Scientific Medicine, Vol 1, No 2 (2009)
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BHAT ET AL
RESEARCH

THE MEDIAL LONGITUDINAL ARCH OF FOOT IN

TREE CLIMBING PROFESSIONALS

P.SHIVARAMA BHAT & ARUNACHALAM KUMAR

P.Shivarama Bhat and Arunachalam Kumar are from Department of Anatomy, K.S.Hegde Medical Academy, Deralakatte , Mangalore – 575018.

Correspondence: P.Shivarama Bhat, Department of Anatomy, K.S.Hegde Medical Academy, Deralakatte, Mangalore
– 575018, Email: deankshema@nitte.ac.in.

Introduction

The human foot, though designed to bear weight and facilitate bipedal locomotion, also shows the combined effects of heredity and acquired lifestyle. Foot morphology is influenced by specialized occupation or specific usage’s Adaptation in shape, and modifications in soft tissue and osteological components of the foot to large extent are dictated by kinesiological stresses and strains it is subject to. Functional biomechanics play a visually verifiable and metrically quantifiable anatomical remodeling of foot structure.

The role of evolution induced ‘arch’ formations in the foot in aiding early hominids adopt a terrestrial existence, abandoning forever, the arboreal life of his simian ancestors, is a landmark milestone in development of homo. The longitudinal arches of the foot, both medial and lateral play a vital and efficient role in easing human locomotion. The ligaments, joints, bones, muscles and soft tissue components of the foot, contribute in its own unique manner, in making man alone among his mammalian cousins, to have mastered the art of walking on hindlimbs 1 as units. The liberation of the forelimbs from its pithecoid compulsions for assisting locomotion,has furthered hominid cerebration to discover its latent potential.

The question raised here is, are these time honoured evolutionary anatomical features of the foot absolute? Can prolonged and sustained strain induced by specific usages such as tree climbing2, influence the foot structure to revert to its simian prototype? Are these changes, if any measurable3? To answer some of these queries, we undertook a study of footprints of adult males drawn from communities that engage in tree climbing as an ancestral and hereditary calling.

The plantar footprint is a unique record of the weight bearing status is man. The print impress itself is a metrically assessable permanent database, which can be used to determine the functional efficiency of feet. Evaluation of the hemi-dome (hollowness) produced by the medial edge of the human foot, essentially the measurements of the components of the medial longitudinal arch4 should present us with data,which can

be compared and analyzed. In this paper we present our findings on the evaluation of booth feet of a hundred adult males, drawn at random from local communities that practice tree-climbing as a fulltime occupation. The results are compared with those collated from measurements in lay population of males drawn from the society at large.

In this paper we present our findings on the evaluation of booth feet of a hundred adult males, drawn at random from local communities that practice tree-climbing as a fulltime occupation. The results are compared with those collated from measurements in lay population of males drawn from the society at large.

Material & Methods

Footprints of both feet were recorded on graph sheets, using ink pads as staining medium. Adult males from Thiyya, Idiga, Billava and Namdhari communities of three contiguous districts of the southwest coast of India formed the nidus for this study. The horizontal length, breadth and surface area of the hollow semilunar space in the prints were measured using Meyer’s line as reference. The height of the medial arch was measured as a perpendicular drawn from the tuberosity of the navicular to the horizontal.

Tabulations and graphical records for visually identifiable gross changes and adaptations were prepared. The control group consisted of adult males drawn at random from similar age range. Field observations of the plantation industry, of palmyrah (toddy), areca and coconut were made to note the techniques of tree climbing used by professionals. The results were subject to statistical analysis and evaluation. None of the volunteers for this project was subject to any hospital-based investigation or invasive procedure.

Results & Observations

The metrical values of both feet in tree climbers of varied ages and years of experience in occupation, along with the values of the control group are shown in Tables 1 to 4. The measurements show an average of 88.63 mms,

SCIENTIFIC MEDICINE 2009;1(2)

BHAT ET AL
RESEARCH
39.95 mms, 53.03 mms and 2538 sq mms for left side. (length, breadth, height and surface area). In controls the same parameters showed 70.14 mms, 27.34 mms, 49.7 mms and 1345 sq mms for left and 72.2, 27.4, 49.81 and 1391.89 sq mms for right foot.
Table 1:Mean of age of normal and tree climbers with mean of experience (years)
Normal (age) Mean Std. Error of Mean
40.74 051
Tree Clibers(age) 42.92 1.11
Experience(Tree climbers) 20.14 1.15
Table 1:Mean of age of normal and tree climbers with
mean of experience (years).

Table 2: Mean of age parameters of Left and Right Foot of Normal and tree climbers (with Standard Error of Mean)
Normal Left Right
Mean Std.Error of Mean Mean Std.Error of Mean
A.Lenght 70.14± 2.08 72.20 2.71
B.Breadth 27.34 1.28 27.40 1.19
C.Height 49.70 1.19 49.81 1.26
D.Surface Area 1345.06 98.26 1391.00 99.88
Tree Climbers
A.Lenght 88.63 1.19 89.00 1.15
B.Breadth 39.95 1.00 39.02 0.74
C.Height 53.03 0.69 53.29 0.64
D.Surface Area 2538.82 84.28 2587.97 76.20

Table 2: Mean of age parameters of Left and Right Foot of Normal and tree climbers (with Standard Error of Mean).

There is an obvious increase in all parameters, length, breadth, height and surface area in climbers compared to controls. It is also noted that the increase is directly proportional to the number of years of practice of the profession. However, oddly, the increase – trend gets arrested with the climbers attaining about 3 decades experience in profession, in fact, there is an overall dip in all dimensions thereafter. The decrease is seen in length, breadth and increase in arch height. Graphs and sketches and are presented as Figures I to IX.

Table– 3: Mean of parameters according to duration of experience of tree
climbers

Experience

(years)

<10 years

10-20

years

20-30

years

>30 years
Side

Para

meters

Mean

Std.

Err.of Mean

Me

an

Std.

Err.of Mean

Me

an

Std.

Err.of Mean

Me

an

Std.

Err.of Mean

Left A.Lenght 85.11 2.49 87.18 1.90 92.96 2.20 91.36 2.95
B.Breadth 35.07 1.67 39.76 1.36 44.28 2.37 42.43 2.63
C.Height 51.25 1.43 53.08 1.19 53.06 1.41 56.432 1.28
D.Surface Area

2232.11

162.85 2547.06 116.78 2802.6 189.79 2661.4 224.57
 
Right side A.Lenght 87.14 2.28 88.74 1.68 93.63 2.35 92.50 3.56
B.Breadth 35.82 1.28 38.85 1.20 42.21 1.33 4.036 2.36
C.Height 52.41 1.32 53.38 1.13 52.81 1.27 55.61 1.25
D.Surface Area 2304.11 140.12 2545.91 112.18 3016.42 158.97 2523.36 206.96
Table– 3: Mean of parameters according to duration of
experience of tree climbers.

Table 4: Percentage increase in values of parameters according to mean duration of experience (years) in tree climbers compared to Normal
LIFT SIDE
Experience <10 10-20 20-30 >30
A.Lenght 21.34 24.29 32.53 30.25
B.Breadth 28.27 45.43 61.96 55.19
C.Height 3.12 6.8 6.7 13.54
D.Surface Area 65.96 89.36 108.37 97.86
RIGHT SIDE
A.Lenght 20.69 22.91 29.68 28.12
B.Breadth 30.73 41.79 54.05 47.29
C.Height 5.22 7.19 6.04 11.66
D.Surface Area 65.64 83.03 116.85 81.41

Table 4: Percentage increase in values of parameters according to mean duration of experience (years) in tree climbers compared to Normal.

Visual observations showed both feet in most climbers, especially those with a number of years of adherence to profession, had ‘in-situ’ partial inversion of foot 4. The hallux itself was invariably separated wide from the fellow toes (hallux valgus). Calcaneovarus and adduction deformation of both feet were also seen.

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Callosities were found pressure spots on plantar surface and on the medial edge dermal changes could be not just due to the stresses transmitted by climbing, but also to the friction and tribadic pressures brought about by rapid descent from the tree tops.

Fig-I: Diagram showing increasing length (A), breadth(B) & Surface Area(D) in experienced Climbers.

Breadth-Comparison

Fig-II: Length-Comparison between normal and tree climbers. & Fig-III: Breadth-Comparison between normal and tree climbers.

Surface Area-Comparison between

Fig-IV: Height-Comparison between normal and tree climbers & Fig-V: Surface Area-Comparison between normal and tree climbers.

Fig-VI: Length-Percentage increase in tree climbers compared to normal & Fig-VII: Breadth-Percentage increase in tree climbers compared to normal

 

 

 

 

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The results of statistical analysis of data using students unpaired ‘t’ test reveals that the ‘P’ value is highly significant in the parameters of length, breadth and surface area for both feet. The P value for arch height is significant for left foot, and highly significant for the right (Table 5 & 6).

Height-Percentage increase in tree climbers

Fig-VIII: Height-Percentage increase in tree climbers compared to normal & Fig-IX: Surface Area-Percentage increase in tree climbers compared to normal.

 

Table 5: Students unpaired ‘t’ test for equality of means
  ‘t’ test for Equality of
Means
Inference
t Sig.2 tailed
Left A.Lenght -2.597 0.011 Significant
B.Breadth -3.047 0.003 Significant
C.Height -1.435 0.154 Not significant
D.Surface Area -2.055 0.043 Significant
 
Right A.Lenght -2.234 0.028 Significant
B.Breadth -2.740 0.007 Highly Significant
C.Height -0.681 0.498 Not significant
D.Surface Area -2.609 0.009 Highly Significant
Table 5: Students unpaired ‘t’ test for equality of
means.

 

Table 6: Comparison between normal to tree climbers (Students unpaired ‘t’ test)
Side Parameters ‘T’ test for Equality of Means
T P Inference
Left A.Lenght -7.844 0.000 Very highly Significant
B.Breadth -6.790 0.000 Very highly Significant
C.Height -2.434 0.016 Not significant
D.Surface Area -7.750 0.000 Very highly Significant
 
Right A.Lenght -7.063 0.000 Very highly Significant
B.Breadth -8.101 0.000 Very highly Significant
C.Height -2.647 0.009 Highly Significant
D.Surface Area -8.440 0.000 Very highly Significant
Table 6: Comparison between normal to tree climbers (Students unpaired ‘t’ test).

Discussion

Sociocultural compulsions make crops such as coconut, areca and palmyrah (toddy) economically viable for the planters. Sessional or regular plucking or tapping of palm produce requires specialized labour. This activity is traditionally carried out by isolated communities, the menfolk adeptly trained in the art of climbing trees rapidly. The communities engaged in this professional calling are distributed wherever palm is cultivated. The Idigas, Thiyya Namdhari and Billava, have been climbers for generations spread over the centuries. The trees are scaled through a series of upward hops along the vertical face of the trunk, the exercise calling for flexion, abduction extension and lateral rotation of hip, flexion extension at knee, plantar and dosiflexion at ankle, inversion at the subtalar articulations and flexion at metatarsophalangeal and interphalangeal joints of the foot. To assist leverage, a ‘rattan’ loop is worn around the waist, which in turn is wound around the tree trunk. A similar loop worm across the ankles, prevents the splaying of feet, keeping them approximated to the trunk surface at all times of ascent or descent5. The climb induces tremendous gravitational strain on the tibiotalar and intertarsal joints, with each professional climber working about 4 hrs a day, scaling 25-30 trees.

The results of this study show that with sustained and prolonged strain at the joints, the foot undergoes permanent and quantifiable shape change The forced inversion, abuts on the osteo-myo-fascial bow of the medial longitudinal arch, which with time, shows an increase in length, breadth, surface area and height.6. These changes through quite rapid in the first few years of climbing, level off somewhat in the second decade of engagement, after which the dimensions once again show a spurt in all parameters. However, after three decades of climbing, the percentage values of increase drops for length, breadth and surface area, but continues to rise for
height of arch.7

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It is our inference that the foot dynamics and kinesiological exertions strain the factors maintaining the medial arch, the stress being overcome through a generalized augmentation in size and strength through intrinsic physiological compensatory counteractions. The failure of compensatory changes, with age and exposure (beyond 3 decades) leads to an arrest of these mechanisms, which now show a reduction in dimensions (and probably strength too.) The continued increase in arch height is mainly due to permanency of osteological changes in the foot architecture. The probable development of pressure induced epiphysis or bony spurs or buttresses in the tarsi through usage make the morphological adaptations in these bones permanent. The medial arch in experienced tree climbers is raised, not so much by the fascial inputs, but remains so by the rigidity of the deformed bony arch base.

It is also interesting to note that, accidental falls and fatalities that are recorded from time to time from groves, usually involve very experienced and old climbers. The mystery, why an experienced and highly skilled labourer should slip, may now be explained through our observations that, there is abrupt failure of arch resilience after 30 years climbing, evidenced in the rapid dip in dimensions of the hollowness.

In recent times, with falling economic returns from once cash – rich plantation industry, coupled with other factors – the rapid dwindling of able bodied men ready to stick to ancestral occupations (with availability of newer more lucrative and less strenuous avenues of income), and the palpable positive out come of free education for all, along with constitutional guarantees to better opportunities for the tribals, backwards and deprived segments of the populations it is very possible that decades hence, the complete lack of pluckers may drive the palm industry to seek totally mechanical means of cultivation. Studies such as this one may serve as retrievable records of the morphometrics of these ‘dying’ communities.

References

  1. Cailliet R; Foot and ankle pain, 1992, Jaypee Brothers, Delhi, 2nd Ed
  2. Devis TA; Attempt at mechanical climbing of palms with special reference to coconut palm Journal of Plantation Cops 1997; 5(1): 31-35
  3. Huang CK Kitaoka HB and Chao EY; Biomechanical evaluation of longitudinal arch stability, Foot Ankle 1993; 14(6): 353-357
  4. Kaye RA Jahss MH; Tibialis posterior: a review of anatomy and biomechanics in relation to support of the medial longitudinal arch: Foot Ankle 1991;11(4):
    244-247
  5. Nandakumar TB; Hard climb made easy, Indian Coconut Journal, 1985; 17-22
  6. Saltzman CL, Nawoczenski DA Talbot KD; Measurement of medial longitudinal arch, Archives of Phy. Med. Rehab, 1995; 76(1):45-49
  7. Takai S; Structured components of the arch of the foot analyzed by radiogrammetric and multivariate statistical method. Acta anat. 1984; 119(3): 161-64

 

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