Biomechanics, Pedography and Orthotics
What is Orthotics?
Orthotics is a Medical device designed to treat or adjust various biomechanical foot disorders. People usually use commercially made devices, such as cushioned heel cups or insoles for shoes. These are sold over-the-counter in pharmacies or other retail establishments, but in order to have successful treatment, the patients must always visit their Podiatrist, who is the specialist for prescribing and designing an orthotic device specifically for their feet and the exact problem that they are experiencing.
The best Orthotics, however, are custom-made devices specifically crafted to meet the needs of a particular individual. This is done by making an impression or digital image of the foot called foot scan or pedography. The pedography system is an accurate and reliable pressure distribution measuring system, for monitoring local loads and motion of the foot during standing and walking.
The information that the Podiatris gathers through the pedography system including the findings of a specific biomechanical assessment, empowers him to prepare the specific device or send the information in an Orthotic laboratory in order to correct the misalignments if there are any and prepare the specific orthotic device.
The final Orthotic is then placed in the patient's shoe and helps keep the foot in proper alignment. Depending upon the patient's needs, the Orthotic may have padding to cushion the foot against the weight of the body.
Who should use an Orthotic?
Due to the hard, manmade, unnatural surfaces that we now walk on, perfect feet are very rare, and almost anyone can benefit from Orthotics. They can prevent and alleviate many of the common foot complications that cause discomfort in otherwise healthy people. They can alleviate Knee, Hip, Back pain and foot function abnormalities. Almost anyone can achieve some benefit from an Orthotic. There are several common symptoms that may indicate misalignment of the feet.
You may be a candidate for Orthotics if:
• One side of your shoe sole wears out faster than the other
• You frequently sprain your ankle
• You have chronic heel, knee or lower back pain
• Your shins hurt
• Your toes are not straight
• Your feet point inwards or outwards when you walk
• Your feet hurt in general
• You have low painful arch
How Does an Orthotic Work?
To explain how Orthotics works, it is important to understand the mechanics of walking. With each step, the vertical axis of the heel ideally should land almost perpendicular to the ground, with a slight inclination of only a few degrees toward the outside of the heel. From there, the weight is distributed progressively toward the lateral (outside) side of the foot. As the little (or fifth) toe starts to touch the ground, the arch of the foot should flatten slightly, shifting the body's weight toward the medial (inside) side of the foot. The heel then should start to lift off the ground, shifting the weight to the medial forefoot, principally the ball of the foot and the big toe.
This co-ordinated motion occurs in much less time that it takes to describe. It is, nevertheless, a complex process in which many things can go wrong. If a structural problem is present, the foot can collapse under the body's weight. Runners in particular exert much greater forces on their feet than those generated by simple walking. This can lead to more severe injuries, such as sprained ankles, shin splints and even fractures.
Over time, stresses on the feet can deform them. One of the foot's main function is to absorb shock as the body's weight shifts with each step. It does this through a complex process in which the arch of the foot flattens slightly. This absorbs and distributes the weight throughout the entire foot. There are two major problems that can occur in this mechanism.
The first occurs when the arch does not flatten at all. This typically occurs in a person with a high arch, called a Pes-Cavus foot. 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 increases stress on the foot, especially the heel. Furthermore, because the weight is not absorbed well in the foot, it radiates up the leg to other joints. Over time, this can cause pain in the knees, hips and lower back.
To correct this condition, an Orthotic is used to bring the ground into even contact with the rest of the foot. This allows the entire foot to support the weight of the body. Extra cushioning can be built into the Orthotic so that some of the force does not even reach the foot.
A different problem results if the arch flattens too much. This is known as a Pes-Planus, pronation, or flat foot. In such cases, the weight distribution on the foot is too far on the medial side. A flat foot is unstable and cannot maintain a proper arch. Over time, the weight of the body on an unstable foot will cause the bones of the foot to become misaligned. This can lead to the development of bunions, hammertoes and other foot deformities, as well as knee and lower back pain. To address this problem, an Orthotic with an increased arch will be prescribed to distribute the weight laterally. Depending on the shape of the foot, the heel of the Orthotic can be slanted to shift the weight more towards the centre of the heel.
Patients must always look for a podiatrist if they have painful feet. Podiatrists are specialists and trained to prescribe and manufacture Orthotic devices. Podiatrists are always ready to give the best health care treatment to their patients. Podiatrists always welcome communication and cooperation with other medical specialties for accurate treatment and for patient’s benefit.