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What is a Biomechanical Evaluation?

A suitably qualified physiotherapist will do a full postural assessment. “The feet are merely the platform that carries the weight of your body”. We need to look at the full body as you walk and run to determine any irregularities in the skeleton. These abnormalities can cause uneven wear and hence result in injury. Similar to the tracking of your tyres in our car, causing uneven wear patterns. Prescription of Orthotic devices can help restore normal alignment and good function.

What are Orthotics?

Orthotics are insoles worn inside shoes to help correct the position of the foot. They support your feet and correct your alignment based on the detailed assessment done for their prescription.

Orthotics come in all shapes and materials, depending on the patients requirements they can be made from a semi-rigid material such as plastic or carbon fibre or a softer material for shock attenuation. The choice of Orthotics will depend on your requirement to relieve your pain/deformity and also your lifestyle and type of footwear. True prescriptions Orthotics are made by taking a mould of your foot in a specific position which captures the proper angular relationship between the various segments of the foot. This information is then used to make a model of your foot in the laboratory so as to make the Orthotic to correct its alignment. Using this technology we contour the orthotic to the patient’s foot requirements producing a truly custom made insole. These devices are not arch supports as they do not work on the principle of supporting the arch, they work on correcting the reason why the arch is abnormal and preventing further deterioration. They give support where required to improve patient comfort.

There are also less expensive option known as off the shelf devices. These can be altered by a suitable qualified physiotherapist and provide a cheaper alternative to prescription Orthotics.

Do I Need Orthotics?

In a lifetime our feet carry the average person more than 100000 miles, they absorbs tons of force each day, much of it on a hard surface. Pain tends to be the greatest reason for needing Orthotics. The conditions that are commonly treated with biomechanical evaluation and Orthotics are:

  • Low back pain
  • Knee pain
  • Shin Splints
  • Achilles tendonitis
  • Calf sprains
  • Hamstrings tears
  • Flat feet/Fallen Arches
  • Heel Spurs
  • Plantar fascitis
  • Bunions
  • Metarsal pain (pain under front of foot)
  • Tiredness in legs from standing
Diabetic patients and rheumatological patients also benefit hugely from Orthotics as it redistributes the weight of the body more evenly on the feet reducing pressure areas. Children with deformity will benefit from Orthotics although they may require replacement more frequently as the feet grow. Proper care and treatment in childhood will prevent many of the problems associated with poor biomechanical alignment we see in adults.

Conditions of the feet

Plantar fascitis (or heel pain)

Heel pain is a common problem in all ages. It presents with pain in your heel or the sole of your foot especially obvious when you put your foot to the ground in the morning. It is primarily caused by strain and inflammation in the plantar fascia, which is the ligamentous stucture that runs along your arch from, heel to the forefoot. There are a number of causes for this condition including abnormal alignment of your feet. Your expert physiotherapist will discuss with you the reasons and treatment options.

Flat feet

Your foot type is hereditary. Some people have flat feet which means that there arches are relaxed and low. In flat feet or otherwise known as pronated feet ,the feet roll inward as they go from heel strike the toe off. As a result it places abnormal stress and inflammation on a number of areas such as metatarsal, heels, tendons, bunions, knee, hip and low back. Proper corrective prescription orthotics can help to control this condition.

Bunions (Hallux Valgus)

Bunions result from incorrect alignment of your foot resulting in abnormal strain at the 1st digit of the foot. The pressure on the 1st digit causes it to drifts to the side resulting in the deformity known as a bunion. Once a person has developed the bunion, it may be difficult to fit shoes and pressure from shoes may aggravate it. Orthotic may address the underlying reason for the bunion and decelerate its progression but they will not correct the bunion deformity once it is established. Orthotic will redistribute the weight away from the painful bunion causing an improvement in the persons pain.

Forefoot pain. ( Metatarsalgia or Mortons Neuroma)

Metartasarlgia is pain in the ball of the foot ,in the area just before the toes. It may develop in people with either the high rigid arched foot or the flat footed person. Pain may come the dropped metatarsal heads or the little nerves in between them causing a mortons neuroma. Accurate assessment of the alignment fault is essential to good orthotic prescription in conjunction with other treatments.

Achilles Tendonitis

The Achilles tendon is the large tendon that connects your calf muscle to your heel. Pain and inflammation of the Achilles tendon may result from the abnormal pull on the tendon that may results in degeneration of the tendon and even rupture of the tendon.

Shin pain

Shin splints is a common injury that can affect any type of athlete. It is a characterized by pain over the shin from overloading the muscle of the lower limb. It is commonly seen in people with flat feet or overpronated as the muscles have to work harder to get the feet out of the flat position to repulse the body forward. People with high arches also experience shin pain from poor shock attention and tight calves. In both situations, orthotics can support the foot to reduce the workload on the shins.

Ankle Sprain

A sprained ankle can occur during a landing or sudden sideways or twisting movement of the foot resulting in an injury of the ligament in the ankle. It is a common injury and more common in people who do not have normal alignment of their feet. It is important to correct any imbalances in the foot after injury to prevent repeat injury which is so common. Orthotic can improve the stability of the foot.