Could your feet be contributing to the pain in your jaw?
The answer is YES. The body is a very complex structure and each part is interconnected. The feet are the foundation or cornerstone of the body. If these are in a poor position the rest of the body will have to compensate and may suffer.
There are 3 main issues that are seen to be contributors. Flat feet, leg length difference and poor big toe joint function.
Flat feet:
Flat feet is generally a term describing ‘fallen arches.’ Most of the time this is genetic in nature but sometimes it can be an acquired condition due to an injury or dysfunction in the foot. ‘Rolling in’ or pronation is often associated with flat feet.
A certain amount of pronation is normal and is necessary for shock absorption of the body. However, too much pronation for too long will stop the foot from propelling the body forward smoothly and efficiently.
Flat feet alter your walk, the way you stand and move, resulting in strain through soft tissue structures, postural dysfunction and inefficient walking patterns. As seen in the diagram; knee, hip, back, shoulder, neck and jaw position will be altered in a detrimental way if the foot rolls in.
Big toe joint stiffness:
The big toe joint or otherwise known as the 1st metatarsal phalangeal joint is one of the most important joints in the foot. The big toe joint provides leverage to the foot allowing the body to move forward efficiently and smoothly. It is also plays a large contributing role in helping us balance.
There are many reasons why the big toe joint may not be working properly. These may include arthritis, bunions, gout, flat feet and trauma to the joint. Normal range of motion in the big toe joint should be approximately between 45 and 60 degrees in an upward direction. If this range of motion is not achieved when walking there will be compensations to get around this. Greater ground forces are created. The head ends up tilting forward to help generate forward movement and centre of gravity. This creates abnormal tension in soft tissue and bony structure around the neck, face and jaw.
Leg length difference:
Almost everyone will have one leg shorter than the other. However, less than 5mm difference in leg length is regarded as normal and is not usually a contributing factor to other pains and pathologies in the body. Only a small percentage of the population will have a difference greater than 5mm. Chronic overuse problems that persist, after the standard therapies are given may lead to the diagnosis of a leg length discrepancy.
There are two main types of leg length difference.
Structural- This is where the actual bones in the leg are different lengths. This is usually the result of trauma such as a break or a knee or hip replacement.
Functional- This is where muscular tightness usually around the hips twists the body and creates a pseudo leg length difference.
The compensation for a leg length difference can be very complex. The spine, pelvis, knee and feet are all involved in trying to compensate for the asymmetry. Usually the center of gravity is moved to the shorter side. The pelvis tilts to the shorter side, a scoliosis is created in the spine, pronation or rolling is seen on the longer leg. The knee on the longer side flexes slightly and so on. The neck, jaw and mouth alignment will naturally be out of alignment as the base that it sits on is not level.
A podiatrist can easily design and manufacture a special innersole to go in the shoe of the shorter leg which will allow the body to function with better alignment and reduced pain.
What can be done?
If you think you have flat feet, one leg longer than the other, a rigid big toe joint and are struggling with jaw and mouth alignment issues please talk to your dentist to get a personalise referral to get your alignment fixed from the bottom up.
Author
Dr. DURGA SARAVANAN (PT., MSc Sports Biomechanics and kinesiology), Consultant physiotherapist.