The Link Between Foot Posture and Back Pain

Foot posture is a key element in maintaining not just foot health, but also the overall structural integrity of our body. It’s surprising how the alignment of our feet can impact our back. This article by Manly Cove Podiatry sheds light on this vital connection, helping you understand how your feet could be influencing your back health.

Understanding Foot Posture

Foot posture, a critical aspect of our biomechanics, refers to the way our feet align with the ground and the rest of our body. This alignment plays a pivotal role in our overall posture and has a significant impact on other areas of our body, particularly our back. The way our feet distribute weight and maintain balance influences our walking gait, standing posture, and the alignment of our entire skeletal structure.

Types of Foot Postures

  • Overpronation: This occurs when the foot rolls inward excessively as we walk or stand. Overpronation typically leads to a flattening of the foot’s arch and can cause a chain reaction of misalignment through the legs and up into the spine. It’s often associated with conditions like flat feet and can increase the risk of injuries and pain in the knees, hips, and lower back.
  • Supination (or Underpronation): In contrast, supination involves the foot rolling outward, often resulting in an exaggerated lifting of the arch. This condition can lead to insufficient impact absorption during walking or running, placing extra stress on the outer parts of the foot and leg. The imbalance created by supination can contribute to problems in the ankles, knees, hips, and back.
  • Neutral Posture: The ideal foot alignment is a neutral posture, where the foot neither overpronates nor supinates excessively. In a neutral posture, the feet best support the body’s weight, allowing for optimal shock absorption and efficient movement. This alignment helps in maintaining a balanced posture and reduces the risk of pain and injury in the feet, legs, and back.

The Foot-Back Connection

The relationship between our feet and our back is more intertwined than one might initially think. When feet overpronate, a common occurrence for many, it can set off a chain reaction within the body. Overpronation causes the foot to roll inwards excessively, leading to internal rotation of the leg. This misalignment can affect the knee and hip positions, often leading to compensatory changes in posture to maintain balance. These compensatory changes can put undue stress on the lower back, potentially leading to various spinal issues over time.

On the other side of the spectrum, we have supination. This condition, where the feet roll outward, results in an exaggerated lifting of the foot’s arch. Supination often leads to an uneven distribution of weight across the feet. The body, in an attempt to balance this uneven weight distribution, may shift its alignment, potentially causing an imbalance in the body’s overall posture. This imbalance can strain the muscles and ligaments in the back, leading to potential spinal misalignment and subsequent back pain.

Common Foot Posture-Related Back Problems

Foot posture problems can lead to a variety of back issues. When the feet do not provide the right support, it can lead to an imbalance in the body’s alignment, resulting in back pain. Common issues include:

  • Lower Back Pain: This is often linked to overpronation. When the feet roll inwards excessively, it can lead to an imbalance in the pelvis, increasing strain on the lower back.
  • Sciatica: Improper foot alignment can pressure the sciatic nerve, leading to pain that radiates from the lower back down through the legs.
  • Muscle Imbalances: Poor foot posture can lead to uneven muscle use, causing some muscles to overwork and become tight, while others weaken, contributing to back discomfort.

These conditions highlight the need for proper foot posture to maintain back health. Early recognition and intervention are key to preventing chronic back issues.

Preventing and Treating Back Pain Caused by Foot Posture

The prevention and treatment of back pain related to foot posture require a multifaceted approach, incorporating both preventative measures and specific treatment options.

Preventative Measures

  • Proper Footwear: Choosing the right shoes is crucial. Footwear with proper arch support and a comfortable fit can prevent the foot from overpronating or supinating. This support helps maintain natural foot alignment, reducing the risk of back pain. In addition, shoes should be appropriate for specific activities – for example, running shoes for runners, which provide extra cushioning and support.
  • Foot Strengthening Exercises: Building foot strength and flexibility is key. Exercises like toe curls, heel raises, and arch lifts can strengthen the muscles of the feet, improving their ability to support proper posture. Additionally, exercises using balance boards or resistance bands can enhance foot stability and coordination.
  • Regular Foot Assessments: Periodic check-ups with a podiatrist can catch potential problems early. These assessments might include gait analysis to understand how your feet impact your posture and back health. The podiatrist can then recommend specific interventions, such as exercises or orthotics, to address any issues.

Treatment Options

  • Orthotics: Custom orthotics are often a cornerstone of treating foot-posture-related back pain. These personalised inserts are designed to correct abnormal foot mechanics, like overpronation or supination. By realigning the foot and ankle, they can reduce the strain transferred up the leg and into the lower back.
  • Physical Therapy: A physical therapist can develop a tailored exercise regimen that not only targets foot strength and flexibility but also focuses on the core and back muscles. This holistic approach ensures that the entire kinetic chain, from the feet up, works harmoniously, reducing the risk of back pain. Techniques may include stretching, strengthening exercises, and posture training.
  • Chiropractic Care: Chiropractic adjustments can be particularly effective for those whose back pain is directly linked to foot posture issues. By realigning the spine and adjusting any joint misalignments, chiropractors can alleviate pain and improve overall body mechanics. This care may be complemented with advice on posture and ergonomics to prevent future issues.

Choosing the Right Footwear for Healthy Posture

Selecting the right footwear is crucial in maintaining healthy foot posture, which in turn can significantly affect your back health.

Tips for Selecting Shoes that Support Healthy Foot Posture:

  • Look for Proper Arch Support: Shoes should have a supportive arch that matches the natural curve of your foot. This is essential to prevent overpronation or supination.
  • Ensure Adequate Cushioning: Good cushioning helps absorb shock, reducing the impact on your feet and, consequently, your spine.
  • Check for a Firm Heel Counter: A sturdy heel counter provides stability and helps control the motion of the foot.
  • Opt for the Right Fit: Shoes that are too tight or too loose can alter your walking pattern, leading to posture issues. Ensure a snug fit, with enough room to wiggle your toes.
  • Consider Activity-Specific Shoes: Different activities demand different types of support. For instance, running shoes are designed differently from walking shoes.

Recommendations for Different Lifestyles or Activities

  • For Office Workers: Opt for comfortable, well-cushioned shoes that support the feet during prolonged periods of sitting and occasional walking.
  • For Athletes: Athletic shoes should be activity-specific to provide the right type of support and cushioning. Replace them regularly to ensure continuous support.
  • For Seniors: Shoes with non-slip soles and a comfortable fit can help in maintaining balance and preventing falls.


In summary, the importance of choosing the right footwear cannot be overstated when it comes to maintaining healthy foot posture and, by extension, a healthy back. Paying attention to shoe features like arch support, cushioning, and fit is essential. Remember, the right shoes do more than just protect your feet; they play a pivotal role in your overall posture and spinal health.