ORTHOTIC THERAPY…WHAT? WHEN? WHY?
Lower leg pain of any kind can have wide-ranging effects on overall health and mental well-being, particularly if allowed to become chronic in nature. Lower leg pain can result from a variety of issues including:
– Training Errors
– Incorrect Footwear
– Biomechanical abnormalities
– Traumatic injuries/accidents
– Underlying health conditions such as: Osteo- or Rhuematoid Arthritis, Diabetes etc.
For many episodes of lower leg pain, relief can be achieved through simple adjustments to footwear, training loads and rehabilitation practices. However, in some instances this isn’t enough and orthotic therapy will be needed.
Orthotics are devices that act to improve cushioning, redistribute pressure and improve foot function. Whilst their mechanism of action is not always agreed upon, they are a great way to reduce the stress/load on injured muscles, tendons and joints of the feet, ankles, knees and hips. Orthotics can be used for a variety of conditions including:
– Heel pain (Plantar fasciitis/fasciopathy)
– Bunions
– Arthritis affecting the foot, ankle or knees
– Shin pain
– Achilles tendinopathy
– Stress fractures of the feet, ankle or shins
– Sever’s Disease (Heel growth plate issues in children)
– Skin lesions (To offload callous and corns)
Orthotics are available in a variety of materials and are split into the following categories:
– Prefabricated: These are pre-made devices and are available in varying levels of support that can be heat-moulded or modified to suit your needs. They typically last around 12-18 months depending on use and can be fitted at your appointment.
– Semi-Customised: These are a more durable option and, whilst still being a generic shape, this method gives the podiatrist more scope to modify the materials that are used and add any additional features they may require. They typically last 4 years depending on usage and are a great option when more support/durability is required but cost is an issue.
– Customised: These are devices that are constructed from a cast or scan of the patients foot. Using these moulds, and the results of a thorough biomechanical assessment, the podiatrist can design an orthotic which is 100% customised to each individual patient. These orthotics can be made from various materials and offer more choice throughout the whole process in regards to design features, material thickness and correction/shape. They are used when the other options will not adequately address the biomechanical deficiencies or when a large variation exists between how both feet function.
The need for orthotics will be determined after your initial biomechanical assessment and gait analysis. At this point the podiatrist will be able to advise you on the best form of treatment. If orthotics are required it is imperative to understand that they will form part of your overall treatment plan and will work best when combined with strengthening exercises and changes to training loads and possibly footwear.