The Foot and Spine Connection


Arch Collapse and Back Pain

Many conditions start in the feet but eventually contribute to health concerns farther up the kinetic chain, such as in the spine. Foot Levelers orthotics PAIN can help preserve the body’s optimal foot-spine STRESS connection. Most people develop solid and flexible arches in childhood. Over the long term, the repetitive stresses of daily life lengthen the connective tissues, causing a slow breakdown of the regular support for the bones and joints of the feet and a decrease in elasticity, STRESS eventually leading to sagging of the foot’s arch. The foundation provided by the feet and legs must bear the entire body’s weight (and considerably more during running and other sports). If there is insufficient or inadequate support
from the pedal foundation, the spine PAIN will be exposed to abnormal stresses and strains that eventually develop
into low back pain.

Excessive stresses on the spine can result from abnormal foot biomechanics, poor function of the foot/ankle complex, excessive shock transmission, or leg length asymmetry.

Recognizing and then responding appropriately to these factors separate the Doctors of Chiropractic from the spinal technicians.

Orthotics and the Foot/Spine Connection

Static support:

While standing, the alignment of the arches in each foot has a significant impact on the position of the legs and pelvis. The knee will rotate medially when the arches are low and/or pronating excessively. A research study using radiographic measurements found that custom-made, flexible orthotics can significantly improve the alignment of the arches when standing.2

Dynamic support:

During gait, the foot must permit a smooth transfer of the body’s center of mass over the leg to conserve energy.3 This requires an orthotic to be flexible, yet supportive, and orthotic designs must consider:

  • Weight and intensity of forces
  • Proper movement and function of the foot
  • Support of all three arches to prevent eventual arch collapse

Postural benefits:

Improving foot alignment can help maintain knee, hip, pelvis, and even spinal postural alignment.4 Preventing joint degeneration requires the additional support and shock absorption provided by orthotics. And a pelvic or spinal tilt or recurrent subluxations will often respond rapidly to orthotic support.5


1 Cambron, J. A., Dexheimer, J. M., Duarte, M, & Freels, S 2017, Shoe Orthotics for the Treatment of Chronic Low Back Pain: A Randomized Controlled Trial. The Archives of Physical Medicine and Rehabilitation 2 Kuhn, D.R., et al. “Radiographic Evaluation of Weight-Bearing Orthotics and Their Effect on Flexible Pes Planus.” Journal of Manipulative and Physiological Therapeutics, vol. 22, no. 4, 1999, p. 221-226.
3 Kirby, K.A., “Biomechanics of the Normal and Abnormal Foot.” Journal of the American Podiatric Medical Association, vol. 90, no.1,2000, p. 30-34.
4 Baylis, W.J. and Rzonca, E.C. “Functional and Structural Limb Length Discrepancies: Evaluation and Treatment.” Clinics in Podiatric Medicine and Surgery, vol. 5, no.3,1988, p. 509-520.
5 Rothbart, B.A. and Estabrook, L. “Excessive Pronation: A Major Biomechanical Determinant in the Development of Chondromalacia and Pelvic Lists.” Journal of Manipulative and Physiological Therapeutics,

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Professional Scope of Practice *

The information herein on "The Foot and Spine Connection" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.

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Our information scope is limited to Chiropractic, musculoskeletal, acupuncture, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.

We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system.

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Our office has reasonably attempted to provide supportive citations and has identified the relevant research studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez, DC, or contact us at 915-850-0900.

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Dr. Alex Jimenez DC, MSACP, RN*, CCST, IFMCP*, CIFM*, ATN*


Licensed as a Doctor of Chiropractic (DC) in Texas & New Mexico*
Texas DC License # TX5807, New Mexico DC License # NM-DC2182

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Dr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
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