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View Full Version : What's the source of the problem when one foot is turned out a little?


Howard Wilcox
04-25-2008, 12:00 PM
Hello folks,

If I randomly look down at moments throughout the day, it seems as if my right foot is turned outward just a little as compared to the left (or the left turned in I guess, not sure which).

What is the likely cause and solution of this? And what kind of person can solve this problem (somewhat skeptical of medical community for "small" stuff like this...mostly I just get tired of going through the whole story every time).


howard

Matt DeMinico
04-25-2008, 12:19 PM
Your right hip {something-or-other-muscle} (don't ask me the name) is tight. I have the same thing. The root cause is likely a movement pattern you're doing, but it could originate anywhere in a number of places. For me it was a tight right ankle in dorsiflexion (think that's what it's called, basically if your knee is over your toes, bent in that direction, the opposite of "pointed toes"). Because it was tight, when I walked, I couldn't get it to full compression, so unconsciously to prevent myself from taking short strides on the right, I turned that foot out slightly to get a little bit more range on it. But because I turned it out, the turn started in the hip, which kept that aformentioned "something-or-other-muscle" in a short position, and it eventually got tight, and it likes to stay in that position now.

As far as who can fix it, a good Physical Therapist can track down the root cause and work to fix it. But make SURE they find out what is causing it, don't let them just loosen it up and not fix the original source of the problem

Christine Reinhart
04-27-2008, 08:26 AM
You may also want to consider seeing a chiropractor. A good one should be able to recognize postural asymmetries (something you have already done), identify the source/cause of the asymmetry, and with treatment, help to correct it. If for some reason the chiro is unable to correct the problem, a good one, should be able to refer you to someone with a different specialization that can help you. I have one leg that is slightly shorter than the other, which had caused all sorts of chaos in my alignment, but with the help of my CrossFit coach and my chiro, things seem to be evening out.

Steven Low
04-27-2008, 08:42 AM
If the knee is turned out it's most likely at the hip. If the knee is forward, then it's most likely at the ankle.

But yeah, get someone to check it out for you.

Howard Wilcox
04-27-2008, 10:32 AM
Thanks folk,

It's good to hear that there are things that can be done about this. The ankle/knee distinction is interesting...I'll have my wife look at that and see if she can tell.


howard

Amanda Faulks
05-04-2008, 02:22 AM
Your right hip {something-or-other-muscle} (don't ask me the name) is tight. could it be the piriformis you are talking about?

Howard when you get your wife to look at your leg get her to do a full view postural as well. to make it easier to see any deviations hang a plumb line (string with a weight on the end) and stand with it hanging evenly between your feet for the front/back view and at your malleolus (ankle bump bone) for the side view. Then she can get an idea of where you are out of alignment. but remember none of us are symmetrical.
Amanda

Steven Low
05-04-2008, 02:59 AM
Generally, outward rotation of the femur occurs because those muscles like glute medius are more dominant than the smaller muscles that rotate the femur in. The the lateral are more numerous.. thus stronger (well, more dominating muscles).

wfs (bottom two)
http://www.exrx.net/Articulations/Hip.html

Amanda Faulks
05-04-2008, 09:33 AM
actually the glute medius while it does transverse abduction (away from midline) the femur in the coronal plane it medially or internally (towards midline) rotates the head of the femur in the hip joint ie: it helps those ladies who lie on their side on the floor and lift their leg up (very nice exercise for spot reduction at hips eh?:rofl:) but it also turns the toes in, not out. The Piriformis, the GOGO's, glute max and very little from the posterior fibers of glute med turn the toes out. A good stretch for it is on this site stretch #3 [URL="http://www.halhigdon.com/15Ktraining/Stretch.htm"] (WFS) All these stretches are great, and remember to hold your stretches for at least 1-2 minutes to really release the muscles as well as the fascia.

Amanda

Howard Wilcox
05-04-2008, 11:37 AM
Thanks folks,


I'm starting to think it is the left foot turning in vs the right foot turning out. I say this because sometimes when I walk I can feel the left foot wanting to turn in...kinda hard to describe.


howard

Amanda Faulks
05-04-2008, 12:19 PM
Howard, never doubt yourself one of my instructors said "always listen to what your patients are saying, they may not have the fancy words but they know what is going on in their bodies."

If that is the case then I wold be looking at things happening at the knee and ankle.

Have you ever sprained that ankle before?

Howard Wilcox
05-04-2008, 12:27 PM
Well, I have sprained ankles and broke my left ankle around the 8th grade (now 36). I don't think this has been a big deal until I noticed it a couple years ago when I thought I had strained my lower back. I think that is what turned out to be a tight/spasm/trigger-point in the psoas and it prevented me from heavy squatting (relative).

I'm pretty much over that and I'm hitting PRs in deads and squats with little to no pain (some tightness perhaps). I make it a point to stretch hard after the workouts and things seem to be moving along just fine. But the foot thing bothers me a little bit and if some extra, targeted stretching will help it, I would like to fix it.

howard

Stephen Macioci
05-04-2008, 08:50 PM
try foam rolling your IT band (outer hip) and your outer calve..

Howard Wilcox
05-04-2008, 08:52 PM
Ok, thanks...I've really got to stop procrastinating on the foam roller. I suspect it will make many things better.


howard

Jeff Alexander
05-04-2008, 09:13 PM
Howard,

I have a client who used to be known for his "Charlie Chaplin walk." Well, here we are 3 years later and no more Charlie Chaplin. You have 7 muscles in the deep hip, the largest of which is the Piriformis. The Piriformis laterally rotates the thigh in a standing position (pulls your butt forward), and it abducts the thigh in a seated position (rotates your knee outward). The stretch shown on the site Amanda mentioned is a good one, only I would add that if you have a wall to place your foot against, then you can completely relax the hip.

An easy test to see if you have tight Piriformis muscles is to sit with your feet flat on the floor, knees at 90 degrees. Take one ankle and lay it across the opposite knee. Lower the knee of your crossed leg while keeping your ankle in place so that your knee rotates down and out. If you can lower your knee to level with the other one easily, then your Piriformis probably isn't the cause of your toes turning out.

If you have a lot of trouble with lowering your knee, then take a deep breath as you rotate your knee up and in, and exhale as you lower your leg down and out again. Repeat 5-10 times, holding the down position a little longer each time. You can gently apply pressure with your hands to aid the stretching process.

Good luck, train hard, and try not to become Mr. Chaplin.

Camille Lore
05-05-2008, 04:55 AM
My R foot rotates out- just tried that test and wow are they both tight!

Amanda Faulks
05-05-2008, 11:20 PM
Howard the reason I asked about sprained ankles was that most sprains are inversion sprains, meaning you roll onto the outside of your ankle and the bottom of your foot turns inwards. This often over stretches the muscles that run down the lateral side or outside of your leg. These muscles work to plantar flex and evert the foot (turn it out). If the tendons of these muscles have been stretched due to a sprain they are not as effective at turning your foot out. Not saying this is what is going on but it is a possibility. The muscles I am talking about are the fibularis (peroneus) brevis and longus muscles. They are known by either name, fibularis is a little more new school I think. Here is a link (wfs) http://www.getbodysmart.com/ap/muscularsystem/footmuscles/fibularislongus/tutorial.html
it shows the origin and insertion as well as the action of this muscle. You can also see the brevis muscle if you click on the more tutorials button at the top right.

One way to test the strength of this muscle is to see if it can do this action, point the foot and turn it so the bottom faces away from the midline of your body. Make sure the action is at your ankle only do not move your knees. Hope this helps you rule some things out.

Amanda

Howard Wilcox
05-06-2008, 08:06 AM
That is a very cool little tool. Thanks.


Well, it's the right foot that is turned out and it is the left that was broken. I can't remember which one was sprained as playing basketball, they both likely were.


So, does anyone think that rather than the right being turned out, in reality the left is turned in?

howard

Amanda Faulks
05-07-2008, 09:35 PM
No problem Howard I was stoked to find it too. I am studying for my massage therapy board exam that is in September I am using these threads to keep my mind in the game without any structured study. I am taking a break till after my b-day in the end of May.

There is a quick way to get a rough idea which foot is turned out more. It is called the "too many toes sign" stand as you would normally don't try and stand the way you think you should and have feet bare. Have someone stand about three or four feet directly behind you, when they look at your feet they should only see your little toe and about half of the one next to it. All this tells you is which foot is misaligned it doesn't let you know where or what is causing it.

Without seeing you and doing my own postural exam and special tests I really have no idea what is going on. But it is awesome that you are looking into this and trying to fix it. :highfive:

Amanda

Cal Jones
05-09-2008, 02:22 AM
I have the same thing. My right foot flicks out when I run. I'm female and have a large Q angle (wide hips, slightly knock knees). I can't seem to do much about it. I did sprain my right ankle quite badly falling downstairs as a kid, though my structure doesn't help I'm sure.

Arturo Garcia
05-09-2008, 01:09 PM
Howard,

I have a client who used to be known for his "Charlie Chaplin walk." Well, here we are 3 years later and no more Charlie Chaplin. You have 7 muscles in the deep hip, the largest of which is the Piriformis. The Piriformis laterally rotates the thigh in a standing position (pulls your butt forward), and it abducts the thigh in a seated position (rotates your knee outward). The stretch shown on the site Amanda mentioned is a good one, only I would add that if you have a wall to place your foot against, then you can completely relax the hip.

An easy test to see if you have tight Piriformis muscles is to sit with your feet flat on the floor, knees at 90 degrees. Take one ankle and lay it across the opposite knee. Lower the knee of your crossed leg while keeping your ankle in place so that your knee rotates down and out. If you can lower your knee to level with the other one easily, then your Piriformis probably isn't the cause of your toes turning out.

If you have a lot of trouble with lowering your knee, then take a deep breath as you rotate your knee up and in, and exhale as you lower your leg down and out again. Repeat 5-10 times, holding the down position a little longer each time. You can gently apply pressure with your hands to aid the stretching process.

Good luck, train hard, and try not to become Mr. Chaplin.

Sir, just curious, what if after performing this test, I find it much easier to lower the knee of the leg with the foot that points outwards? It's always been like this for me. It's my right foot that points outwards, yet when I cross my right leg over my left, the knee can go down, to level with the left, with no problem. However, when I cross my left leg (left ankle over right thig), the left knee stays higher up. If I push down I could get it to a lower level, but I'd have to conciously be doing an effort to do that.

Is there another test to figure out if it's something else? :)

Steve Ericson
05-10-2008, 08:53 PM
Your right hip {something-or-other-muscle} (don't ask me the name) is tight. I have the same thing. The root cause is likely a movement pattern you're doing, but it could originate anywhere in a number of places. For me it was a tight right ankle in dorsiflexion (think that's what it's called, basically if your knee is over your toes, bent in that direction, the opposite of "pointed toes"). Because it was tight, when I walked, I couldn't get it to full compression, so unconsciously to prevent myself from taking short strides on the right, I turned that foot out slightly to get a little bit more range on it. But because I turned it out, the turn started in the hip, which kept that aformentioned "something-or-other-muscle" in a short position, and it eventually got tight, and it likes to stay in that position now.


Hey Matt, what tests were done in order for you to figure out that your tight ankle was the root of the cause? I have the same problem with my right foot turning out and my right IT band / Piriformis in noticeably tighter than my left. What did the PT (assuming you saw one) have you do?

Emil Berengut
05-11-2008, 08:39 AM
Howard, may ask why you want to fix it? Are you having any pain or loss of function as the result? We all have variations in our gait, posture that fall within the normal curve. Also, to really determine why it's happening it would be necessary to do an examination, again which would focus on the functional deficits as opposed to cosmetic variations. If it's not causing any problems, for all you know it's serving a function and you start trying to to fix it something else will give. I'll give you an example-a while back I became determined increase my hamstring flexiblity, mostly for grappling. Well, after about a month or so of regular stretching, I got about 4-5 inches. Soon after, I started having knee problems, because while I addressed the length of the muscle, I failed address the strength of hamstrings, which was the problem to begin with. In other words:" If it ain't broke..."

Steven Low
05-11-2008, 08:59 AM
Except it's not really "normal" to have internally or externally rotated feet. It will ultimately mess with your movement patterns and most likely make you more susceptible to injury.

Howard Wilcox
05-11-2008, 01:56 PM
Hello Emil,

Well, I guess it doesn't stop me from doing anything. Asymmetry bugs me in general though, and as Steven said, it could lead to other problems. I sometimes feel weird pain that isn't symmetric (only on one side of the body) that could be related, not sure (sometimes in the glutes, sometimes in the hamstrings, sometimes in the lower back/sacro region, etc). Nothing debilitating, but I don't think it is merely DOMS...hence my concern.


howard

Emil Berengut
05-11-2008, 06:42 PM
Except it's not really "normal" to have internally or externally rotated feet. It will ultimately mess with your movement patterns and most likely make you more susceptible to injury.
Steven, I disagree. It is absolutely normal. Every single human on the planet has variations in their allignment. What is the standard that makes us declare 5 degree ER normal and 6 degree not? There are population norms for ROM, but they are just guidelines and AVERAGES, not medians. And still, if one falls outside of that , if it doesn't cause problems , why fix it?
Many dancers have genu recurvatum-are they abnormal?

Steven Low
05-21-2008, 06:26 PM
Steven, I disagree. It is absolutely normal. Every single human on the planet has variations in their allignment. What is the standard that makes us declare 5 degree ER normal and 6 degree not? There are population norms for ROM, but they are just guidelines and AVERAGES, not medians. And still, if one falls outside of that , if it doesn't cause problems , why fix it?
Many dancers have genu recurvatum-are they abnormal?
The point is if you want anything close to optimal athletic performance you need your stuff very close to in line. Obviously, some people have poor genetics, and they're going to be off because they're born that way; no one is perfect. However, if someone is off by ~5 degrees it's not going to make THAT much of a difference. But if you're trying to do sprints with a hip that's externally rotated out 30 degrees... I think you're gonna have some problems.

Don't mess with my generalizations. :) Didn't see this sooner but I thought it was worth commenting on.