A good, worn pair of tennis shoes can tell rehabilitation professionals a lot about our patient's gait pattern (how they walk), mechanics, and posture. Look at the pair of shoes in the picture above. First, be aware that the right shoe is on the left, and the left shoe is on the right side of the picture. It's the same view you would get if you were looking at the bottom of this person's shoes as they lied on their back on a table in front of you. 

Can you spot any differences between the two shoes? The right shoe has more wear in the heel area. It's also evident that as the patient stands on this leg while walking, their weight stays heavily off to the right. You can see how much wear there is on the outside part of the right shoe versus the left. There is also much more wear under the toes on the right shoe. 

First let's talk about normal gait. When our foot hits the ground, we should hit on our heel, slightly on the outside. As that leg supports your weight and moves under your body during midswing, your weight should begin moving toward the center of your foot and your arch should flatten somewhat. As the leg moves behind you in terminal stance, your weight should have moved directly under your big toe so you can use it as a rigid lever with which you can push off from. Essentially, your weight should move from the outside of your heel to the inside of your foot, under your big toe, as your body advances over and in front of your stance foot. 

Based on the wear pattern of the above shoes, it is evident that this person keeps their body weight toward the right, no matter which leg they are walking on. As their body moves over their right foot, their weight stays lateralized on the outside of their foot. They are finally able to transfer some weight to the inside of their shoe, under their big toe, as their leg is behind them to push off.

This person does not know how to properly stand on their left leg. Sure, it supports enough weight so that this person is able to use both legs while walking, but they never get their body properly centered over their left foot as they walk. 

Why is this? Their body is in what PRI professionals call a Left AIC position. It stems from a naturally occuring asymmetry of the diaphragm which has been exaggerated. The right side of our diaphragm is more robus and typically stronger than the left side. When this naturally occuring imbalance gets too out of proportion, our ribs will flare on the left side and it becomes hard to use our left abdominals. This means that our relatively stronger right abdominal wall is able to pull our thorax's over to the right a bit, transferring our weight over our right foot. It will also cause our pelvis' to rotate toward the right side which places the right hip in a more functional position to bear weight as we walk. 

If you see asymmetrical wear like this on your shoes, it's a red flag indicating that sooner or later you will develop some type of pain, dyfunction, or injury. Think of it like when the alignment in your car is off - you'll see asymmetrical wear on your tires. The physical therapists at Integrate 360 Physical Therapy and other PRI therapists across the country are the only rehabilitation professionals that take this anatomical imbalance into consideration in their treatment approach. Minimizing this asymmetry is the key to restoring the natural balance in your body, perfecting mechanics, and avoiding or alleviating pain. 

Call us at 314-733-5000 or email Lesley@Integrate360PT.com or Nancy@Integrate360PT.com to set up your evaluation.