Osteopathy & Foot pain

Osteopathy and the Foot: Biomechanics and Myths 

Foot pain (podalgia) affects approximately 20% of the adult population. Whether dealing with plantar fasciitis, hallux valgus, or walking-related pain, osteopathy is often sought out. However, it is crucial to distinguish concrete clinical results from sometimes overly ambitious theories.

Understanding the Complexity of the Foot 

The foot is not just a simple base of support; it is a complex assembly of 26 bones and numerous joints that must work in harmony.Getty Images

• The Role of Fascia: The plantar fascia acts as a natural shock absorber. When overstressed, it becomes inflamed (plantar fasciitis).

• Ascending Chains: The foot is the first link in the chain. A mobility restriction at the foot level can have "cascade" repercussions on the knee, hip, and lower back.

The Myths of Osteopathy 

Certain misconceptions circulate regarding the effectiveness of osteopathy. Let's set the record straight.

• A. The Myth of Hallux Valgus Correction 

  • The Belief: An osteopath can "straighten" a hallux valgus (bunion) through manipulation.

  • The Critical Reality: Osteopathy cannot correct a structural bone deformity. On the other hand, it is very effective at relieving pain and improving joint mobility to limit further worsening.

• B. The Myth of the "Displaced" Bone 

  • The Belief: A foot bone has "popped out" of place and the osteopath must "put it back."

  • The Reality: Except in the case of a dislocation (a medical emergency), a bone does not move out of place. It is a matter of joint mobility restriction. Manipulation (the "crack") aims to restore the natural gliding of the joint, not to reposition a bone.

• C. The Myth of the Purely Emotional Approach 

  • The Belief: Foot pain necessarily means you are having "trouble moving forward in life" or have an emotional conflict.

  • The Reality: While stress can influence the perception of pain, podalgia is first and foremost a physical and mechanical reality. Focusing solely on the emotional aspect without treating the mechanics of the foot risks letting the pathology settle in.

Scientific Reality: What Really Works 

Osteopathy shows concrete results when used in a reasoned manner:

• Plantar Fasciitis: Studies (López-Rodríguez et al., 2020) show that a manual approach is more effective in the short term than simple stretching for reducing pain.

Shutterstock

• Release of Tension: Working on the calf muscles and the plantar fascia allows for better load distribution during walking.

• Optimizing Vascularization: Manual techniques promote local microcirculation, which helps attenuate inflammation.

Toward Pain-Free Walking 

Osteopathy is a valuable tool for treating functional foot disorders. It "unlocks" joints and relieves tissues, but it often requires active patient participation (exercises, wearing orthotics) for lasting results.

Alain Guierre

References (Selection):

• López-Rodríguez et al. (2020). Osteopathic Manipulative Treatment for Plantar Fasciitis. J Am Osteopath Assoc.

• Franke et al. (2017). Osteopathic manipulative treatment for chronic low back and pelvic pain. BMJ Open.

• Dufour et al. (2019). Hallux valgus and manual therapy. Foot Ankle Int.