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Demystifying Orthotic Therapy

10 Sep 2015
James Pope
In the past ten years there has been a revolution of sorts and the podiatry profession has been forced to reconsider its thinking. A long required shift from a focus on just the foot, to an inclusive carefully considered evaluation of the entire body and how it functions in sequence when we exercise or simply just move. Some would argue this isn’t a revolution, it is merely the Podiatry profession upskilling to the level of current thinking, alas we have arrived safely.

Orthotic therapy is and has been for years a mainstay in a Sports Podiatrist’s kit bag. Whether treating Plantar Fasciitis, Achilles tendinopathy or great toe problems, a podiatrist can always justify an orthotic to suit any foot. It does however get murky when the orthotic wearer doesn’t fully understand the purpose of the device, and what is more concerning is that maybe the device isn’t fully understood by the podiatrist either.

Orthoses, much like other treatment tools, when used properly, can be invaluable for influencing stresses on the foot, knee and ankle. They can also be targeted to help reduce injury and reduce return to play times. In most cases it should be remembered that orthotic therapy is a treatment tool for injury rehabilitation and prevention, not for the common flat foot.

We often forget the foot tells us a story; how the body functions and where the forces and stresses are moving during exercise are most accurately obtained by gait analysis. The foot is the last point of contact with the ground to absorb stresses of movement. How much the foot moves, or what we sometimes see as excessive movement (over pronation), may actually be required to absorb or make up for insufficient joint range of motion at the ankle or even further up the chain. To simply block this can be disastrous for normal function. The foot, if excessively moving, can also be an indication that there is weakness of core strength. This needs to be taken into account and treated with a good strength and conditioning program in conjunction with an orthotic, to help with redistribution of forces through the foot to treat injury.

Orthoses prescription can be both beneficial and detrimental to injury prevention and recovery. If you have considered them as part of your treatment then make sure you understand what effect they are designed to have and how they are targeted to your needs. Don’t be afraid of orthoses and don’t hesitate to ask questions.

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