Colin Papworth's Thoughts About Orthoses

Foot orthoses can be used to a variety of jobs and what we want them to do will be obtained during the assessment process. Many people find that they are essential in allowing continued pain free movement and ensuring they can continue to keep up their activities. Some people are reluctant to use them as they may have had bad experiences with them. There are many different types and often a small change in the way they work can make a big difference in how effective they are. They have to be prescribed to do a certain job and will have some sort of effect on your body. This should be in a positive way to either / or reduce pain and make your body work in a different way. Not everybody is the same and the effect the orthsoes have on you will be individual to you and the way you move. The role of our podiatrists is assess and analyse the way you move and to identify what is the problem and why it is occurring. The orthoses are then designed to address the damaging element of how you are moving.

As a summary they can be used to either reduce pain directly or by altering the way you are moving and so reducing strain being applied to certain tissues. So in plantar fasciitis for example they may reduce how much your arch is dropping and so reduce the stretch being applied to the plantar fascia. Or in the case of Runners knee they may reduce how much movement is occurring at your knee by controlling how much your foot moves when you stand on it. They can also alter the way your body moves over your foot, so if your Iliotibial band is painful due to your knee moving laterally (sideways) as your foot rolls onto the outside then orthoses can help reduce this. Or if your low back is always tight and the mobility of your feet is causing tightness of your legs due to the muscles working hard to create stability then the orthoses can reduce the load on your muscles by providing this support.

We have a variety or orthoses to chose from and the pros and cons of each sort will be discussed at the assessment. Some are used for a short term intervention – to off load some tissues or help change a movement pattern, whilst others may be used for a longer term duration. This may be due to the fact that no matter what we do to reduce the load on the tissues whilst maintaining current (or wanting to increase) activity levels is not going happen due to the way your body is working. This may be down to a very mobile foot or a bony change that has occurred that we cannot alter without surgery.

Orthoses may be the only treatment you need but often there is need for other interventions as well. If this is the case we shall explain why we feel this is so and how it will benefit you. This could be foot and ankle mobilisations, stretching and strengthening exercises, walking and running movement changes as well as advising on which type of footwear are going to be of most benefit. We have a variety of options in our clinic but happy to work with other therapists you may be seeing.

Orthoses are fitted for you as we may need to do some treatment at the time, make any immediate adjustments, advice on any questions you have once they are in shoes about how they feel, explain the effect they are going to have on your body and how to manage this and ensure you are walking or running in the what we feel is a good position. We also offer a follow up appointment and this may be anywhere between 2-8 week and will depend on what we are trying to achieve.

Orthoses can be used to help with any of the following:

Plantar fasciitis / heel pain

Forefoot pain

Arch strain / pain

Ankles rolling in or outwards

Shin pain

Knee pain on inside, behind knee cap (runners knee) or outside (ITBFS)

They can also help with posture and so help with reducing tension in the low back as well as helping you move more efficiently.

They will potentially take a little while to get used to and even our most compact and dainty versions will fill up your shoes slightly. You may not need them forever and in the short term you will need to wear them as much as possible to give them the best change to do the job they have been designed to do.

to do the job they have been designed to do.

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