Apes, Evolution, and the Root of all Evil in Disorders of the Foot
- 14 April 2016
- Apes, Evolution, and the Root of all Evil in Disorders of the Foot
- Dr. Chong Keen Wai
As humans evolved from quadrupedal gait to a bipedal gait pattern, our Achilles tendon, in particular the gastrocnemius component of the Achilles tendon was required to undergo lengthening to allow a plantigrade stance. However, in reality, many of us still preserves some degree of gastrocnemius equinus contracture. The vast majority has mild or no symptoms and should rightfully be left alone. However, many disorders of the foot can be traced to the problem of gastrocnemius tightness and the ensuing biomechanical abnormalities. Problems such as flat feet, bunions, claw toes, diabetic Charcot arthropathy, stress fractures, midfoot osteoarthritis, metatarsalgia, planta fasciitis, Achilles tendinopathy are in one way or the other, caused by such a biomechanical problem. Increasingly, clinical outcomes and research has shown that solving this by physical therapy or by surgery, does lead to good clinical outcomes and minimal adverse effects. Surgical techniques have also changed. Minimally invasive gastrocnemius recession has improved recovery times and cosmesis.