Figure showing the consequences of foot position on those with reduced hamstrings Dr. Barend ter Haar
For normal everyday performance, the position of our head is crucial– for breathing, consuming, hearing, balance, seeing, communication, etc– so why is this article looking at the position of the feet?
Over the years I have actually delighted in listening to and gaining from inspiring presenters from worldwide– these have actually included Bengt Engstrom, Bart Van der Heyden, and others.
Usually, these presentations have been summaries that have actually looked at seating from the needs of all parts of the entire person, not simply the pelvis.
The foot bone does connect eventually to the head bone, and having the feet in the incorrect position has a significant knock-on impact on the head position.
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When consuming a meal, we like our feet back, and our heads forward over the plate. When sitting on a toilet, this is ideally a comparable position, to encourage rectal reflexes. When typing on a keyboard, we like our feet and head in a neutral position.
In contrast, when seeing TELEVISION, we probably like our feet out in front, serious posterior pelvic tilt, and our heads back.
Dr. Barend ter Haar has been associated with seating and mobility for over 30 years, including lecturing globally and developing worldwide seating standards.
As in the spiritual song Dem Bones, every bone in the body is connected to the next, or a minimum of that’s the case for many people. How does this relate to seating? Many people who have reduced movement have shortened hamstrings. (The hamstrings are a set of three muscles utilized, inter alia, for bending the knee.
The effect of this is that the feet, having actually been progressed, will link through the lower leg, then through the hamstrings to the pelvis: with shortened hamstrings, this will pull the hips into a posterior tilt, which in turn results in kyphotic curvature of the spinal column. For the individual to be able to raise their head for normal function, this then requires the neck to be hyperextended, or else the head drops down, visual contact is lost, drooling starts, and dignity is lost. The hyperextended neck is the position utilized for mouth to mouth resuscitation because it opens the air passages– not an excellent position to be in when trying and consuming to swallow down the neighboring path!
When eating a meal, we like our feet back, and our heads forward over the plate. When sitting on a toilet, this is ideally a comparable position, to encourage rectal reflexes. When typing on a keyboard, we like our feet and head in a neutral position.
Further to the above, and under normal scenarios, where we put our feet relative to our head, and to our hips, varies according to what we are attempting to accomplish.
They mainly connect around the top of the lower leg at one end, and the lower part of the hips at the other.) Individuals with minimized movement are often in wheelchairs, with the foot supports way out in front of the casters (so that the casters can rotate unblocked).
Therefore, to those of you designing or prescribing wheelchairs, please do take note regarding where the feet can and will be positioned for optimal functionality, and prevent placing clients into a position where a resulting kyphotic spine is an inevitable effect, and where the foot position avoids normal activities. The exact same applies to the design and prescription of comfort/recreational seating.
The effect of this is that the feet, having been moved forward, will link through the lower leg, then through the hamstrings to the pelvis: with reduced hamstrings, this will pull the pelvis into a posterior tilt, which in turn leads to kyphotic curvature of the spinal column. The hyperextended neck is the position utilized for mouth to mouth resuscitation considering that it opens up the airways– not a great position to be in when trying and eating to swallow down the neighboring path!