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The origin of the conflict, a new evolutionary paradigm
To understand why the human foot is so vulnerable to FHL, we may need to go back five million years. A meeting with anthropologist Yvette Deloison, around a theory that rethinks the place of bipedalism in human evolution.
A rarely asked question
FHL is not a disease in the classic sense of the word. It is not an infection, it is not a cancer, it is not a degeneration. It is a mechanical conflict between a tendon and a bony tunnel, occurring at a precise moment of the step, in enough people that we encounter it every day in consultation. So where does this conflict come from? Why does our anatomy end up trapping itself?
The answer does not lie in the present. It lies in five million years of evolution.
A meeting, a book, a thesis
While preparing the 2023 Medicol Congress on FHL, Dr Jacques Vallotton met Yvette Deloison, an anthropologist specializing in human evolution. From this meeting arose a line of thought that sheds light on the condition from an unexpected angle, the evolutionary one.
Author
Yvette Deloison
Anthropologist, specialist in human evolution and the origins of bipedalism. Author of a theory that proposes a semi-aquatic proto-hominoid as the ancestor of the human lineage, distinct from that of the australopithecines. Reference: La préhistoire du piéton.
Two evolutionary paradigms
Classical evolution teaches that modern humans descend from the australopithecine lineage, themselves derived from tree-dwelling primates. Bipedalism would therefore be a recent and gradual acquisition, the consequence of a progressive descent from the trees toward the savanna. Yvette Deloison offers another reading.
Classical paradigm
Humans would descend from the australopithecines
Modern humans would derive from the australopithecine lineage, partially bipedal primates that appeared about four million years ago. Bipedalism would be a relatively recent acquisition, linked to the move out of the forests toward the African savannas.
Alternative hypothesis
Original bipedalism, semi-aquatic
Our lineage would descend from a bipedal proto-hominoid living in a semi-aquatic environment, distinct from that of the australopithecines. Bipedalism would not be a late conquest but an original characteristic. This thesis, supported by eminent specialists, has never been disproven.
The fossil footprints of Crete
The discovery of fossil footprints in Crete dating back more than five million years has reopened the debate. These footprints show anatomically modern features (the presence of a plantar arch, a hallux aligned with the other toes, a roll-over of the step) at a time when, according to the classical paradigm, bipedal humans should not have existed.
5 million years
The footprint that unsettles the official narrative
This fossil footprint, older than the earliest documented bipedal australopithecines in Africa, shows a morphology already very close to that of the modern human foot. It suggests that a bipedal lineage existed well before what the classical timeline admits, and that it may have followed a distinct evolutionary path.
The full interview on video
Dr Jacques Vallotton and Yvette Deloison discuss these questions in detail in a series of three videos. The main interview addresses original bipedalism, and two supplements explore the genetic angle and the angle of human reconstructions.
Original bipedalism, a new paradigm
Evolution and genetics
Human reconstructions
The link with FHL
What is the connection between this anthropological thesis and the FHL that the Centre du pied encounters every day? The connection is direct. If our lineage evolved in a semi-aquatic environment, the anatomy of our foot was optimized for constraints different from those we impose on it today. Prolonged walking on hard ground, Western footwear, even surfaces, long distances spent standing — so many demands that our foot may not have been designed to bear fully.
A working hypothesis
The retro-talar tunnel and the fibrous pulley that constrains the FHL tendon could be an evolutionary legacy of a different foot function, optimized for a use we no longer have. FHL would then be less an anomaly than a conflict between an ancient anatomy and a modern use.
« The human foot is an evolutionary compromise that has not quite finished evolving. FHL is one of the prices we pay for walking upright on sidewalks. »
Dr Jacques Vallotton, Centre Orthopédique d’Ouchy
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From theory to practice
To understand the origin of the conflict in your own case, its manifestations and the treatment options available, the Centre Orthopédique d’Ouchy offers a complete assessment.
In brief
Anthropologist
Yvette Deloison
Thesis
original bipedalism
Footprints
5 million years
Location
Crete
Hypothesis
semi-aquatic environment
Videos
1 interview + 2
Go further
Related pages
Patient testimonials
Accounts from patients and practitioners who have lived with or observed FHL in their daily lives.
Anatomy of the tunnel
The anatomical detail of the retro-talar tunnel and the five variations that predispose to the conflict.