……….an arch that collapses when doing any sort of bilateral or unilateral squatting motion. I’ve assessed him for anterior pelvic tilt and hip internal rotation, thinking this might be the driving force behind the collapse, but nothing shows up. I’m wondering if it’s stemming from structural issues in the foot? If so, am I stuck with referring him to a podiatrist?
If basically the individual is awesome at the hip and core and still falls into valgus collapse, here are some things to think about……
1) They are not awesome at the hip and core. Recheck ASLR and SM in the FMS and be very discriminate. Recheck MSF and MSE. Recheck everything.
Is it terribly likely that an upper body limitation is going to filter through a solid middle and lead to the feet falling? No, it’s not, but it is possible. I think it’s fair to be skeptical here.
2) Look at the foot. As we know what is flat is not always flat.
What does the foot look like off the ground? Does the shape change to something more resembling an arch when it’s unloaded?
Can they walk on their toes? No one walks on their toes without an arch.
What’s big toe mobility? If the big toe doesn’t hyperextend, the midfoot won’t have a “reason” to stabilize with an arch. The Windlass Mechanism won’t be set up if there isn’t substantial push-off.
Do you teach, or does the person claw with their toes during lifts. Clawing the toes gains stability, but I believe it also inhibits the deep foot muscles as well as the hip. Without the freedom of the toes to go into push-off, I suspect the brain does not allow for maximal neural flow to the hips to blast through. They won’t blast because the brain doesn’t think propulsion is being asked for.
3) Mobilize the foot.
If the foot appears flat, don’t give up yet. Joints can be mobilized through manual therapy and neuromuscular training.
There are aggressive manipulative techniques for the foot as well as softer PIR/MET that I have used recently.
Training on wobbles and teeters that have a flat surface as Pr Janda taught have been shown to facilitate the short foot. DNS positions, particularly, Creeping with hanging, is another powerful neuromuscular mobilization of the foot.
4) If you are confident of all else, try static training, with a surface angled up and away from half the foot. This was something Shelby Turcotte published years ago on Strengthcoach.com.
Foot is flat. Put say a thinnish mat underneath half of the foot, so the lateral foot is raised. The foot basically starting in what resembles pronation/valgus collapse. Then ask the individual to engage the exercise. See if this RNT allows for a fix.
5) Yes, send them to someone if you can’t filter through one of the routes above. I don’t care if it’s a podiatrist or a ditch digger.