Orthotics

I have known for years that foot problems can be the source of pain in other parts of the body. The most common foot problem we see in our office is pronation. This is a fancy way to say that the arch of your foot has collapsed causing your foot to flatten. This in and of itself is a serious problem and can cause arch pain, plantar fasciitis, Achilles tendinitis, and painful bunions to form. We also know that if the arch of the foot is collapsed it can put stress on the knee, making it painful to walk, and cause conditions like chondromalcia patella and Ilio tibial band syndrome. When the knee is twisted due to a collapsed arch it causes the pelvis to rotate. This puts stress on the hips and sacro-iliac joints causing sacroiliitis and hip capsulitis. When the hips and SI joints are rotated they cause the low back to tilt off its level foundation. This puts increased biomechanical stress on the lumbar spine causing low back pain and potential disc problems. When the level foundation of your pelvis is tilted, the rest of your spine has to compensate by twisting in a scoliosis like fashion. This twisting of the spine can cause a burning midback pain and significant neck muscle strain. When the neck is strained it can cause disc problems that can lead to numbness and tingling, and weakness in the hands and arms as well as serious headaches. So, you can see that foot problems can be a real pain in the neck!

I have studied foot problems for years, and have tried several devices to correct foot pronation. Many people use commercial off the shelf devices that can work OK as long as the person evaluating the foot problem knows what they are doing. The problem is that most do not. This leaves the customer unsatisfied and the problem unresolved, or potentially worse. I have found that custom orthotics designed by a competent physician are the best solution to this problem.

We do a wet cast of the foot and a thorough evaluation of the feet. We then send this negative cast to the Biomechanical Services lab where a positive cast is made. This positive cast is then altered by a technician to my specifications and the rigid plastic that makes up the backbone of the orthotic device is vacuformed to the cast making a perfect impression of that foot. This is important, because every foot is different. A commercial off the shelf product doesn’t even come close to this level of precision.

I have seen a considerable amount of orthotics in my career, and have wondered how most people wear such poorly constructed devices. They are either too soft and don’t make any king of meaningful correction to the foot, or they are so hard and rigid they look like they were designed by a sadist. The devices we use from Biomechanical Services are in my opinion the best of both worlds. They are semi-rigid devices that are firm enough to support the foot and correct the pronation, but accommodating enough to be comfortable to wear all day.