Orthotics are custom made shoe inserts designed to treat biomechanical foot disorders. Poor foot biomechanics may lead to ankle, knee and even back pain. Orthotics may be simple over-the-counter shoe inserts, or they can be custom-moulded inserts specifically crafted to meet the needs of a particular individual. This is done by making an impression of the foot, called a cast, in an ‘ideal position’. Specialists in an orthotic laboratory use this cast to mould a high quality orthotic for your shoe. The finished orthotic helps keep the foot in proper alignment. Dysfunctional feet are either over-supinating or over-pronating.
Over-supination occurs when the arch of the foot does not flatten. This may occur in a person with a very high arch. Because the arch is too rigid, it does not absorb shock well. Instead of spreading it throughout the entire foot, the weight of the body falls only on the heel and the bases of the toes. Muscle spasm of the some of the leg muscles can contribute to over-supination.
A different problem results if the arch flattens too much. This is known as over-pronation. Stress from the flattening of the arch of the foot can cause problems of the sole of the foot, like plantar fasciitis and heel pain. The leg muscles must work harder to control the motion of the foot and this can lead to pain over the shins or “shin-splints” and pain at the Achilles tendon at the heel. Over-pronation causes excessive internal rotation of the entire leg. This internal rotation of the foot places stress on joints in the foot, the knee, the hip and even the low back. In the foot, bunions can develop as well as stress fractures of the bones of the foot. Knee pain can occur as the internal rotation of the leg causes stress on the joint and the “knee cap” or patella is pulled outward by the strong muscles of the thigh. Hip, thigh and knee pain can be caused by tightening and strain on the iliotibial band on the outside of the thigh as an over-pronated foot causes the thigh to rotate internally.
With both over-pronation or over-supination, the ability of the foot to absorb force changes. Strain is placed on the foot and leg. Muscles of the foot and leg must work harder. These muscles and tendons eventually fatigue and break down by developing microscopic tears. This triggers inflammation leading to swelling, pain, and scarring in these tissues. In addition, your joints may suffer excess wear and tear leading to inflammation and possibly degeneration. Treatment for any of the above conditions includes reducing inflammation, strengthening and stretching the involved muscles, and promoting proper joint mobility. In addition, orthotics can play an integral role in the overall treatment of many problems caused by ankle and foot dysfunction and more importantly, prevent re-occurrences.