Teachers, do you ever walk around and take a look at your students' poses from the back of the room? You'll see many interesting things from that perspective that you may not notice or just can't see from the front. Take Adho Mukha Svanasana (Downward-Facing Dog Pose), for instance. While you can't see the upper body, you can learn a lot about the hip, leg, and foot action in the pose by looking at the back of the legs. Are the hips level? If not, your student may be bending one knee a little, which could indicate one weaker or tighter leg. Or the student could be fully straightening both knees, but one leg is actually longer. Look at the tendons, inner and outer, that cross the back of the knee. You may see that both legs turn in or out, or you may see, by comparing the positions of left and right knees, that one leg is turned in or out more than the other.
Letting your gaze continue down the leg, look at the ankles and feet. A back view of Downward Dog teaches you a lot about arches, ankles, and how the feet relate to the floor. Sometimes the foot has its own problems, due to injury or structural anomalies. However, foot problems and misalignments are often a reflection of what's going on up the line in the lower back, knees, and hips, be it leg length discrepancy, rotation of one or both legs, or some other issue.
In Downward Dog, you're stretching the gastrocnemius and soleus, powerful muscles that form the bulk of the calf and insert (or attach) into the Achilles tendon, which in turn attaches to the calcaneous, or heelbone. The gastroc and soleus are normally strong enough to lift your entire body weight as you rise into tiptoes, even standing on one leg. With that kind of strength, they also have great potential for tightness and shortness. In an attempt to stretch tight calves, students may supinate or pronate, depending on their structural tendencies. For simplicity, we'll combine anatomical terms and say pronation (usually a combination of pronation and eversion) when the arch is dropping, and supination (usually supination plus inversion) when the arch is overly lifted and weight has shifted to the outer edge of the foot. With repetition and practice of bad alignment in Downward Dog and other poses, pronation or supination can cause pain and problems in the foot and contribute to the progression of problems to joints up the line.
Effects of a Supinated FootStudying Down Dog from the back, here's what to look for with a supinated foot: The flat part of the heel that eventually touches the floor won't be level-the medial, or inner, heel will be higher than the lateral, or outer, part. The lateral foot, just in front of the lateral malleolus (outer anklebone, which is part of the fibula) bulges out. A habitually supinated foot is a problem because it overstretches the ligaments of the outer ankle, which sets the stage for them to be sprained. Also, the big toe isn't as grounded as it should be, and we get important kinesthetic information from the big toe to help us balance. How to correct supination in Downward Dog? Instruct students to balance the weight between inner and outer foot. In this case, press down in the inner heel more, and keep the base of the big toe grounded and firm on the mat.
Problems of a Pronated FootOn the other hand, telling students with pronated feet to press the inner heel down takes them in the wrong direction. Studying this pronation from the back of Downward Dog, you may see the Achilles tendon curving inward instead of running in a straight, vertical line. The space below the lateral malleolus usually looks compressed and wrinkled, while the space below the medial malleolus (part of the tibia, the lower legbone that articulates with the femur to form the knee joint and, on the other end, helps form the ankle) looks stretched and smooth. A pronated foot is a problem because it can contribute to foot pain and bunions. Also, the foot loses its normal springiness, which is important in walking and running. Finally, the lift of the arch helps form the foundation of the lift of the pose in standing poses.
Problems Up the LineHow do problems up the line in the knees, hips, and lower back contribute to foot and ankle misalignments? Lower back pain and injuries can cause pain and tightness in the back of one leg, keeping that heel higher off the ground. If one leg is longer, the foot on that side may pronate in an attempt to "shorten" that leg. Arthritis and other misalignments of the knee can contribute to either pronation or supination, depending on the position of the tibia.
Pronated feet may be compensating for too much internal rotation of the leg (the kneecap turning inward) in relation to the foot. The feet should be fixed and parallel in Downward Dog, and if there's too much emphasis on taking the inner, upper thigh back, and grounding the inner heel, the arch will get flatter and flatter over time. Instead, be sure to give a counter cue, such as "Take the outer knee or calf back too, and balance the conflicting actions so that the kneecaps point straight ahead."
After a regular, careful practice of leg and foot alignment in Downward Dog, your students will have developed flexible calves with feet that are grounded in the big toe and inner heel, enlivened by a strong, light arch. This training will also help improve grounding and lift in other poses too, and even be reflected in standing and walking—your yoga practice off the mat.
Julie Gudmestad is a certified Iyengar Yoga teacher and licensed physical therapist who runs a combined yoga studio and physical therapy practice in Portland, Oregon. She enjoys integrating her Western medical knowledge with the healing powers of yoga to help make the wisdom of yoga accessible to all.