If you ask anyone, doctor, trainer, therapist or anyone at all who deals with the orthopedic and mechanically induced musculoskeletal pathologies along the entire kinetic chain what exactly causes these sometimes debilitating problems to occur, most every time they will tell you that “there is an imbalance present in the body that most times stems from an imbalance in the feet”. Some may tell you that all of the problems stem from the fact that “the patient pronates too severely and furthermore they pronate to different degrees on each foot and therefore there an imbalance is created and that is why their knee hurts.”

And if the allied health care professional did in fact answer your question with some variation of one or both of the above answers, they would be one hundred percent correct. It is a great thing that the awareness of the three dozen or so most common mechanically induced orthopedic problems that occur in the body stem from a common etiology, namely over or hyper pronation. However, with that being said, why does well over ninety percent of the population over pronate to the point where injury ultimately results? Pronation is good and necessary and clearly too much pronation is bad, but why then do so many of us pathologically pronate?

If the same allied health professional even gave you a response to that question, it would most likely be a single word; concrete! And once again they would be correct, but why is concrete bad for us other than it is a hard unyielding surface that offers no shock absorption. These obvious facts are usually presented and most people are happy with that as a final reason. I am very thankful that Robert Levine DPM was in fact not happy with that explanation as it did not cover the actual reason why concrete has such a negative impact on our bodies. At this time I wish to give credit to my partner, Bob Levine for his insight and observations which ultimately led to him defining the actual mechanism of why concrete so adversely affects our entire body.

Bob has in fact posed that concrete is the main culprit and cause of the vast majority of our populations current orthopedic woes, but he did not just glibly throw this out like so many dilettantes and self proclaimed biomechanical “gurus” do in their lectures or presentations. Also, stating that “gravity” is a major deforming force is another obvious fact that some present, but unless one has a way to over come that, blaming gravity is in essence like griping about paying taxes; it is inevitable so we must deal with it as a constant.

But back to the point, yes concrete is hard and unyielding and it does obviously cause some shock absorption problems, but the real reason why concrete is such a deforming force is that it causes us to function largely in only one very limited position. This may seem rather benign in itself, but upon further analysis of “it causes us to function largely in only one position” leads us to the crux of our discussion and in fact, this is the basis of the reason for our technology.

Functioning largely in only one position was posed through the observation that our forefathers walked the earth and they walked upon a variety of surfaces; some smooth, some slanted, some rocky and some very uneven and rather hard to negotiate even in the light of day. When you are walking, living and working on these varied surfaces, it would stand to reason that you would function throughout all the available ranges of motion that your body could possible achieve. This is to say walking on slanted uneven surfaces would cause you to at times grossly invert and evert your rear foot which in turn would cause the maximal amount of tibial rotation which in turn would cause the maximal amount of femoral rotation and so on up the kinetic chain. You could also see that muscle use in general would be dramatically increased as you would be forced to stabilize your body from tipping this way or that while negotiating this uneven terrain, not to mention the strength and coordination needed to climb up and over things that would have been a common occurrence waking through woods or over a rolling country side.

The point is that it was not from want, but rather out of necessity that we were forced to function in these extreme positions. And although life was physically more challenging compared to walking on and over smooth, solid, flat and stable surfaces, from a sheer physical body standpoint, it would not be hard to see a very obvious advantage to putting your body through this physical challenge and full ranges of motion each and every day.

But because we do not live or work on the varied surfaces that our forefathers did, our feet and all of the joints and muscles of the entire body do not function in the many positions that our forefathers feet, joints and muscles did. Subsequently we do not possess the range of motion or muscular strength that we would have otherwise if we walked on a variety of surfaces because we function largely at the end of our range of motion on primarily one universal surface which is hard, flat and unyielding.

A conceptual example away from the foot and ankle would be what would occur if you braced your elbow so that it only had function in let’s say thirty degrees instead of the usual 150 or so degrees of normal available functional motion. And let’s say you kept that up for twelve weeks. What do you think would happen once you took the brace off?

Well for starters, you would be very stiff and sore moving your arm through its entire range of motion if you could even actively move it thorough the entire range that you could have easily done before you limited the motion twelve weeks prior. And even if you could move it actively through the range which I doubt you would be able to do at first, you could see how you would have good strength in the thirty or so degrees in which you had functioned in over the past twelve weeks, but you could also see how you would have a considerable weakness in the positions outside of that thirty degrees range. Over just a period of period of twelve weeks you could see the potential damage and loss of function that you could induce from doing this to someone’s elbow. Now think of the effects that that situation would present if done for a year, a decade or a lifetime.

We in fact see this phenomena when a person is placed into a cast for a fractured bone for any significant period of time. Even periods of four to six weeks of immobilization usually necessitates extensive exercise and “rehabilitation” to just get the person back to the point where they were functioning previously to the fracture and immobilization.

The point here is that your foot functions the same exact way and in the same exact position and limited range of motion with each and every step you take over the hard flat surfaces we walk on all the time. We challenge you to ask yourself when the last time you actually stepped off a concrete like surface was. You would probably say “never” if you thought about it. Hardwood floors, bathroom tile, paved sidewalks, paved parking lots, thin carpet over slabs of concrete in every office building, and the obvious bare concrete floors in factories and businesses around the world are the surfaces that we live on day in and day out.

So, just like immobilizing your leg or arm in a cast, or more like the example of immobilizing a person’s elbow in a very limited range of motion, when you step down and your foot only moves or stays in a limited range of motion, the same phenomena occurs as with the elbow; you develop and maintain strength in certain positions and you develop dramatic weakness in other positions. This is to say that if someone over pronates over many years functioning on concrete type surfaces, the tendons and ligaments get stretched and “become accustomed” to that fully flattened out position that most over pronators eventually function in all the time. And remember that the fully collapsed arch maximally internally rotates the tibia which places a significant torque at the knee and the femur can in turn be forced to maximally or significantly internally rotate and so on until the lower back and entire chain is adversely affected. So, just as an apple falls from a tree to hit the ground, so does the arch. It eventually does this every time because, your foot’s arch, just like anything else will seek the weakest and subsequently the lowest position which is in fact the completely collapsed “flat on the floor position”. And the muscles and the ligaments try in vain to combat this but over time they slowly loose the battle until at last your arch drops lower and lower and lower until it literally hits the floor.

Here is another perspective on the constant battle your body goes through to continually hold up your arch while walking over only concrete. Try holding a standard full soup can with your arm fully extended out in front of you. Well, anyone can do that for a minute or two, but try doing it for thirty minutes or sixty minutes or for an entire day. This is what you are asking the muscles and ligaments that support your arch to do as they try to maintain by “holding up” the bones of the foot in a somewhat congruous arrangement so that when the body’s weight is placed down onto the foot, the brunt of the weight is held up and maintained by the boney architecture of the foot. But once the bones have too significantly separated or disarticulated, they never have the ability to lock up as they become in essence 26 separate bones with too far a gap in between them to ever truly and correctly interlock with each other.

The analogy of a fallen arch is really quite apropos as if you could pitcher an old Roman arch way and then pitcher it collapsed and seeing the dozens of bricks or stones laying on the ground, so it is with the bones of the foot. And to keep with the same analogy, the carpenters would have to collect the stones and replace them so that they could one again interlock and form that solid arch way that could then bear weight from above, likewise the muscles and ligaments of the feet have to pull back up and re-orientate the bones of the foot so that they can likewise regain their ability to interlock with one another.

More specifically, concerning why the damage occurs, remember that when your foot is locked up or placed in the most stable supinated position, virtually no injury is possible because it in essence acts as one big bone. A machine with no moving parts is not prone to break down. The same concept applies here. Conversely, as the foot pronates, the bones disarticulate to varying degrees and you now have 26 separate bones verses one solid unit. This is where the foot widens upon weight bearing and why you get bunions and hammer toes (are caused by the toes trying to grip the ground to cause a more stable base of support because of the relatively instable situation caused by the excessively pronated foot), arch pain, heel pain and dozens of other diagnoses are just as easily explained and are explained in the “Indications” section of this web site.

With this data presented as it is, I would hope that you can see that is not simply the fact that concrete itself offers no shock absorption because the foot has the capability to function quite nicely on this surface when the foot is functioning properly and the bones of the feet can remained close to their ideal configuration. But even now understanding this, what is to be done because I can assure you that we as a society are not going to abandon our nice smooth, hard and flat surfaces? And I will also state that even if you were to rehabilitate the muscles and they were able to lift the bones of the foot to once again place them into perfect alignment, the following would eventually happen functioning on this single surface; just like the extended arm with the soup can, the muscles and ligaments of the foot would eventually fail.

As this section of the web site is winding down, I have one last thought for you to ponder. With all this being said, how do you think the developing feet of our children are affected by concrete. With all this taken into effect, how do we prevent our children’s skeletal system from being adversely affected before their bones even have a chance to full ossify? Now imagine what effect just a few years of walking on concrete surfaces can do to a child’s feet and entire skeletal and muscular systems. Do you think that functioning in that limited position can affect the way that the bones of their feet grow? And since the position of the foot bones directly effect how the entire skeleton develops, do you think that this can severely affect the child’s entire skeleton system proper? Well, if you don’t, we do.

Like all problems, truly understanding the basic cause or etiology if the first thing you must achieve before you can solve the problem. And although it can be said with full assuredness that “concrete breaks a body down”, we have solved the problem with our theory and technology.

Read about our solution ►