FOOT PAIN

Many types of foot pain, especially on the bottom of the foot or heel pain (plantar fasciitis) may be treated with Foot Orthoses, commonly called "orthotics". These are custom made devices that fit into your shoes. They are made of light-weight, durable materials, with special modifications for your particular problem. There is a brief casting procedure, with examination and measurements taken. This cast and information is then sent to the lab, where the orthotic devices are made.

Conditions that may improve with foot orthotics include: bunions, plantar fasciitis, metatarsalgia, neuromas, ankle pain, chronic ankle sprain, shin splints, knee pain, patellofemoral tracking syndrome, chondromalacia patellae, iliotibial band syndrome (ITBS), tendonitis, hallux rigidus, hallux limitus, pes planus, sesamoiditis, Morton's neuroma, and many, many more.

Foot orthotics encompasses the field of knowledge about improving the function of the foot. The use of foot orthotics has gained acceptance and popularity in recent years.

Overpronation of the foot takes place in the sub-talar joint. The sub-talar joint is located between the talus and the calcaneus and is considered the keystone joint of the foot. Supination and pronation are normal motions of the foot. Overpronation of the foot causes the tibia to medially rotate. This rotation has an effect on the femur, patella, ilium, sacrum and the entire musculoskeletal system.

Overpronation causes 60-90% of all foot and lower extremity pathologies associated with overuse injuries.


Examination Procedures

Examination procedures for overpronation are simple to perform. The patient stands facing away from the doctor with his shoes and socks off. He/she would then be put through a series of certain movements to determine the degree of pronation.

To fully understand overpronation, one must have a working knowledge of the gait cycle. The gait cycle is defined as the motions of a leg from the heel strike of one foot to the heel strike of that foot again. The gait cycle has two phases: the stance phase and the swing phase.

The stance phase is the most important part of the gait cycle in relation to sports injuries. The stance phase is divided into three parts: the contact phase, the midstance phase, and the take-off phase.

The contact phase is from the heel strike until the foot is flat- footed. Normal contact is with the foot in a slightly supinated position and the heel contact taking place on the lateral side of the heel. In this plane, the foot rapidly pronates which allows for shock absorption and for the foot to adapt to the terrain.

The midstance phase is from the flat-footed position until the heel lifts off. In this phase the foot supinates to become a platform for support of the body's weight. This phase can be described as a conversion to a rigid lever.

The take-off phase is from heel-lift to toe-off. In this phase the foot continues to supinate and the tarsals are locked for the foot to become a rigid lever.

Today's sports injury specialist must be able to diagnose abnormal foot biomechanics to successfully treat the cause of many sports injuries. Usually, a foot orthotic is required to correct overpronation of the foot.