Feet Cause Back Pain

How Your Feet Can Cause Back Pain

How often do you think about your feet? We walk around on them all day, cram them into tight fitting shoes, and sometimes even high heels. We use them, abuse them, and in general most of us take them for granted, not even considering how what happens at our base affects the rest of our body. So let’s take a moment to focus on what our feet really do for us.

Our feet are our foundation. Let’s think about this in terms of construction. If there is a weakness or crack in the foundation of a building, eventually the entire structure will collapse. The same thing goes for our bodies. If our foundation is weak and disconnected, it will translate to everything above it. Consider the body in its most stable standing position. The feet are hip distance and parallel, the ankles are situated directly over the heel bone, the knees directly above the ankles, the hips stacked directly above the knees, the shoulders over the hips, and finally the head floats into place so that the ear canal lines up above the shoulders and you could in theory draw a straight line from the ear down to the heels. Unfortunately, standing like this doesn’t come naturally, so we have to practice it. Add to that how disconnected we as a species have become from our feet through the constant use of shoes and you have a recipe for various unpleasant circumstances in the body.

Many of us do not have the luxury of being barefoot all the time. When we wear shoes, we deprive our feet the opportunity of working the way they are supposed to work, which means all of the tiny muscles in our feet begin to atrophy. We no longer have the ability to spread our toes wide apart from the toe mounds or the ability to hold our ankles in proper alignment. If our ankles misalign, then so do our knees, hips, pelvis and low back! And what happens when we have chronic misalignment? You guessed it. Chronic pain. If it hasn’t reached your back yet, don’t worry; it will eventually. Now, let’s take a look at the most common issues people face with their feet. I encourage you to go stand in front of a full length mirror and play with the different foot positions as you bring awareness to each part of your body and see what happens with each variation. The best way to learn about your body is to feel it!


Some of us pronate, which means the inner arches collapse. People who are flat footed suffer from pronation. When this happens, the ankles bulge inwards and the knees collapse towards one another (knock knees). Now the upper body has to adjust in order to stay upright above this awkward base. To do this, the lower back rounds which causes the hip flexors to shorten, and the shoulders round forward, causing the head to drift forward and the weight of the head to be supported by the back of the neck and the muscles of the upper back. This will cause pain in the lower back as well as in the neck and shoulders.


Supination is the opposite of pronation. Those of us who supinate roll to the outside edge of the foot so that the inner arch lifts and most of the weight falls onto the pinky toe side of the foot. The ankles will bulge out to the sides and the legs may bow out as well. You can also see this when the feet are not bearing weight. If someone who supinates sits down with their legs straight out in front of them, the foot will sickle, meaning the inner ankle will shorten and the inner foot will pull up towards the groin while the outer foot lengthens away from the body.

To compensate, the pelvis will spill forward and the buttocks will protrude out causing a sway back and low back pain.

In-Toeing (Pigeon Toed) and Out-Toeing (Duck Feet)

In-toed folks stand and walk with their toes pointed in and their heels pointing out, while out-toed people have their heels closer to one another and their toes pointing out like a duck (or Charlie Chaplain). This issue generally stems from higher up in the body, usually an imbalance around the hips causing the thigh bone to either internally rotate or externally rotate in the hip socket which becomes outwardly visible by in-toeing or out-toeing respectively.

Being pigeon toed tends to affect the back less so than being duck footed, and usually corrects itself in children by the age of 12. It does, however, still present the body with an imbalance to have to compensate for which may or may not cause pain.

Out-toeing, on the other hand, puts the sacrum at much risk. When we externally rotate our thighs inside the hip socket, the mere mechanics of that movement compresses the sacrum and draws it into the body and creating a swayback. Less space in the sacrum means more opportunity for bones to jam into one another, which certainly isn’t comfortable. If you walk around with only one foot pointing out, then in addition to compressing the low back, you’re also doing it asymmetrically, thus creating yet another imbalance.

So, Now What?

Now that we have identified a few of the most common misalignments of the foot, what do we do about it? The first step to changing something is awareness and mindfulness.

Begin by standing in front of a mirror barefoot, or simply looking down, and see what it is that your feet are doing when you are standing. Next, see if you can bring your body into a neutral position. If your feet turn in or out, make the necessary corrections of the thigh within the hip socket to make the feet parallel and the knees point straight forward. Also, make sure that one foot isn’t in front of the other. If your feet pronate, practice pressing down through the outer heels and the pinky-toe side of the foot. If your feet supinate, press through the big toe mound and the inner heel. No matter your malady, practice lifting all ten of your toes and spreading them out as wide as you can. Notice how all three arches (lateral, medial, and transverse) lift as the muscles of the feet activate. Practice evenly distributing the weight across the entire foot.

Beyond how we stand is how we walk. Figure out your gait by marching in place slowly and consciously. Bring one knee up to hip hight and then place it back down, and then repeat on the other side. Pay close attention to how you place your foot back down on the ground. See if you can place them back down in the neutral position you originally found.

Follow up by walking around barefoot as much as possible, all the while being particularly conscious of how you place your feet as you step and bringing this kind of awareness into your feet regularly. Over time your neural pathways will change and your unconscious habits of how you place your feet will change with them. One day it just might hit you that something in your body has changed and where there once was pain, there is not.

Andrea Clemente

Andrea Clemente is a yoga, fitness, and wellness professional based in Los Angeles, CA. She is a registered teacher with the Yoga Alliance as well as a certified Massage Therapist and has been helping people alleviate back pain since 2007. She currently teaches both public and private yoga and fitness classes, as well as offers services in health and wellness coaching.