Our feet carry us through life – on average 40 000 km or once around the earth.
They have to withstand up to a tone in weight, and need to be flexible and stable. They must be able to adapt to various surfaces. Each step is an impact which travels up the body like a wave.
A coordinated foot provides each step with bounce. It rolls off the floor and develops dynamic force and energetic bounce – step after step.
How does the foot work?
Bone – a living tissue which adapts according to its needs and uses – is the framework of the foot. There are 26 bones, 33 joints, 107 ligaments and 19 muscles in a foot. These form the element of the heel, the middle foot and the forefoot.

The ankle is not a load bearing joint and needs to be protected. Therefore one has to place weight on the heel evenly and straight. The weight gets transferred from above over the ankle to the heel bone, which carries the weight.
Looking at the foot from the front, we can see wedge like bones, which make long term weight bearing possible. Further forward are the bones of the toes. They form a transverse arch which creates an effective suspension for the foot.
The Arch principle
An arch distributes the forces weighing on it in an even manner. It becomes more stable under load.
When several arches run in different directions, they form a three-dimensional dome.
There should be enough space under the transverse forefoot arch, that a small ball (eg: a big marble) can be totally hidden under it, ie: we should have a hollow underneath the foot.
A correctly aligned foot forms a spiral rotation which mirrors the basic principles of the skeleton of the foot, and this enables the joint of the big toe to reach the floor whilst the heel remains upright.
In a coordinated foot the heel carries the weight on the outside (not on the edge of the foot, but towards the outside from the middle of the heel), whilst the big toe and its joint keep stable contact with the floor. The other toes remain relaxed and stretched out, lying lightly on the floor.
What happens when the spiral rotation is reversed and the forefoot arch collapses?
Looking at the foot from behind: due to the change of weight distribution the heel bone kinks towards the inside of the foot – one becomes knock-kneed. The foot gets overloaded on the inside, and the arches drop, which results in a so-called flat foot. This causes the bones of the forefoot to touch the floor, where there should – by nature – be an arch.
This causes the transverse arch in the forefoot to collapse and the small bones of the middle foot get pressed into the floor – we get a so-called splay foot. At the same time the foot experiences a deviation of its axis towards the side, which – over time – results in the formation of a bunion or halux valgus.
The straightening and lifting of the heel bone re-establishes the arch and therefore a coordinated foot: you can hear, see and feel it.
What is the purpose of the toes?
They enable the foot to strongly push off, which is needed for walking, running, jumping or crawling.
The arches of the foot are not rigid, but flexible and supple, made possible by the help of muscles, tendons and bones. This is necessary so the foot can adapt to uneven terrain.
The interaction between bones, muscles and tendons make the foot into an efficient tool for moving.
Which muscles co-ordinate the foot?
The muscle running from the outer part of the knee down the shin and crossing over the foot, ending in a ligament inside and under the foot (tibialis anterior muscle) is of central significance for the formation of the longitudinal arch of the foot. The long calf muscle (peroneus longus muscle) ends in a ligament underneath the outside of the foot. Together these two muscles form a muscle loop which holds the arches forming the dome under the foot. In a coordinated foot these two muscles work evenly together.
If the tibialis anterior is too strong, it is difficult to keep the big toe on the floor – you tend to stand and walk on the outer edge of the foot.
If it is too weak, knock knees result – you tend to stand and walk with flat feet (ie: fallen arches).
In these cases one of the two muscles is stronger than the other. This in turn pulls on the knee ligaments, which – over the years – can pull the cartilage out of alignment, as the knee ligaments are attached directly to the cartilage, leading to uncomfortable knee problems.
With a straight heel both muscles work together, keeping the balance.
A healthy foot starts moving by rolling from the heel over the outside of the foot to a strong pushing off of the toes.
Incorrect foot positioning often starts very young in childhood already. However it must be pointed out, that the heel is only becoming upright around the age of about 5 or 6 years; before that the muscles are not sufficiently developed to keep the heel upright. If the heel has not straightened by the time the child starts school, an orthopaedic specialist should be consulted and specific foot exercises should be incorporated into daily life (in a playful way), to avoid later problems.
As we get older, feet get fixed in a deformation to a greater or lesser degree, which causes all sorts of problems, affecting not only the feet but also other parts of the body. In the end an operation is often necessary.
But even in old age it is possible to reverse foot problems to a certain degree.
Here we can see two pictures of the feet of a 60 year old woman.
The 1st picture shows the feet with bunions.
The 2nd picture was taken a year later after regular and frequent
exercising and awareness training of the feet, and incorporating
the correct foot alignment into every day life.
With regular, frequent and correct exercise, structural changes are possible, even in old age. A coordinated training is best started with slow and simple exercises, which can then be integrated into every-day life.
Due to the lack of movement and the ‘sitting culture’ of our time the development of a healthy foot cannot be taken for granted any more. The long hours of sitting start already in childhood, during watching TV, playing video games, in school, in the car etc.
Walking barefoot over uneven terrain is very important. Lack of exercise, walking on hard surfaces and unsuitable shoes are all causes of foot problems.
The deciding element of healthy feet is the coordinated use of the feet and taking own responsibility for this (no doctor or therapist can do it for you).
Does the shoe fit?
Draw the outline of your foot on a sheet of paper and place all your shoes, one after the other, on top of this outline. What can you see? Are the shoes too narrow for your feet? Are they too wide?
Furthermore, a sole which is too hard, will cause problems.
High heels transfer the weight too far forward. Instead of through the heel, the impact goes through the forefoot. The transverse arch in the forefoot cannot withstand these demands and collapses.
Shoes do not have the purpose of forming, supporting or adorning the feet! They should prevent injuries and protect us from cold.
Besides specific foot strengthening and awareness exercises and the wearing of good, well fitting shoes (for more on shoes and correct walking go to http://www.swissmasai.com), foot reflexology and foot mobilisation treatments may also be helpful in preventing and correcting foot problems. If you look after your feet, your whole body will greatly benefit.
Walking on heels 5 cm or higher tightens and weakens the calf muscles, making you susceptible to Achilles tendonitis. If you must wear high heels, take your shoes off as much as possible during the day and stretch your calf muscles. Source: Benjamin Gelfand, physiotherapist.

Dynamics of the forefoot: during walking and running the forefoot has the important function of a shock absorber. During the coordinated touch-down of the foot (pic 1 & 2 on top) all the toes point towards the floor, and not up into the air. The same is valid for the pushing off. The forefoot ‘grasps the floor’ (Pic 3 & 4)
Awareness exercise to help straighten the heel:
Sit on the edge of a chair with feet hip wide open, without shoes, on your sitting bones with an upright spine. Ankle, knee and hip should be in line. Have a look at your heel from behind and check whether the heels are straight, or whether they are kinking inwards or outwards.

Then adjust them by shifting the weight onto the outer heels, whilst keeping the joints of the big toes in good contact with the floor.
Now lift one heel up and bring it back down to the floor in as straight a position as possible.
Start very slowly, then after a few times, do this a bit faster, but slow down, if you notice that the heel is not touching down straight any more. 6 x slow, 10 x fast.
Repeat this with the other foot, then alternate the feet and then lift both heels at the same time.
Awareness exercise practicing standing up from a sitting position without allowing heels to kink in:
Sit as shown and lengthen the crown towards the ceiling, letting the coccyx ‘flow’ into the chair.
Now concentrate on your feet and make sure that they stand on the floor with the heels upright, ie: weight on outer heels and big toes in good floor contact. Activate the pelvic floor and with a straight back, upright neck and the shoulders back, down and out stand up with a smooth movement. The weight remains on outer heels and big toes, the heels upright.
A common mistake: uncoordinated sitting down, the feet collapse inwards, knees turn towards each other or even touch. Stand up and sit down slowly 5 – 7 times, and during the day stand up like this as often as you can remember, whenever you have to get up off a chair.
Strengthening exercise for the forefoot arch: sucking up the floor – or a coin for advanced people.
Place the foot flat on the floor. Without lifting toes or heel off, pull the toes towards the foot, lifting the transverse arch in the forefoot – as if you were trying to suck up the floor into this arch (a little niche should form behind the middle toe. With a bit of training you will be able to create this niche also when the foot is not on the floor, eg: during lifting the foot and looking at it in a mirror. 
Do not curl your toes under, keep them quite flat on the floor. It is as if you were trying to shorten the toes or retract them into the foot. You will feel the muscles across the transverse forefoot arch quite strongly. Hold this position for a split second, then release and start again.
30 – 100 x with each foot.
Once you can do this exercise well, you can do both feet together or alternate them.
Be aware which of your feet is weaker and do extra repetitions with the weaker foot.
When you get very good at this, you can try and pick a coin up with the transverse forefoot arch.
Make sure to use the area behind your toes for this, and not the toes themselves.
It is difficult, but occasionally people manage with a five Rand coin.
For a complete foot workshop and exercise programme contact the Callanetics Teachers Assoc. of SA, info@ctasa.org.za, 011 795 3311. Foot workshops are held in Johannesburg and Cape Town at least once a year, but can also be organised in other parts of South Africa, depending on numbers of participants.
Sources:
DVD: Fuss Schule (Foot School)
Book: Spiraldynamik© – die 12 Grade der Freiheit: Kunst und Wissenshaft menschlicher Bewegungskoordination
(the 12 degrees of Freedom: Art and Science of human movement coordination)
Book & DVD from the series: Spiraldynamik© – das Erfolgsrezept fuer die 10 wichtigsten Koerperregionen (the recipe for success for the 10 most important body regions)
‘Gesunde Fuesse – schmerzfrei und beweglich’
(Healthy Feet – pain free and flexible)
All by
Dr med. Christian Larsen, Doctor and co-founder of the Spiraldynamik© Medical Centre, Zuerich (where he devotes his time to patients, research and training; his books are bestsellers and have all the same theme:
‘Art and Science of Human Movement’). Translated by permission from Dr Larsen by Sylvia Lampe, SA Callanetics Instructor and Trainer; president of the Callanetics Teachers Assoc. of SA other sources: author’s own.