Common Problems Which Can Be Helped By Orthotics:
| FOOT AND ANKLE |
| PROBLEM |
SYMPTOM |
CAUSE |
SOLUTION |
| Achilles Tendonitis |
Inflammation of the sheath surrounding the Achilles tendon; pain behind the heel, ankle, and lower calf. |
Counter rotation of the tibia against the femur (as a result of excessive pronation) causes the two heads of the Achilles tendon (gastrocnemius and soleus) to torque against each other and overstretch the tendon. |
Therapy for inflammation: ice, ultrasound etc. Orthotics to reduce excess pronation and abnormal torquing of the tendon due to biomechanical imbalance. Reduce activity until inflammation subsides. |
| Neuroma (Intermetatarsal Forefoot Pain) |
Pain in the ball of the foot and/or numbness in the toes. Usually between the 3rd and 4th toes. |
Chronic irritation of the intermetatarsal nerves due to the shearing of the metatarsal heads. |
Careful shoe selection and orthotics to provide the forefoot with proper balance, spreading the metatarsal heads to allow a clear passage for the nerves. |
| Plantar Fasciitis (Heel Spur Syndrome) |
Pain directly beneath or in front of the heel; chronic inflammation of the plantar fascia, sometimes accompanied by a bone spur where the fascia originates at the calcaneus. |
Excessive abnormal pronation stretching the plantar fasciitis over and over with every step. The origin at the calcaneus in the hindfoot is weakest and generally where fibres are torn. |
Reduce activity until inflammation subsides, and perform daily exercises. Orthotics to control over-pronation and eliminate repeated elongation of the plantar fascia. |
| MUSCULOSKELETAL |
| PROBLEM |
SYMPTOM |
CAUSE |
SOLUTION |
| Shin Splints |
Inflammation of the tendons and muscles in the front or side of the leg. |
Excessive pronation combined with overuse causes pulling of the tibialis anterior or tibialis posterior muscle with damage done to the insertion of these muscles on the tibia. |
Sport shoes with very solid heel counter combined with orthotics to restore normal foot and leg biomechanics to restore excessive pronation. Reduce activity until inflammation subsides. |
| Chondromalacia Patella (Runner’s Knee) |
A degenerative inflammation of the cartilage covering the underside of the patella; knee pain and medial soreness. |
Excessive pronation counter-rotates the tibia against the femur creating undue stress that prevents the knee cap from tracking in its proper groove on the femur bone. The femoral condyles irritate and damage the back of the patella. |
Orthotics are necessary to control abnormal pronation and prevent counter rotation of tibia against the femur. |
| Iliotibial Band Syndrome |
Pain on the lateral side of the knee often extending up the lateral side of the thigh, as high as the hip. |
Caused by excessive counter rotation of the tibia and femur as a result of over-pronation. The ilio tibial band is torqued and stretched resulting in the distal end of the band rubbing across the lateral condyle of the femur. |
Apply ice to decrease inflammation. Orthotics to correct the over-pronation and eliminate excessive counter rotation between the femur and the tibia. |
| Low Back Pain |
Pain in the low back. |
The shock of the heel strike is transmitted up the leg, through the pelvis, and to the lumbar spine. Over-pronation causes stress and misalignment of the kinetic chain, affecting the alignment of the spinal column, facet joints, and possibly alignment of the discs. |
Along with localized physiotherapy, manipulation, exercise etc., orthotics to correct abnormal pronation and reduce shock to the heel. |
|
|
| PROBLEM |
SYMPTOM |
CAUSE |
SOLUTION |
| Rocker Bottom Feet |
Collapse of the midfoot, prominent bones cause tissue breakdown (ulceration) |
Changes to bone density due to biomechanical imbalance inherent in diabetes |
Orthotics to properly distribute body weight onto healthy foot surface areas to unweight collapsed midtarsal area. |
| Peripheral Vascular Disease (P.V.D.) |
Poor circulation causing hands and feet to feel cold and wounds (ulcerations) to develop and heal slowly. Pain in the legs when walking, relieved by rest. |
Ability of arteries to carry blood is reduced to diabetic peripheral vascular disease. |
Orthotics to properly distribute body weight (pressure along the plantar surface of the foot) to reduce the risk of ulceration. |
| Peripheral Polyneuropathy |
Dulling of the sensation of pain, temperature and pressure especially in the lower legs and feet. |
A symptom of long term diabetes (>6 yrs old); on occasion appears early. Cause is uncertain, being researched extensively. |
Orthotics to properly distribute body weight (pressure along the plantar surface of the foot) to reduce the risk of ulceration. |
| Plantar Ulcers |
Open, deep wounds on the feet that are very slow to heal. Foot ulcers are the leading cause of hospital stays among diabetics. |
Peripheral vascular disease and diabetic polyneuropathy combined with poor biomechanics. |
Orthotics to correct faulty biomechanics and reduce plantar pressure. Ongoing biomechanical foot screening a must. |
Arthritis is not one disease but a group of diseases, all of which can cause pain, inflammation, and limited movement of the joints. The different types of arthritis are Osteoarthritis, Rheumatoid arthritis, Psoriatic and Gout. The two most common types of Arthritis are osteoarthritis and rheumatoid arthritis.
Osteoarthritis
Osteoarthritis or “Wear and Tear” arthritis is specific to one or several joints. Pain is the major symptom but others include stiffness, crackling, enlargement and deformities of the afflicted joint or joints, with inflammation possible in the advanced stages. It occurs when the joint surfaces of the bones wear down, possibly caused by a previous injury, long term mechanical stress on a joint, over use, or mechanical factors.
Treatment
If the joints are simply being stressed in an abnormal way, there are ways of unloading them or removing excessive pressure. Techniques for taking a load off the joints include:
• Brief periods of rest
• Using a mobility aid
• Losing weight, if necessary
• Custom Foot Orthotics
Custom orthotics relieve pressure and stress on the joints by facilitating proper alignment. Once the foot is correctly aligned, the knees and hips have decreased wear and tear. Orthotics are prescribed to improve the biomechanics to counteract stress to the joints.
Rheumatoid Arthritis
Rheumatoid arthritis is the most crippling form of arthritis. It not only affects the joints like osteoarthritis, but also can cause severe deformities of the joints, especially in high stress areas such as the feet. It is an autoimmune disease brought about when the body has “turned on itself”, with the immune system attacking bodily tissues just as if they were foreign invaders.
Treatment
The treatment for rheumatoid arthritis is designed to alleviate pain, reduce inflammation, stop or slow joint damage, and improve overall body functioning. Aside from drug therapy and surgery, exercise and therapy can help reduce joint stiffness and swelling, alleviate pain and increase joint mobility.
Orthotics provide a non-invasive therapy by correcting mechanical imbalances and helping to relieve and off-load pressure.
Gout
In gout, uric acid, a waste product in the urine cycle, is either overproduced or underexcreted or both. When a person has too much uric acid in their system some of it forms uric acid crystals. The crystals find their way to the big toe joint where it becomes hot, painfully swollen and stiff. These crystals (like sharp pieces of glass) are deposited into the joint space, causing swelling and stiffness, rather than being cleared by the kidneys.
Treatment
Gout is usually controlled with proper treatment, which usually includes the use of non-steroidal anti-inflammatory drugs for pain and inflammation, dietary restriction and medications to reduce the amount of uric acid production.
Orthotics assist in off-loading the affected area and normalizing the patient’s gait.cli8c
Psoriatic Arthritis
An inherited disease, this form of arthritis sometimes occurs in people with the skin condition called psoriasis. Psoriatic arthritis settles in the end joints of the fingers or toes, causing them to become so swollen that they’re often referred to as “sausage digits”. Although the disease is chronic, most people with psoriatic arthritis feel well with the exception of their joint pain.
Treatment
Treatment regimes of psoriatic arthritis include non-steroidal anti-inflammatory drugs (NSAIDS) as well as exercises to improve joint mobility and rest.
Orthotics assist in maintaining alignment, reducing plantar pressures, off-loading affected joints and facilitating proper biomechanicl foot function during exercise.
Conclusion: Custom Foot Orthotics and Arthritis
Improper alignment or incorrect use of muscles, bones, tendons, ligaments, and joints can cause excessive wear and tear on the body, leading to injury and arthritis. If you don’t correct the underlying problems, you can’t reduce the progression of the disease.
Orthotics correct joint motion and relieve pain associated with arthritis. They remove the abnormal stress and strains on the foot by maintaining proper foot and ankle position, relieving mechanical stress and alleviating pressure on sensitive areas of the foot.
With arthritic patients, the main focus of care should be to reduce pain and improve function. This can be accomplished with custom foot orthotics.
Footprints Orthotics can evaluate biomechanical problems with a computerized gait and pressure analysis and orthotics can be made from that same data to treat biomechanical problems.
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