalar joint, and can be corrected with the use of special insoles called foot orthoses.

So how does this contribute to a fall? Well, your foot is required to do 4 main things when you are walking. Firstly, as your heel strikes the ground, it must be a stable base to support your body. As the foot becomes flat it must then become flexible, so that it can adapt to the underlying terrain, and also absorb shock. As your heel lifts off the ground and you come up onto your toes, the foot must again revert to a stable and locked position to be a rigid lever to propel the body forward. As the foot leaves the ground and goes into swing, it again becomes flexible.

Someone who is an over pronator, with big ranges of motion in the joints of the foot has to work extra hard to move their foot between being flexible and rigid. If the foot struggles to do this, then a fall may occur. So, as my mum went to step off the pavement during her walk, her foot was flexible in the swing phase. She then had to get it back into a stable and rigid position for heel strike, but she did not make it in time! As the heel struck the ground it was not the stable base that she needed it to be, and so she went over on it and fell.

My mum now wears functional foot orthoses. These are special insoles worn inside her shoes. They limit the amount of motion occurring at her subtalar joint, and essentially support the foot so that it doesn't have to work so hard. This means that her foot is in a better position, and finds it easier to move from the flexible to the stable states.

Functional foot orthoses can be very useful for many people. Prevention is better than cure, and having your foot in the optimal position will prevent injuries and enable people to carry on with their activities for longer. It is not only elite athletes that wear orthotics! We prescribe special insoles for a whole range of people. We believe that everyone has the right to healthy feet and to move, perform and achieve to the best of their ability, regardless of age or activity level. If you would think that you may like to find out more about walking, foot orthoses, or falls, then please contact us, we would be delighted to hear from you!