What are Orthotics?
Orthotics are inserts we use in shoes to correct the way our feet work. When deciding on orthotics you will have to make one of two decisions:
1. A pre-moulded insert that you can buy in a shop that is usually referred to as an insole. This version is often a one size fits all and can be bought at most footwear shops and drugstores. Its main function is for comfort therefore it cannot correct any biomechanical issues you have in walking and standing.
2. A custom measured and fitted orthotic that is unique to your foot that solves a specific set of issues.
Why do we need them?
Orthotics do more than just raise and support arches, they also realign the ankles and feet for added support.
Who should wear Orthotics?
Orthotics are beneficial for everyone as they are an effective way to give your feet added support no matter what activity you’re doing. Orthotics also provide benefits to people with certain foot problems and other health issues (arthritis, diabetes, muscle tightness, joint and bone pain, etc.)
Choosing between custom orthotics and off the shelf orthotics
Despite the cost people swear by the positive changes associated with custom orthotics. Including reduced back pain and hip pain.
When should I choose an off the shelf option? Choosing an off the shelf option is optimal if you are just looking for some extra comfort or shock prevention while you walk.
If you have any other issues such as the issues, we discuss later in this article then custom orthotics is your best bet for correction of your problems.
OVER-PRONATING – What is it?
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.
What to expect when getting fitted for custom orthotics.
The process of getting fitted for orthotics will involve several visits.
Your first initial visit will involve an overall evaluation of your body. How you walk, run and stand will all be observed and examined. This will determine what your issue is and what’s the best orthotic for your condition.
After your condition has been determined a 3d scan of your foot will then be made of your foot.
Your orthotics will then be made and your final visit to the practice will involve a fitting of the orthotics. All orthotics require a ‘break-in’ time. If after this time, they still feel uncomfortable, you will need to visit the clinic again to be assessed.
If you have any of the above issues or think you need a custom orthotic then please email us on firstname.lastname@example.org to book an appointment or assessment. To get fitted for custom orthotics book online by clicking - https://www.one80health.com/book-now.