The Foot Tripod

The foot is a very complex structure that is suited to handle several key tasks involving human movement. With 28 bones, articulating joints between each of those bones, and many muscles acting on those bones and joints, the foot can be a bit overwhelming when attempting to understand its intricacies in movement.

When I work with clients, the feet are an area I am always paying attention to. Some of the most common dysfunctions and symptomatic presentations throughout the body often involve compromised function of the feet. If you think about how often we use our feet when we move, most of the time we are on our feet. Standing in line at the grocery store. Walking around the house cleaning. Commuting to work on foot. Going for a run. Hiking. Particularly with traditional strength training exercises like deadlifts, squats, and lunges, the feet are the foundation.

In my estimation, the feet have several major functions. First, the feet provide the foundation for gait. In gait, the foot needs to dynamically stabilize and oscillate between pronation and supination to feed into the kinetic chains upstream. Secondly, the feet are rich with receptors providing copious amounts of feedback about body position, the surfaces we are walking on, balance, etc. Lastly, the foot often acts as a tripod to provide isometric stability during many different closed-chain exercises, particularly those that are common within traditional strength training methodologies like squatting, deadlifting ,lunging, etc.

For the purposes of this article, we are focusing on the tripod function of the foot, briefly reviewing the anatomy, the role the foot tripod plays in providing a stable foundation for strength training, and some ways to improve the function of our foot tripod through exercises and drills.

Anatomy of the Tripod Foot

Let’s start by talking about the three-points that make up the foot tripod. First, we have the calcaneus (heel) as the first contact point. The medial contact point of the tripod is the first MTP joint or the first metatarsal head (ball of the foot). The lateral contact point is the head of the fifth MTP joint (base of the pinky toe). See the points highlighted below.

(Picture from Tony Gentilcore’s blog – Tony’s is an excellent blog to follow.)

Easy enough to conceptualize and visualize, right? Understanding the structure of the tripod is important. We need each of these three points to be able to maintain contact with the ground. If one point cannot engage with the floor, then the rest of structure above (lower leg, knee, upper leg, hip) will have its alignment and function compromised during movement. For example, an inability to load the medial contact point typically leads to excessive pronation, which often creates a cascade of rotational compensation in the knee, hip, and pelvis.

In order to understand how to ensure each of these points is functioning to promote a strong tripod and stable foot, we need to also understand the primary muscles involved. These are:

  • Posterior Tibialis
  • Abductor Hallucis
  • Flexor Hallucis Longus
  • Extensor Hallucis Brevis

While there are more than just 4 muscles that have a direct impact on the structural integrity of the foot tripod, these are the main players. The posterior tibialis helps to supinate (think – “turn in”) the foot, which lifts the arch, facilitating inversion of the ankle. The abductor hallucis is key in controlling the “gripping” or “reaching” movement of the big toe through the midfoot. The extensor hallucis brevis is important in how it affects the first MTP joint, allowing the ball of the foot to settle onto the ground instead of the pad of the big toe simply just pressing into the floor. The flexor hallucis brevis runs through the sesamoid bones (for mechanical advantage) and ultimately helps the 1st metatarsal (big toe) to press down and engage with the floor, similarly to the abductor hallucis.

Each of these muscles help provide structural integrity of the foot arch. Being able to have a normal foot arch is paramount for having a stable and functional foot tripod. If there are dysfunctional relationships between the ankle, rearfoot, midfoot, forefoot, or toes, our arch and thus our tripod will function less than optimally.

Tripod Foot During Training

Other than low-back pain, knee pain might be the most common pain out there, for both sedentary folks and high level athletes alike. Not taking into consideration acute trauma to the knee, such as ACL sprains or meniscus tears, knee pain is most often a product of mechanical stress created by dysfunction in the feet or hips. Not spending enough time on our feet, coupled with the fact that the time we do spend on our feet is typically in cushioned footwear, is not a recipe for healthy and functional feet. When someone comes to see me with knee pain, 8 out of 10 times, improving their foot function resolves their knee issues.

When it comes to understanding the feet from a strength training perspective, here a few key principles to think about:

  • Inability to bear weight on outside of the foot will emphasize the medial quads, hamstrings, calves, and adductors.
  • Inability to bear weight on inside of the foot will emphasize the lateral quads, hamstrings, and calves.
  • Inability to load the forefoot will often lead to synergistic dominance of the toe extensors and lumbar erectors.
  • Inability to load the rearfoot (heel) will often lead to synergistic dominance of the distal quads and adductors.
  • An unstable foot tripod will lead to an inability to load at least one part of the foot.

For the sake of simplicity (foot mechanics are anything but simple), we are referring mostly to closed-chain (foot is in contact with the ground or a platform) exercises like squats, deadlifts, and lunges. An inability to load any given part of the foot is a problem when you’re working with appreciable loads. If you can’t efficiently distribute load through the whole foot, you will inevitably compensate somewhere further up in the kinetic chains. As previously mentioned, suboptimal compensation usually leads to mechanical stress on adjacent structures like the knees, hips, pelvis, and lower spine. The key to a functional capacity for lower body strength training starts with the foot.

Establishing a functional foot tripod is the first step in restoring and maintaining healthy feet. After we learn how to create isometric stability in our feet via our tripod, we can then branch out and start to explore the dynamic stability of our feet on the pronation-supination continuum. But we will save that for another day.

Strategies to Improve Function the Tripod Foot

Try this: Stand hip width apart with your glutes engaged so your pelvis is in neutral alignment, and lift just your toes off the ground. Can you feel the 2 forefoot tripod points? How about if you start to bend at the knees and hips to initiate a squat?

If not, there is a compromise in your ability to load either the inside of the outside of the foot properly. This will lead to inefficient loading in the primary leg and hip muscles.

In order to restore our foot tripod we need to improve mobility within the bones and joints of the foot. If the bones can’t move, it’s typically indicative that they do not have the capacity for load. If either the structural integrity of the joint, or the muscular support required to stabilize the joint during any given movement are not functioning optimally, the nervous system often creates compression in the joint in an attempt to create stability. This is a less than ideal compensation strategy. While it makes the joint more stable, it also decreases joint space, increases mechanical stress in the joint, and creates short-circuiting of the muscles (tight, painful, weak) that act on that joint.

In my experience, the quickest and most effective way to restore mobility in a joint is to specifically assess and correct neurological compensation via specific manual therapy techniques like P-DTR. Manual adjustments performed by a qualified professional can sometimes be helpful and necessary. Problem is that they often don’t stick. The way to make manual adjustments stick is to reinforce and integrate the adjustments or mobilizations with movement.

One of the best self-administered ways of improving joint mobility over time is through gentle joint flossing drills. By progressively subjecting the joints to mobilization techniques that allow the joints and muscles to adapt over time, both the structure and nervous system will process and manage the movements better.

Three key areas to ensure have the requisite bone-on-bone mobility are the calcaneus, cuboid, and navicular. Each of these midfoot bones’ ability to load is paramount for foot tripod function. Here are three drills that I have had tremendous success utilizing with myself and with clients to help restore mobility in the calcaneus, cuboid, and navicular bones of the feet.

Utilizing these drills to “wake up” the foot and get the joints moving more freely is an effective first step in improving our foot tripod. After we mobilize the feet, we then need to integrate the feet with the ankles. Here’s one of many drills I like to work on this:

From here, there are no shortage of other drills you can use to specifically address whatever deficiencies your feet might have. To start, I suggest trying out the above drills, and then training bearfoot more often, especially on your lower body focused training days.

The feet can be understood and broken down so many different ways. Hopefully this perspective is helpful in better understanding the foot tripod. Plenty more information on the feet is in the works.

Biomechanics 101: Making Sense of the Human Machine in Movement

By Josh Landis

If you’ve been reading any of the articles I’ve written and shared over the last several months, you might have noticed that I’ve made it a point of emphasis to illustrate the importance of how many systems in our body, not just our tissues, contribute to neuromuscular function and consequently pain and performance. The term “neuromuscular” refers specifically to how our nervous system (brain, spinal cord, and peripheral nerves and receptors) controls how our muscles contract and relax. Our muscles function based on how our brain tells them to function; muscles are slaves to the orders given to them by the brain. How our muscles function determines how our joints move individually and in larger coordinated patterns to produce movement.

Even though muscle function and movement are ultimately determined by the outputs of the nervous system, understanding the components of the human machine and how things work together biomechanically is still important. The main problem I have found when it comes to understanding biomechanics and functional anatomy is that we have largely left out the “bio” part, and tend to focus too much on the “mechanical.” But I digress…

For the purposes of this post, I’m going to focus on what I consider to be some of the most important tenets and principles of biomechanics and functional anatomy as they relate to training and rehabilitation. There are a handful of principles that are at the forefront of what some the best coaches and therapists out there are utilizing. Three prevalent ideas that have come to really define higher-level assessment and correction strategies when it comes to training and rehabilitation are the “Joint-by-Joint Approach”, fascial slings, and kinetic chains. I’m going to break down each one and attempt to extrapolate the most useful tools that can be derived from each.

The Joint by Joint Approach

What is It?

When I first started out in this industry, I began as a personal trainer trying to get my hands on everything related to corrective exercise and functional training; I wanted to explore the depths to which strength and conditioning could be catered towards rehabilitation. The first foundational principle that really defined my training paradigm early was the “Joint by Joint Approach,” popularized by physical therapist Gray Cook and strength coach Michael Boyle.

The joint by joint approach is based on the idea that when it comes to movement, the body is essentially a series of joints working in sequence to produce movement, and that each of these joints has a specific function, and those functions generally alternate as follows (as broken down by Boyle):


  • Ankle–Mobility (sagittal)
  • Knee–Stability
  • Hip–Mobility (multi-planar)
  • Lumbar Spine–Stability
  • Thoracic Spine–Mobility
  • Scapula–Stability
  • Glenohumeral–Mobility

Some joints require more range of motion, some joints require less. Some primarily move in rotation (glenohumeral) while others might be more suited for flexion and extension (knee). If we lack mobility in a joint designed to be mobile, the next joint involved in the movement will often pick up the slack, and we may end up getting too much movement in a joint that is more suited to remain more fixed and stable. This can obviously cause problems. The joint-by-joint approach is a helpful principle for determining how one area of the body can potentially affect another.

How Do We Use It?

When we are utilizing the joint by joint approach in our clinical application and forming treatment and training strategies, we are largely breaking the body down into its components (joints in this case), determining which components are not working, and then provide treatment on those dysfunctional components in the hopes that with all the components working individually, we can improve how they work together synergistically.

An example would be something like this:

  1. Client squats.
  2. Client can’t squat deeply.
  3. We understand the involved joints to be the ankles, knees, and hips primarily.
  4. We assess each joint.
  5. The mobility in the ankles is limited, therefore a key component of the squat is not available.
  6. We mobilize the ankle.
  7. The client can now squat more deeply.

By working with this model, we can often determine where our clients are breaking down in large-scale movements like a squat, provide therapy or corrective strategies to the specific area that needs it, and then recheck our large-scale movement. We are operating on the idea that a chain is only as strong as its weakest link. If we fix the weak link, the whole chain improves.

Fascial Slings

Superficial Back Line.jpg

What are They?

Another incredibly viable and useful anatomical principle is the idea of continuities of connective tissue (fascia) spanning across areas of the body in long slings. This idea has been popularized by one of the predominant great minds in the world of fascia, Tom Myers. His book, Anatomy Trains, has had a huge influence on how movement professionals and therapists understand human movement.

If we take a look at a basic fascial sling, like the “Superficial Back Line,” we can see that instead of looking at the body as an alternating series of mobile and stable joints and how they interact, we are more so looking at longer lines of fascia and how these fascial continuities form groups or longer slings of muscles that work synergistically together. The superficial back line includes (from the bottom up) the plantar fascia, achilles, calf muscles, hamstrings, sacrotuberous ligament, sacrum, spinal erectors, and neck extensors. Even though there are multiple components throughout this “line,” the idea behind these fascial slings is that if there is a problem in one part, the rest of the line will be affected via fascial tension imbalances.

How Do We Use It?

When we are using the fascial slings as a guide, we must appreciate not only the fascia, but also the muscles and joints included along a fascial continuity. Thinking about a long chain of muscles as a singular functional unit can be helpful in the sense of understanding how one part of the chain is directly connected functionally AND anatomically to another part of the chain.

A good example of this, sticking with the “Superficial Back Line” as our functional unit, is plantar fasciitis. If you identify the involved components of the superficial back line, it includes the plantar fascia on the bottom of the foot as well as the gluteal muscles. Many times, we can make a direct connection between the glutes not contributing enough during movements involving the superficial back line (deadlifts, for example), and thus another area along the chain, in this case the plantar fascia, is getting overstimulated. Too much stimulation to any area can lead to mechanical stress over time and potentially pain. For a case like this, getting the glutes to work more efficiently can be the key to alleviating symptoms at the feet and resolving the plantar fasciitis.

Using this line of thinking and appreciation of how longer chains connect seemingly unrelated structures, we can operate with more possibilities for treatment and training strategies.

Kinetic Chains/Subsystems

What are They?

Another way to categorize and compartmentalize the body in order to facilitate our understanding of movement is to use kinetic chains and subsystems. Utilizing kinetic chains has become my preferred method for mapping out dysfunctions in the body over the years. Far and away the most comprehensive and useful system for understanding kinetic chains are the “5 Primary Kinetic Chains” as taught by Joseph Schwartz in his Dynamic Neuromuscular Assessment” course.

While there are many ways to organize the body biomechanically, the 5 primary kinetic chains are broken down in a way that is more specific to how humans are biologically designed to move. Not only is each chain important to consider in and of itself, but understanding how each chain interacts with and supports the others is an important underlying concept. The 5 primary kinetic chains are building blocks for assessing and restoring functional movement.

How Do We Use It?

Looking at kinetic chains is usually more helpful than simply considering how joints interact, or by how muscles are strung together via fascial lines. Understanding kinetic chains allows us to build a functional foundation from the inside out, taking into consideration all pieces of the chain; muscles, ligaments, joints, and fascia included.

5 Kinetic Chains'.png
  1. Intrinsic kinetic chain – Includes the muscles of the inner core and respiration. Breathing and core stability are the foundation of any movement. We must start here. Once our breathing and core are optimized…
  2. Deep Longitudinal kinetic chain – Includes the lower leg muscles, hamstrings, sacrum, and spinal erectors. The purpose of this chain is to allow us to dissipate ground reaction force and absorb shock. It begins to create axial stability to allow for the large more powerful muscles to produce force.
  3. Lateral Kinetic Chain – Includes lower leg muscles, adductors, abductors, and the QLs, and has the primary role of setting a foundation for our spiral kinetic chains to operate on. Stability of the pelvis and ribcage are paramount here.
  4. Posterior Spiral Kinetic Chain – Includes the toe and plantar flexor groups, ITB, glutes, SI joint, TL fascia, contralateral lats, and extensors of the shoulder and arm. The primary purpose is to store and release elastic energy through rotation.
  5. Anterior Spiral Kinetic Chain – Includes dorsiflexors, hamstrings, hip flexors, adductors, abdominals, pecs, and shoulder and elbow flexors. The primary purpose of the anterior spiral kinetic chain is to translate much of the elastic energy stored by the posterior chain. Think punching or throwing after a windup.

Understanding that each of these chains builds on the previous one, that they all have a distinct function, and that these chains play a role in almost every movement, we can utilize them to help guide our training and treatment protocols. If the core isn’t functioning well, that’s where we start. If we identify a lack of ability to absorb shock, we build on that. Then we assess how stable the axial skeleton can stay during stability challenges. Then we start to focus on build strength and power in rotation.

We parse out the pieces of these chains that are not able to participate or respond well to different movements, we treat those areas with any numbers of therapeutic interventions, and then we integrate the pieces back into their respective kinetic chains. Integration occurs are several levels; within each chain individually, between the chains relative to each other, and each corrective intervention should take into account the integration of various body systems.

Wrapping Up

All these models for understanding functional anatomy and biomechanics are helpful, but it’s also important to understand that our experience of movement and sometimes pain is always context specific. Certain principles or models for understanding movement have a lot of carryover. But we also need to make sure our training and therapy is helping us specifically for what we are trying to improve.

Biomechanics can be broken down many different ways. No matter what lens you are viewing the body through, there are a few key principles to appreciate. Firstly, we must understand how interconnected the body is, not just structurally, but also functionally. Dysfunction in one area of the body affects adjacent or other sometimes seemingly distant and unrelated areas of the body. Secondly, we should have some way to deconstruct global complex movements into its requisite parts in order to thoroughly assess the weak links. A chain is only as strong as its weakest link. Third and most important, no matter what model you use to assess and correct movement, remember while that biomechanics, anatomy, and structure are all important, that humans are more than just machines. There is a hierarchy that we must appreciate. Muscles, joints, and tissues are at the mercy of the nervous system. We are deeper and more complex than just a collection of mechanical parts. Yes, we are physical bodies, but with emotions, and thoughts, and feelings, and souls. Never forget to treat the person, not just the parts.

Hopefully this was a relatively helpful breakdown of some popular biomechanical models for understanding movement. These concepts can be applied many different ways. In the coming weeks, I will be taking these broader concepts and applying them to specific musculoskeletal issues. I’m sure some of you are antsy to finally get some specific breakdowns and have me dive into the meat and potatoes of the physical stuff. Let me know if there are any specific things you want me to breakdown!

The Problem with Medical Imaging

by Dr. Victoria Welch

“Based on the MRI, my surgeon said I need surgery.” This is a sentence I have heard countless times over many years in practice. I would love to share some opinions and observations I have regarding this sentence and diagnostic imaging in general.

Sometimes surgery is necessary. There’s no amount of neurological manual therapy, massage, nutrition, adjusting, or energetic awareness that can put a broken femur back together. However, situations like this are the exception, not the rule. The image below shows a number of common findings that often result in a patient “going under the knife.” The statistics listed here are “incidental” findings, meaning the person was experiencing NO symptoms of discomfort. (For example, 87% of people over 20 years old have a bulging disc but no pain.) And yet, when these findings are accompanied by discomfort, the abnormalities in the imagining are immediately assumed to be the cause. So if a bulge or tear is seen in the imaging, but many people with similar imaging are not in pain, then why assume your bulge or tear is causing the pain you’re experiencing?

Let’s think about pain for a minute. There are several series of neurologic inputs that can be interpreted by the brain as “pain.” Many things can feed in to this “pain” input: physical changes in the body, aberrant nerve signaling, emotions, nutrition, attitude, etc. Pain is not an exact equation, and therefore does not “have” to be present in all situations, even if there are changes evident on imaging. This is fantastic news! The following are a few examples of what I’ve seen over the years:

Example one: Two men entered within a week of each other with nearly identical low back injuries. Both acquired the injury during the warm up set of deadlifts, both with pain and numbness down the leg, both fit and in their mid 40s. The MRIs revealed moderate disc herniation at L5/S1. There was one stark contrast between these two men. One man was happy, the other pictured himself as a victim. The first improved substantially within 8 weeks. The second had no improvement with conservative care, surgery, still no improvement after surgery, and remained angry and victimized the whole time. These men were on two very different journeys and had two very different experiences, despite having similar imaging. I know they each had the experience they needed. However, it is interesting to ponder the influence of the mind on the body and the not-so-definitive findings of diagnostic imaging.

Example two: I have had three individuals enter my office within the last year with hip replacement surgery already scheduled. All three had findings of arthritis on their MRI and had pain for several years. Using neurological manual therapy, some nutritional shifts, and improving energetic awareness, all three have been virtually pain free for greater than 9 months. The arthritis is still present, but the brain is no longer interpreting pain within the body. All three cancelled their surgery. Again, imaging still showed the same abnormalities, but the individuals were no longer in pain.

The work we do at DPPS is geared toward not only reducing this electrical signaling of pain to the brain, but also addressing the body and mind as a whole. We are complex, unique beings, and trying to define our experience in our bodies just by looking at an x-ray or MRI can be misleading. Luckily, we don’t work with the MRI, we work with client, listening to what your body is asking for and helping create positive change you can feel.


There comes a time when we must choose between rage and bitterness and being wild again.

There comes a time for us to look at all of the little and big deaths we have experienced in our lives. Women have died a thousand deaths before they turn 20, and of course this is all a part of becoming awake and aware and growing up.

That time we lost our virginity and it felt empty.

The times we were beaten and bruised, just for speaking.

The time our coach told us we weren’t good enough.

The time we caught our husband cheating.

The babies we lost.

The babies we wanted and couldn’t have.

The loss of our mothers and sisters.

The sting of our first female betrayal.

All of the times we hurt our bodies with food and exercise and other substances.

We must allow ourselves to make descansos to all of these broken hearted moments, mourn them, and celebrate how they have forged our inner beauty and strength.

I have spent the last year and a half doing descansos, and I can tell you there is no more powerful and liberating thing we can do for ourselves.

(And each descanso can be healed many ways, but many of our clients choose Cellular Release Therapy®)

Shamanic Journey-Work. Intuitive Soul Readings. Psychic Mediumship and Counsel Online or in the Portland Maine Area.


“Forgiveness comes at the end of a process, not at the beginning. In order to forgive yourself or another person, three obstacles must be overcome. Let’s call them the three dragons of judgment, anger, and blame.”

Forgiveness comes when we abandon the blame of others and of ourselves for some event, interaction, experience. This process of forgiving sometimes takes years. Sometimes it doesn’t happen at all, and we carry this hurt throughout our lives, allowing the blame to be like a poison in our bodies, minds, hearts, and energy systems.

It would be really great if we could just “get over it” and be able to forgive, but unfortunately it’s not that easy, because forgiving is not a process that involves only the conscious mind. This is a process that also involves the subconscious mind, and the subconscious can be holding onto blame, judgement, and anger as a protection.

The way we move forward into forgiveness is by releasing the trauma. Clearing away whatever experiences we blame others or ourselves for, clearing away the blame, and the need to blame. By doing so, we free ourselves to look back on the events that had resulted in so much pain, and see them with new eyes, as just a part of our story.

This article I thought was really fantastic at describing the process of forgiveness. Cellular Release Therapy® is the tool I have used to help people release the trauma and blame so that forgiveness can be possible.

If you are interested in Cellular Release Therapy®, please reach out to us via email or call (617)233-5837.

All of us, I feel fairly certain, believe that forgiveness is a positive quality. But the fact that religion has been the traditional basis for findin…