| FOOT
AND ANKLE |
| PROBLEM |
SYMPTOM |
CAUSE |
SOLUTION |
| Achilles Tendonitis |
Inflammation of the sheath surrounding the Achilles tendon;
pain behind the heel, ankle, and lower calf. |
Counter rotation of the tibia against the femur (as a result
of excessive pronation) causes the two heads of the Achilles
tendon (gastrocnemius and soleus) to torque against each other
and overstretch the tendon. |
Therapy for inflammation: ice, ultrasound etc. Orthotics to
reduce excess pronation and abnormal torquing of the tendon
due to biomechanical imbalance. Reduce activity until inflammation
subsides. |
| Neuroma (Intermetatarsal
Forefoot Pain) |
Pain in the ball of the foot and/or numbness in the toes.
Usually between the 3rd and 4th toes. |
Chronic irritation of the intermetatarsal nerves due to the
shearing of the metatarsal heads. |
Careful shoe selection and orthotics to provide the forefoot
with proper balance, spreading the metatarsal heads to allow
a clear passage for the nerves. |
| Plantar Fasciitis (Heel
Spur Syndrome) |
Pain directly beneath or in front of the heel; chronic inflammation
of the plantar fascia, sometimes accompanied by a bone spur
where the fascia originates at the calcaneus. |
Excessive abnormal pronation stretching the plantar fasciitis
over and over with every step. The origin at the calcaneus in
the hindfoot is weakest and generally where fibres are torn. |
Reduce activity until inflammation subsides, and perform daily
exercises. Orthotics to control over-pronation and eliminate
repeated elongation of the plantar fascia. |
| MUSCULOSKELETAL |
| PROBLEM |
SYMPTOM |
CAUSE |
SOLUTION |
| Shin Splints |
Inflammation of the tendons and muscles in the front or side
of the leg. |
Excessive pronation combined with overuse causes pulling of
the tibialis anterior or tibialis posterior muscle with damage
done to the insertion of these muscles on the tibia. |
Sport shoes with very solid heel counter combined with orthotics
to restore normal foot and leg biomechanics to restore excessive
pronation. Reduce activity until inflammation subsides. |
|
Chondromalacia Patella
(Runner’s Knee)
|
A degenerative inflammation of the cartilage covering the
underside of the patella; knee pain and medial soreness.
|
Excessive pronation counter-rotates the tibia against the
femur creating undue stress that prevents the knee cap from
tracking in its proper groove on the femur bone. The femoral
condyles irritate and damage the back of the patella.
|
Orthotics are necessary to control abnormal pronation and
prevent counter rotation of tibia against the femur.
|
|
Iliotibial Band Syndrome
|
Pain on the lateral side of the knee often extending up the
lateral side of the thigh, as high as the hip.
|
Caused by excessive counter rotation of the tibia and femur
as a result of over-pronation. The ilio tibial band is torqued
and stretched resulting in the distal end of the band rubbing
across the lateral condyle of the femur.
|
Apply ice to decrease inflammation. Orthotics to correct
the over-pronation and eliminate excessive counter rotation
between the femur and the tibia.
|
|
Low Back Pain
|
Pain in the low back.
|
The shock of the heel strike is transmitted up the leg, through
the pelvis, and to the lumbar spine. Over-pronation causes
stress and misalignment of the kinetic chain, affecting the
alignment of the spinal column, facet joints, and possibly
alignment of the discs.
|
Along with localized physiotherapy, manipulation, exercise
etc., orthotics to correct abnormal pronation and reduce shock
to the heel.
|
|
|
| PROBLEM |
SYMPTOM |
CAUSE |
SOLUTION |
|
Rocker Bottom Feet
|
Collapse of the midfoot, prominent bones cause tissue breakdown
(ulceration)
|
Changes to bone density due to biomechanical imbalance inherent
in diabetes
|
Orthotics to properly distribute body weight onto healthy
foot surface areas to unweight collapsed midtarsal area.
|
|
Peripheral Vascular Disease (P.V.D.)
|
Poor circulation causing hands and feet to feel cold and
wounds (ulcerations) to develop and heal slowly. Pain in the
legs when walking, relieved by rest.
|
Ability of arteries to carry blood is reduced to diabetic
peripheral vascular disease.
|
Orthotics to properly distribute body weight (pressure along
the plantar surface of the foot) to reduce the risk of ulceration.
|
|
Peripheral Polyneuropathy
|
Dulling of the sensation of pain, temperature and pressure
especially in the lower legs and feet.
|
A symptom of long term diabetes (>6 yrs old); on occasion
appears early. Cause is uncertain, being researched extensively.
|
Orthotics to properly distribute body weight (pressure along
the plantar surface of the foot) to reduce the risk of ulceration.
|
|
Plantar Ulcers
|
Open, deep wounds on the feet that are very slow to heal.
Foot ulcers are the leading cause of hospital stays among
diabetics.
|
Peripheral vascular disease and diabetic polyneuropathy combined
with poor biomechanics.
|
Orthotics to correct faulty biomechanics and reduce plantar
pressure. Ongoing biomechanical foot screening a must.
|
