A patient recently attended Dubai Podiatry Centre with an interesting story that led to a much wider discussion about menopause, movement, muscle strength and the importance of keeping our bodies active as we age.
She had completed menopause and described how, during the previous year, she had gained weight and noticed a significant change in her muscle tone and the way her body felt. She felt that she had lost some of the strength, firmness and resilience that she previously had.
More recently, however, she had become very proactive about her health. Under professional guidance, she had been exploring treatments aimed at supporting her health after menopause, while also paying closer attention to her vitamin D and calcium intake. Most importantly from our perspective, she had started walking every morning and was feeling considerably better.
She also mentioned feeling particularly motivated after listening to Mel Robbins’ podcast discussions about longevity and maintaining strength and health as we get older.
This prompted a fascinating conversation in the clinic about something we often discuss with our patients:
When it comes to movement, we really do have to use it or lose it.
Think of Your Fascia Like a Springy Spider’s Web
Fascia is the connective tissue network that runs throughout the body, surrounding and connecting muscles, bones and other structures.
I often describe it to patients as being a little like a three-dimensional spider’s web running throughout the body.
When we are young and active, our bodies tend to have a wonderful natural springiness. We run, skip, jump, change direction, climb stairs and step over obstacles without giving these movements much thought.
As we get older, particularly if our activity levels reduce, we can gradually stop performing many of these movements.
We may still walk, but perhaps we no longer skip.
We may climb stairs, but rarely jump.
We may exercise, but always in straight, predictable movements.
Gradually, we can lose some of our strength, agility, balance and natural rebound.
The answer is not necessarily extreme exercise. It is about continuing to give our bodies a variety of movements.
Walking and Our “Second Heart”
One of the best forms of exercise remains one of the simplest: walking.
The calf muscles are sometimes referred to as our “second heart” because their contractions help pump venous blood from the lower legs back towards the heart.
Every time we walk and activate our calf muscles, we are helping this natural pumping mechanism.
Regular walking is therefore wonderful for maintaining calf muscle activity, circulation, cardiovascular fitness, mobility and general wellbeing.
But walking does not have to be the only movement we practise.
Bring Back a Little Agility
I am delighted to see movements similar to traditional step aerobics becoming popular again.
Step exercises require us to lift our feet, judge the height of a step, transfer our weight, turn, coordinate our legs and maintain our balance.
These are valuable skills.
As we age, maintaining the ability to change direction, step sideways, lift our feet over an obstacle and react to an irregular surface becomes increasingly important.
Simple activities can include:
- Walking regularly
- Stepping up and down from a low exercise step
- Side stepping
- Gentle direction changes
- Appropriate strength exercises
- Balance exercises
- Practising safely stepping over small obstacles
- Maintaining the ability to get up and down from the floor
The exercises chosen should, of course, be appropriate for the individual’s health, balance, strength and medical history.
But What Happens When Walking Hurts?
Our patient’s motivation was excellent, but there was another part of the story.
She was experiencing plantar fascia discomfort as well as lower back and shoulder blade pain, particularly on one side.
Her chiropractor had also identified significant asymmetry and felt that her alignment could be contributing to her symptoms when walking.
This is an important point.
We frequently encourage patients to walk more, but if somebody is significantly mechanically misaligned, repeatedly walking with that imbalance can sometimes continue to aggravate certain tissues.
We therefore assessed her using our 3D scanning system.
The scan demonstrated an apparent leg length discrepancy of approximately 3.1 cm, with the left side measuring longer. For somebody approximately 5 feet 4 inches tall, this represented a considerable asymmetry.
Rather than simply treating the painful plantar fascia, we needed to look at what was happening throughout the body.
The Feet Can Affect What Happens Above Them
The feet are the foundation of the body when we stand and walk.
If one side functions differently from the other, compensation can occur through the legs, pelvis and higher into the body.
I sometimes describe this as a Z-shaped compensation pattern.
The body does not necessarily remain neatly vertical when trying to accommodate an imbalance. Soft tissues tighten, joints adapt and the pelvis and upper body may compensate in different directions.
For this patient, we therefore made the left and right orthotics quite differently.
The angles and thicknesses were individually designed to improve her overall alignment rather than simply giving her two identical insoles.
An Immediate Change From 3.1 cm to 1.3 cm
We then repeated her 3D assessment while she was standing on her new orthotics.
The apparent leg length discrepancy reduced immediately from approximately 3.1 cm to 1.3 cm.
That was an excellent initial change.
Importantly, however, our aim was not to make both sides completely equal on the first day.
The body has been compensating for its existing position for a long time. Muscles, fascia and other soft tissues have adapted to that position too.
Changing everything immediately can therefore be too much.
Instead, we make an initial correction and allow the body time to adapt.
Why We Review Again After 6–12 Weeks
We will review this patient again after approximately 6–12 weeks.
During this period, the muscles and soft tissues have time to respond to the altered skeletal alignment.
An apparent leg length discrepancy can sometimes look greater during the initial assessment because the measurement is influenced not only by the bones themselves but also by rotation and compensation occurring throughout the body.
As these compensatory patterns reduce, the apparent discrepancy may also change.
At the review appointment, we can repeat the assessment and adjust the orthotics according to how her body has responded.
This gradual approach allows us to work with the body rather than trying to force an immediate correction.
Healthy Ageing Starts From the Ground Up
One of the most positive things about this patient’s story was her motivation.
She wanted to walk.
She wanted to become stronger.
She wanted to maintain her mobility and enjoy her body as she moved into the next stage of her life.
That is exactly what we want to encourage.
Menopause and ageing can bring changes in muscle mass, bone health and body composition, but becoming older should not mean accepting that we can no longer move freely.
Walk.
Maintain your strength.
Challenge your balance.
Practise changing direction.
Lift your feet.
Use stairs and steps when appropriate.
And, if you used to skip, perhaps don’t completely forget how to skip.
Our bodies are designed for movement.
Use your movement, maintain your strength, and look after the foundations carrying you through life: your feet.
For more information or to book an appointment please call our clinic +971 4 3435390 or WhatsApp +971 50 3553024
