Are you experiencing foot, knee, or even back pain? Custom Orthotics may be a good option for you. Custom made orthotics are prescription based inserts customized to fit you for your specific needs. Orthotics work by reducing stress and strain on your body by bringing your feet back into proper alignment. Call us to schedule an appointment with our friendly staff today to see if it is a good option for you!
Foot orthotics are custom made shoe inserts designed to treat biomechanical foot disorders. Poor foot biomechanics may lead to ankle, knee and even back pain. Foot orthotics may be simple and generic devices, which are sold over-the-counter, or they can be custom-moulded orthotics specifically crafted to meet the needs of a particular individual. This is done by making an impression of the foot in an 'ideal position' called a cast. Specialists in an orthotic laboratory use this cast to mould a high quality orthotic. The finished orthotic is then placed in the patient's shoe and helps keep the foot in proper alignment. Dysfunctional feet are either over-supinating or over-pronating.
A different problem results if the arch flattens too much. This is known as a pes-planus or flat foot (over-pronation). An excessively pronated foot may cause excessive internal rotation of the entire lower limb during weight-bearing and this increases demands on numerous structures. The increased force placed on the medial aspect of the foot contributes to abnormalities of the 1st MTP joint, including hallux valgus (bunions). Interdigital (Morton's) neuromas may be caused by metatarsal hypermobility. Over-pronation also causes flattening of the medial longitudinal arch and increased strain on the plantar fascia and plantar musculature (connective tissue and muscles on bottom of foot). The gastrocnemius-soleus complex and tibialis posterior may overly contract while lengthening (eccentric contraction) to decelerate the rotation of the leg and pronation of the foot. This may contribute to damage of the achilles and tibialis posterior tendons. Overload of the long flexors of the leg may result in medial tibial stress syndrome (shin splints) which may lead to stress fractures of the tibia. Metatarsal fractures may occur due to uneven distribution of weight and excessive movement of the metatarsals with forefoot lowering. Stress fractures of the little bones of the foot (sesamoids). Excessive pronation leads to an increased internal rotation of the tibia, which results in the patella moving outwards (lateral displacement) and muscular imbalance of the quadriceps, all of which contribute to patellofemoral joint dysfunction. Internal rotation of the tibia contributes to a change in alignment of the patellar tendon, which may predispose to patellar tendonitis, and later patellar tendinopathy. Internal rotation of the tibia may also contribute to tightening of the Iliotibial band (ITB).
Supination occurs when the arch does not flatten at all. This typically occurs in a person with a high arch, called pes-cavus (over-supination). Because the arch does not flatten, it absorbs shock poorly. Instead of spreading it throughout the entire foot, the weight of the body falls only on the heel and the bases of the toes. This may occur as a result of weakness of the peroneal muscles (muscles at outside of leg) or as a result of spasm or tightness of the tibialis posterior and the gastrocnemius-soleus complex (muscles at back of leg). The supinated foot is often less mobile, which may result in poor shock absorption. It is possible that this may predispose to the development of stress fractures of the tibia, fibula, calcaneus and metatarsals (especially the fourth and fifth metatarsals).
With over-pronation or over-supination, the wrong muscles contract during gait, or they contract out of their proper sequence. These muscles and tendons eventually fatigue and break down suffering microscopic tears. This triggers inflammation leading to swelling, pain, and scarring in these tissues. In addition, your joints may suffer excess wear leading to inflammation and possibly degeneration. Treatment for any of the above conditions should include reducing inflammation with ice or non-steroidal anti-inflammatories (NSAIDs, prescribed by a physician), strengthening and normalizing normal muscle function with Active Release Technique® (ART®) and joint mobility with manipulative techniques. In addition, custom made orthotics can play an integral role in the overall treatment of many problems caused by ankle and foot dysfunction and more importantly, to prevent their re-occurrences.
Conditions That Are Successfully Treated With Orthotics
Any over-use injury can be prevented from proper foot wear and well made custom orthotics. Some examples of this are:
Patellar Femoral Syndrome
Shin Splints & Stress Fractures