A common issue raised by our patients is that of orthotic devices in shoes.
Our Senior Physiotherapist, Nick Syrett, has worked alongside podiatrists both in the past and indeed in our clinic.
"I have used various types of insole myself over the years. It’s not as simple as “Do I need orthotics?” The individual, their foot type and way the foot behaves, the footwear (or lack of) all need to be considered."
If you think you need orthotics, our team may be able to help you. Nick has answered some of the most common questions we get asked below;
Q: Does a rigid orthotic just transmit and pass on force further up the kinetic chain of the leg?
This may depend on what material the orthotic is made of, how the foot moves and functions. Is this person equipped physically to cope with this force transference?
Q: Are there factors higher up in the mechanical chain that are affecting the foot function?
Leg length difference, hip strength and stability, knee position in mid-stance of running and calf-muscle length are just some, for example. If some of these can be improved, there may be a role for a temporary orthotics – maybe.
Q: Can the foot position and leg alignment be improved through rehabilitation to correct the biomechanical faults thus phasing out the need for a corrective device?
Yes! It depends on the individual and their response to treatment - this can vary considerably.
Q: Why is it that some people’s kinetic chain seems more forgiving than others in the face of poor biomechanical alignment?
I have met very flat footed ultra-runners that seem to get round their failings. I have also seen people with good foot position and seemingly good running form with overuse injuries around the foot and ankle. This is highly likely to be a combination of many factors such as the durability of a person’s body, surfaces and training schedules are also relevant as is the choice of footwear in and out of the athletes chosen sport. A combination and balance of both strength and flexibility in the body is once again crucial.
I have certainly been influenced by texts such as Born to Run, Chi running, Running free, the research behind the barefoot science insoles and even the day to day poses and postures that you may find in yoga. Balance and alignment in both mind and body is crucial. Call it physical and mental form if you like. These influences are not necessarily the answer but will promote debate and ultimately the need to find and read well researched evidence to back up what we are using to address the problems we find.
Q: Do you make custom made insoles?
We can work on the areas that can be manipulated and influenced. Sometimes that may involve a temporary orthotic (a number of options exist). If the combination of foot and lower leg mechanics makes for an asymmetric headache then I always consult a local podiatry option. This is a field of expertise in itself, so whilst the boundaries of both professions overlap, stick to your strengths!